Fat Fiction Fat, lies and measuring tape

22Oct/108

Diet of a fat man: flour tortillas and beans

Food for a fat man?

Think of food and obesity and what do you picture? Burgers perhaps? Pizzas? Well, what if obesity was nothing to do with fatty foods? Nothing to do with exercise? And nothing to do with greed? This isn't wild speculation - the evidence already exists.

Let's look at what we know. Right now, obesity is an epidemic. What started out with the odd kid at school has been replaced by a generation whose waistlines are expanding faster than Government’s policies to deal with it.

It seemingly began as  an American phenomenon where currently 30%+ of the population is now clinically obese (1), but it’s since spread worldwide. Other countries have rapidly caught up, with Mexico and the UK creeping up in the 2nd and 3rd place, and China reportedly boasting a rate of 1 in 5 obese (2).

So far, so tragic. And we all know the reasons why this happens, yes? The World Heath Organisation, talking about childhood obesity sums up:
“The fundamental causes behind the rising levels of childhood obesity are a shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, minerals and other healthy micronutrients, and a trend towards decreased levels of physical activity.” (3)

So, because we eat foods which are really high in calories, we accidentally ‘overdose’ on high density foods and don’t move around enough to burn them off. Seems sensible at first blush, but I’m proposing something different - the deficiency theory.

The deficiency theory

Obesity is a form of malnutrition. People get fat because of what they don’t eat or don’t absorb, as opposed to the foods that they do eat.

It’s all about nutrients. Obesity is caused by overeating through excessive hunger, which the body is triggering in order to find nutrients. That’s either because the food isn’t nutritious (insert favourite candy bar here), or more worryingly, because people are eating foods which are actively stripping nutrients, or preventing absorption of nutrients. Sugar strips nutrients from the body. Grains and legumes (that’s bread, pasta, rice etc and yes, beans) actively prevent you absorbing nutrients in the gut which the body needs to fully function. The more processed the foods are,  the worse this effect is.

Obesity is one form of malnutrition. Another is gallstones, which were my way into this labyrinth of food issues. Gallstones are caused by a lack of minerals – magnesium, manganese, selenium to name a few. Minerals are required both to produce balanced bile which is stored in the gallbladder, and to absorb water-soluble vitamins through bile transport. The inbalance of bile causes supersaturation of cholesterol and slow turnover of bile in the gallbladder, resulting in gallstones. As for why the lack of minerals – either you’re not eating enough, or your body cannot absorb them because it has been damaged by grains and legumes, or both. This overall inbalance of vitamins in the body can also lead to overeating to regain those nutrients, which explains why gallstones and obesity are often seen hand in hand.

Gallstones and obesity are tightly correlated because they’re two symptoms of the same problem. Malnutrition. If you’re overweight, exercise and calorie restricted diets will make no long-term difference, as you haven’t dealt with the cause. Obesity is simply the symptom of malnutrition.

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It’s quite easy to skim over that text thinking it says nothing new, so let me spell out the implications in case it's not clear:

- lack of exercise and high fat foods are not directly responsible for obesity
- obesity is caused by excessive hunger
- excessive hunger is caused by lack of nutrients in the diet or a lack of absorption of nutrients in your gut. Appetite - your hunger - is a direct result of your body’s energy needs and nutritional needs
- grains and legumes, in particular refined carbohydrates, have been proven to deplete nutrients while adding to caloric load. These foods then in turn increase hunger in the body's quest to receive the right nutrients.

If you’ve read that and understood, your bullshit-ometer should be peaking right now. Although saying that refined carbohydrates are bad is probably the least controversial statement on the planet, the rest of those statements surely need some analysis. Some of the many questions you may have right now will include:

-          Everyone knows exercise is good for your health; you’re not seriously suggesting lack of exercise has nothing to do with obesity are you?
-          So are you saying fat doesn’t make you fat?
-          If this were true, you could presumably cure obesity with some vitamins and minerals?
-          Wouldn’t this mean you could eat some vegetables and deep fry everything else and you would never gain weight?
-          Isn’t this just a caveman (Paleo) diet by any other name?
-          Doesn’t this mean  paradoxically that white bread makes you hungry?
-          Doesn't malnutrition make you starve to death (which is why it's called hidden hunger) rather than put weight on?
-          My cousin/best friend/wife/husband/mistress/milkman etc  eats sandwiches morning, afternoon and night and he/she/it doesn’t get fat, so that completely discredits your theory. My other friend who eats pizzas and burgers all day is a right fatso. Who are you kidding?

Over the coming months, I’m going to focus on different questions that I had (and so I'm sure you have too) and provide evidence that shows unequivocally, obesity is a disease of malnutrition. The best place to start is where I began my research - with the Pima Indians.

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It’s all about the Pima Indians

A bit of background

Rewind a few months. All of this research started because I was diagnosed with gallstones and I wanted to find out who was the most likely to get gallstones in the world – and maybe something about their diet could shed some light on why I got mine. What I started unravelling was shocking and confusing. Pima Indians have the highest incidence of gallstones in the world – so surely something in their diet could explain why I got mine. But what was interesting was that gallstones were the least of their worries as we’ll see...

The sickest people in the world?

The Pima Indians are a group of American Indians that live in Southern Arizona and Sonora in Northern Mexico. Colonised by Americans in the mid 1800s, before long, water was diverted by local farmers away from Pima land to non-native farmers. Combine that with the greater integration of the Pimas into mainstream America in World War II, by the 1950s, their diet was forcible changed  into one of non-perishable foodstuffs, which was all they could get their hands on.

Right now, in 2010, these people are suffering. In particular:
a) 50% of Pima Indians have type 2 diabetes, of which 95% are overweight (4)
b) 48% of men and 65% of women aged 45-74 are clinically obese (5)
c) 49% of Pima Indians have gallstones  (6)

The cause

Originally, it was thought that genetics must play a part – and to some degree, maybe they do. However, studies have shown that their genetically identical relatives in Mexico don’t suffer from the same diseases, and don’t suffer from the same illnesses either. The only key difference between the two groups is their diet. As such, the original genetic theory as to why Pimas are getting so overweight – known as the thrifty gene hypothesis – has now “largely collapsed” according James Neel – the man who came up with the hypothesis.

Scientists and the dog with a bone

In spite of this, scientists can’t let the idea go that it must be some genetic abnormality, and as late as 2007, scientists are still finding evidence that it’s all down to the genes (7).But could it be any more ridiculous? According to that research, Pima Indians are particularly affected because of their thrifty gene which is better used to times of scarcity. So, let me get this clear:

A country colonises an entire tribe, changes their diet, watches them get fat and progressively die of diabetes, then tells them it’s because of their genes?

It’s like arriving at the scene of the car crash and deciding all the fatalities were because their bones couldn’t withstand the crash and ignoring the fact a 10-ton juggernaut just tipped their car over.

The Pima diet

Anyway, so scientists continue to be fascinated by Pimas and a Pathfinder for Health project has been set up to explore their illnesses (8). They’re interesting because here is a group of people that remain genetically stable (as they mostly marry from within their community), whose diet has radically changed in the past century, who are demonstrating the biggest problems known to the Western world, all within a few  square miles of one another. Crack the Pimas, and you’ve cracked the obesity, diabetes and gallstone disease in one. Everything points then to their diet. And this is where the controversy comes in. What did it used to be like, and what is it like now?

The old diet

Searching through the studies we can find that apparently it constituted around 80% carbs, 10% fat, 10% protein (9). That’s a little less detail than I’d really like but OK, it’s a starting point. So, how’s it changed?

The new diet

What are they eating today? Apparently 47% carbs, 35% fat, 15% protein, 3% alcohol (10). If this is the case, it seems fairly obvious. The rapid increase in fat consumption has caused huge increases in obesity, gallstones and type 2 diabetes. Let’s all go home and celebrate a job well done. To quote from the study:

“Obesity has become a major health problem in American Indians only in the past 1–2 generations and is believed to be associated with the relative abundance of high-fat foods and the rapid change from active to sedentary lifestyles”

And in fact, many scientists have done exactly that – it’s high fat to blame, so let’s move on. The high fat bandwagon rattles forward. But something about this didn’t gel. Not least because I had (past tense) a very low fat diet and had developed gallstones. I wanted to know what exactly were they eating? These summaries didn’t really seem to cut it.Quoting the dietary study:

“Despite the widespread obesity in American Indians, there is a paucity of data on their dietary and physical activity patterns. Several dietary practices that may contribute to obesity have been identified, including the wide use of butter, lard, whole milk, fry bread, and fried meats and vegetables, as well as the generous use of fats in the preparation of beans. Sweets and snacks may account for high energy intakes in some groups. Gilbert et al reported that Navajo adolescents consumed sweetened soft drinks at more than twice the national average. In addition, many of the commodity foods that are used widely in American Indian populations are high in fat as well as energy. The NHNS found that, in Navajos, intake of fruit and vegetables was low and intake of fats was high.”

So, are they actually saying, in spite of all their academic research, nobody thought to study what exactly they were eating? Pompous language to cover up simple failings. It reminds me of someone at work who once said “There’s been a malfunction with the transport arrangement process which is currently being rectified”. Read, some tool forgot to book the train tickets. Back to the Pimas. Someone, somewhere, must have done some proper research into their diet, surely. And indeed they have – albeit back in 1959 (11).

The real diet

In this study, they note that the diet was around 25% fat and comprised mainly of beans, tortillas and bread. Every day. And what’s more, it was seen as reasonably nutritionally sound, albeit a little low in calcium, vitamin A and riboflavin. OK, so their fat intake was 25%. Does that sound quite high? How did it compare to the American diet at the time? Funnily enough, the American fat intake was higher at 40% fat. That means that the Americans were consuming nearly double the amount of fat as the Pima Indians at the time they were in the throws of the obesity epidemic.

Ah, I know what you’re thinking. Maybe the Pima’s obesity, diabetes and gallstone diseases started much later than 1959 – after all, junk food has really only swept the nation in the 1970s, right? Nice try, but no. High rates of obesity, diabetes and gallstones had already been extensively recorded in 1959 (10,11).

So let’s be quite clear – the Pima’s were suffering from obesity when their fat intake was lower than the average American. Their diet was also characterised by a high intake of white flour, beans and sugar. Since those early studies, it appears they’ve upped their sugar intake with sugary fizzy drinks, and they appear to be frying foods more, in line with their American cousins. But either way, something about this didn’t make sense. It really didn’t. The Pima’s were eating less fat than non-Natives and suffering from obesity.

This is just one of many examples that  prove the point that it’s not fat that’s making people fat. It might also make you question the title of this original post. Are flour tortillas and beans genuinely the diet of a fat man? Really?

Really.

More soon.

References

1)      OECD: http://www.oecd.org/document/16/0,2340,en_2649_34631_2085200_1_1_1_1,00.html
2)      Study: http://www.bmj.com/content/333/7564/362.full
3)      World Health Organisation: http://www.who.int/dietphysicalactivity/childhood/en/index.html
4)       Pathfinders for health: http://diabetes.niddk.nih.gov/dm/pubs/pima/obesity/obesity.htm
5)       Study: http://aspe.hhs.gov/hsp/07/AI-AN-obesity/report.pdf
6)       Study: http://www.nejm.org/doi/full/10.1056/NEJM197012172832502
7)      Article: http://www.sciencedaily.com/releases/2007/10/071016074958.htm
8)      Study: http://diabetes.niddk.nih.gov/dm/pubs/pima/index.htm
9)      Study: http://care.diabetesjournals.org/content/16/1/369.abstract
10)   Study: http://www.ajcn.org/cgi/reprint/69/4/747S.pdf 11)   Study: http://www.ajcn.org/cgi/reprint/7/5/532

Image: Carlos Porto / FreeDigitalPhotos.net

Comments (8) Trackbacks (1)
  1. Mike:

    Found this post again while shuffling bookmarks, and I think there is something to your theory. The Jaminets (of Perfect Health Diet fame) like to note that voluntary protein intake tends to be relatively constant among people eating ad libitum in trials: people eating a high-protein diet eat less, people eating a low-protein diet eat much more.

    So perhaps that extends to other nutrients: our bodies are remarkably good at telling us we’re short on something. Even butterfiles are smart enough to lick water from mineralized rocks. But in the modern environment, the urge to “find something nutritious” gets shortcircuited by the easy availability of refined sugars and starches (the same thing, really), so when you’re hungry for nutrients you reach for the Wheat Thins or Skittles. (And then there’s the physically addictive qualities of both sugars and wheat, which you’ve noted, and which I cover as well in “Why You’re Addicted To Bread”.

    I’d like to see some studies on this: feed people a controlled diet deliberately deficient in single specific nutrients and see what happens to appetite, cravings, and food choices.

    JS

    • Interesting John – I’ll check out your post this w/end. With the controlled studies, there’s a few that have been done showing vitamin fortification increase consumption, but few the other way around (deficiencies leading to increased appetite).

      I think you’re right about the shortcircuit – the presence of sugar & salt confuses the body into eating more, suggesting that the foods are more nutritious than they really are. For eg high salt foods are also high in minerals in their natural form.

      thanks for the feedback

  2. I do have one issue here, and that is the overeating assumption. In gallstone provoked lab rats, they admitted that they ate fewer calories than the normal rats. This was just an observation, they didn’t make a conclusion about why that was. But it does explain some gallstone victims. I know some severely obese gallstone folks who will eat a small bowl of cereal in the 8 hours that I spent with them.
    I do know that skipping meals is a risk factor, presumably because the bile is not getting used but just sitting there waiting to be used.

    My morbidly obese husband is tending to skip breakfast and lunch and have a normal dinner, and has done this for years and never lost weight. He does tend toward hypoactive thyroid.

    • Hi,
      Fat causes gallstones – the myth never dies eh? I know GPs get virtually no training in diet and diseases so no surprise that you don’t get much either but it’s a crazy situation.

      I’ve read NPG a while back and skirted through a lot of Weston stuff. Lot of lessons in his stuff.

      And overeating – I largely agree – have a look at fat people eat less than thin people elsewhere on this site. It’s confused by the fact that anyone fat if they stopped eating would lose weight, so it seems they are eating too much whatever that is, but I’ve tried to break that down in other posts.

  3. Got another suggestion; look up westonapricedotorg. And read his study Nutrition and Physical Degeneration. There is a LOT more to the diet story of the healthiest peoples in the world that can be learned. He found the healthiest tribes in the world ate 80% calories in fat, and the rest in protein, and some never ate carbs at all. One of the groups that has survived to this day are the Massai, who down (in their natural way of life, which is disappearing) a gallon of very high fat (6%) raw milk daily. These are very tall and very “superb” specimens as Price put it. Price counted cavities, took pictures and detailed diets. he came home to make a butter for his patients of high mineral soil pastured cows’ milk. He saw great success in improving health in his patients including a Downs’ syndrome boy.

  4. Mike, Really excellent info, thanks for all your study.

    I am a nurse and they really leave out lots of stuff, i think they don’t even think about the real physiology going on. They just tell us in class, too much fat causes gallstones, this is how you care for the patient before and after surgery. Note EVERYTHING is about caring for the patient before and after surgery because taking things out is simply what they do.

  5. The comment above (aparadekto) is a comment spammer, probably a bot, which leaves that comment on every single website in the world (including mine). Your comment links are set nofollow, so it probably doesn’t help their Google ranking (the objective), but you should delete that comment (and mine).

  6. I’ll leave yours and delete his. This was from my initial weeks before I had twigged on…

    Anyway, keeping your comment because I’d not heard of your site before – will definitely give it a read, looks interesting:
    http://www.gnolls.org


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