Blackburn sounds like a real scum bag. I’ve been re-reading Alicia Mundy’s “Dispensing With The Truth”, in which Blackburn is a notable character because of his Wyeth-sponsored promotion of Fen-Phen, that horrible off-label cocktail of diet drugs that caused so much death and disease.

A 2006 CBS News report stated “Dr. George Blackburn says the practice is untested, and patients who seek off-label drugs for weight loss are desperate and vulnerable. “They need therapy,” he said. “They need counseling, they do not need an off-label medication.”"

Ha ! What a change of heart he’s had ! I guess all of those Fen-Phen lawsuits have made an honest man out of him after all. But I do wonder … if he thinks that patients who seek off-label drugs for weight loss are desperate and vulnerable, I wonder what he thinks of physicians who advise people to use off-label drug combos for weight loss ? Perhaps desperate and greedy ? I wonder how much he made from promoting Fen-Phen ? I wonder if he’ll start pushing Lorcaserin when it’s approved by the FDA ?

If you measure the changes over time in your fat stores (and of course, to a lesser extent, protein and glycogen stores), you can always count backwards: If you know your total calories-in, just add or subtract the calorie worth of the changes, and you get a good estimate of your total calories-out. And this may be the only realistic way of estimating calories-out…

The logical fault that non-physicists seem to love is to believe that it follows from the laws of energy conservation that, by modifying energy intake, you could control the fat stores. For instance, as Blackburn sugests, by lowering energy intake by 100 calories a day, you would force the body to burn an extra 100 calories’ worth of stored body fat.

It is not an inherently impossible idea – the storage of fat just might be unlike any other comparable processes in the body by lacking what is known as homeostasis – active regulation mechanisms (often hormone mediated) that keep for instance electrolyte balances closely regulated, or body temperature. Within limits of course – you could drink water and upset the balance lethally, and in sufficiently hot or cold environments, the temperature regulation can and will fail.

But is it a reasonable model of reality? Do calorie-counting dieters actually achieve the weight change predicted by the change in calorie intake? Or, by modifying the calories-out by exercising? Has anybody tried ? In a very short perspective, yes, but any data from the literature will show you it doesn’t work like that over any reasonable time.

A very different way of thinking would be considering obesity as a fat-storage disease, where the normal regulation of the fat stores fails for some reason. Like body temperature – one person might keep the body temperature within bounds, while another might fail and die of heat stroke – and a third, due to some infection, might have significantly elevated temperature in a perfectly normal environment.

So, if this model is of any use, why would the fat-store regulation ever fail? It might be overloaded by what’s in a “Western” diet – the ubiquitous Pima indians or the Pacific islanders seem to get universally obese when leaving their traditional eating for “imported” food habits. Is it insulin mediated? Often, I think, but other mechanisms (thyroid or adrenal hormones, etc) might be more important for some.

But why is extreme calorie reduction at least temporarily effective? For instance, there are low-calorie powder preparations (designed to supply protein to cover losses, and some carbs thrown in) that are low enough in carbs to be ketogenic, and lower insulin levels very strongly. It is, for all I’ve seen, taken for granted that the calorie reduction is what leads to the quick weight loss – instead, could it be the effect of it being a low-carb diet instead? And can the almost inevitable long-term failure be the consequence of the calorie deficiency?

Or take exercise. In some cases, but not all, it seems exercise aids fat weight loss – again, if so, is it by the increase in calories-out or the improvement in insulin resistance of the muscles?

Just wondering.

“As carbon dioxide levels rise in the atmosphere, most plants accumulate more carbon in their tissues, Taub explained, which can reduce concentrations of other elements, such as nitrogen, a key component of proteins.

“Taub says that the decrease in nitrogen could be partially overcome by using fertilizers that contain nitrogen, but that these can have negative environmental consequences of their own, particularly for nearby waterways. Another option would be to breed strains of grains that have higher protein concentrations under elevated carbon dioxide levels, he said.”

http://www.livescience.com/environment/080122-co2-nutrition.html

Interesting overlap between Protein Power and global warming, eh?

Except when I asked him, the famous author of Protein Power said he is a agnostic on the idea of global warming. So where does that leave us?

Cheers

A number of such studies.

Overall (95% CI) -1.0 (-3.5 to 1.5)

IOW, with 95% confidence the authors believe their data shows that the advantage of a low-carb diet is somewhere in the range of -3.5 kg to +1.5 kg after a year, relative to a low-fat diet. This doesn’t show that low-carb diets are better, it shows that the data they analyzed isn’t strong enough to resolve the question with reasonable confidence. The data is even consistent with the possibility that the low-fat diets had a 1.5 kg advantage, although since that’s at the extreme end of the confidence interval, it’s unlikely to be true. Put that all together, and “similar results” is a fair assessment.

That said, I’m personally surprised that most studies don’t show stronger advantages for low-carb, high-protein diets. High-carb, low-fat eating never made sense to me, and never “worked” for me either, but it’s darned hard to do a randomized, placebo-controlled, double-blind study on myself

Keep up the great work!

That’s true at the 12 month mark. But two out of three studies showed a significant advantage to the low-carb diet at 12 months. If you read this entire article, you can see that it is not particularly predisposed to low-carb dieting, so the studies used were not selected to show an advantage to low-carb diets. It was the only chart I had available without having to make on myself. Good eye on catching the confidence interval crossing the zero line. We’re I not biased in favor of low-carb diets, I would have caught it myself.

MRE

The chart reproduced here summarizing a meta-analysis doesn’t refute Blackburn’s stated view of this: it shows a measly 1-kilogram mean advantage after 1 year for low-carb vs low-fat diets, and the 95% confidence interval ranges from a 3.5 kg advantage to a 1.5 kg disadvantage. IOW, Blackburn’s “similar” is spot-on with respect to this data — this specific meta-analysis didn’t find a clear winner after 1 year, although it suggests low-carb may enjoy a small advantage over low-fat after 1 year. It did show a low-carb advantage after 6 months, but Blackburn said “similar long-term weight loss”, and while I don’t know what “long-term” means to him, I’m charitable enough to grant he meant /something/ by it

I’m not arguing that Blackburn is right in all he says, but except for cheerleading purposes it doesn’t really help to work at misconstruing him.

I don’t think I am misconstruing him. He clearly favors a low-fat diet, and the chart I posted showed that a low-fat diet came in second to a low-fat diet. With such a wide spread of results in the number of subjects in meta-analyses, small differences are actually pretty large if significantly different.

I keep hoping things are changing, but I agree with David, they’re just getting louder!!

It’s simply mind-boggling that study after study is being ignored!

Huge LC weight loss gets no credit. It was all the exercise, don’t you see.

http://www.cnn.com/2008/HEALTH/diet.fitness/02/01/weightloss.phill.novak/index.html

jw

John

Pitiful. But invaluable for a point I want to make. I’m going to use for a post.

MRE