Okay.  I said I was through with Anthony Colpo, but now I’m going to quote from him once again.  What gives?

What gives is that I’m stuck in the airport in Seattle – my flight to Chicago is delayed for almost four hours because of bad weather in the Windy City.  I figured I would use this time to stick up a quick post about thermodynamics and provide a long quote from Robert McLeod, who writes Entropy Production, a physics (sort of) blog.  As you can see below, he pretty much trashes Bray and other nutritional researchers who blithely use the 1st Law of Thermodynamics to prove the old a-calorie-is-a-calorie notion.  To show the way the average nutritional writer looks at this law, I needed to find a quote.  As it works out, the only thing I have with me is Anthony’s book The Fat Loss Bible, which just happens to have the perfect quote.  So, sorry AC, I’m not really trying to pick on you.  And you certainly aren’t the only nutritional writer who thinks this way – you’re just the only one who has a quote handy I can use.

The First Law of Thermodynamics states that energy can neither be created nor destroyed. It can only be converted from one form to another. In other words, energy just doesn’t just magically disappear; it must be converted to something else. In the case of any excess calories you ingest, they will be stored as fat, used to accommodate an increase in lean tissue mass, or dissipated as heat through thermogenesis. Manipulating the proportion of protein, fat and carbohydrate you eat each day will not excuse you from the Law of Thermodynamics.

This is the way just about all nutritional scientists and writers look at the First Law.  Let’s take a look at how a physicist sees it.  Robert McLeod wrote a long post a while back reviewing Gary Taubes’ Good Calories, Bad Calories.  Near the end of the post, he discusses the energy balance equation and one of our old friends, Dr. George Bray, who gave Gary’s book a bad review in an obesity journal.  (I posted on this same review a couple of times here and here.)

Here’s what he says:

I was somewhat confused to see this [a nutritional description of the energy balance equation] Surely the nutritional scientists did not not really believe this, right? I mean, any idiot undergraduate students knows that the 1st Law is only useful in a closed system, and humans live on the planet Earth, not in an insulated box. Right?

Enter a rebuttal by G. Bray in the journal Obesity Reviews. Bray is a to be a major obesity researcher and one of the 2nd tier villains in the book. Taubes relates a story of Bray excising a section of a British report on obesity, where Bray removed the material pertaining to the relationship between insulin and obesity. He clearly has editorial support to make his case. Bray is one of the second-tier villains in Taubes’ book. Taubes has a footnote (p. 421), which suggests that Bray actively suppressed the carbohydrate-insulin hypothesis.

“According to Novin, when he wrote up his presentation for the conference proceedings Bray removed the last four pages, all of which were on the link between carbohydrates, insulin, hunger, and weight gain. “I couldn’t believe he would make that kind of arbitrary decision,” Novin said.”

Unfortunately, to a physicist this energy balance hypothesis looks like a silly hand-waving exercise, not a serious argument. Frankly I was flabbergasted when I first read this article. This conservation of energy argument is on the same scientific level as the ridiculous “drink cold water to lose weight” idiocy. A human organism is:

1. Not in thermal equilibrium with their environment. Last time I checked I have a body temperature around 38 °C and spend most of my time in 21 °C rooms.
2. Capable of significant mass flows (e.g. respiration).
3. Capable of sequestering entropy (e.g. protein synthesis).

Is wearing a sweater fattening (by insulating you from your environment)? Here’s a quote from the rebuttal,

“Let me make my position very clear. Obesity is the result of a prolonged small positive energy surplus with fat storage as the result. An energy deficit produces weight loss and tips the balance in the opposite direction from overeating.”

According Bray’s thermodynamics argument, wearing sweaters makes you fat. This illustrates the greatest fallacy of trying to apply the 1st Law to a human: it makes the implication that living organisms consume kilocalories for the purpose of generating heat rather than perform useful work (i.e. breathing, contracting cardio and skeletal muscle, generating nervous action pulses, etc.). In reality heat is the waste product of basal metabolism. The first law does not distinguish between different types of energy. Heat, work are all equal under the First Law of Thermodynamics.

Applying the 1st Law to living organisms is Proof by Tautology. Yes, 1 + 1 = 2, but this tells us absolutely nothing about the underlying mechanics. The 1st Law does not (I repeat N-O-T) tell us whether you store excess energy in the form of fat, or bleed it off into the atmosphere by dilating blood vessels next to the skin, sweating, etc. To do so would require an accounting of entropy.

What would a semi-rigorous description of the thermodynamics of a human organism look like? Look at the title strip on the top of the page. See that equation in the background?

[The above is the background of the header of Robert McLeod's blog]

This type of equation would be a bare starting point for energy balance in a complex system like a living organism. Good luck actually accounting for all the terms. Those Σs are sums.

On to the second and, mercifully, final part of the critical review of the metabolic advantage as presented by A Colpo in his book The Fat-Loss Bible. As discussed in the previous post, our friend, like the kid to the left, is focused so intently on his refusal to believe in even the possibility of the existence of a metabolic advantage that he can’t read the literature correctly – not even the very literature he uses to try to prove his own position.  His bias has hypnotized him to the point that he can’t see anything that doesn’t confirm his what he already believes.  And this same bias prevents him from even taking a scientific approach to the problem.

We all fall victim to the confirmation bias and have to fight it constantly.  Gary Taubes thinks I may even have succumbed a little in the earlier post on AC and the metabolic advantage.  He emailed me saying he had read the post and thought it was great up to the point right at the end where I wrote that the data on the whole showed that, if anything, there was a metabolic advantage.  Gary thought the data presented in all the studies in AC’s chart was ambiguous and that I was going out on a limb a little in making the statement that I thought, if anything, that the papers argued for a metabolic advantage.

I disagree.

I decided to base this critique not on the scientific literature at large, but instead on only the papers that AC mustered for his argument.  I intended to make the critique much like a court case in which one side presents the information and the other attempts to counter it.  I didn’t want to go out myself and gather a bunch of papers that confirmed my viewpoint, because then we would have had nothing but a bunch of dueling Ph.Ds, a  bunch of he saids, she saids, that wouldn’t prove anything.  I stuck with the papers AC used and presented my arguments as to why I didn’t think his papers proved his case.  After going back and rereading the post, I still feel that if this ‘evidence’ were presented to a jury, the verdict would come back in favor of my arguments.  If anything, AC’s own ‘evidence’ argues for the existence of a metabolic advantage, and, at worst, certainly doesn’t ‘prove’ that one doesn’t exist.

Since I posted the first part of my critique, AC has responded using his customary restraint and understated gentility designed to appeal to his sort of reader.  His response – as I figured it would be – is merely a listing of even more papers he believes substantiate his claims.  Instead of undertaking a serious scientific inquiry, he is looking for more white swans.  Let me explain.

I wrote a long post a couple of years ago on Sir Karl Popper and the metabolic advantage.  Popper set the standards by which hypotheses should be structured.  A well-stated hypothesis should be able to be falsified.  That doesn’t mean it will be falsified, but it should be structured in a way that it can be.  And real scientists – of which, sadly, there are all too few in the field of nutrition – don’t try to confirm their hypotheses: they try to refute them.

One of the examples Popper used in explaining how a hypothesis should be established involved swans – white and black.  He used the following as an example of a good hypothesis:  All swans are white.  He made the case that this hypothesis cannot be confirmed by simply pointing out more and more white swans.  The hypothesis can be strengthened by doing so, but it can’t be proven.  It can, however, be disproved by the discovery of even a single black swan.  Popper argued that scientists should be working to find black swans instead of simply adding more and more white swan sightings to their data.  The more effort scientists expend to find a black swan without finding one, the more their hypothesis is strengthened.  Diligently searching for black swans is a much more valid scientific endeavor than simply looking for more white swans.

Many scientists don’t want to hunt for black swans, however, because they don’t want to blow up their hypotheses.  The easy way to bolster their hypotheses is to continue to tally up all the white swans they find and forget about looking for black ones.

Which, of course, is what our young friend AC has done and written about in his latest missive.  He tallies up a bunch more white swans and ignores the black ones, even the black ones in hiding in plain sight in his own list of papers.  This failure of his to try to puncture his own hypothesis leads me to believe there exists a large chasm of incomprehensibility between the way AC thinks and the scientific method.

To give but one example of this, AC argues in his book that the studies by Rabast that clearly show a metabolic advantage aren’t valid because, as AC puts it,

Regardless of whether Rabast et al’s findings were the result of water loss from glycogen depletion, pure chance, or some other unidentified factor, they should be regarded for what they are: An anomaly that has never been replicated by any other group of researchers. For a research finding to be considered valid, it must be consistently reproducible when tested by other researchers. As proof of the alleged weight loss advantage of low-carbohydrate diets, the findings by Rabast and colleagues fail dismally on this key requirement.

(In other words, AC is saying: that black swan over there isn’t really a black swan, because all the other swans I’ve pointed out are white.  And since all the others are I’ve pointed out are white, that one can’t be black.  It’s impossible.)

In point of fact, Rabast’s group in Germany has performed a number of studies showing a significant metabolic advantage in subjects in metabolic wards who follow low-carb, high-fat diets as compared to those taking in the same number of calories as high-carb, low-fat diets.  This group pursued this line of inquiry and published a number of studies showing this metabolic advantage.  Suddenly, however, they quit publishing on this subject and turned their attention elsewhere.

While in the research phase for Good Calories, Bad Calories, Gary Taubes interviewed Dr. Rabast about his group’s work, and here is what he said.  They were inspired by an old scientific paper (more about which later) that offered up some data they found interesting and wanted to test themselves.  They did the studies using formula diets, so they could more easily control intake and confirmed the data from the old study.  They continued to perform these studies, all with similar outcomes, until Dean Ornish published his paper on dietary fat and heart disease.  Dr. Rabast and his group decided that Ornish might be correct.  They felt that although their own data showed that high-fat diets brought about substantially better weight loss than low-fat diets of equal calories, their work might encourage people to consume more fat, which, thanks to Ornish and the low-fat movement, they had come to believe may cause heart disease.  So, they abandoned their research on high-fat diets and moved on to other interests.

The study that inspired them to study high-fat diets?  An study from the 1950s done by a couple of British researchers, Dr. Alan Kekwick and Dr. G.L.S. Pawan.  Their famous paper showed a definite metabolic advantage, a black swan writ large, as it were.  And their famous paper is well known to AC, who has a few things to say about it.  As you might suspect, given the results of this study, he declares it not worthy of consideration. Here is what he says in his book after he’s gone through his list of white swan studies, which, of course, are all worthy of mention.

Not-so-worthy mention

There is one metabolic ward trial that due to its short duration did not qualify for inclusion in Table 1a, but still warrants a mention. Incessantly cited by supporters of low-carb diets, this is the famous metabolic ward study conducted in the 1950s by Kekwick and Pawan. The London researchers conducted two experiments. In one of these, they claimed that patients maintained or gained weight on a typical mixed diet of 2,000 calories, yet consistently lost weight when placed on a 2,600 calorie low-carbohydrate diet for periods ranging from 4 to 14 days. In the second of their experiments, they had 14 patients alternate between four different 1,000 calorie diets, spending a grand total of 5-9 days on each diet: 1) 90 % protein; 2) 90% fat; 3) 90% carbohydrate, and; 4) a mixed diet. According to Kekwik and Pawan, all of the subjects in the protein, fat, and mixed diet groups lost weight, with the high-fat group experiencing the greatest weight loss of all. However, despite the very low calorie intake, many of the patients reportedly gained weight during the high-carbohydrate diet! Not surprisingly, the Kekwik and Pawan study is frequently cited by supporters of low-carbohydrate nutrition. That they ignore the studies in Table 1a, yet eagerly embrace a short-term study conducted over 50 years ago, speaks volumes about their complete disregard for rational scientific inquiry. [Italics in the original]

Here’s why: Firstly, it has long been known that in the first week or two of low-carbohydrate dieting, there is often a far greater reduction in water weight due to excretion of sodium and/or glycogen, both of which bind water in the body. Therefore, studies of such short duration are next to useless as indicators of the comparative longer-term weight loss effects of these diets.

Secondly, the Kekwik and Pawan study was a poorly controlled mess. The researchers were even driven to denigrate their study participants, writing: “The first and main hazard was that many of the patients had inadequate personalities. At worst they would cheat and lie, obtaining food from visitors, from trolleys touring the wards, and from neighbouring patients. (Some required almost complete isolation.)” [Italics in the original]

Given that protein and fat have been shown numerous times to exert satiating effects, while low-fat, high-carbohydrate diets (especially the liquid, low-fiber variety!) typically result in ravenous hunger, it’s not hard to guess during which diet the participants may have ‘cheated’ the most!

The researchers also wrote: “The results we report are selected, a considerable number of known failures in discipline being discarded”. Note how the researchers included the words “known failures”; how many failures did they not know about? How many of the patients were crafty enough to sneak extra food without being caught? Why should we trust Kekwik and Pawan’s unlikely results, given their study’s numerous flaws? The answer is simple: Unless you are a famous low- carb diet ‘guru’ who has made millions promising people they will lose extra weight at the same calorie intake by cutting carbs, we shouldn’t! At least not if we believe good science mandates a tightly controlled process of investigation. [Italics in the original]

As we shall see shortly, this commentary is all so much piffle.

(Here is the full-text version of the Kekwick and Pawan study so that you can pull it down and follow along with the rest of the discussion if you like.)

Let us begin.

It is apparent from his critique that AC read the first part of this study, found a black swan, used a bunch of incorrect gibberish and swagger to try to say it wasn’t really a black swan and moved on without ever getting to the important part of the paper. Or, an alternative explanation is that, as with the Leibel study mentioned in my first critique, he either didn’t really read the paper thoroughly or he seriously misunderstood what he read.

Drs. Kekwick and Pawan start off by explaining why they undertook this study in terms that any of us who have struggled with excess weight and found different results with different diets can understand.

Many different types of diet have been successfully used to reduce weight in those considered obese.  The principle on which most of them are constructed is to effect a reduction of calorie intake below the theoretical calorie needs of the body.  Experience with these patients has suggested, however, that this conception may be too rigid.  Many of them state that a very slight departure from the strict diet which can hardly affect calorie intake results in them failing to lose for a time.  Though it is realized that evidence from such patients is notoriously inaccurate owing to their approach to this particular condition, it is too constant a belief among them to be entirely discarded.

Drs. K & P did a number of experiments.  First they kept hospitalized subjects on diets of similar macronutrient composition but differing calories and found that reducing calories made the subjects lose weight.  And, unsurprisingly, the more the calories were cut, the more weight the subjects lost.  Next, the good doctors decided to see if changing the macronutrient composition of the diets made a difference.  They started the subjects on 1000 calorie per day diets of one of the following three structures: 90 percent of calories as carbohydrate; 90 percent of calories as protein; or 90 percent of calories as fat.  The structure of the diets made an enormous difference in how much weight the subjects lose.  As Drs. K & P wrote:

So different were the fates of weight-loss on these isocaloric diets that the composition of the diet appeared to outweigh in importance the intake of calories.

In an effort to confirm their findings, Drs. Kekwick and Pawan went on to a third series of experiments as described here:

…patients…were put on to 2000-calorie diets of normal proportions to show that their weight could be maintained while in hospital at this level and then placed on high-fat, high-protein diets providing 2600 calories per day.  It was demonstrated that these patients on the whole could maintain or gain weight on 2000-calories but, except in one instance, lost weight consistently on a 2600 daily calorie intake.

It’s easy to see why AC doesn’t like this paper.  And we haven’t even gotten to the good stuff yet, which AC doesn’t make mention of in his book.  We’ll get to that in a bit, but before we do, let’s take a look at AC’s critique of this much of the study (which is, apparently,  all he bothered to read). You can read along from the above quote in his book.

His first complaint is that the study is over 50 years old.  I find this a strange complaint, since the first study he lists in his chart of studies ‘proving’ his point was published a mere eight years after this Kekwick and Pawan study.  The Kinsell paper was published in 1964, 46 years ago.  Is there some magic cutoff date at 50 years that makes scientific papers unreliable?

Second, he claims that on low-carb diets all the weight loss from the first two weeks is water, and since these studies lasted less than two weeks, the difference was all water.

Kekwick and Pawan were a little smarter than Anthony gives them credit for being.  They understood well the notion of water loss.  (As we will see shortly, they understood it vastly better than our young friend.)  They pointed out the following:

During these periods [the different diet studies] the patients were weighed daily and in some of them balance studies were carried out in respect of water, nitrogen, fat, sodium, chloride, and potassium.  Total body-water and the basal metabolic rate were estimated weekly or at the end of each period on the diet.

If you look at the full-text version of the study I linked to above, you can see graphically how this all plays out.  In these studies the weight loss was definitely not all water.

In an effort to be meticulously accurate, not only did K & P monitor all the above carefully, they even went further.  Since these patients were not on formula diets but were on real foods instead, making it more difficult to accurately determine caloric intake, the staff would take representative samples of the foods eaten, blend them into a soup, then analyze samples to make sure the protein, carbohydrate and fat content were as estimated in the food tables.  It was hardly a “poorly controlled mess” of a study.

AC next attacks the study because the researchers admitted as to how difficult it is – even in hospitalized studies – to prevent cheating.

In such a study the difficulties are formidable.  The first and main hazard was that many of these patients had inadequate personalities.  At worst they would cheat and lie, obtaining food from visitors, from trolleys touring the wards, and from neighbouring patients. (Some required almost complete isolation.)  At best they cooperated fully but a few found the diet so trying that they could not eat the whole of their meals.  When this happened the rejected part was weighed, and the equivalent calories and foodstuffs were added to a meal later in the day.  The results we report are selected, a considerable number of known failures in discipline being discarded.

Kekwick and Pawan simply wrote of the difficulties in preventing cheating.  They were on the lookout for it, threw out data they knew was compromised, and compensated for episodes of cheating of which they were aware.  I believe the fact that they recognized cheating as going on and were keeping an eagle eye out for the cheaters makes their data more accurate, not less.

I also find it strange that AC is more than willing to toss data because of cheating in this study and is more than willing to accept data from other studies in which there was probably just as much – if not more – cheating that the authors neglected to mention either by design or because they didn’t realize it was happening.

One other thing that points to the degree into which K & P watched over this study is one that all female readers who have had trouble losing will be familiar with.

Another factor of importance which could not be eliminated was that many patients were women, in whom the retention and the losses of water associated with the menstrual cycle affected the daily weight and the estimation of total body-water.  We were surprised to find how great such factors could be, amounting in one woman to the retention of more than 3 litres of water.

Only a fool or a seeker of white swans only would think the good doctors didn’t monitor this study closely.

Now to the fun part, the part AC probably didn’t read.  And the part that really demonstrates the metabolic advantage.

The first part of this paper, the part AC has critiqued, is only a minor part of the paper.  The majority of the paper is devoted to the efforts the Drs. K & P made to determine what happened to the excess weight lost in dieters on the higher-fat diet.  They checked fat loss in the stool, they checked (as mentioned previously) water loss, they checked about everything they could think of.  You can read in the full version how careful they were.

After sifting through all the data and finding no reason that their results should have been invalid, the docs checked yet one more item.  They looked at insensible water loss.

Insensible water loss is the loss of water we all experience minute by minute that we not aware of.  We know we lose water when we urinate and/or defecate, and we know we lose some water when we visibly sweat, but we are not aware of the large amount of water we are getting rid of through our breath and via sweating that we don’t notice.  And this amount of water we lose is fairly large.

Do this experiment.  Get an accurate scale and weigh yourself immediately before going to bed.  Go ahead and urinate (and do anything else you might need to do) before weighing.  Don’t drink or eat anything, hop in the sack and sleep through the night, then get up and weigh before you urinate in the morning.  I absolutely guarantee that you’ll weigh less than before you went to bed.

If you breathe on a mirror, you will fog it from the water vapor in your breath.  This vapor is water that you lose every single time you take a breath.  You breathe approximately 12 times per minute (while resting), which means you breathe 720 times per hour and 17,280 times per day.  And that’s if you’re at rest.  If you are active, you take a lot more breaths than that.  Probably something in the neighborhood of 20,000-23,000 breaths per day, depending upon activity level.  Each one of these breaths contains water vapor that you are losing from your body, which is why you drink liquids throughout the day.  If you didn’t replace this water, you would become dehydrated.

If you have a fever or if you exercise, you breathe a lot more rapidly and lose a lot more fluid.  Thus, one of the things doctors have to be concerned about in very sick patients with high fevers is dehydration.

You also lose insensible water through constant perspiration.  When you awaken in the morning, if you’ve slept tightly covered up, you’ll notice you’re a little damp.  Not a lot, unless you’ve had a fever, but a little.  This is insensible water that you lost.

I remember how amazed I was the first time I ever looked at my own hand under a dissecting microscope.  Looking at my hand with my naked eye, it appeared normal and dry.  When I stuck it under the scope and looked, I could see little volcanoes of perspiration bubbling up from unseen pores.  It’s part of the way we regulate our temperature, and unless we work up a visible sweat, we never notice.

This loss of insensible water is why we lose weight overnight.  In eight hours of sleep, we breathe out about 5,760 breaths filled with water vapor and we sweat all night.  This water weight usually ends up being between 1 to 2 pounds or even a little more.

If I were to take a bunch of thyroid hormone or take an amphetamine, I can assure you that my metabolic rate would rise and that my insensible water loss would increase.  In fact, insensible water loss is a surrogate for metabolic rate.  If your metabolic rate rises, your insensible water loss rises.  And since insensible water loss can be easily measured, the metabolic rate can be easily estimated without having to do metabolic chamber studies.

Which is exactly what Drs. Kekwick and Pawan did with several subjects on the various diets.

They kept the subjects isolated and under supervision and weighed them on extremely accurate scales throughout the day.

Measurements were made by weighing the patient at intervals of one hour on scales specially constructed for this purpose by Messrs. W. & T. Avery Ltd. which are sensitive to 2 g. over the range of weights concerned.  During these hours no food was taken and neither urine nor faeces voided, and errors due to temperature, activity, and air draughts were avoided as far as possible.

(Scales that are sensitive to 2 g are extremely sensitive.  Two grams weighs about seven one hundredths of an ounce.)

So, here is what the researchers did.  They first fed the subjects the standard diet available to the patients on the ward and discovered what the insensible water losses were throughout the day.  You can see how this came out in the graph below, Fig. 11.

When Drs. K & P put a single patient on the different diets – 90 percent fat, 90 percent protein or 90 percent carbohydrate – and measured the insensible water loss throughout the day, the table below, Fig. 12 shows what happened. There was an increase in insensible loss with the high-protein diet as compared to the high-carb diet, and a much greater increase in insensible water loss with the high-fat diet.

The area of the chart that I colored in is the difference between insensible water loss, which represents a change in metabolism, between the high-carb diet and the other two diets.  This colored part of the chart represents the metabolic advantage of the high-protein and high-fat diets compared to the high-carb diet of the same number of calories.  The peach colored part of the chart represents the metabolic advantage of the high-fat diet as compared to the high-protein diet while the grayish color represents the metabolic advantage, as measured by increased insensible water loss, between the high-protein and high-carb diets.

The researchers wanted to make sure this wasn’t an isolated phenomenon, so they analyzed three other patients and created the graph below, Fig. 13, which mirrors the results in Fig. 12 and demonstrates that this wasn’t an outcome isolated to just one subject.

The ever cautious Drs. Kekwick and Pawan interpreted their findings thus:

The rate of insensible loss appears to be much affected by the type of food, provided that the water and sodium intakes are kept constant throughout the period of observation; whether this increased rate of insensible loss is a measure of bodily metabolic activity must remain in question.  Even if metabolic activity cannot be measured directly, the difference in weight responses seen with these diets does not seem to be completely due either to an altered state of hydration or to a simple deficiency of calories.  We suggest that the rate of katabolism of body-fat may alter in response to changes in the composition of the diet.

And their summary:

As the rate of weight-loss varied so markedly with the composition of the diets on a constant calorie intake, it is suggested that obese patients just alter their metabolism in response to the contents of the diet.  The rate of insensible loss of water has been shown to rise with the high-fat and high-protein diets and to fall with high-carbohydrate diets.  This supports the suggestion that an alteration in metabolism takes place.

If you haven’t already, I would encourage you to read this entire study and make your own judgment.  I’m sure you won’t find it the “poorly controlled mess” that AC does.  In fact, I suspect you’ll find just the opposite.  Unlike most of the studies published today, this one is not loaded with incomprehensible jargon, is delightfully well written and is extremely accessible to those with little medical or scientific knowledge.  You can see for yourself how precise these researchers were and now meticulously they looked for anything that might confound their results.  It would be great if more studies were done this carefully today and written this clearly.

This is the end.  I am through with AC. I’ll leave it to the readers of this post and the previous one on this subject to make their own decisions as to whether or not a metabolic advantage exists for low-carb, higher-fat diets.  I won’t be provoked again into jumping into the mud and wrestling around.  So this is my black swan song on the subject.

I read a quote a few days ago by Nassim Taleb, the author, appropriately enough, of the book The Black Swan and, for my money, the infinitely better Fooled by Randomness that is apropos to this situation:

A good foe is far more loyal, far more predictable, and, to the clever, far more useful than any admirer.

So, to you, Anthony Colpo, I raise my hat. Had you not attacked me out of the blue, I would be less knowledgeable than I am today.  I wouldn’t have bothered to dig into all the ‘white swan’ papers you posted trying to figure out why these researchers got the results they got.  I, like you, would still be mired in the notion that metabolic ward studies are squeaky clean without any hint of sullied data as a consequence of cheating.  Like you, I would still probably be confusing metabolic ward studies with metabolic chamber studies, which are horses of a much different color.  Also, I thank you because I had kind of blown off the Kekwick and Pawan papers (there are others besides this one from The Lancet) as being too old to be worth studying.  You forced me to take another look, and I was delighted at what I found.  And, sad to say, like you, I, too, had read only the first part of the these studies, the parts about the diet comparisons.  It wasn’t until your attack that I actually read this paper all the way through and found the gold mine in the latter pages.

So, AC, I sincerely hope the best for you; I thank you for pushing me into this exercise and wish you godspeed on your journey through life.

There are a lot of disagreeable  jobs out there.  Dealing with Anthony Colpo is one of them.  Trying to make sense of thermodynamics is another.  Whereas dealing with AC is kind of like the job pictured at the left – distasteful but fairly simple – delving into the workings of the laws of thermodynamics is intellectually challenging but far from easy.  Problem is, it appears kind of easy, and everyone, it seems, fancies himself to be an expert.  (How many people have we heard blather on about how a calorie is a calorie is a calorie, thinking they are accurately stating the 1st law of thermodynamics?) But the truth is that the more you study thermodynamics and the more you seem to learn, the less you really understand.

I’ve had a family medical emergency that’s been occupying my time for the past week so I haven’t really had the consolidated time I’ve needed to finish off Part II of the AC book critique, but I haven’t forgotten about it.  I should have it up in a day or two.

Until then, I’ll give you a little thermodynamics to chew on so you, too, can see that it is far from simple.

A commenter wrote the following in response to Part I of the AC critique:

Dear Dr. Eades,

I read the Feinman-Fine second-law article you cited above with interest, but found a mistake in the Figure 2 plot and the corresponding text. I didn’t notice any erratum either.

The figures in section “Efficiency and thermogenesis” should add up to 1825.5 kcal effective yield and not to the 1848 kcal given.
They seem to have interchanged the thermogenesis percentages of CHO (7%) and lipids (2.5%) in their calculation. The error source was perhaps the order in which they list the numbers: first percentages for F, C, and P from Jequier’s review, and then the diet C:F:P = 55:30:15. Go figure.

Nevertheless, it doesn’t affect the main result about metabolic advantage, weakens it a bit, though.

This came in while I was in the throes of dealing with the family problems, so I didn’t take the time to go back, pull the paper, figure out what the commenter was talking about and put my two cents worth in.  I simply posted it as it was.

Thankfully, Dr. Feinman saw it and wrote a response on another website.  I asked for permission, which he gave, to put it up here.

1. The approach taken by many that the idea of metabolic advantage has to be consistent with thermodynamics is correct.  However, one has to understand and apply thermodynamics correctly, especially as it is used in bioenergetics.

2. People who get involved in this discussion have not followed the approach in biochemistry texts and traditional bioenergetics but have not explained why that approach is wrong.  In the traditional approach from bioenergetics, for example, one usually looks at the Gibbs Free Energy, G rather than the internal energy, E.  (G includes the effect of entropy from the second law).

3. What Figure 1 of the paper shows is that metabolic advantage must exist between systems that rely to different degrees on gluconeogenesis.  You learn this in biochemistry: it costs you 6 ATP to obtain glucose from GNG but, of course nothing if you start with glucose.  So, there is a built in metabolic advantage.  Not could be.  Not debatable.  It is there.  Period.  That is an absolute biochemical fact.  So just as people thought metabolic advantage was excluded by the “laws” of thermodynamics (by which they meant the first law), “a calorie is a calorie” is excluded by the combined first and second law.  (To try to use the first law in the absence of the second law is like, actually exactly like, using gravity without considering friction).

4. Now whether you measure it [the metabolic advantage] in any particular experiment, whether the effect is great, whether it is compensated for by other processes (in low fat diets you make fatty acids which costs many ATP although the net effect may be to increase fat storage) is a different question than whether it is there or whether you want to ignore it.

5. Most of the time, as in Leibel’s experiment with the hospital patient, there is calorie balance but Leibel’s group have also done experiments with catch-up fat where there is not energy balance.  But, again, application of the theory is different than what the theory says must be true.  We have made the point that thermodynamics predicts a difference between high and low carbohydrate diets.  It when it is not found that has to be explained.  (The explanation lies in the specific homeostatic mechanisms of biological systems, not in physical law).

6. I personally believe a) Volek’s studies show the effect because the level of experimental error necessary to account for differences would be too large and, more important b) given the potential benefit in palpable metabolic advantage it would be worthwhile to try to find the conditions in which it can be seen and that this would be time better spent than in trying to disprove it with incompletely understood thermodynamics.

7. The other reason for looking for how the theory could be seen in a real weight loss experiment, is that it occurs unambiguously in numerous other biological systems: hypo- or hyper-thyroid conditions, catch-up fat in humans and animal models, animal knock-out or over-expression experiments.

8. I generally don’t pull rank on anybody and I don’t know that there is special criteria for being a scientist but you do have to understand the difference between an effect that is absolutely dictated by physical science (e.g. general theory of relativity) and the difficulty in demonstrating it experimentally (waiting for a solar eclipse and winding up with unreadable photographic plates).

9. Along these lines, like most chemists (or maybe most everybody), I have always found thermodynamics difficult and I am willing to learn from anybody who has an insight.  However…

10. I grew up in Brooklyn so I am capable of a dialogue in the style favored by Colpo and Lyle McDonald but I mostly outgrew it and don’t want to debate at that level.

11.  Relevant ideas to ponder:  I once challenged Colpo to give me a definition of the nutritional calorie (because this makes clear what the issue is), that is, not the definition of the physical calorie (raises a gram of water 1 degree C ) but what we mean when we say carbohydrate has 4 kcal/g.  His answer suggested that he had undergone spontaneous combustion but anybody else can answer the question.  The other question is that in bioenergetics we talk about calories as the free energy, G, which is a potential, analogous to gravitational potential.  When you throw the boulder off the cliff its potential energy is converted to kinetic energy and then goes to zero when it hits the bottom.  Where does the energy go?  The delta G (energy of reaction) for hydrolysis of a peptide bond is about 2 kcal.  When it reaches equilibrium (amino acids) the energy is zero.  In other words, thermodynamics talks about dissipation of energy, not conservation.  How is that possible?  Where does the energy go? 

Hope this helps.

Richard David Feinman
Professor of Cell BiologyTher
SUNY Downstate Medical Center

As a bit of lagniappe, here is a short video Dr. Feinman created on thermodynamics and irreversibility:

Click here to view the embedded video.

Addendum:

Richard Nikoley over at Free the Animal posted his take on the latest Colpo meltdown. As a part of his post, Richard dug out and put up one of my responses to a commenter from a post I wrote a couple of years ago. I had completely forgotten about it, but since it applies to the situation discussed above, I’m reprinting the comment by Ryan and my response below.  A hat tip to Richard for ferreting this out:

I have a question that may be related to this.

On several low carb forums right now, there is a debate going on about what happens to the extra fat calories if carbs are kept extra low so that insulin is kept low. Some say it will be stored as fat anyway, others say it will be burned as heat and still others say it will be excreted. One member even did near-zero carbs and very high fat for a week (4500 calories instead of a normal 2500, with an average of about 80-90 g of protein). He lost a pound off of his already lean physique.

So, where does that extra fat go? Is it excreted? The detractors say that fat is completely digested before reaching the colon but I am not sure. If it is excreted, could you go ultra high fat, zero carb for a week or so and get the same detox results as the cosmic pizza grease?

Hi Ryan–

Your comment raises an interesting question. Where does all the excess energy go?

I’ve had a number of patients and countless letters from readers who have had the same experience. They consume a ton of fat, but don’t gain weight…or even, as with the guy you described, lose a little. Mostly the letters we get are from people who complain that they are following our diet to the letter, yet not losing weight. When we investigate, we find that in virtually every case these people are consuming huge numbers of calories as primarily fat. We always ask them if it doesn’t strike them as strange that they’re eating as much as they are, yet not gaining.

In order to lose weight, one must create a caloric deficit. This can be done in a number of ways. People can burn more calories by increasing exercise; they can eat fewer calories; or they can increase their metabolic rate. Or they can do any combination of the above.

Most people going on a low-carb diet decrease their caloric intake. A low-carb diet is satiating, so most people eat much less than they think they are eating even though the foods they’re consuming are pretty high in fat. Some people, however, can eat a whole lot on a low-carb diet, and, can in fact, eat so much that they don’t create the caloric deficit and don’t lose weight. But the interesting thing is that they don’t gain weight either. They pretty much stay the same. They are eating huge numbers of calories and not gaining, so where do the calories go?

First, I don’t think they go out in the bowel. If they did, people would have cosmic pizza grease stools whenever they ate a lot of fat over a period of time, and they don’t. And a number of studies have shown that increasing fat in the diet doesn’t increase fat in the stool.

Eating a very-low-carbohydrate diet ensures that insulin levels stay low. Unless insulin levels are up, it’s almost impossible to store fat in the fat cells. With high insulin levels fat travels into the fat cell; with low insulin levels fat travels out. So, it’s pretty safe to say that the fat isn’t stored. So what happens to it?

The body requires about 200 grams of glucose per day to function properly. About 70 grams of this glucose can be replaced by ketone bodies, leaving around 130 grams that the body has to come up with, which it does by converting protein to glucose and by using some of the glycerol backbone of the triglyceride molecule (the form in which fat is stored) for glucose. If one eats carbs, the carbs are absorbed as glucose and it doesn’t take much energy for the body to come up with its 200 gram requirement; if, however, one isn’t eating any carbohydrates, the body has to spend energy to convert the protein and trigylceride to glucose. That’s one reason that the caloric requirements go up on a low-carb diet.

The other reason is that the body increases futile cycling. What are futile cycles? Futile cycles are what give us our body temperature of 98.6 degrees. Futile cycles are just what the name implies: a cycle that requires energy yet accomplishes nothing. It operates much like you would if you took rocks from one pile and piled them in another, then took them from that pile and piled them back where they were to start with. A lot of work would have been expended with no net end result.

The body has many systems that can cycle this way, and all of them require energy. Look up the malate-aspartate shuttle; that’s one that often cycles futilely.

Another way the body dumps calories is through the inner mitochondrial membrane. This gets a little complicated, but I’ll try to simplify it as much as possible. The body doesn’t use fat or glucose directly as fuel. These substances can be thought of as crude oil. You can’t burn crude oil in your car, but you can burn gasoline. The crude oil is converted via the refining process into the gasoline you can burn. It’s the same with fat, protein and glucose–they must be converted into the ‘gasoline’ for the body, which is a substance called adenosine triphosphate (ATP). How does this conversion take place? That’s the complicated part.

ATP is made from adenosine diphosphate (ADP) in an enzymatic structure called ATP synthase, which is a sort of turbine-like structure that is driven by the electromotive force created by the osmotic and electrical difference between the two sides of the inner mitochondrial membrane. One one side of the membrane are many more protons than on the other side. The turbine-like ATP synthase spans the membrane, and as the protons rush through from the high proton side to the low proton side (much like water rushing through a turbine in a dam from the high-water side to the low-water side) the turbine converts ADP to ATP.

The energy required to get the protons heavily concentrated on one side so that they will rush through the turbine comes from the food we eat. Food is ultimately broken down to high-energy electrons. These electrons are released into a series of complex molecules along the inner mitochondrial membrane. Each complex passes the electrons to the next in line (much like a bucket brigade), and at each pass along the way, the electrons give off energy. This energy is used to pump protons across the membrane to create the membrane electromotive force that drives the turbines. The electrons are handed off from one complex to the other until at the end of the chain they are attached to oxygen to form water. (If one of these electrons being passed along the chain of complexes somehow escapes before it reaches the end, it becomes a free radical. This is where most free radicals come from.)

There are two parts to the whole process. The process of converting ADP to ATP is called phosphorylation and the process of the electrons ultimately attaching to oxygen is called oxidation. The combined process is called oxidative phosphorylation. It is referred to as ‘uncoupling’ when, for whatever reason, the oxidation process doesn’t lead to the phosphorylation process. Anything that causes this uncoupling is called an ‘uncoupling agent.’

You can see that the whole process requires some means of regulation. If not, then the electromotive force (called the protonmotive force, since it’s an unequal concentration of protons causing the force) can build up to too great a level. If one overconsumes food and doesn’t need the ATP, then the protonmotive force would build up and not be discharged through the turbines because the body doesn’t need the ATP. The body has accounted for this problem with pores through the inner mitochondrial membrane where protons can drift through as the concentration builds too high and by proteins called uncoupling proteins that actually pump the protons back across. So we expend food energy to pump protons one way, then more energy to pump them back.

One of the things that happens on a high fat diet is that the body makes more uncoupling proteins. So, with carbs low and fat high, the body compensates, not by ditching fat in the stool, but by increasing futile cycling and by increasing the numbers of uncoupling proteins and even increasing the porosity of the inner mitochondrial membrane so that the protons that required energy to be moved across the membrane are then moved back. So, ultimately, just like the rocks in my example above, the protons are taken from one pile and moved to another then moved back to the original pile, requiring a lot of energy expenditure with nothing really accomplished.

This is probably all as clear as mud, but it is what happens to the excess calories on a low-carb, high-fat diet.

Cheers–

MRE

I’ve got to apologize in advance for the length of this post, but in order to thoroughly do what needs to be done, it took the space.

Readers of this blog who have been around for a couple of years have been through the Anthony Colpo (AC) fiasco with me.  For those of you who weren’t around at the time, I’ll give a brief – a very brief – overview of what happened so you’ll understand what this is all about.

I wrote a post in September 2007 describing two different diets and their outcomes.  The first was designed by Ancel Keys and was a 1500+ calorie low-fat, high-carb diet; the other, designed by John Yudkin, was a 1500+ calorie low-carb, high-fat diet.  The subjects following the two diets experienced drastically different results.

This post, for whatever reason, inspired AC, a trainer and self-taught nutritional guru from Australia, to go into mad-dog attack mode.  I wasn’t the first person he had gone after, but I became the first to fight back.

Around the same time AC took it upon himself to attack me, he had just published an online book on weight loss that he was beginning to promote called The Fat-Loss Bible.  A more cynical person than I might have thought AC picked this fight in an effort to get some free publicity for himself and his book.  If that was indeed his motivation, he may have gotten a little more publicity than he had bargained for.

I took a look at his book – which I hadn’t realized even existed prior to this kerfuffle – and found it to be much like the ad for the educational software pictured above to the left.  At first glance, it looked reasonable, but upon closer inspection, it had some problems.

I made the offer to readers to dissect AC’s book if that’s what they wanted.  Or I could ignore the whole thing and continue with my regular posting.  A majority in the comments section voted for me to dissect.  I dug into the book, pulled all the papers cited, but subsequently got involved in other stuff and forgot about AC and his book.  He more or less dropped from sight, but has surfaced lately.  I had forgotten all about him, his book and the whole situation, but his new antics have stirred a few readers to ask about the dissection that I promised but never came through with.

So, with that preamble, here it is.

The crux of AC’s objection to me (and a few other people, namely Gary Taubes, Richard Feinman and Gene Fine) is that I (and they) believe there is a metabolic advantage that becomes manifest during low-carb dieting.  AC has taken the position that my idea of the low-carb driven metabolic advantage means that people following low-carb diets can eat all the calories they want and lose massive amounts of weight as long as they keep their carbs reduced.  He accuses me of leading people astray by encouraging them to eat, eat, eat as long as carbs stay low.

I don’t know where he got this idea because I have certainly never said such a thing anywhere.  The metabolic advantage brought about by low-carb dieting is probably somewhere in the neighborhood of a 100-300 calories, which isn’t all that much.  This few hundred calories don’t even come into play until the 1500-2000 calorie range of consumption.  I’ve written about this numerous times and have always used these figures, so, as I say, I don’t know where the idea that I believe the metabolic advantage allows low-carb dieters to eat huge numbers of calories and still lose weight.

I don’t plan to go through The Fat-Loss Bible in its entirety or this post would take on the dimensions of War and Peace.  I’m going to limit my comments to Chapter 1, titled “Myth 1: Don’t Count Calories.”  This first chapter is the one that tells why AC so fervently believes there is no metabolic advantage.

AC sells his book online, but (at least the last time I checked) it can be downloaded only on a PC.  At the time this dispute started I had a PC, which I used to download the book.  Since then, my PC has given up its ghost and I now use Macs exclusively.  So, the copy I have is about two years old.  I don’t know if AC has changed it since; consequently, I don’t know if my critique applies to the book as it exists today.  AC changes his book all the time, updating here and there, and I don’t blame him for it.  I do it with this blog all the time.  I find typos in old posts and sentences that I don’t like.  I change these things all the time and the blog is the better for it, so I don’t blame him if he does the same thing.  But I just want everyone to know that I’m critiquing the book as it was when he launched his attack.

AC firmly believes that a calorie is a calorie is a calorie.  He believes that people lose the same amount of weight dieting irrespective of the composition of whatever diet they’re on.  He believes that a given person will lose exactly the same amount of weight on, say, a 1600 calorie diet whether that diet is a low-carb diet or a low-fat diet or any other kind of diet.  It is the calories that set the weight loss, not the macronutrient composition or any other factor.

I don’t know if AC came to this conclusion then went looking for studies to confirm his bias or if he came to this conclusion because of the studies he read.  The first chapter of his book contains a number of studies he trots out to ‘prove’ his idea that only calories count.

There have been many out patient studies that have shown a metabolic advantage and many that haven’t.  Overall a greater number of studies demonstrating a metabolic advantage exist than studies showing no such metabolic advantage.  The first part of the first chapter of The Fat-Loss Bible goes into great detail describing why such studies are worthless.  He makes a fairly plausible argument as to why people on low-carb diets might tend to overreport consumption while those on low-fat diets may underreport.  If correct, this difference in reporting would create the appearance of a metabolic advantage where none exists.

To solve this problem, AC turns to what he calls

strict ‘metabolic ward’ studies in which, for the entire duration of the study, the participants are confined to a research facility where they can only eat the foods supplied by the researchers.

On the surface this seems to make sense.  Put the subjects under lock and key, give them just the food you want them to eat, and see what happens.  You’re going to have some individual variation, but if evaluate enough subjects and they all end up losing the same amount of weight irrespective of macronutrient composition, then you’ve got some pretty good evidence that there probably isn’t a metabolic advantage.

But as obvious as this appears at first glance, there are problems with this approach.

The first problem is a problem of measurement.  Newton derived his gravitational laws and everything scientists measured obeyed them.  These laws became sacrosanct.  If some observation didn’t conform to Newton’s laws, then the observation was faulty because Newton’s laws were infallible.  Those quirky movements of planets way out on the edge of the solar system were off a little from Newton’s predictions, but, hey, it’s got to be a measurement error somehow.  Then Einstein came along with his theory of relativity, and all the weird deviations conformed to Einstein’s laws.  Newton had been superseded.  Because the caloric differences brought about by a metabolic advantage (at least as I see it) are so small, weighing subjects in pounds and kilograms may miss it.

That’s the first problem.  But there is a problem much greater than that.  One that AC isn’t aware of because he doesn’t really have any real-world experience in doing nutritional studies in a hospital.

When subjects are studied in ‘metabolic wards’ they aren’t locked away and under constant observation.  In fact, often enough, they aren’t even in a hospital at all.  A ‘metabolic ward’ is simply a part of the hospital set aside to do nutritional studies.  And often it isn’t even a specific part of the hospital.  Subjects can be scattered about among the other patients.  Subjects can have visitors, can roam through the hospital, can even go to the cafeteria.  A ‘metabolic ward’ study can mean anything from: careful observation; to check into the hospital for a couple of days; to get trained on the diet then follow it at home; to check in, go to work all day, then come stay in the hospital all night. They are definitely not the strictly-controlled studies AC thinks they are.  He confuses them with ‘metabolic chamber’ studies, which are a horse of a different color.

The opportunities to cheat in a ‘metabolic ward’ study are, for the most part, as great as the opportunities to cheat in an outpatient study, especially since many of the subjects are outpatients most of the time.  There is a difference though.  When people are on outpatient studies they are more likely to at least admit their cheating and record what they cheat with than they are in ‘metabolic ward’ studies.  Some of the studies AC sites are formula diet studies in which shakes made of specific caloric and macronutrient composition are provided to subjects throughout the day.  (Or are given to them to consume outside the hospital at work or wherever.)  These are the kinds of programs you wouldn’t want to report cheating on.  And these subjects do without question cheat.  The fact that the data is reported as coming from a ‘metabolic ward’ study gives it a veneer of accuracy that it doesn’t really deserve.

AC gathered up a bunch of these ‘metabolic ward’ studies – 17 to be exact – that he uses to prove his point that there is no metabolic advantage and that only calories count.  He lists these studies in a chart (reproduced below), then proceeds to go through them one at a time.

On the ones that confirm his bias, he spends little time.  Just a brief description typical of this one describing the first study.

In a paper aptly titled ”Calories Do Count”, Kinsell and co-workers admitted five obese subjects to a hospital metabolic ward, then fed them liquid formula diets.  The diets ranged in protein content from 14 to 36 percent, fat from 12 to 83 percent, and carbohydrate from 3 to 64 percent.  The calorie content of the various diets was held constant for each patient irrespective of diet composition.  As they switched from one diet to another, each patient continued to lose weight at a similar pace.  Concluded the researchers: “…it appears obvious that under conditions of precise consistency of caloric intake, and essentially constant physical activity, qualitative modification of the diet with respect to the amount or kind of fat, amount of carbohydrate, and amount of protein, makes little difference in the rate of weight loss. [Italics in the original]

This is a great study to start with because it contains many, many flaws that AC is blinded to by his own confirmation bias.  It’s a terrible study.  Let me show you why.

Here is the first paragraph of the study.  And I’m not kidding.  This is directly quoted from the paper.

The accumulation of excess adipose tissue is a malady which affects many people.  That undue preoccupation with the pleasures of the table contributes to the disease has geen [sic] generally accepted in most quarters; or, to express the matter differently, majority opinion has held that the first law of thermodynamics applies to the human machine quite as predictably as it does to inanimate machines.  Despite this body of “official opinion” one finds many obese individuals who are either convinced that their food intake completely fails to explain their adiposity, or who spend time and money in the search for the magic potion or pill which will enable them to consume food in any quantity but still maintain or achieve a slim figure.

Do you think there might be just a little bias in this author and his co-workers?  From this first paragraph one sees by the reference to the first law of thermodynamics the set of the sail of these researchers.  Plus it’s pretty clear that these researchers don’t like overweight people and think obesity comes from a “preoccupation with the pleasures of the table…”  How do you suppose their data is going to turn out?

First of all, were these five subjects inpatients in a metabolic ward or did they just pick up their formula and take it home.  Did the live in the hospital or just spend the night?  No information is given.
Here is the sum total of the information given on the ‘metabolic ward’ status of the first patient described:

His weight on admission to the metabolic ward was 270 pounds.

Was he admitted to the ward where he stayed full time for the full 70 days of the study?  I doubt it, and I’ll describe why in a bit.  Or was he admitted for his initial workup then released to continue his diet at home.  I suspect the latter.  Whatever the situation, this is all the study says about it.

Here are the descriptions of how the rest of the subjects entered the study:

Second subject:

Weight on admission to the study was 227 1/2  pounds…

Third subject:

At the time the study was undertaken her weight was 199 pounds…

Forth subject:

At the time the study was undertaken, her weight was 211 1/2 pounds…

Fifth subject:

Patient GTAY was a 61 year old white female with a history of diabetes for more than 20 years.  She had received insulin in the past but could be maintained in a satisfactory diabetic control with diet and tolbutamide.  Milky fasting plasma was discovered in July 1962.  Other findings included evidence for coronary and peripheral atherosclerosis, and diabetic retinopathy.  She had partial removal of a goiter 40 years ago, but was essentially euthyroid during her stay in the metabolic ward.

The study in this patient was actually directed toward evaluation of her hyperlipidemia, but she is included in this report since she was maintained on quantitatively constant, eucaloric regimens containing high fat and high carbohydrate respectively, and also received both saturated and unsaturated fat.

This last patient wasn’t even accepted into the study as a subject for a diet study but more or less added after the fact.

There were five subjects in this study that lasted for anywhere from 65 to 77 days.  We can’t really tell which subjects went how long. Nor can we really tell if it was an inpatient study or just one where the subjects checked in.  Nor do we know how much weight each lost over how long a period.  We know the starting weights and that’s about it.

The data as displayed looks like data collected in an inpatient study, but the paper itself only implies that it is.  As you might imagine, inpatient studies are tremendously expensive, and, consequently, authors tend to make sure readers of the study know they are inpatient studies.  In this paper, we have to guess.

If these are truly inpatient studies for 65 to 77 days, we need to address another point: the quality of the subjects in such studies.  Who do you know who would have the time or inclination to spend two to two and a half months in a hospital full time?  People who are willing to spend the time in such facilities are usually not the most reliable. They are typically unemployed with little education and, for the most part, are imbued with a lack of understanding as to how important their rigid adherence to the protocol truly is.  I will be the first to say that not everyone who has ever volunteered for such a study falls into this category, but, unfortunately, many do. I’ll let a couple of the authors of these metabolic ward studies expound on this fact a little later.

The age range of these subjects is from 25 to 61. All of the subjects in this trial save one have serious medical problems and are under treatment with multiple drugs.  The one who doesn’t have serious problems is a 25 year-old male who has “been grossly obese since childhood.”  These are not the subjects you would want in a study of this nature.

The subjects getting the most calories got 1200 per day while those getting the least consumed 800 calories per day.  As I’ve written before, if calories are kept ultra low, all the calories – irrespective of composition – are going to be used for energy.  And under those circumstances, you would expect there to be no metabolic advantage.  And you would expect weight loss to pretty much follow a trajectory driven solely by caloric deficit, which is pretty much what happens in this study.  But it’s difficult to tell because of how terrible this study is presented.  There is a starting weight, but no ending weight for the subjects.  And, although the Methods section reports that the study lasted from 65 to 77 days, my calculations based on the data provided shows the study lasted from 64 to 82 days.  Which are we to believe?  Without an ending weight for the subjects and a precise number of days under caloric restriction, how do we really know how much they lost verses how much they should have lost given the number of calories they were getting?

And we have this other little tidbit thrown in when discussing the results of one patient, RTEA, who was a 26 year old female with “a history of resection of a cystic chromophobe adenoma of the pituitary…followed by radiation”:

Rate of weight loss was greater during the last 2 weeks on the high fat, high protein intake than during either of the other 2 dietary periods.  This probably does not have significance on view of the “stair case pattern” of weight loss.

Say what?  So they do have a subject that shows greater weight loss (and late in the program rather than early), yet they toss off the data with a bunch of weasel words implying that it probably isn’t significant.

I suggest you pull down the full text of this study at the bottom of this post so you can see for yourself how terrible it is.

I’m certainly not going to go through all 17 of the studies in this fashion because this post would then truly gargantic, but I wanted to go into this one at length to show that so-called ‘metabolic ward’ studies, those AC terms the ‘gold standard’ of medical research can be very, very flawed.  I, for one, would not want to be making any categorical statements based on the data contained in this study we just evaluated, that’s for sure.  If AC weren’t so blinded by his own confirmation bias, he would have laughed this study off.  If I had used it to ‘prove’ a metabolic advantage – based on the one patient described above who had more weight loss on the high-fat diet – he would have had a field day.

Next, let’s turn our attention to the Liebel et al study.  It’s number 11 down the chart if you’re counting.  Here’s what AC says about it:

Leibel and co-workers took 13 subjects, determined how many daily calories each needed to maintain his/her weight, then proceeded to feed them, in crossover fashion, diets differing in their macronutrient content.  Despite wide variations in protein, fat, and carbohydrate intake, the subjects maintained their weight irrespective of diet type.  This included two subjects who followed low- and high-carb diets (15 percent and 75 percent carbohydrate, respectively) for a minimum of 34 days each.

That’s it.  That’s AC’s commentary on the study.  I suppose readers are meant to believe that this study showed that it was all a matter of calories with no difference in terms of weight lost versus macronutrient composition of the diet.

The Leibel et al paper is a great one because it shows just how sloppy AC is in his presentation of data and, no doubt, in his own evaluation of the medical literature.

Go back and reread AC’s description of how the study was done.  Looks like Leibel et al did a hands-on study of these subjects, right.  Well, that’s not exactly how it worked.  Here is what really happened as reported by Leibel et al:

The records of all subjects studied by the Lipid Laboratory of the Rockefeller University Hospital between 1955 and 1965 who were fed lipid-formula diets of various carbohydrate (CHO) and fat composition were reviewed.

Leibel et al didn’t do squat in terms of studying subjects.  They went back through 40-year old records of subjects who had undergone formula feeding in the 1950s and 1960s to drag out records of 13 subjects (they actually drug out 16, but three were of children) who met their experimental parameters.  They weren’t looking for evidence of a metabolic advantage; they were looking to see if fat intake irrespective of calories made people gain weight.

Out of the countless studies done in those early years, they wanted to see if any could show that fat intake increased weight gain to a greater extent than the calories consumed as fat.  As they put it in the Introduction to their paper:

One group of investigators concluded that “fat intake may play a role in obesity that is independent of energy intake.”

The Leibel et al paper was published in 1992, the time in which the low-fat mantra was at its zenith.  It was a time that many people who should have known better were telling us we could eat all we wanted as long as we limited fat.  Fat makes us fat, we were told.  Cut it and you lose.  What Leibel et al were trying to show in this paper was that the weight gain or loss effects of fat were a function of the calories contained in the fat, not some other magical property that makes people gain weight above and beyond calories.

Before we get to the interesting data in this study, let’s take a look at what the guy who actually did this work had to say.  Leibel’s group went through old formula feeding studies done by Edward H. Ahrens, M.D., the head of the formula feeding lab at the time and the lead author of all the old papers referenced by Leibel.  Says Dr. Ahrens about the subjects in the inpatient studies:

Thirty-eight of forty patients were observed continuously under strict metabolic ward conditions; four of the forty [I know, the math doesn’t add up] were sufficiently motivated and intelligent to follow the regimen at home. (Ahrens EH et al 1957)

A couple of points here.  First, if four subjects out of 40 were “sufficiently motivated and intelligent” to be sent home with formula and instructions, what does that say about the other 36 (or 38)?  Which is to my point earlier about the quality of subjects recruited into metabolic ward studies.  Second, were some of the patients whose data was used for the Leibel paper those who were sent home?  If so, it blows AC’s notion of being unable to rely on any data gathered from free-living subjects.

Dr. Ahrens in another paper describing his 15 years of experience using formula diets says this about cheating in metabolic ward studies:

Such cheating is a natural (but dismaying) consequence when a patient’s dissatisfactions with any part of the ward routine are not quickly enough appreciated by the ward personnel.  Anticipation of the discontent is the clinician’s daily concern.  The closer the relationship between the patient and his medical attendants, the less likely cheating is to occur.  We have detected [my italics] cheating in only eight patients; undoubtedly others have gone undetected, but we feel the problem has been surprisingly minor. (Ahrens, EH 1970)

These are the subjects under lock and key.  The people running the study have to maintain constant vigilance to prevent cheating.  How about those who only check into the metabolic ward to sleep and spend the rest of their days at work or home?  And those are the subjects who make up most of the metabolic studies you read about.

One last interesting point about the Leibel paper.  The subjects they looked up in their retrospective analysis had undergone experiments during which they were given formula in amounts sufficient to maintain their weight.  As they lost or gained weight, their caloric intake was increased or decreased to compensate so that their weight stayed about the same.  According to the old papers about the original studies, the researchers tried to keep the subjects from fluctuations greater than one kg.  One kg equals two pounds.  If there was a metabolic advantage, it would probably show up within this two pound range and would be considered insignificant in terms of how this study was presented.

Some of the subjects, however, did lose or gain weight. Leibel et al then adjusted their caloric intake on paper to compensate for the weight differential.  In other words, if a patient lost weight on a given number of calories of a precise formula in the original study, Leibel et al would adjust the intake (40 years after the fact) to compensate for the weight loss.

One subject, a 55-year-old male with a BMI of 32, maintained his weight on a high-carb formula at 2871 calories per day.  The same subject then required 3501 calories to maintain his weight on a 70% fat, 15% carbohydrate diet.  Sounds like a metabolic advantage to me.

There were two papers in AC’s list of 17 that did show what could be considered a metabolic advantage.  In other words, subjects on the low-carb diet lost greater amounts of weight than subjects on low-fat, high-carb diets of the same number of calories.  These are two of the three studies by Rabast et al that are the 4th and 6th studies on the list of 17 shown above.

How did AC deal with this seeming refutation of his notion that no metabolic advantage exists?  By typical AC flimflammery.

In their 1981 study, Rabast et al observed significantly greater potassium excretion on the low-carbohydrate diets during weeks one and two.  A considerable amount of potassium inside our bodies is bound up with glycogen, so the greater potassium losses in Rabast’s low-carbohydrate dieters may indeed be a reflection of greater glycogen, and hence water losses.  Until recently, potassium excretion was often used a a marker or lean tissue loss; in Rabast’s study, this would indicate that the low-carbohydrate diet subjects lost more lean tissue.  As lean tissue holds a considerable amount of glycogen, this would again point to glycogen-related water loss as the explanation for the allegedly “significant” differences in weight loss. [Italics in the original] If the low-carbohydrate groups maintained greater lean tissue and/or glycogen losses at the end of the study, then this would easily explain their greater weight loss.

Regardless of whether Rabast et al’s findings were the result of water loss from glycogen depletion, pure chance, or some other unidentified factor, they should be regarded for what they are: An anomaly that has never been replicated by any other group of researchers.  For a research finding to be considered valid, it must be consistently reproducible when tested by other researchers.  As proof of the alleged weight-loss advantage of low-carbohydrate diets, the findings by Rabast and colleagues fail dismally on this key requirement.

Wow!  Where do we start?

First, AC didn’t mention Rabast’s 1979 study in which 117 patients were admitted to the hospital and studied on formula diets.  I assume these subjects were hospitalized round the clock because in the body of the paper it states:

…and as the patients were under constant supervision differences in food intake between the two groups could be excluded.

Unlike the Kinsell study (the first of AC’s 17 I described in detail above), the authors of this study were expecting a different outcome.  As discussed, Kinsell was obviously biased going in against the notion of anything other than calories count.  Rabast et al went in biased against low-carb diets:

The popularity of so-called ‘fad’ diets, low in carbohydrates and relatively high in fat, has continued to spread, especially among lay groups.  The caloric intake is only slightly limited, if al all; alcohol is allowed most of the time, and fat is consumed in the form of saturated fatty acids.  However, this kind of dieting, which must always be carried out on a long-term basis, has proved harmful.  The cholesterol intake can lead to severe health damage and clearly contributes to atherosclerosis.

After keeping the 117 subjects on low-carb vs high-carb diets of the same number of calories for 25 – 50 days, and probably hoping to find that those on the low-carb diet didn’t lose any more weight than those on the low-fat diet, the subjects on the low-carb formula diet lost considerably more weight than those on the low-fat diets.  Here are the graphs from the paper.

After going through all the data, Rabast et al conclude

Differences in fluid and electrolyte balance could not be measured but marked fluctuations can occur.  However, the change in body water and electrolytes could only be considered in short-term studies as the cause of the differences in weight loss.  Variation in the depletion of the glycogen pool is also a feasible explanation, as up to now, sufficiently long-term studies have not been reported.  However, the glycogen pool can be restored even under fasting conditions.  Therefore, an increased rate of metabolism presents itself as the most feasible explanation. [my italics]

The 1981 Rabast study that AC does comment upon refutes his commentary on the difference being due to greater fluid loss from the low-carb diet.

Potassium excretion during the low-carbohydrate diets was significantly greater for as long as 14 days, but at the end of the experimental period the observed differences no longer attained statistical significance.  At no time did the intake and loss of fluid and the balances calculated therefrom show significant differences.  From the findings obtained it appears that the alterations in the water and electrolyte balance observed during the low-carbohydrate diets are reversible phenomenon and should thus not be regarded as causal agents.

As to AC’s comment that the work of Rabast et al should be ignored because it has never been replicated by another group of researchers, I’ll leave to you to decide the validity of that.  There have been a number of such studies, including ones (as I’ll describe in a moment) in AC’s own list that confirm what Rabast found.  The 1979 Rabast paper discussed earlier lists 17 of them.

Hang in there; we’re almost through.  If I have to read all these papers and type all this stuff, the least you can do is stick with me ‘til the end.

Most of these studies don’t list the amounts of weight lost by the subjects because most of them aren’t designed to really look at weight loss.  Most are designed to look at other metabolic parameters such as protein sparing or branch chain amino acid use or nitrogen balance and the authors weren’t particularly interested in how much weight the subjects lost.  The authors mention that the two groups of subjects lost similar amounts of weight.  Other than the Rabast studies that we’ve already discussed, only four studies listed the weight lost over the course of the study by the subjects on either low-carb or high-carb diets.  In none of these cases did the weight loss difference reach statistical significance, so AC is presenting them as if there is no difference.

But in reality, there was a difference.  It just wasn’t statistically significant.

Statistical significance as it pertains to weight loss is a function of both number of subjects and amount of weight loss.  If I enroll 10 obese subjects in a weight-loss study and put five subjects on one diet and five on another, observe them for four weeks, and find that one group has lost an average of 2 pounds more than the other, that probably won’t be a statistically significant difference.  Why?  Because with only five subjects in each arm of the study, it requires a much larger weight loss to show a statistically significant difference.

If I do the same exact study, but enroll 100 subjects with 50 in each arm, and get exactly the same results – a two pound differential – then I achieve statistical significance.  The more subjects, the smaller the difference in outcomes it takes to reach significance.

In the case of these metabolic ward studies, the numbers of subjects are small.  As we’ve discussed, it is extremely expensive to keep subjects hospitalized 24 hours per day.  Consequently, most metabolic ward studies don’t enroll very many subjects.

I went through all the papers in AC’s list and found four (aside from the Rabast that we’ve already discussed) that list both starting and ending weights for the subjects.  I’ve listed them in the chart below.

As you can see, the study with the largest number of subjects had only 22 subjects in each arm.  These studies all use a caloric intake that is lower than would be expected to produce any kind of a metabolic advantage because all are at an almost starvation level.  Yet, as you can see, three out of the four show a greater weight loss in the low-carb arm than in the low-fat arm of the study.  Equal caloric intake, greater weight loss with the low-carbohydrate diet.  But, due to the small number of subjects, the difference doesn’t reach statistical significance.

If we had these same findings and same difference in weight loss between the two diets with a larger number of subjects, we would indeed have a significant difference.  If we did a meta-analysis of these studies, we might find that adding the subjects together would end up showing a significantly difference in weight loss.  Even though these differences don’t add up to statistical significance given the number of subjects involved, you can see the definite trend.

But what about the Piatti study, the one that showed the low-fat diet producing more weight loss than the low-carb?  I have it marked with an asterisk for a reason.  The paper by Piatti et al titled Hypocaloric High-Protein Diet Improves Glucose Oxidation and Spares Lean Body Mass: Comparison to Hypocaloric High-Carbohydrate Diet looked at how 25 obese women fared in terms of lean body mass and insulin sensitivity.  They were put on 800 kcal diets for 21 days.  It was found that the low-carb diet spared more muscle tissue and improved insulin sensitivity more than the low-fat diet of an equal number of calories.

Since the authors weren’t specifically studying weight loss, they didn’t really randomize the subjects by weight but did so by other parameters.  As it turned out, the group on the low-fat, high-carb diet were much heavier than those that ended up in the low-carb arm.  The average starting weight of the subjects in the low-fat arm was 213 pounds (96.8 kg) whereas the starting weight of those on the low-carb arm was 191 pounds (86.8 kg), a significant difference.  It would stand to reason that subjects starting off at 213 pounds on a 800 calorie diet would lose more over 21 days than subjects starting out at 191 pounds and following the same diet, and indeed they did.

This post has gone on way, way too long, but I think it’s pretty obvious that these studies fail to ‘prove’ that a metabolic advantage does not exist.  I would say, if anything, that they ‘prove’ just the opposite.

Just so you can go through these studies yourselves if you so desire, I’ve put them all up on Scribd.  The links are below to the full text of all.

The next post will a) be much, much shorter and will b) go into detail on a beautiful study that AC totally disses in his book.  We’ll look at his diss and what the study really says.  That should put paid to AC.

All the papers referenced by AC listed below.  All full text.

Kinsell et al

Grey Kipnes

Rabast et al 1979

Rabast et al 1981

Yang et al

Bogardus et al

Hoffer et al

Leibel et al

Vazquez 1992

Vazquez 1994

Vazquez 1995

Piatti et al

Golay et al

Myashita

MD and I wish all of you a most prosperous and healthful New Year!

We’ve had a great time with family and friends over the holidays, but now it’s time to get back into the swing of things.  We ended the year last night with a great dinner for friends.  MD went all out on one of her mega dinners, which, of course, included foie gras, her all-time favorite food.  (That’s my serving of foie gras pictured on the left.  The little jelly-like stuff is a pomegranate pepper jelly that was out of this world and well worth the four or five carbs.)  We had a terrific time ringing out the old year and ringing in the new. I, myself, could have done with a few fewer glasses of wine and the champagne we drank to toast in the new year.

MD’s menu for our New Year’s Eve feast:

• Roasted red pepper soup
• Foie gras (cooked sous vide)
• Duck breast (cooked sous vide) with cabernet cherry reduction
• Golden beets
• Fresh herb salad with vinaigrette
• Epoisses (a soft French cheese)
• Poached pears (cooked sous vide) with pomegranate reduction and heavy cream

Various wines for the different courses and champagne at midnight.

I’ve just now barely recovered.

Everyone is busily making resolutions for the new year, and I suspect that in many cases the list includes weight loss.  In cruising through the web today while regaining my sobriety, I came across a number of posts offering to help by giving weight loss recommendations.  As a weight-loss method, it seems this year that caloric restriction is all the vogue.  Most of the articles I read had a sort of smarmy condescending nature to them, as in, hey, guys, it’s really, really simple to lost weight.  All you have to do is just cut your calories and you’ll lose.  It’s not difficult.  Just do it.

One particular article on losing weight that was representative of most was in Wired Wiki How-To.  By his tone, it’s pretty obvious that the author of this article figures he’s found the holy grail of weight loss.  It’s easy and fast and foolproof.

What does he recommend?

First, you decide how much you want to lose and how long you want to diet. You then multiply the amount (in pounds) you want to lose times 3,500 (the number of calories in a pound of fat).  Take this number and divide it by the number of days you plan on dieting, and you’ve got the number of calories you’ve got to cut back by to lose the weight you want to lose.

The article even gives an example to show how it works.  Let’s say you need to lose 10 pounds and you’re willing to spend two months dieting to lose the weight.  You multiply 10 times 3,500, which gives you 35,000 calories you need to get rid of.  Divide this 35,000 by 60, and you find you need to reduce your intake by 583 calories per day, and, Voila!, your ten extra pounds will be gone at the end of the month.  What could be easier?  Why didn’t I think of that?

The author even presents a version of the energy balance equation to show what he’s talking about.  It’s just a system, says he, and all you’ve got to do to be thin is operate the system.

If it were only that easy, no one would be overweight.

Here is the energy balance equation:

Change in weight = Calories in – Calories out

Below is another way of stating the same thing:

Change in weight = Calories from food consumed – Calories from BMR and exercise

It all sounds so easy.  If your calories coming in from food are balanced by the calories you get rid of during daily living, then your weight remains constant.  If you decrease your intake of calories and keep the calories going out the same, then you’ll decrease your weight.

Problem is, these two terms ‘calories in’ and ‘calories out’ aren’t independent of one another.  If you reduce the number of calories coming in, you’ll also reduce the number of calories you burn.  Your metabolic rate will drop, you will decrease your activity more, and your weight won’t change as much as you would expect.  If you ratchet up your exercise, then you’ll compensate by unconsciously increasing the food you eat by a bit.  The fact that these two components of the energy balance equation aren’t independent is what makes losing weight by counting calories so difficult.

In my opinion, it’s much easier to lose excess body fat by following a diet that both restricts calories without your having to think about it and that does it in a way that doesn’t really cause you to drop your metabolic rate.  Plus, a good diet followed correctly actually gives you a little boost in that it provides a small metabolic advantage.  In other words, you lose a few extra calories (maybe up to 200-300 per day) without having to do anything to lose them other than following the diet.

Take a look at this post on Is a calorie always a calorie? I wrote a couple of years ago to see what I mean.

But beware.  This post comes with a caveat.  If you are in the least bit psychologically unhinged, you might not want to read the post.  It was this very post that pushed Anthony Colpo over the edge.  It inspired him to launch a jihad against me and against anyone else who might possibly believe that a slight metabolic advantage exists.  He wrote an entire book that he made available free to anyone who wanted it showing how Gary Taubes, Richard Feinman, and MD and I were idiots.  Of course, my redneck genes, such as they are, compelled me to answer.  For those of you who weren’t readers in those days, the end result of the whole affair was that after receiving a number of pretty severe canings on this blog, our friend Anthony just sort of drifted away, never to be heard from again.

All this aside, read the post and come to your own conclusions as to what the best diet is for simple, quick weight loss and act accordingly should one of your New Year’s resolutions be to lose weight.

If you need some motivation to jump in with both feet and do it, then read this post, this one and this one.

Best of luck with all your resolutions.  I look forward to continuing our journey together in 2010.

I’ve just discovered that the soft-cover version of Good Calories, Bad Calories is out.  I guess it has been out for a few weeks, but I just discovered it was available.  If any of you have been waiting for the paperback before reading this terrific book, now is the time to get it.

Since GCBC came out a year or two ago, I’ve gotten countless comments asking me what Gary thinks about this topic or that one.  And I’ve gotten comments from folks asking me to ask Gary a question for them.  I was going to interview Gary and post his responses to my questions when it occurred to me that you all might like to ask questions of him directly without having them come through me.  I contacted Gary this weekend to see if he would be willing to answer specific questions from people on this blog.  He very generously agreed to do so.

Send your questions in via the comment section.  I ask on Gary’s behalf that you ask no personal medical questions, but questions about the science and the history of the science behind the way we eat today and the way we probably should be eating.  I promised Gary that he wouldn’t have to answer questions by the score, so we’ll see what comes in.  He and I will look at the questions and answer those that are a) the most common, b) those of the most general interest, and c) those that he feels are particularly important.

I know I don’t have to tell the readers of this blog not to be shy, but I will anyway.  Don’t be shy.  Get those questions in. If you’ve had a question that’s been gnawing at your brain, now’s the time to ask.

I’m heading off for a 9 hour drive to make it home in time to do my civic duty tomorrow, so I’ll be out of the loop for a while.  I can post comments through my Blackberry, however, so don’t hesitate to ask the question you would like to ask.

Note: I have closed the comments on this post.  Since Gary agreed to answer a number of questions, I think 101 is probably enough.  Thanks for all your interest and intelligent questions.

Hodgson Mill, near Gainesville, MO. Built in 1884 Photo by Hemant (click to enlarge)

Someone I know gave me a look at a book by a guy named Dr. Gregory Ellis, who is a Ph.D. body builder and an ex-pro footballer, and asked me to take a look at it. The book suffers from being self published and not having the helping hand of a professional editor. It is way overwritten and about three or four times as long as it needs to be (it’s about the size of the Little Rock, AR telephone directory) to make the case Dr. Ellis is trying to make.

Dr. Ellis, like my good friend from Down Under, is a firm believer in the calorie is a calorie is a calorie theory. In fact, he is such a firm believer that it seems to have reached the point of almost being a religion to him. His book contains 26 chapters, and starting with Chapter 3 (I don’t know why he didn’t start with Chapter 1, but he didn’t) and going all the way through the rest of the 26 chapters, he puts this statement at the top of the chapter page:

Calories Count! The Energy Balance Equation is weight control’s Golden Rule: it’s Ultimate, Irrefutable, and Holy Law. Calories consumed cannot exceed those burned off without gaining weight. The myth of the “fast” and “slow” metabolism that varies widely from person to person – is just that, a myth. It’s a myth that Uncle Harry “eats everything in sight and remains slim.” It’s a myth that Aunt Alice “gains weight at the whiff of a hot muffin.” Resting metabolism depends on body size and we can predict it by a formula; we aren’t that different. And large differences in the amounts eaten only come because one person is far more physically active than another. The Law is always obeyed. It’s unbreakable. All are accountable. No one escapes; no one is above the Law. This is the First Principal, failure to learn the Law will lead you to failure in bodyweight regulation. “But,’ you say… there are no Buts! [all bold text in the original]

This same statement – word for word, bold text for bold text – is how 21 chapters out of 23 start, so it’s got to be assumed that Dr. Ellis finds this important. Extremely important.

(It is obvious that he is unfamiliar with or oblivious to the multitude of overfeeding studies that give the lie to this notion, but we won’t go in to that now.)

The reality is that our bodies have the capacity to deal with calories by changing the rate at which we burn them. Calories in and calories out are dependent variables, not independent variables: the one depends upon the other. Let me show you what I mean and explain why it’s often so difficult to lose weigh while dieting.

It always drives me nuts when people use a car or another piece of machinery as an analogy to the human body. Why? Because in a car the gasoline in/gasoline out equation (the energy balance equation for a car) works the way Dr. Ellis thinks it does in the human body. You put gas in the tank, and if you run the engine harder (exercise for the car), you burn more gas. And it can be easily calculated how much you’ll burn at a given engine speed on level ground. And it can be replicated. As the gas runs low in the tank, the car can’t help itself get better mileage to conserve.

If a car is going to be used as an analogy to the human body, we need to include the driver to make the system perform more human-body-like. We have a body and a brain – the car has a body and a brain (the driver).

A few years back MD and I were driving through the Ozarks in southwest Missouri where I grew up. We had just been to visit Hodson’s Mill, pictured above, the mill where my maternal grandfather used to take corn on muleback to be milled when he was a kid circa the turn of the 20th century. The countryside is beautifully picturesque with loads of hardwood trees, rolling hills and large bluffs, the Ozark Mountains. We were riding in an SUV, and as we motored along, I suddenly noticed that the gas gauge was banging on empty. Then it dawned on me that it was a Sunday, and it was likely that in rural America there weren’t going to be a lot of service stations open. Especially not out where we were. And I didn’t even know exactly where we were relative to any towns because I hadn’t been paying close attention to the road signs. I went into gas conserve mode. As we approached hills, I timed my speed so that we would barely make it to the top, then be able to coast down and halfway up the next hill before I had to hit the gas pedal. I let my coast speed build up to way more than I felt comfortable with given the winding roads and blind curves, all the while trying to ignore MD’s sharp intakes of breath, her legs and feet pushed against the floorboard braced for collision, and her death grip on the handhold. Even though I was driving a gas-guzzling SUV, I’ll bet I milked 40 miles to the gallon out of that sucker until we finally found an open service station, and the day was saved. Once we were filled up, and I was back at the wheel driving normally, we probably dropped back down to the 18 mpg range.

If I’m running late and in a hurry, I get a lot less gas mileage than normal. I race up to stoplights, slam on the breaks, floor the accelerator when the light changes – all activities that minimize gas mileage, but get me wherever I’m going a little sooner.

In both of the cases described above, it’s the car/driver combo that makes the difference. It’s the same with our bodies. Numerous overfeeding studies have shown that when weight-stable people are overfed huge numbers of calories over varying periods of time, their body weights change minimally, at best, just a fraction of what would be estimated based on their increased caloric intake. Why? Because their body/brain combination is performing much like my driver/car example when I’m trying to get somewhere in a hurry. I waste gas in exchange for speed; these overfeeding subjects waste calories in exchange for stable body weight.

Underfeeding or starvation studies show just the opposite. When people are fed calorically-restricted diets, they go into kind of a metabolic slow down process to conserve fuel just as I did with the vehicle when we were running out of gas. These calorically-restricted subjects become lethargic – they move less and they sleep more. Their reduced calories in induces their bodies to reduce the calories going out.

This phenomenon is called adaptive thermogenesis, which is defined as increase or decrease in energy expenditure in response to overfeeding or underfeeding (or even temperature change).

Adaptive thermogenesis is the reason that my friend from Down Under, who is so taken with his metabolic ward studies showing no difference in weight loss irrespective of dietary macronutrient composition, doesn’t understand or believe in the metabolic advantage. In his book he has assembled a number of studies done in metabolic wards (sort of; but that’s a topic for another post) showing that subjects fed primarily fat or primarily protein or primarily carbohydrate all lose the same amount of weight. These papers show that it doesn’t really matter what the protein/fat/carbohydrate composition of these restricted diets are, the subjects all lose the same amount of weight. Which to our friend, who hasn’t really bothered to think it all through, proves that dietary composition doesn’t matter. He, like Dr. Gregory Ellis, believes it is simply a matter of calories, not macronutrient composition. And most of the studies he lists seem to corroborate his belief. But there is a problem. A big one.

Virtually all of these studies are ones in which the subjects are severely restricted in calories. In some the caloric restriction is so great (500 kcal total intake per day) as to be truly starvation diets. When the body is severely calorically restricted, it uses every scrap of food that comes in. It burns protein; it burns fat; and it burns carbs. And it burns them efficiently. During starvation it doesn’t matter what the composition is, the body simply consumes the calories. And, under those circumstances, it makes perfect sense that there would be no difference in weight loss regardless of what the ratio of macronutrients happens to be.

As the caloric intake increases, a point is finally reached at which the body can afford to be a little more discriminating as to what it does with the calories coming in, and at that point the macronutrient composition begins to matter. As the caloric intake increases, as it does in the overfeeding studies, there comes a time at which the body again doesn’t particularly care what the macronutrient composition is – there is simply too much of everything, and so the body blows it all off.

In between these two points, in the caloric range where most of us operate most of the time, macronutrient composition does matter. In fact, in our friend’s book, he actually lists a couple of studies in which there does appear to be a metabolic advantage. And guess what? Those are studies in which the caloric intake is up more in the range one would expect while dieting, not starving. And those studies do indeed show that a low-carb diet brings about more weight loss than an equal number of calories given as a high carb diet. These studies were done in Germany under metabolic ward conditions by a researcher named Udo Rabast. Dr. Rabast did the studies mentioned in this book plus a few that weren’t mentioned because, although they were done under metabolic ward conditions, they didn’t fit the selection criteria of our friend, i.e., they didn’t show what he wanted them to show to substantiate his argument. The Rabast studies do indeed show a fairly robust metabolic advantage to the low-carb diet. The two studies that were mentioned were sort of included in the book chapter as oddities, I suppose. So how did our friend deal with these studies. He blew them off. He simply stated that since all the other studies he presented don’t show a metabolic advantage, then these have to be aberrations and should be ignored. Don’t believe me? Here he is in his own words:

Regardless of whether Rabast el al’s findings were the result of water loss from glycogen depletion, pure chance, or some other unidentified factor, they should be regarded for what they are: An anomaly that has never been replicated by any other group of researchers. For a research finding to be considered valid, it must be consistently reproducible when tested by other researchers. As proof of the alleged weight-loss advantage of low-carbohydrate diets, the findings by Rabast and colleagues fail dismally on this key requirement.

Could the “some other unidentified factor” possibly be a metabolic advantage? Methinks so.

There is another study in his list showing a large metabolic advantage that he totally misinterprets, but we’ll leave that one for another day. I want to write on it in more detail because it shows all the problems inherent in these kinds of studies. And in the interpretation of them by people with little experience and/or an axe to grind.

Following a low-carbohydrate diet that is in the calorie range where the metabolic advantage exists makes one able to lose weight without the weight-retaining effects of adaptive thermogenesis kicking in. You can, so to speak, have your cake and eat it too. The body is getting enough calories to keep it from going into starvation mode yet the macronutrient composition of the diet leads to enough of a caloric deficit to ensure weight loss. The best of all worlds.

The phenomenon of adaptive thermogenesis is getting a lot of play currently in the scientific literature. There are a number of researchers who feel that certain factors have changed in our environment making it more difficult for us to lose weight once we’ve gained it. And making it easier to gain in the first place.

I’ll address these factors in a later post and show how you can overcome them.

Virtually all of the results presented in medical studies are displayed as ‘average’ or ‘mean’ values. I’m sure everyone knows how to come up with an average or mean (the two are synonymous) value for a group of data points is to add them and divide the sum by the number of data points analyzed. For example, if you are a teacher, and you want to find out the average score on a test you gave to 30 students, you would add all the test scores together and divide by 30. You would then have the ‘mean’ or ‘average’ score of the students in your class.

Most medical papers list the mean values of whatever is being studied. If the researchers are trying to determine whether or not an experimental weight-loss therapy works, they add the weight lost by all the subjects participating in the study then divide by the number of subjects. The number they get is the ‘mean’ or ‘average’ weight loss brought about by the therapy being tested. It all sounds pretty reasonable and scientific, but is it really?

It would be realistic if we were all average people. But we’re not. And averages don’t represent us all that well. In fact, if you think about it, the average American would have one breast and one testicle.

Averages don’t always represent the true findings in a scientific experiment, either. Let’s look at an example to demonstrate. Let’s say we are testing a new weight loss regimen on 10 people. We start these people on the program, keep them on it for three months, then evaluate. When we look at the numbers we find the following results:

• Subject #1 -4 lbs
• Subject #2 -5 lbs
• Subject #3 – 7 lbs
• Subject #4 – 4 lbs
• Subject #5 – 2 lbs
• Subject #6 -6 lbs
• Subject #7 +12 lbs
• Subject #8 – 1 lb
• Subject #9 + 4 lbs
• Subject #10 -3 lbs

If you add these numbers up and divide by 10 you find that the average or mean weight loss for the group is 1.6 pounds, which doesn’t seem like a lot. But if you look at the data itself instead of the average, you see that most of the people lost around 4-5 pounds. In fact, assuming these numbers to be accurate, if you went on this same regimen, the odds are that you would lose 4-5 pounds instead of the 1.6 pounds that the ‘mean’ of the data would predict. You could also gain 12 pounds, but that would be unlikely (a 1 in 10 chance). This is the problem in simply looking only at average values and not the data as a whole.

Another way to look at this data is to calculate the median, which is basically the midpoint within the data set, i.e., the point at which half of the subjects are above and the other half below. You can do this by arranging the data in ascending or descending order and finding the midpoint by lopping off from both the top and the bottom until you get to the middle.

If we do this to our data, it looks like this:

• Subject #7 +12 lbs
• Subject #9 + 4 lbs
• Subject #8 – 1 lb
• Subject #5 – 2 lbs
• Subject #10 -3 lbs
• Subject #1 -4 lbs
• Subject #4 -4 lbs
• Subject #2 -5 lbs
• Subject #6 -6 lbs
• Subject #3 -7 lbs

We can see that the median falls between 3 and 4 or 3.5. So in this experiment the mean (average) weight loss is 1.6 pounds, the median is 3.5 pounds, about twice what the mean is. But if you look at the actual weights lost you can see that most clustered around the 4-5 pound level. You can see that the results of our experimental weight-loss regimen look different depending upon how they’re reported.

It works this way in the real medial literature as well.

Let’s look at a study from a couple of years ago (full text pdf) that many people have used to ‘prove’ there is no metabolic advantage and to ‘prove’ that a calorie is simply a calorie irrespective of its macronutrient composition.

Boden et al studied 10 overweight patients with type II diabetes in metabolic ward for 21 days. During the first 7 days the subjects were allowed to follow their regular diet (the control) and were switched to a low-carbohydrate diet (21 g carb/day) for the next 14 days. During the course of the study, numerous parameters were evaluated, including fasting glucose levels, insulin sensitivity, HbA1c, weight change, caloric intake and energy expenditure.

After the 14 days on the low-carb diet subjects lost weight and markedly improved in all parameters measured. Blood glucose levels normalized, HgbA1c decreased from 7.3% to 6.8%, insulin sensitivity improved by about 75%, triglycerides dropped by 35% and total cholesterol fell by 15%. Pretty dramatic results for only 14 days on the low-carb regimen, I would say.

The subjects lost weight as well. They lost an average (mean) of 3.63 lbs (1.65 kg) while decreasing their food intake from 3111 kcal/day to 2164 kcal/day, a decrease of 947 kcal/day. Multiplying 947 X 14 gives us a total caloric deficit of 13,258 kcal. If we divide this number by 3500, the kcal in a pound of fat, we get 3.79, which is the amount of fat that should be lost simply from the caloric deficit. And which is pretty close to the actual 3.63 lbs actually lost. The difference is insignificant, so it really is, as they say, close enough for government work.

The authors of the study conclude that irrespective of all the other markedly positive benefits of the low-carb diet, the “weight loss…was completely accounted for by reduced caloric intake.” In other words, there is no metabolic advantage to a low-carb diet. Weight lost simply occurs because the satiating effects of the low-carb diet bring about a spontaneous reduction in calories.

But is that all the story here? Not really. Let’s see why.

Below is a chart from the study showing graphically what happened to caloric intake and weight during the course of the experiment.

Look at the lines in the upper half of this chart that represent the body weight ranges of all the subjects and the lines representing the caloric intake of all the subjects. Notice that the lines for caloric intake are small while the lines representing the amount of weight loss are large. If you compare the dimensions of these lines to the scale, you find that these subjects varied their caloric intake by about only 200-250 kcal/day. But the variation in weight loss is much, much larger, which means that some subjects lost considerably more weight than would be expected from the caloric deficit while others didn’t lose as much or may have even gained a little. What this chart shows us is that there is indeed a metabolic advantage for some of these people even though on average there wasn’t for the group. And remember the post on Carl Popper: if the metabolic advantage can be shown to be present, that means the hypothesis that a metabolic advantage doesn’t exist is false.

Unfortunately, most medical articles don’t show the array of data as this one has, so all we have to go by is the average, which doesn’t always tell the whole story. One of the things I like about my favorite journal, Nutrition & Metabolism, is that the editors almost always require the raw data to be shown along with the averages, which truly allows astute readers of the medical literature to come to meaningful conclusions about the data. Only after they report it in this way, can you really decide what happened.

About a month ago I posted on a Swedish overfeeding study and how the results were misreported in the press. This study showed that increased carbohydrate intake can cause an increase in certain liver enzymes associated with the metabolic syndrome. Along with this liver enzyme data the authors reported on metabolic rate changes that are instructive in our quest to determine the existence (or lack thereof) of the metabolic advantage.

I would imagine that most people reading this blog have had problems with excess weight sometime in their pasts. Those of you who have struggled with overweight probably have little sympathy for those who have the opposite problem – that of inability to gain. Despite how easy it seems for those with weight problems to gain weight and especially to regain lost weight, it is extremely difficult for many people to gain weight almost irrespective of how much they try.

The medical literature is full of overfeeding studies in which subjects are encouraged to eat substantially greater amounts of food than they typically eat in an effort to get them to gain weight. Probably the most famous of these are the Vermont prison overfeeding studies conducted by Ethan Sims back in the 1970s. These studies, like the starvation studies of Keys, would probably never make it past the ethics review today, and will likely never be repeated.

Sims and his team overfed prisoners and found that despite being overfed the same number of calories there were large differences in the rate of weight gain between individuals. And he discovered that when the overfeeding stopped, there were differences in the rates at which inmates lost the weight they had gained. One of the lessons from these studies is that individuals have different predispositions to gain and lose weight independent of caloric intake.

Another lesson is that overfeeding tends to increase metabolic rate, allowing a dissipation of many of the excess calories consumed. As I’ve pointed out before, the calories in/calories out part of the energy balance equation are not independent variables. In other words just because you decrease (or increase) calories in doesn’t mean that calories out stays the same. Virtually all overfeeding studies show that there is much less weight gain than the increased caloric intake would predict. This effect is so common that German researchers in the early 20th century gave it the name luxusconsumption, meaning the wastage of calories by increasing metabolic rate during overfeeding.

We can see luxusconsumption at work in the Swedish fast food overfeeding study. The authors were a little hazy about the actual caloric consumption of the subjects, reporting it differently in two places, so we really can’t use their figures for our own calculations. The table below shows the increases in weight and metabolic rate during the 28 day study. We can make some calculations from these numbers.

Since the data isn’t broken out by male/female I did my calculations based on all the subjects being male since two thirds of them were. I worked backward from the BMI and calculated the average height of the subjects as being 176 cm.

I used the Harris-Benedict equation to determine starting and ending resting metabolic rates (RMR). The Harris-Benedict equations were developed in 1919 and have been used extensively since then. A few researchers have come along and improved on them since, but most of the online RMR calculators use the Harris-Benedict equations, so that’s what I used. These equations assume that given a sex, height, and age that the RMR correlates with weight, which is one of the reasons many people who should know better state categorically that RMR is simply a function of weight.

My calculations show that prior to starting the overfeeding, the average subject should have had an RMR of 2064 kcal/day. After 28 days of overfeeding and a 6.4 kg ( 14 lb) weight gain, the RMR calculates to 2152 kcal/day, about a 4% increase.

When the Swedish researchers measured the RMR directly using the ventilated hood technique they found a starting RMR of 1615 kcal/day that increased to 1813 kcal/day, a little over a 12 % increase.

Weight increased from 67.6 kg to 74 kg, a little over a 9% increase, while the RMR increased by 12% as compared to the 4% predicted by the Harris-Benedict equation. This measured increase in RMR that is greater than the weight gain would predict is luxusconsumption in action.

Another name for luxusconsumption is metabolic advantage. Metabolic advantage is defined as a lesser weight gain than a given number of extra calories consumed would predict, and is brought about by an increase in metabolic rate driven by the diet. In other words, calories in increase calories out to a greater extent than the calories in. The subjects in this study were definitely experiencing a metabolic advantage.

As more calories are consumed, luxusconsumption increases. And this effect takes place irrespective of the type of calories – macronutrients – consumed. The metabolic advantage is firmly established in the medical literature dating back over 100 years and was once again confirmed in this study. The debate we’ve been having is whether there is a different metabolic advantage for differing macronutrient consumption, i.e., does restricting carbs produce more of a metabolic advantage than restricting fat in diets of the same number of calories. We will address this in a future post, but for now I want everyone to realize that a metabolic advantage does exist and has been demonstrated countless times.

Before we proceed to the question of metabolic advantage and macronutrient consumption there is one other notion we need to discuss and clarify: data presented in medical studies as averages of all the data collected. This often confusing issue will be the subject of the next post.

A few days ago I got an email through the Protein Power website from Anthony Colpo. I won’t reprint the email because I don’t reprint personal emails from others unless I have their permission, but let it be said that it wasn’t particularly kind. Or, I guess, let it be said that it was typical for Anthony Colpo. The email contained a link to Anthony’s $20,000 challenge to me.

Here is a pdf of the challenge: anthony-colpos-challenge-to-eades-and-his-mad-followers.pdf

The challenge had a low signal to noise ratio, probably about 3 percent. But without all the accompanying blather, the challenge boiled down to these three requirements for me to get Anthony’s 20 grand:

1. Show me published peer-reviewed metabolic ward research that compared isocaloric low- and high-carbohydrate diets and found statistically significant greater fat-derived weight losses among subjects following the low-carb diet.

2. You must present conclusive proof that the metabolic ward studies I have cited in Table 1, Chapter 1 of The Fat Loss Bible have been misreported, and in fact really show greater fat loss in the low-carbohydrate groups.

3. The evidence requested above must be presented on an internet web site readily viewable by the general public by Midnight, March 1, 2008, Australian EST.

This so-called ‘challenge’ is, of course, constructed in such a way that I can never collect the $20K. Here’s why.

The first requirement is no big deal. The problem, however, is that Anthony – who is the person who decides whether or not I satisfy the requirements – would find some bogus issue with any peer-reviewed study I come up with, although the challenge clearly states that the only requirement is that the study be peer-reviewed, conducted in a metabolic-ward setting and show a metabolic advantage.

The second requirement is the one set up to ensure Anthony doesn’t lose his money. I don’t disagree with the studies he cites in his ebook. I think the problem comes from Anthony’s misinterpretation of what those studies mean in the context of the metabolic advantage. But as for the studies themselves, they are what they are. The authors (I assume) reported their data truthfully. Since I can’t disprove the data from those specific studies, I can’t possible complete requirement #2. Which, I’m sure Anthony knows, and which made me believe that all this was simply a desperate ploy for publicity on his part.

Plus, I was beginning to think that maybe Anthony was obsessed with me. I couldn’t figure out if it was because I actually came back at him instead of ignoring him like everyone else does or if it’s simply a man crush kind of thing. But irrespective of the cause, he’s definitely obsessed. If you take a look at the actual challenge document you can see that he has really spent a huge amount of time and energy on this issue. As proof I offer this: buried somewhere in all the noise is a little section that starts like this:

The Eades’ emphasis on carbs and insulin instead of calories may explain the following less-than-flattering reviews of Protein Power:

[He then puts up links to a dozen or so negative reviews of Protein Power on Amazon.com]

The failure of these folks to lose weight on the Protein Power diet is due to one thing – eating too many calories – an unfortunate result of the Eades’ claim that carbs and insulin, not calories, are the primary determinants of weight status.

What I find amazing, and why I think he is obsessed is that there are 439 reviews of Protein Power on Amazon! I haven’t even read through them, yet Anthony found the time to go through them one by one (a tedious process to say the least – I tried going through about 30 just to see what it was like) and link to the few that were negative. Plus, he’s remembered and referred to every single less-than-flattering thing I’ve had to say about him in this blog and in the answers to all the comments on this blog. If that’s not obsessed, I don’t know what is.

So, I decided to email him back to see. And I wanted to see if the Anthony in private is the same Anthony one sees in his online persona. It’s hard to tell because he converted a private email into a public email. Since I don’t know Anthony other than through his online persona, I thought I would try to reach out and establish some sort of friendship. As I told him, I’m friends with a whole lot of people I don’t agree with about everything. I figured from some of the stuff I’ve read of his that he couldn’t find a publisher for The Great Cholesterol Con, and I offered to help. I even offered to help him get The Fat Loss Bible looked at by an agent. And I told him the real truth about the publishing industry. Why? Because Anthony’s books promote a low-calorie, low-carb way of life. And his books show the folly of the lipid hypothesis. Why wouldn’t I want these books in print with a legitimate publisher? Anything that furthers the message helps. As I told him, I would rather see the press full of reports about people arguing over which version of the low-carb diet is best and over whether or not low-carb diets have a metabolic advantage rather than as it is today where the press basically reports the low-carb diet (if it reports it at all) as a fad diet. My books don’t appeal to everyone as Anthony proved by digging out a dozen negative reviews from the 439 available. So if his book appeals and converts someone to the low-carb message that I can’t reach, I’m happy as a clam.

After I wrote it, I figured the email would put Anthony on the horns of a dilemma. After our very public feud, he would wonder, as would I were I in his shoes, why is this guy offering to help me? I also figured that he would suspect some kind of trap, one in which I make him a nice offer, he takes me up on it, then I publish our private email exchange to make him look bad. To put him at ease, I suggested that we keep our private emails between the two of us. I also figured that the lure of any publicity he thought he could get by posting my private email for all to read would be great, and that a request to keep our emails private would be a test to see whether I was right or not. Turns out I was on the money. He had the email posted as soon as he could crank out an answer to it.

I replied to his public email back to me, which he replied to and immediately posted. He went through my emails and commented specifically to them almost paragraph by paragraph, and I planned to do the same on this blog, but I decided that the emails kind of speak for themselves, so I’ve put them up below for all to read. You can come to your own conclusions.

I do want to make a couple of comments: one at the start and one at the end.

First, Anthony makes much of the fact that in a post a while back I took a couple of women to task for their idiotic statements. He seems to imply that I’m some kind of sexist or misogynous bully. I can assure you that I couldn’t have survived living for decades with one of the smartest people I’ve ever known if that were the case. Second, I treat women in a professional setting just like I would men, which, I think, is the way they want it. These women were trained professionals with advanced degrees who were making their statements in a public forum with the press in attendance. They were fair game. If I had treated them with kid gloves because they were women, I would be a sexist. I maybe went a little overboard in calling them ‘chicks’ but no more so than if they were males and I had called them ‘dudes.’ (Disclaimer: I did ask Richard Feinman about it, and he thought I went a little over the top with the ‘chick’ business, so I’ll avoid that in the future. But if professional women say stupid things, they need to be taken to task.)

The other comment I’ll make at the end of the emails when it will make a little more sense.

My email to Anthony:

Hey Anthony–

Thought I would drop you a note and give you an email address to write to me directly instead of through the Protein Power website. I often don’t get emails that come through the site for several days since I don’t take them down.

Your challenge intrigues me, but it is, of course, rigged in your favor. The second condition is one I can’t meet because I don’t think the studies listed in the FLB have been misreported by their authors. I think the data from those studies are what they are. What I believe is incorrect is your interpretation of that data, which has nothing to do with the #2 condition. So, I can’t possibly grab the twenty grand, because of the way you have the ‘challenge’ constructed.

Also, before I would ever engage in such an idiotic activity designed basically to generate publicity for you, you would have to put the $20,000 (which I doubt you have to give away should I triumph anyway) in an escrow account in advance so that it would really a) exist, and b) be available should I win. And we would have to agree on a panel of experts to make the determination as to whether I collect or not. Much though I like and trust you, I wouldn’t rely on your interpretation of my challenge to be the deciding factor as to whether or not you parted with said twenty grand.

Besides, I’m going to dissect the first chapter of the FLB for free. You won’t have to worry about paying the $20K. Your accusation that I’m resorting to the-dog-ate-my-homework excuse for not having posted it already is ludicrous, as you would know if you had any inkling of my schedule. Since we started this little spat I’ve been in a half dozen countries in two different continents and back and forth from coast to coast in the US a couple of times. Plus I’ve written a book proposal and gotten a book contract with a short deadline, which I’m working apace on. I’m involved in three different companies that require a lot of my time, and I post on my blog almost every day. I’ve had to quit answering comments on said blog because I’ve run out of time. So don’t think I haven’t dealt with our situation because I can’t. I simply haven’t had the time. I envy you the time you obviously have to write these long, repetitive pieces that you do. Which, by the way, have a high noise to signal ratio. You really need to work to sharpen your writing style.

Speaking of which, let me give you some advice. I don’t know you from Adam’s off ox, but I suspect that what you enjoy doing is researching (library researching; not bench researching) and writing. I do, too. I suspect you would like to be paid for the work you do, which, I suspect, is why you write it in books that you sell. I do, too. The difference between us is that I do make a good living from writing. The reason I do and you don’t is that I have credentials. That doesn’t mean that I’m smarter than you – it simply means that I have a bunch of merit badges that you don’t. These merit badges allow me to get published while your lack of merit badges hampers you. The sad truth about the publishing business (a truth that has taken me a long time to learn) is that to publishers the content of the book doesn’t matter a whit. Sad but true. What publishers look for is someone whom they can promote. And to publishers, the more merit badges one has the easier to promote.

If I were you (here comes the advice) I would put my Omnivore site back up start writing new material for it. This will give you a platform, which is the big word in publishing these days. When someone tells a publisher about a great book that someone has written, the publisher’s first question is: What’s his/her platform? Meaning does this person have a way to sell his/her book because, God knows, the publishers don’t have a clue as to how to sell it. Publishers seem to be in the book printing business, not the book selling business. And if they have an author who can sell his/her own book, the publishers are willing to pay an advance and buy the book. But no platform means no book contract.

You were well on your way to developing a pretty good platform with the Omnivore website. As you gain readers (who are often a pain in the rear and want all kinds of info free that you’ve worked hard to dig out – but that’s the price you have to pay) and the site grows in content, then you have a platform that publishers will pay attention to. And pay for. You will have a built-in readership that they figure they can sell books to.

And you’ve got to quit alienating everyone in the low-carb field. These are all people who can help you. I know Richard Feinman and Loren Cordain very well, and I consider both of them close friends. But I don’t agree with them on everything. In fact, I have the same disagreement with Loren over the saturated fat issue that you do, but he’s still a close friend. I didn’t know who you were until Feinman mentioned you to me. He told me you had written a pretty good book on the the cholesterol idiocy that all of academia was consumed with. He told me he would send me a copy. Before his copy had reached me, you sent me an online copy. At that time, Richard Feinman was an ally of yours; now he probably wouldn’t give you the time of day. You can (and should) disagree with people when you have a solid basis for disagreement, but you don’t have to do it so vituperatively so that it severs the relationship.

The disagreement you have with me is a case in point. I suspect we have much more in common than points on which we disagree. Arguing about the issue of the metabolic advantage is almost as ludicrous as arguing over how many angels can dance on the head of a pin. We’re talking about a few hundred calories at most under specific circumstances. You’ve managed to convert what is at best a molehill into a giant mountain.

Don’t think for a minute that I’m trying to get you to back off because I’m not. I’m planning on destroying your argument and giving you no quarter. Your behavior demands nothing less. I’m simply encouraging you to think next time before you leap into such a chasm of idiocy over so minor an issue.

Having said that and despite your recent relentless public barrage of insulting and unfounded attacks on my integrity and upon me personally, I’m not one who holds a grudge (except where George Blackburn is concerned – he’s the exception), so while we go at each other publicly, I can maybe help you a little privately. In order to get a publishing contract you have got to have an agent. I can at least get an agent to look at your stuff. I don’t know how many copies of The Great Cholesterol Con you’ve sold, but the magic number seems to be around 10,000. In other words, if you sell 10,000 publishers will be interested. A friend of mine named Ray Audette self published a little book titled Neanderthin. I wrote the foreword for it. Ray is much like you – he has no credentials but he’s a smart guy and a good researcher and integrator of what he reads. He managed to sell about 10,000 copies on his own and ended up getting a nice advance from St. Martin’s Press for a hardcover version. There’s no reason you can’t do the same. You would have to be willing to change the title because of Kendrick’s book. Or you may be able to sell the FLB. I don’t know. But I can at least get a big time agent to look at the stuff.

Let me know.

Best–

Mike

P.S. I don’t have a problem with any of our published stuff (i.e., books, blogs, internet writings, idiotic challenges, etc.) to be fair game in our little spat, but let’s keep our email exchanges private. Thanks.

Anthony’s response:

Dear Michael,

thank you for your reply. I’ll be honest and admit that I’m not quite sure what to make of your email. I’m unsure whether this is your way of extending the olive branch, or simply a ploy to get me off your back, your assurances to the contrary notwithstanding. Given the recent animosity between us, I’m sure you’ll understand if I’m a little sceptical.

I must say that I am pleased that your email – for the most part – is absent of the slanderous ad hominem diatribe that has characterized every other attempt you have made to address my criticisms of your work. Unfortunately, your email is not completely free of derogatory innuendo.

Let me address your comments one by one:

“Your challenge intrigues me, but it is, of course, rigged in your favor. The second condition is one I can’t meet because I don’t think the studies listed in the FLB have been misreported by their authors. I think the data from those studies are what they are. What I believe is incorrect is your interpretation of that data, which has nothing to do with the #2 condition. So, I can’t possibly grab the twenty grand, because of the way you have the ‘challenge’ constructed.”

Your accusation that the study is “rigged” is untenable. I have made a number of clearly articulated requirements, and if you can meet those requirements I will donate US $20,000 to the registered, non-profit charity of your choice.

The requirements are not at all unreasonable. If the phenomenon of MAD exists in human beings, as you and other MAD proponents so enthusiastically insist, then you should have no problem presenting clinical trial evidence that supports this claim. If you cannot supply this evidence, then it merely confirms my insistence that you are making claims with no scientific basis.

MAD claims that human beings lose more fat-derived weight when consuming a low-carb diet than when consuming a higher-carb diet of identical calorie (isocaloric) content.

The only way to prove this contention is to take real live human beings – not rats or mice, but real live human beings – and conduct tightly controlled clinical trials to test the hypothesis. In these studies, volunteers would be fed isocaloric low-carb and high-carb diets, either in parallel group fashion or in crossover fashion.

The very nature of the hypothesis necessitates that these studies be conducted under ward conditions in order to ensure isocaloric intakes. Free-living studies, where food intake is totally uncontrolled and dietary misreporting is common could not even begin to be relied upon when isocaloric dietary intakes are a pivotal requirement for testing the hypothesis. You yourself have publicly acknowledged that “patients tend to underreport”.

So all I’m asking is that you provide the clinical research showing that MAD exists, which I don’t think is at all unreasonable. You make a claim, you provide the relevant evidence to back it up.

You admit you cannot meet requirement 2; actually, I think we both know you cannot meet requirement 1 either.

In Chapter 1 of The Fat Loss Bible, I factually report the actual results of the metabolic ward studies shown in Table 1. When Joe Researcher compares isocaloric low-carb and high-carb diets and finds no statistically significant difference in weight or fat loss, and I write “Joe Researcher compared isocaloric low-carb and high-carb diets and found no statistically significant difference in weight or fat loss”, then I’m really not sure what part of my report constitutes “misreading” and “misinterpreting”. But hey, I’m all ears…

In the context of the challenge, requirement 2 is also not at all unreasonable. If you somehow manage to find a metabolic ward study supporting MAD, you must then explain why numerous other researchers have failed to replicate these findings. After all, a key requirement before clinical research findings can be accepted as valid is replication. If the findings repeatedly fail to be replicated under similar conditions by other groups of researchers, they can hardly be considered valid.

Over seven decades’ worth of metabolic ward trials have failed to demonstrate MAD. Did the researchers who conducted these studies misreport their results? You have just admitted that you cannot fault their data, which has completely failed to find evidence of greater fat-derived weight loss in individuals.

The bottom line is that I have simply asked for the human evidence that proves MAD, and you now acknowledge that you cannot furnish it.

“Also, before I would ever engage in such an idiotic activity designed basically to generate publicity for you, you would have to put the $20,000 (which I doubt you have to give away should I triumph anyway) in an escrow account in advance so that it would really a) exist, and b) be available should I win. And we would have to agree on a panel of experts to make the determination as to whether I collect or not. Much though I like and trust you, I wouldn’t rely on your interpretation of my challenge to be the deciding factor as to whether or not you parted with said twenty grand.”

Now, now, let’s not fall back on name-calling and innuendo.

You think the challenge is “idiotic”? I have defined 3 very clear, specific requirements. You meet those requirements, I will donate $20,000 to the charity of your choice, be it one that helps sick children, provides refuge for victims of domestic violence, nurtures abandoned babies, fights slavery, feeds starving refugees, or one of any other numerous worthy causes. What’s so “idiotic” about that?

As for the claim that it is a publicity stunt, as a successful marketer I think you know full well that there are much better ways to generate publicity for my book. The real reason that I am issuing this challenge is to show that, unlike you and the rest of the MAD propagators who have so vigorously attacked my honesty and character, I’m prepared to put my money where my mouth is. The challenge is simple and straightforward: MAD propagators insist that a weight loss metabolic advantage exists, and I’m asking them to prove it.

So please make your comments on the challenge factual and matter of fact. I’m not interested in your personal opinion of the challenge. Hey, I’m not expecting you to like it, as it is a challenge that you cannot meet and therefore casts you and your claims in a negative manner. All I want to know is whether you have the evidence required to win the challenge. You have just acknowledged that you don’t. That is what I really wanted to know; I could care less for name-calling.

You claim to like me and trust me (again, forgive me for being rather wary of this claim based on our past history), but in the same paragraph state that you doubt I have the money to hand over should you “triumph”. While I may not live the jet-setting lifestyle you boast of, after 40 years on this planet I have managed to accumulate a heck of a lot more than $20,000. I do indeed have the money required to meet the challenge, but as you have already acknowledged that you cannot meet the requirements of the challenge, I guess you won’t be seeing it anytime soon.

“Besides, I’m going to dissect the first chapter of the FLB for free. You won’t have to worry about paying the $20K.”

I was never worried about having to fork over the 20 grand. MAD is a sham that has been repeatedly contradicted by tightly controlled research. My goal is to alert others to this fact, and to do my bit get the weight loss arena back on track – i.e. to work on feasible and sustainable ways in which it can help overweight people achieve a calorie deficit. Feeding people a load of untenable hogwash about a non-existent weight loss metabolic advantage does not assist this aim.

“Your accusation that I’m resorting to the-dog-ate-my-homework excuse for not having posted it already is ludicrous, as you would know if you had any inkling of my schedule. Since we started this little spat I’ve been in a half dozen countries in two different continents and back and forth from coast to coast in the US a couple of times. Plus I’ve written a book proposal and gotten a book contract with a short deadline, which I’m working apace on. I’m involved in three different companies that require a lot of my time, and I post on my blog almost every day. I’ve had to quit answering comments on said blog because I’ve run out of time. So don’t think I haven’t dealt with our situation because I can’t. I simply haven’t had the time.”

As for the claim that you have not had time to finish your “exegesis”, this is what you wrote on November 19, 2007:

“It will take me a couple of days because even though I’ve already done the work, I have to write it up. I’ll continue to post on other subjects in the interim, but I should have the exegesis posted this week.”

Did you take all your international trips within the remainder of that week?

On December 9, almost 3 weeks later, you wrote:

“I’ve just had a lot going on lately and haven’t been able to give it the attention it needs.”

And then on January 12, 2008:

“The critique of The Fat Loss Bible proceeds apace. Problem is that it’s so easy to critique, but it takes a lot of space to do it. There is so much misinformation contained in the FLB it will take a blog post the size of Texas to refute it all. The book is so dreary, pompous and self-serving that any critique that takes it apart limb from limb will be kind of dreary as well. And every time I get ready to start putting all the stuff on paper (so to speak) something pops up that’s more immediate and requiring a shorter blog, so I opt for that and put Anthony off for another day. All my professional friends – who have stayed out of the fray – are encouraging me to forget it because it will look like piling on since at the core Anthony is really only an amateur. Why give some young, clueless prat the attention he craves? they all say. But I’m committed and I will eventually put up the critique.”

So over 6 weeks ago you claimed that you had already done the work and just needed to write it up, and that this would only take a few days. And now you’re claiming that it’s a whopping big job that requires a significant chunk of time to be set aside for completion.

As you have been so gracious to offer me free advice, let me return the favor. Here’s my first piece of advice:

Don’t make promises you can’t keep. If you don’t intend to write something, don’t promise it to your readers. If you do intend to write it, don’t promise to deliver it within a few days when it allegedly “will take a blog post the size of Texas to refute it all.” People can’t help but doubt your authenticity when, after several weeks, you fail to deliver something that you originally promised within a few days.

“I envy you the time you obviously have to write these long, repetitive pieces that you do.”

Actually, with a busy schedule that includes reading, researching, writing, training, consulting, and a host of other non-health-related commitments that I won’t divulge here because they are no-one else’s business, I don’t have a whole lot of spare time on my hands. So I likewise envy someone like you who has the time to go scouring through posts on both my own and other low-carb forums in search of quotes that can be used in a lengthy ad hominem diatribe against me, such as that which constituted your September 27 blog post. This post contributed no new scientific evidence to the debate whatsoever, it was simply an underhanded attempt to attack my persona.

On every occasion that I have answered your MAD claims throughout this “spat”, I have cited specific studies. You, on the other hand, initially made attempts to appeal to the scientific literature, but when I consistently demolished these attempts you appear to have become increasingly frustrated and angry. You eventually gave up citing the literature and relied solely on issuing personal insults at me. You claim a dire shortage of spare time, but you still have found plenty of time to keep up the mudslinging.

So here’s my second piece of advice to you:

If you cannot support your claims with valid scientific evidence, don’t abandon the scientific method and resort to slander and ad hominem attacks. It simply demonstrates that… you cannot support your claims with valid scientific and must therefore resort to slander and ad hominem attacks.

“Which, by the way, have a high noise to signal ratio. You really need to work to sharpen your writing style.”

OK, while we’re all in the mood for critiquing writing styles, let me offer my assessment of your writing style:

You have an exceedingly high slander to fact ratio.

As I stated above, I have consistently demolished each and every one of your MAD claims using specific references to the scientific literature. You, on the other hand, initially made attempts to cite supportive scientific literature, but when I consistently demolished these attempts you evidently became increasingly frustrated and angry and eventually gave up citing the literature and started relying solely on issuing personal insults.

While I was uncovering even more tightly controlled ward studies examining (and further disproving MAD) you were not citing any new evidence to bolster your case. Instead you and your readers were busy inferring that I was a mentally unstable steroid-abuser. Some of the choice terms you have used to describe me during our “spat” include “pipsqueak”, “snivelling dreck”, “a legend in his own mind”, “a pretty slippery fellow”, “pigheadedness”, “humorless”, and “young, clueless prat”. These are among the ones that I am aware of – no doubt there are plenty more, but unlike yourself I don’t have the time to go scouring through your blog archives for more examples.

After all this, you then have the temerity to accuse me of being vituperative! This, from the same guy who claims that: “There is far too little civility in today’s world, and I try to do my part to contribute. I’ve always believed in civility in my personal encounters and in my online encounters and try to stay true to my beliefs.”

And let’s not forget the repeated accusations of dishonesty/duplicity that you and your readers seem to be especially fond of issuing. BTW, would you or any of your followers like to prove this? Would any of you be prepared to place $20,000 in an “escrow account” and it hand it over if you cannot prove your claims that I have deliberately misled anyone on the MAD issue?

Don’t all jump at once now…

If we were to tally up the citation of actual scientific studies by yourself and I, and then the number of childish names and unfounded allegations, it would be no contest – your insult to fact ratio would be higher than mine by a massive margin.

I’ll be the first to admit that my initial open letter to you was hardly a textbook example of social nicety. But after 2 years of having my integrity repeatedly assailed by malicious Internet assholes simply because I have had the temerity to state the plain facts about MAD, and then reading your highly biased blog post of September 11, 2007 in which you claimed folks like me were fools, and then publicly stating that you thought I was wrong, well…you figure the rest out.

And you of all people are hardly in any position to be acting high and mighty about the issue of aggressively addressing the questionable claims of others. In fact, your conduct in this area clearly leaves much to be desired. Let’s consider the little matter of a March 30, 2007 blog post you write titled “Fisking Repovich and Peterson”:

http://www.proteinpower.com/drmike/uncategorized/fisking-repovich-and-peterson/

Note the date – it was long before I posted my open letter to you.

Now let’s see, how does the “civil” Michael Eades choose to address a couple of female exercise physiologists who committed the heinous crime of presenting what they considered to be the “Top 10 Nutrition Myths” at an American College of Sports Medicine Summit?

Why, in a post that is clearly hostile and personal, he calls them “idiots”, condescendingly refers to them as “chicks”, and describes their work as “idiocy” and “breathtakingly stupid”!

Is this how you choose to promote “civility” in “your online encounters”? By acting like an uncouth bully towards a couple of relatively harmless female academics?

Did these ladies previously infer you were a “fool” and “wrong” for making valid claims, as you did to me? Did their demented followers repeatedly, publicly and wrongly insist that you were dishonest, as the MAD crowd have repeatedly claimed of me? Have they persisted in that claim even though you have provided evidence to prove them wrong? Did any of them come on your forum with the sole purpose of anatagonizing you, then have the temerity to ask you for training and diet advice? And when you justifiably told that person/s to stick their request where the sun doesn’t shine, did that person/s then proceed to turn into a deranged stalker, rejoining your forum under dozens of different usernames after repeatedly being banned, and making vile statements about your sexual habits…as has happened to me?

If not, then why did you feel the need to rip on these ladies in a post dripping with ridicule and hostility?

You have no qualms about associating with someone like Loren Cordain, who enthusiastically promotes the low-fat, anti-saturate, anti-cholesterol paradigm. He promotes this paradigm – which, by distracting people from the real cause of heart disease, has probably killed millions of people – in popular format books and numerous journal articles. That evidently doesn’t bother you, but you did feel the need to launch a most aggressive and rather chauvinistic attack on a couple of female exercise physiologists who presented a single and rather inconsequential presentation on low-fat sports nutrition at an ACSM meeting in Texas? Their contribution to furthering anti-saturated propaganda would completely pale in comparison that that of Cordain; mention the names Wendy Repovich and Janet Peterson and most people will draw a blank. You felt compelled to scorch them, but you are quite OK with the idea of taking beach holidays with Loren Cordain and his family?

You don’t see any contradiction or incongruence in that?

Here’s my third piece of advice:

People in glasshouses shouldn’t throw stones. Don’t treat others like crap and then complain when you are subsequently treated in the exact same manner.

And cut the ladies a little slack. I’m not sure what your true attitude towards women is, but if you do harbor any misogynistic tendencies I suggest you accept the fact that other women besides your own wife are involved in academic pursuits. And like your wife, I doubt these women would appreciate being called “stupid”, “idiots” and being condescendingly dismissed as “chicks” instead of their appropriate academic title.

“Speaking of which, let me give you some advice. I don’t know you from Adam’s off ox, but I suspect that what you enjoy doing is researching (library researching; not bench researching) and writing. I do, too. I suspect you would like to be paid for the work you do, which, I suspect, is why you write it in books that you sell. I do, too. The difference between us is that I do make a good living from writing. The reason I do and you don’t is that I have credentials. That doesn’t mean that I’m smarter than you – it simply means that I have a bunch of merit badges that you don’t. These merit badges allow me to get published while your lack of merit badges hampers you. The sad truth about the publishing business (a truth that has taken me a long time to learn) is that to publishers the content of the book doesn’t matter a whit. Sad but true. What publishers look for is someone whom they can promote. And to publishers, the more merit badges one has the easier to promote.”

Ah, it’s good to hear the plain truth straight from the horse’s mouth. I have commented publicly several times, big publishers couldn’t give a damn about the scientific credibility of what they publish, so long as it makes them money. As I have stated, fame and notoriety are far more important requirements for attracting the affections of publishers than honesty and meticulous research habits. When folks like Andrew Weil and Dr Phil McGraw, who clearly could use a little slimming advice themselves, score diet/health book publishing deals, but folks like Jamie Hale, Lyle McDonald and myself are forced to self-publish, well, I think that in itself speaks volumes.

Of course, as someone who was unsuccessful in attracting agency or publisher interest in my book The Great Cholesterol Con, many people may be tempted to erroneously dismiss my statements as the disgruntled whining of a spurned author. So it’s good to hear from a best-selling author who has no reason whatsoever to whine that publishers really don’t give a rat’s ass about the contents of the books they publish.

“If I were you (here comes the advice) I would put my Omnivore site back up start writing new material for it. This will give you a platform, which is the big word in publishing these days. When someone tells a publisher about a great book that someone has written, the publisher’s first question is: What’s his/her platform? Meaning does this person have a way to sell his/her book because, God knows, the publishers don’t have a clue as to how to sell it. Publishers seem to be in the book printing business, not the book selling business. And if they have an author who can sell his/her own book, the publishers are willing to pay an advance and buy the book. But no platform means no book contract.

You were well on your way to developing a pretty good platform with the Omnivore website. As you gain readers (who are often a pain in the rear and want all kinds of info free that you’ve worked hard to dig out – but that’s the price you have to pay) and the site grows in content, then you have a platform that publishers will pay attention to. And pay for. You will have a built-in readership that they figure they can sell books to.”

Make no mistake, TheOmnivore website is dead and buried. When I look back upon that website, the question I ask myself is not whether or not I should have shut it down, but what took me so long to do so. While that website did bring me in touch with some great folks (most notably Uffe Ravnskov, who I admire greatly) it also brought way too many screwballs into my world, and I like it much better now that most are gone (I say “most” as there still lurks the pungent odor of ketosis-breathed MAD fanatics).

Plus, to be quite honest, I’m a little over the whole cholesterol thing. Forgive my jaded attitude, but reading about the finer points of Apolipoprotein A or reading yet another so-called research paper that is actually nothing more than thinly disguised statin propaganda just doesn’t do it for me anymore. In fact, it downright bores me to tears. There are very capable folks like Uffe, Duane Graveline, and Malcolm Kendrick that still give a damn about that stuff, so I’ll leave the cholesterol fight to them.

Training, diet, performance, fitness, and matters of body composition are my main research interest, and are much more “fun” topics for me personally, so that is where my future writing efforts will be directed.

“And you’ve got to quit alienating everyone in the low-carb field. These are all people who can help you. I know Richard Feinman and Loren Cordain very well, and I consider both of them close friends. But I don’t agree with them on everything. In fact, I have the same disagreement with Loren over the saturated fat issue that you do, but he’s still a close friend. I didn’t know who you were until Feinman mentioned you to me. He told me you had written a pretty good book on the the cholesterol idiocy that all of academia was consumed with. He told me he would send me a copy. Before his copy had reached me, you sent me an online copy. At that time, Richard Feinman was an ally of yours; now he probably wouldn’t give you the time of day. You can (and should) disagree with people when you have a solid basis for disagreement, but you don’t have to do it so vituperatively so that it severs the relationship.”

Thanks for the advice, but let it be known that I am not into kissing up to people I have little regard for just because it might advance my writing career. I’m not joking when I say I have an extremely low regard for the “research” of Feinman and Fine. And if you can hang out with someone like Cordain, who enthusiastically promotes the scientifically untenable anti-cholesterol paradigm, more power to you. Personally, I couldn’t.

“The disagreement you have with me is a case in point. I suspect we have much more in common than points on which we disagree. Arguing about the issue of the metabolic advantage is almost as ludicrous as arguing over how many angels can dance on the head of a pin. We’re talking about a few hundred calories at most under specific circumstances. You’ve managed to convert what is at best a molehill into a giant mountain.”

Whoa, wait a minute! First your book Protein Power makes the astounding revelation that obesity is more closely related to carbs and insulin than calories. Then you unabashedly claim in a sensationalist post on your blog, complete with scary pictures, that following a low-carb diet instead of an isocaloric high-carb diet can mean the difference between losing weight and feeling great or becoming an emaciated, finger-chomping psychotic.

After I highlighted the folly of the aforementioned post, you then cited rodent studies, once again in a most exuberant manner, claiming they demonstrated a metabolic advantage”. When I destroyed that line of argument, you then began changing your tune: “Look, Colpo is making a mountain out of a molehill here, we’re only talking a few hundred calories a day difference.”

I don’t care how many calories per day difference you and folks like Feinman and Fine arrive at via your elaborate theorizing – the indisputable fact is that isocaloric low- and high-carb diets show no difference in weight loss that cannot be attributed to greater water/lean losses. Over seven decades’ worth of tightly controlled metabolic ward studies show this.

So my next piece of advice is:

Don’t make exuberant claims for a phenomenon that you can’t prove exists. When you later back pedal away from these exuberant claims and start issuing watered down qualifiers, don’t accuse others of making a mountain out of a molehill. If you really thought it were a molehill at the outset, you shouldn’t have come dressed as a mountaineer.

And let’s not forget the bigger issue: obesity. This is an alarmingly common problem with a wide array of potential adverse psychosocial and physical health effects. The problem has been steadily worsening over the last three decades, including the last decade in which low-carb diets rose and fell. Part of the reason for the bubble-like rise and fall in low-carb’s popularity was the unfulfilled promises made by many of its promoters. Namely, such claims as you can eat all you want and still lose weight because carbs and not calories are allegedly the true determinants of weight gain. The end result of such nonsense is that many people failed to lose weight because they did not create a calorie deficit, or they hit a plateau after that deficit was negated and could not understand why.

This is what happens when you feed people nonsense information. It distracts them from what they really need to do in order to achieve their goals. This is my beef with the cholesterol theory and with MAD. Neither heart disease nor obesity are “molehills” – they are both exceedingly common health problems that have a very real and harmful impact on the lives of millions of people around the world.

“Don’t think for a minute that I’m trying to get you to back off because I’m not. I’m planning on destroying your argument and giving you no quarter. Your behavior demands nothing less. I’m simply encouraging you to think next time before you leap into such a chasm of idiocy over so minor an issue.”

Knock yourself out. Just remember that I will destroy any attempted attack on my book by you just as decisively as I have destroyed all your previous failed attempts to rebut my contentions.

“Having said that and despite your recent relentless public barrage of insulting and unfounded attacks on my integrity and upon me personally, I’m not one who holds a grudge (except where [name edited] is concerned – he’s the exception), so while we go at each other publicly, I can maybe help you a little privately. In order to get a publishing contract you have got to have an agent. I can at least get an agent to look at your stuff. I don’t know how many copies of The Great Cholesterol Con you’ve sold, but the magic number seems to be around 10,000. In other words, if you sell 10,000 publishers will be interested. A friend of mine named Ray Audette self published a little book titled Neanderthin. I wrote the foreword for it. Ray is much like you – he has no credentials but he’s a smart guy and a good researcher and integrator of what he reads. He managed to sell about 10,000 copies on his own and ended up getting a nice advance from St. Martin’s Press for a hardcover version. There’s no reason you can’t do the same. You would have to be willing to change the title because of Kendrick’s book. Or you may be able to sell the FLB. I don’t know. But I can at least get a big time agent to look at the stuff.”

Now this is where I become really perplexed. First let me state that, if your offer is genuine, then you have my sincere gratitude.

But you mention the possibility of getting a book deal not only for The Great Cholesterol Con but also The Fat Loss Bible. The latter, remember, is the book you have publicly described as “dreary, pompous and self-serving ” and containing “so much misinformation [that] it will take a blog post the size of Texas to refute it all.”

You claim it is written by someone who “at the core…is really only an amateur”, a “young, clueless prat”. The same guy, remember, that you claim has “misinterpreted” and “misread” the results of dozens of key studies in chapter 1 of the same book.

To paraphrase Denzel Washington’s character in Philadelphia: “OK Mike, explain it to me like I’m a four-year-old”. Why on Earth you would ever want to assist in bringing a book to market if you truly believe it to be misleading, dreary, pompous and self-serving? If I truly felt that way about a book, I’d be doing the exact opposite – I’d be doing all I could to ensure that it did not make it to the mainstream market! I guess I’m one of these strange, old-fashioned people who doesn’t promote things he strongly disagrees with.

“P.S. I don’t have a problem with any of our published stuff (i.e., books, blogs, internet writings, idiotic challenges, etc.) to be fair game in our little spat, but let’s keep our email exchanges private. Thanks.”

I can’t believe you’re really asking this. We are having a very public dispute that is being keenly followed by thousands of people. I think we owe it to these folks to be perfectly upfront and transparent about the nature of our relationship and communications. I’m not prepared to conduct one style of interaction for public consumption involving you and I in “books, blogs, internet writings, idiotic challenges, etc”, but then another covert one in private. I think that’s rather dubious and misleading.

How would your readers feel if they knew you had made such a request? I guess you’ll soon find out, because I am going to publish your email and my reply on my website. Please be aware that I will do the same for any and all future communications on the MAD issue. If this is unacceptable to you, then I suggest you cease and desist in sending such emails.

Obviously, certain things are not fit to be shared with third parties. However, we’re not discussing confidential business, financial, or family matters, nor private health issues, nor your affair with that woman who works at the local Kinkos (just kidding Mary Dan!!!).

We are discussing a very public disagreement you and I have been having on the MAD issue, and I think we both owe it to our readers to be perfectly upfront and honest about the nature of that dispute at all times. I don’t see how keeping “our email exchanges private” in any way aids that goal. So like I said, I will be letting people know we have made contact. And I will do so by sharing our conversation in full – failure to do so would no doubt result in more of the usual malicious accusations of dishonesty and duplicity from the more slanderous members of your following.

I’m sure you’ll understand. If you had read the email exchanges that I used to publish on TheOmnivore, then you’ll already know that I value transparency.

Rest assured that I will not publish your private email address. Who you give that to is your business. I have also edited out the name of the researcher you state you have a grudge against, as I’m not sure whether you wish the extent of your disdain for him to be made public. And at any rate, he has nothing to do with the MAD issue (at least not to my knowledge).

Regards,

Anthony.

My second email back to Anthony in response:

Hey Anthony–

I’m sorry that you’ve disregarded my request to keep our emails between the two of us. I don’t want to engage in the MAD debate via email anyway, which wasn’t my purpose in emailing you. I will continue the debate on my own website.

I can see that there are a couple of basic differences between you and me. One is that I’m able to separate people from their beliefs and opinions. Both Loren Cordain and Richard Feinman are warm, friendly, generous, helpful people that I like and respect very much. The fact that their opinions differ from mine on a few issues doesn’t mean that I can’t enjoy their company. Many of my best friends have political views that are diametrically opposite of mine, yet we continue mutually beneficial friendships. If the only friends one has are those who agree with him 100 percent on every issue, it would – in my opinion – make for a very dull life. Which was the main reason I emailed you. Since I don’t really have a problem being friends, even with those whom I disagree with on many issues, I was simply reaching out to perhaps establish some sort of personal relationship outside of our public internet quarrel. I wasn’t offering an olive branch, nor was I trying to get you off my back. I was also throwing out a fleece to confirm my analysis of your intentions. I suspected this whole affair was not so much an ideological debate, but an effort on your part to generate publicity for yourself. Had you agreed to abide by my request to keep our correspondence between the two of us, it would have gone a long way to disabusing me of my suspicions as to your intent with all the folderol. But you played into my hands and rushed my letter sent to you into print on your website despite my request to keep it private. Not a gentlemanly thing to do, but given your proclivities, it was expected. And, as I say, it confirmed my suspicions.

As to the offer to help you with your publishing efforts, that offer was genuine. Still is. I stand by my critique of the writing style of the FLB, but it would be made better by an editor, as would TGCC. And I don’t really care whether the book disagrees with me or not. I’m comfortable enough with my own opinions and ego that I don’t mind competing books on the shelves. Despite my critique of the FLB, I suspect it will appeal to and help a subset of people who fall into two categories: a) those who would, for whatever reason, not read my own books, b) those who buy and read every weight loss book around, and c) those into hardcore body building. I’ve even said that Ornish’s books helped people if they do nothing else but initiate a change from the Standard American Diet, almost any deviation from which is bound to promote better health. Besides, the more books out there that promote some form of low-carb dieting, the more low-carb will make it into the mainstream. The world would be a much healthier place if all the arguments and niggling were over which particular low-carb diet works best or whether or not a metabolic advantage exists with low-carb dieting rather than over whether or not low-carb diets are fad diets.

The other reason I made the offer is that I genuinely admire autodidacts. I’m one myself. I didn’t learn 99 percent of the stuff I now know about nutrition in medical school – I’ve learned it on my own. Fortunately, I did go to medical school and post-graduate training and was in practice for a long time so I got to see what worked and what didn’t first hand by taking care of literally thousands of patients. All of which got me the merit badges I referred to in the last email. And which made it easier for publishers to buy my first book proposal, coming to them from a complete unknown. Had I submitted the very same proposal without having an MD degree and without having a large practice, it would never have sold.

In the publishing biz the toughest step is getting an agent because agents know how the game is played. They make their money only if a book gets sold to a publisher, and if an agents don’t think a book will sell for whatever reason, they’re not inclined to waste their time taking it on. But if an agent takes it on, the publishers all figure that the agent has done the diligence on the book and are willing to at least take a look at it.

I can get you a reading with a big time New York agent who has a host of bestselling authors under her belt. I can’t guarantee that said agent will take it on, and I can’t guarantee that if even if the agent takes it the book will sell to a publisher. But if the agent takes it your chances are much, much greater.

But let me tell you a tale of how the publishing business works that will give you pause.

When MD and I were filming our TV cooking show, we made it a habit after the long days of shooting to head to an Irish pub near our hotel and grab a cider to unwind. One night I happened to be sitting at the bar next to a guy who was working feverishly on some kind of document. I’m pretty much of a private, keep-to-myself kind of guy in these situations, so I just sat and drank my cider. The guy on the other side of him, however, struck up a conversation, asking him what he was working on so hard. The guy told him he had written a book and was working on the marketing plan for it. Of course, my ears perked up at that.

I asked the guy the question all people in the book biz ask: who is your publisher? He told me that he was self-publishing. As we talked on I found out that his book was a business book, and as he described it, it sounded like he had a pretty fresh take on a lot of business situations. I ended up liking the guy and, as I’ve done with you, offered to see if my agent would take a look at his book to see if maybe it would be salable to a mainstream publisher. I ran it by my agent who said, Sure, have him send it to me.

He sent it, the agent loved it, and proceeded to help him get it in shape to present to publishers. Typically the way the publishing process works is this: agents ‘do lunch’ with specific agents they think would be possible buyers. At lunch they briefly describe the book, and the editor always says Send me the proposal. The agent then sends out a dozen or so proposals to these wined and dined editors. And the agent puts a closing date on the ‘auction.’ Usually nothing much happens until the week or so before the closing date (typically, the closing date is a month or so after the proposals are sent out). A week before the agent starts getting bombarded with questions. And sometimes potential publishers even want to have a phone conference with the author. A couple of days before the closing date, editors who are not interested begin sending their letters saying they won’t be in the auction. On the closing date, the interested publishers send in their offers. The agent then takes the best one. Or, even better, if there are a couple that are the same, a bidding war can ensue.

In the case of the author of the business book, my agent started getting questions within a few days after sending off the proposals. Publishers loved the book – they thought the content was spectacular. Then they asked the dreaded question: What is the author’s platform? Meaning is he a big-time professor at a business school? Does he do seminars? Does he have Fortune 500 clients? In other words, can he help us sell this book? When told that he wasn’t any of the above, but that he was a small business turn-around consultant in a mid-sized midwestern city who happened to be a real smart guy who had figured out a bunch of good stuff, all interest evaporated.

This is the horror story of publishing right now. It hasn’t always been that way and it probably won’t always be that way. But that’s the way it is now. So if you have no platform, you get no book contract regardless of quality of the content. (These rules, of course, apply only to non-fiction. Fiction publishers are always on the lookout for fresh, new voices.) With non-fiction it is the author and the author’s platform that count, not the content. Which is why I recommend that you do something to get yourself a platform, which I thought you were well on your way to with the Omnivore site. If you’ve can confirm that you’ve sold at least 10,000 copies of either book, that will also give you a platform. Without some platform (a word I’ve really come to hate), though, other than just an angry guy who does a few interviews and trashes anyone who disagrees with him, I doubt that you have much of a chance with mainstream publishing. But that doesn’t mean you can’t give it a shot.

And, BTW, you totally misunderstood my criticism of #2 in your challenge. I didn’t write that I thought the studies were rigged, but that the #2 component of the challenge was rigged. But I’ll take that up on my own site.

Best–

Mike

P.S. How did you find out about the woman at Kinkos?

And Anthony’s answer and, at his request, the end of the communication:

Dear Michael,

I’m sorry that you’ve disregarded my request to keep our emails between the two of us. I don’t want to engage in the MAD debate via email anyway, which wasn’t my purpose in emailing you. I will continue the debate on my own website.

Do as you please, but don’t pretend it’s a “debate” when you are not prepared to engage me directly. Personally, I think it reflects very poorly on you that you have never been prepared to debate the matter with me directly. Instead you rely on insults and absurd excursions in pseudo-science. All of which appears perfectly acceptable to many of your readers, who never get to see my answers.

I invited you to my forum to conduct a debate with the guarantee that no-one else would be allowed to participate, as I didn’t want any debate to degenerate into a slanging match between your followers and mine (and I demonstrated the authenticity of this promise when I promptly removed a post from a member of the forum who disregarded the request).

Now you have the opportunity to engage me directly via email, and you are refusing to do so. This is an opportunity for a 2-way debate on the matter that can be reprinted on both your website and mine, but you clearly are not up to it.

That’s fine, but I would have a lot more respect for you if you just admitted that you cannot defend your MAD nonsense, instead of hiding behind a cloak of feigned indignity and righteousness.

I can see that there are a couple of basic differences between you and me. One is that I’m able to separate people from their beliefs and opinions. Both Loren Cordain and Richard Feinman are warm, friendly, generous, helpful people that I like and respect very much. The fact that their opinions differ from mine on a few issues doesn’t mean that I can’t enjoy their company. Many of my best friends have political views that are diametrically opposite of mine, yet we continue mutually beneficial friendships. If the only friends one has are those who agree with him 100 percent on every issue, it would – in my opinion – make for a very dull life. Which was the main reason I emailed you. Since I don’t really have a problem being friends, even with those whom I disagree with on many issues, I was simply reaching out to perhaps establish some sort of personal relationship outside of our public internet quarrel. I wasn’t offering an olive branch, nor was I trying to get you off my back. I was also throwing out a fleece to confirm my analysis of your intentions. I suspected this whole affair was not so much an ideological debate, but an effort on your part to generate publicity for yourself. Had you agreed to abide by my request to keep our correspondence between the two of us, it would have gone a long way to disabusing me of my suspicions as to your intent with all the folderol. But you played into my hands and rushed my letter sent to you into print on your website despite my request to keep it private. Not a gentlemanly thing to do, but given your proclivities, it was expected. And, as I say, it confirmed my suspicions.

And your email once again confirmed my suspicions: that you are an individual who behaves in a most dubious manner. Don’t ever write to me again asking me to participate in actions that are patently misleading to my (and your) readers, using the prospect of a publishing deal as some sort of bait.

As for my “proclivities”, do you mean my proclivity for being perfectly upfront and honest in my dealings with others? The same proclivity that automatically led me to refuse your request to conduct a public charade, hiding the fact that we had established email contact? Am I supposed to be ashamed of that proclivity?

I’m not.

Do me a favor and spare me the piety. It is you that made the rather dubious request to hide our “private” conversations. I explained to you quite clearly that I can not in good conscience do this. But I guess you would need a conscience to understand that.

I didn’t fall into any “trap”. It is you that has been caught red-handed attempting to cajole me into joining you in duplicitous behavior. In my case, I just did what I’ve always done, and what I will always continue to do. If you had spent even a modicum of time reading the old TheOmnivore website (which your own comments would indicate is the case), you would know full well that I regularly reprinted the full email exchanges of critics and myself.

And if you truly have nothing to hide, then you have absolutely no reason to fear or object to my insistence on transparency.

As for the claim that I “rushed” to get your letter “into print”, I’m really not sure how taking two days to respond to and post your email constitutes a “rush”…

As for the world being a rather dull place if everyone agreed 100% on the same thing, I totally agree. I’ll happily tolerate disagreement with my mates about whether Hugi or Chris King make the best road bike hubs or whether Randy Couture could ever beat Fedor, but I wouldn’t even consider being “best friends” with someone who was a devoted adherent of, for example, communism or xenophobia. Nor would I ever consider being good friends with someone who enthusiastically promoted dietary or health paradigms that were unfounded, counterproductive, and even downright harmful. If you can maintain friendships with such people, good luck to you. Again, I cannot, and I’m not about to apologize to you or anyone else for that.

Believe it or not, some people tend to gravitate towards friends with similar interests and ideologies. Imagine that!

And you still have not explained why, if you believe it so important to be extraordinarily accommodating to those with conflicting viewpoints, you chose to act like an acidic chauvinist boor towards Wendy Repovich and Janet Peterson. Were you separating them from their beliefs and opinions when you called them “idiots” and belittled their academic status by referring to them as “chicks”?

I think you really need to take a moment to sit down and get it into your head that you are in no position to be getting high and mighty here. Like I said, people in glasshouses shouldn’t throw stones – the fact is that you yourself are guilty of the exact same things you accuse me of. I’ll be the first to admit that I’m no angel, but I’m not about to be lectured by someone who acts like an uncouth yobbo towards a couple of women whose only crime was to give a rather tepid and inconsequential presentation at an ACSM summit. Not a gentlemanly thing to do!

You are indeed correct when you state that there are a number of differences between you and I. One glaring example is that I am always ready to admit I’m no angel, while you flatly refuse to acknowledge and accept responsibility for your own behavior, which to date has been far from exemplary. You repeatedly avoid the issue of why you think it’s perfectly acceptable for you to refer to others with such endearing terms as “idiots”, “pipsqueak”, “snivelling dreck”, “a legend in his own mind”, “slippery”, “pigheadedness”, and “clueless prat”, but a major violation when someone unmercifully calls BS on your own untenable nonsense?

You can’t have it both ways mate. What’s good for the goose is good for the gander, and you are one extremely vituperative gander.

So again, spare me the piety – it’s nauseously hypocritical.

As to the offer to help you with your publishing efforts, that offer was genuine. Still is. I stand by my critique of the writing style of the FLB, but it would be made better by an editor, as would TGCC. And I don’t really care whether the book disagrees with me or not. I’m comfortable enough with my own opinions and ego that I don’t mind competing books on the shelves. Despite my critique of the FLB, I suspect it will appeal to and help a subset of people who fall into two categories: a) those who would, for whatever reason, not read my own books, b) those who buy and read every weight loss book around, and c) those into hardcore body building. I’ve even said that Ornish’s books helped people if they do nothing else but initiate a change from the Standard American Diet, almost any deviation from which is bound to promote better health. Besides, the more books out there that promote some form of low-carb dieting, the more low-carb will make it into the mainstream. The world would be a much healthier place if all the arguments and niggling were over which particular low-carb diet works best or whether or not a metabolic advantage exists with low-carb dieting rather than over whether or not low-carb diets are fad diets.

Do you, or do you not stand by your claim that The Fat Loss Bible is “dreary, pompous and self-serving ” and containing “so much misinformation [that] it will take a blog post the size of Texas to refute it all”?

Do you, or do you not stand by your claim that it is written by someone who “at the core…is really only an amateur”, a “young, clueless prat”. The same guy, remember, that you claim has “misinterpreted” and “misread” the results of dozens of key studies in chapter 1 of the same book.

Dreariness and pompousness can indeed easily be alleviated by editing; patently misleading information from an allegedly “amateur” and “clueless” author cannot. One of the underlying premises of the book is that calories, not carbohydrates, are the key determinant of weight loss. Chapter 1, which you claim is based on “misread” and “misinterpreted” studies, is pivotal in establishing the scientific basis for this stance – a stance that you vehemently oppose.

So again, please explain to me why someone who doesn’t read your own books, why someone who is a prolific diet book purchaser, or someone who is a serious bodybuilder (that’s three categories by the way, not two…) deserves to be subjected to a book that you claim is so blatantly misleading?

Do you hold some sort of grudge against these groups, one that inspires you to ensure they remain misinformed? Or is it that you actually think my book is fine, but you made your comments in a fit of anger, in an attempt to discredit me and attempt to scare people away from it? Or is your moral make-up truly structured in a manner that allows you to have no qualms assisting the publication of a book you so strongly believe to be misleading?

Again, if I truly thought a book was misleading and written by a clueless amateur, I would not in any way be acting to assist its publication.

As for helping low-carb diets crack the mainstream, I think I have made it perfectly clear that I believe one of the best ways to facilitate this goal is to ensure any claims made for low-carb diets are based on sound, valid scientific evidence. I truly don’t know how you could even begin to claim that MAD meets that requirement when decades of tightly controlled ward trials show that the whole MAD-weight loss concept is nonsense.

You keep trying to dismiss the argument over MAD as “niggling” and making “a mountain out of a molehill”, but you, Atkins and others were quite happy to let the MAD concept grow into a mountain, so long as your wealth and popularity grew in step.

What MAD does is distract a lot of people from the true requirement of a calorie deficit. Even you admit as much:

“Both MD and I have had patients who complained to us that they were following our program to the letter and weren’t losing any weight. When we asked them for their diet diaries we found that they were consuming huge amounts of food but were rigorously keeping their carbs below 30 grams per day. Sometimes we calculated that these patients were eating 4000+ kcal per day, which could have even been higher given that patients tend to under report what they eat instead of over reporting. What was amazing to us was that they weren’t gaining. They were pretty much maintaining their weight on an enormous number of low-carb calories.

We would explain to them about how they needed to create a caloric deficit to lose. Most people will create the caloric deficit when they go on a low-carb diet because the increased fat and protein in the absence of carbs is extremely satiating.”

So there it is – there’s no avoiding reality, even when you’re the patient of a best-selling diet author. Calories, not carbohydrates are the ultimate arbiter of weight loss. No calorie deficit, no weight loss. Period.

The other reason I made the offer is that I genuinely admire autodidacts. I’m one myself. I didn’t learn 99 percent of the stuff I now know about nutrition in medical school – I’ve learned it on my own. Fortunately, I did go to medical school and post-graduate training and was in practice for a long time so I got to see what worked and what didn’t first hand by taking care of literally thousands of patients. All of which got me the merit badges I referred to in the last email. And which made it easier for publishers to buy my first book proposal, coming to them from a complete unknown. Had I submitted the very same proposal without having an MD degree and without having a large practice, it would never have sold.

In the publishing biz the toughest step is getting an agent because agents know how the game is played. They make their money only if a book gets sold to a publisher, and if an agents don’t think a book will sell for whatever reason, they’re not inclined to waste their time taking it on. But if an agent takes it on, the publishers all figure that the agent has done the diligence on the book and are willing to at least take a look at it.

I can get you a reading with a big time New York agent who has a host of bestselling authors under her belt. I can’t guarantee that said agent will take it on, and I can’t guarantee that if even if the agent takes it the book will sell to a publisher. But if the agent takes it your chances are much, much greater.

But let me tell you a tale of how the publishing business works that will give you pause.

When MD and I were filming our TV cooking show, we made it a habit after the long days of shooting to head to an Irish pub near our hotel and grab a cider to unwind. One night I happened to be sitting at the bar next to a guy who was working feverishly on some kind of document. I’m pretty much of a private, keep-to-myself kind of guy in these situations, so I just sat and drank my cider. The guy on the other side of him, however, struck up a conversation, asking him what he was working on so hard. The guy told him he had written a book and was working on the marketing plan for it. Of course, my ears perked up at that.

I asked the guy the question all people in the book biz ask: who is your publisher? He told me that he was self-publishing. As we talked on I found out that his book was a business book, and as he described it, it sounded like he had a pretty fresh take on a lot of business situations. I ended up liking the guy and, as I’ve done with you, offered to see if my agent would take a look at his book to see if maybe it would be salable to a mainstream publisher. I ran it by my agent who said, Sure, have him send it to me.

He sent it, the agent loved it, and proceeded to help him get it in shape to present to publishers. Typically the way the publishing process works is this: agents ‘do lunch’ with specific agents they think would be possible buyers. At lunch they briefly describe the book, and the editor always says Send me the proposal. The agent then sends out a dozen or so proposals to these wined and dined editors. And the agent puts a closing date on the ‘auction.’ Usually nothing much happens until the week or so before the closing date (typically, the closing date is a month or so after the proposals are sent out). A week before the agent starts getting bombarded with questions. And sometimes potential publishers even want to have a phone conference with the author. A couple of days before the closing date, editors who are not interested begin sending their letters saying they won’t be in the auction. On the closing date, the interested publishers send in their offers. The agent then takes the best one. Or, even better, if there are a couple that are the same, a bidding war can ensue.

In the case of the author of the business book, my agent started getting questions within a few days after sending off the proposals. Publishers loved the book – they thought the content was spectacular. Then they asked the dreaded question: What is the author’s platform? Meaning is he a big-time professor at a business school? Does he do seminars? Does he have Fortune 500 clients? In other words, can he help us sell this book? When told that he wasn’t any of the above, but that he was a small business turn-around consultant in a mid-sized midwestern city who happened to be a real smart guy who had figured out a bunch of good stuff, all interest evaporated.

This is the horror story of publishing right now. It hasn’t always been that way and it probably won’t always be that way. But that’s the way it is now. So if you have no platform, you get no book contract regardless of quality of the content. (These rules, of course, apply only to non-fiction. Fiction publishers are always on the lookout for fresh, new voices.) With non-fiction it is the author and the author’s platform that count, not the content. Which is why I recommend that you do something to get yourself a platform, which I thought you were well on your way to with the Omnivore site. If you’ve can confirm that you’ve sold at least 10,000 copies of either book, that will also give you a platform. Without some platform (a word I’ve really come to hate), though, other than just an angry guy who does a few interviews and trashes anyone who disagrees with him, I doubt that you have much of a chance with mainstream publishing. But that doesn’t mean you can’t give it a shot.

Thanks for the tale, but let’s not waste any more of each other’s time. As I stated, TheOmnivore is dead and buried, and it will stay that way. If a big publisher feels that I am not famous or notorious enough, so be it. I guess I’ll just have to keep following the lead of folks like Leo Costa, who wrote a terrific best-selling training program without any help whatsoever from mainstream publishers.

So having said that, and if you are not prepared to debate the MAD issue via email, I really don’t see the point in any future email contact. It’s a bit rich for my liking to receive lectures about my alleged misbehavior from someone of advanced age (I assume you are at least in your 60s) who himself behaves like a spoilt tantrum-throwing brat when his arguments don’t hold sway, but then accuses me of doing the same; who happily acts like a hostile jerk towards a couple of female exercise physiologists, but then rabidly protests when I similarly highlight his own absurd claims; who pompously boasts about his superior level of civility but then proceeds to call me a “pipsqueek”, “prat”,”sniveling dreck”, “pigheaded” etc, etc, etc…

And, BTW, you totally misunderstood my criticism of #2 in your challenge. I didn’t write that I thought the studies were rigged, but that the #2 component of the challenge was rigged. But I’ll take that up on my own site.

Keep calling it “rigged” if it makes you feel better, but the bottom line is that you cannot prove MAD. That’s because MAD is garbage.

P.S. How did you find out about the woman at Kinkos?

I’ve been seeing her younger and more attractive sister

There you have it. The emails speak for themselves. As I said earlier, you can draw your own conclusions.

I do want to clarify one thing, however, so that no one else gets the wrong idea. Anthony has seized on what I wrote about the book publishing world to make his case that mainstream publishers aren’t interested in the truth, but only in the name and/or reputation of the author. I think he may have misunderstood my point and I don’t want readers of this blog to misunderstand it as well.

Editors in the mainstream publishing world, who are the people who make the decision whether to buy books or not, are typically lit majors. They do not have the scientific qualifications to evaluate book proposals from people making scientific claims on the merits of the specific claims. They aren’t scientists. What editors have to rely on is the name, reputation and experience of the author to make a determination as to the merit of the book’s content. If you are an editor working for a major publisher in New York and you get a book proposal from a total no one (by that I mean someone with no credentials, no university affiliation, no advanced degree, no medical practice, no published papers) on the idea that the lipid hypothesis is bogus, are you going to rush it into print? Especially when you are inundated with book proposals from practicing physicians and scientists on a whole range of subjects. I doubt it. But if it came from a complete no one who had managed to sell 10,000 or so copies of a self-published version, that’s a different story. That means that this person has a following and has something to say. And now you’re interested. That’s what I mean about a platform.

Anthony’s take is that there is a conspiracy afoot to thwart him and all his friends out there (who by his definition all think exactly the same way he does) from spreading the true and complete gospel as known to them. They can’t imagine that there could be another reason that they’re not published.