Good Calories, Bad Calories

see, is critical.

Return to text.

^*86Obesity and Leanness was the first serious book on obesity published after 1900, when von Noorden published Die Fettsucht. In the years since, there have been only half a dozen similar attempts (out of the innumerable professional texts and proceedings now available) to present a comprehensive and balanced analysis of the evidence, and only three come close to Obesity and Leanness in critical analysis—the chapters on obesity and undernutrition in the 1933 English translation of Eric Grafe’s Metabolic Diseases and Their Treatment, Hilde Bruch’s Importance of Overweight, and, a distant fourth, John Garrow’s Energy Balance and Obesity in Man.

Return to text.

^*87 A hormone also secreted by the pancreas that tends to counteract the effects of insulin.

Return to text.

^*88 This phenomenon led to the notion of low-protein diets for weight loss. Regrettably, the ability to burn off excess calories when consuming a protein-deficient diet appears to be specific to young animals, and maybe even young pigs. When researchers tried to replicate this result in other animals—rats, sheep, cattle, or even older pigs—they noted that the animals eating the lower-protein diet got considerably fatter. They had more fat and less muscle, even if they weighed the same as the control animals.

Return to text.

^*89 Although, as we discussed in Chapter 16, the total energy expenditure of obese individuals is likely to be greater, because they have, simply put, more pounds to expend energy and generate heat.

Return to text.

^*90“The mean diet for Japanese people,” Nishizawa et al. reported, citing a 1972 survey by the Ministry of Health and Welfare, “consists of 359 g of carbohydrate, 50.1 g of fat, 82.9 g of protein and a total of 2,279 calories.”

Return to text.

^*91“Obesity itself,” as the National Academy of Sciences noted in 1989, “has not been found to be associated with dietary fat in either inter-or intra-population studies.”

Return to text.

^*92 The Duke University pediatrician James Sidbury, Jr., who would go on to become director of the National Institute of Child Health and Human Development, made the same observation about the obese children he treated in the early 1970s: “A pattern of constant nibbling was consistently found. Most common snack foods are predominantly carbohydrate: crackers, potato chips, french fries, cookies, soft drinks, and the like.”

Return to text.

^†93 Evans’s first test diets “called for no carbohydrate whatever” only later did he settle on twenty grams of carbohydrates to address nitrogen balance.

Return to text.

^*94“Wheat contains all of the essential amino acids,” explained the Columbia University nutritional anthropologist Marvin Harris, “but to get enough of the ones that are in scarce supply a man weighing 176 pounds (80 kilos) would have to stuff himself with 3.3 pounds (1.5 kilos) of whole wheat bread a day. To reach the same safe level of protein, he would need only .75 pounds (340 grams) of meat.”

Return to text.

^*95 These included Graham Lusk and Eugene Du Bois from Cornell and the Russell Sage Institute of Pathology; Russell Pearl and William McCallum from Johns Hopkins; the Harvard anthropologist Earnest Hooton; and Clark Wissler of the American Museum of Natural History.

Return to text.

^*96 There are only four experiments in the medical literature, not including Stefansson and Anderson’s, in which the goal was to induce scurvy in human subjects—in one, four, twenty, and four subjects respectively. In each case, the goal was accomplished and the diets were carbohydrate-and/or sugar- rich.

Return to text.

^*97 According to Lewis Finn, then president of the Delaware Academy of Medicine, Gehrmann’s department at DuPont was “one of the most outstanding industrial medical departments in the country.”

Return to text.

^*98 One DuPont executive, discussed by Pennington in a later report, lost sixty-two pounds on the diet and kept it off for more than two years, while averaging thirty-three hundred calories of meat a day. If he ate any carbohydrates, “even an apple,” Pennington wrote, his weight would climb upward.

Return to text.

^*99 These critiques were written by anonymous “competent authorities.” In this case, the likely authority was Philip White, formerly at Harvard, now beginning his job as secretary of the AMA’s Council on Foods and Nutrition and a columnist for JAMA. He would write a similar dismissal of high-fat, carbohydrate-restricted diets under his own name in 1962, and then edit another anonymous version in 1973.

Return to text.

^*100 Ohlson worried that “the large servings of meat” could get monotonous and that the diet did not meet the recommended daily allowances for essential vitamins recently introduced by the Food and Nutrition Board of the National Research Council. She therefore included in her diet more milk, cheese, and eggs than Pennington had recommended, and expanded the choice of fruits and vegetables.

Return to text.

^*101 Drug studies were encouraged by the relative ease of obtaining money and resources from the pharmaceutical industry, and the absence of funding for dietary treatments.

Return to text.

^†102 In 1989, William Dietz, who now serves as director of the Division of Nutrition and Physical Activity at the Centers for Disease Control, reported that Bistrian and Blackburn’s diet was “especially successful” on obese patients with a genetic disorder called Prader-Willi syndrome, “whose characteristic ravenous appetites appeared to be suppressed.”

Return to text.

^*103 When the authors included only randomized control trials in their calculations, they identified seven relevant studies of this severe carbohydrate restriction and seventy-five of higher-carbohydrate diets. The average weight loss was eight pounds for the carbohydrate-restricted diets and four for the higher- carbohydrate diets.

Return to text.

^*104 Indeed, the AMA’s 1973 critique escaped the issue of hunger by including “anorexia” as one of the “untoward side effects” of the diet. Since anorexia, in this context, is the technical term for loss of appetite, it seemed a peculiar criticism to make of a weight-loss diet.

Return to text.

^*105 The auxiliary “may” is critical here, because Yudkin based his conclusions on three-day dietary records, which are notoriously inaccurate. He then assumed that these three-day records could be extrapolated to the entire two weeks of the study, and from there to what would happen over months or years on