English breakfast at our hotel. A good low-carb diet.

It was bound to happen.  Forever the low-fat diet promoters, whenever asked about low-carb diets, would always say: Show me the studies.  Well, we showed them the studies, the vast majority of which demonstrated the superiority of low-carb diet, but they didn’t like what they saw.  So they demanded more.  The rallying cry became: Show me the long-term studies.  Now that those are in, the anti-meat folks are running out of options.  But one of their own great lipophobes (Lipid  = fat; phobic = fear of.  Lipophobe = fearer of fat.), David Jenkins, has come to the rescue.

Since the low-carb diet has proven so effective, opines he, why not make it even more so by making a vegetarian version?  Then dieters can have all the advantages of a low-carb diet along with all the advantages of a plant-based diet.  That is, assuming there are advantages to a plant-based diet, more about which later.

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In the last post I wrote that I would explain why George Bray and his brethren in the academic obesity research world are in great measure responsible for the toxic world they all blame for the obesity epidemic.  We live in a world, they say, filled with impossible to resist foods that throw us into hedonic overdrive.  As long as we live in such a world, there is no hope – other than drugs, of course – for the obesity epidemic to be reversed.  They may be correct.  But, as I said, they are in part responsible.  Let’s see why.

You can’t just go around gibbering as they do about a toxic environment without defining what it is that is toxic about it.  If pressed, these folks almost always default to the position that it is the elevated levels of fat in the diet that are toxic.  They will often say – as Bray did in his rebuttal to Taubes – that the ready availability of high-fat, high-sugar foods is what makes the environment toxic, but that is just a kind of code for high fat, which is what they really believe causes obesity.

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Dr. George Bray's model of obesity

In July 2008 I posted on Dr. George Bray’s critique of Gary Taubes’ book Good Calories, Bad Calories that appeared in Obesity Reviews.  Included in my post was a copy of Gary’s response.  Now Dr. Bray is back with a rebuttal to Gary’s response to his (Bray’s) original critique.  In conversation, Gary told me he has elected to drop the issue because the discussion is going nowhere.  Gary makes substantive points; Bray obfuscates the issues and will continue to do so.  I, however, am not going to drop the case.  Maybe I’ll have the last word here.

I want to go over Dr. Bray’s response to Gary’s letter in some detail because it is emblematic of all that is wrong with obesity research today and clearly demonstrates why we will never get anywhere until the people of Bray’s generation fade away. I don’t know that I’ve ever seen so many instances of one writer missing the point as often as Dr. Bray does in this short reply.  The entirety of his response is an example of either shoddy thinking or intellectual dishonesty.  Or maybe both. It brings to mind Mary McCarthy’s famous quote about Lillian Hellman: “Every word she writes is a lie, including ‘and’ and ‘the’.

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Almost ten years ago when we were in practice in Boulder, Colorado we started looking for a good weightloss supplement to help our patients on low-carb diets lose a little more quickly.  We evaluated a lot of supplements on the market that were supposedly weight loss accelerators – chromium, hydroxycitric acid (HCA), ephedra, phenylpropanolamine, pyruvate and a few others – with out a lot of success.  The ephedra and, to a lesser extent, phenylpropanolamine unquestionably helped people lose weight, but were fraught with side effects.  Pyruvate showed promise, but was pretty expensive.  Our partner found a couple of medical papers using a combination of supplements, some of which individually didn’t work all that well but in combination seemed to show promise.  We cobbled together from healthfood-store supplements a sort of beta-prototype of this combination and used it on a number of our willing patients.  The vast majority, all of whom were on low-carb diets, tolerated the supplement and felt it made them lose weight better.

Happy with these results MD, our partner and I decided to take the next step and get an actual product made.  We did, and let patients try it.  Again, the patients liked the supplement and though they lost weight better on it.  Although we, too, thought the patients did better, we couldn’t really say because we hadn’t compared the supplement with a placebo in a controlled fashion.  We decided to take that next step.

We contacted a clinical lab that does testing for a fee (a substantial fee, I might add) and talked to the director of the facility, who was pretty discouraging.  He told us that he would be happy to take our money and test our supplement, but that we shouldn’t get our hopes up.  He related that his company had tested scores of nutritional supplements and had never found one that really did much.  And that he figured ours wouldn’t do well against placebo either.

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