British TV Programme: Sugar v Fat

[Demi]

On BBC TV programme, Horizon (http://www.bbc.co.uk/programmes/b006mgxf), on Wednesday, 29 January:

Sugar v Fat

Duration: 1 hour

What's worse for us: sugar or fat?

To answer the hottest question in nutrition, twin doctors Chris and Xand Van Tulleken go on month long high-fat and high-sugar diets. The effects on their bodies are shocking and surprising.

But they also discover that in the debate about fat and sugar, the real enemy might have been hiding in plain

http://www.bbc.co.uk/programmes/b03t8r4h




From The Express
London, UK
26 January, 2014

Sugar vs fat: Twin brothers take radical steps to show the real impact of our fad diets

DANNY BUCKLAND meets the identical twins who tested the real impact of food and discover which of our treats is to blame for the obesity crisis


The race to demonise sugar in the fight against Britain’s soaring obesity levels could be heading in the wrong direction, according to a unique experiment. The “white stuff” is being targeted as public health enemy No. 1 as the nation struggles to cope with personal misery and an annual £5billion bill for treating illness and disease caused by overeating.

Our dimensions are disturbing: 25 per cent of adults are obese and the figures are expected to climb to 60 per cent of men and 50 per cent of women by 2050. Three in 10 children aged between two and 15 are overweight or obese.

Yet as public frenzy builds around the status of sugar, two doctors have conducted a fascinating experiment to see who is the most to blame in the heavyweight fight: Fat or Sugar?

Chris and Xand van Tulleken, who have pushed themselves to extremes on expeditions to the Arctic and the jungle, devised an innovative personal challenge to find the answer.

As identical twins with identical genes, they are ideally placed to test the impact of high fat and sugar diets. Xand, director of the Institute of Humanitarian Affairs at Fordham University in New York, went on a high-fat diet with just 5 per cent carbs while Chris had a super low-fat, high-carb regime with no food containing higher than 5g per 100g.

Their gruelling month-long quest, detailing the rival metabolic impacts on their minds and bodies, sees them both lose weight with a worrying conclusion that will be revealed on BBC2’s Horizon programme on Wednesday.

After duelling through a cycle challenge and a cognitive test trading shares on a virtual stock market however, the verdict surprised both. Neither fat nor sugar was completely culpable and the real villain, a potent combination of high fat and high sugar in processed foods, had escaped the dock and was sunning itself on a metaphoric extradition treaty-free beach.

“We should not vilify a single nutrient. We will be demonising protein next after we have done with fat and sugar,” says Chris, an infection doctor at University College Hospital, London, and a Medical Research Council fellow at University College London. “It is too easy to demonise fat or sugar but that enables you to let yourself off the hook in other ways. The enemy is right in front of us in the shape of processed foods.”

Research by Professor Paul Kenny, of the Scripps Institute, provides sobering evidence of what is happening a little way down the evolutionary scale.

Feeding laboratory rats with either high-fat and high-sugar diets did little to change their daily habits or health but supply them with chocolate, biscuits and cheesecake (a near 50-50 fat and sugar split) and behaviour changed radically.

They ignored other foods for the cheesecake, going back to it regularly rather than gorging, and put on weight. Their self-regulation system, that naturally stopped them eating too much fat or sugar, effectively switched off.

“It became their main source of calories,” Kenny tells Horizon. “They gained massive amounts of weight, became sedentary, slept a lot and did not move around.”

He found that the allure of processed food was overriding the body’s natural hormones that regulate intake by alerting the brain that the body has enough calories. It is the same faculty that is impaired in drug addicts whose On-Off mechanisms are degraded by the release of pleasure hormones in the brain’s hedonic system, he says.

Susan Jebb, Professor of Diet and Population Health at the University of Oxford, has studied the impact of fat and sugar on diets for a decade and believes it is difficult to pin guilt simply on either.

“Processed foods pack calories in and are unbelievably attractive and delicious,” she says. “They are temptations for all of us and it is astonishing that any of us stay slim.

“In Britain, where we are surrounded by pretty delicious, relatively affordable and palatable foods, you have to exert quite a level of dietary restraint if you are not going to sleepwalk into obesity.”

She adds that no one food is “saint or sinner” while modest lifestyle changes and balanced diet are the way to health.

Chris agrees: “Research over 10 years gives us great confidence to say that no single macro-nutrient diet reduction is the answer. Cutting out a single thing will not solve your problem. Faddish diets simply do not work very well.

“It is about building an environment in your life where you could easily eat a cheap and healthy diet and get enough exercise. It is amazing that we are not all fat and I come away with a sense that I know enough about diet and nutrition and I should be reducing the calories and building an environment where I can do that rather than looking for one toxic ingredient.”

The statistics that have lead to a rush to condemn sugar include a tin of tomato soup containing four teaspoons of sugar, the same as a serving of Kellogg’s Frosties with semi-skimmed milk, while a can of Coca-Cola has nine teaspoons of sugar and a 51g Mars Bar, eight.

With the typical Briton consuming 12 teaspoons of sugar a day, experts want that reduced to five. The newly formed Action on Sugar is calling for the food industry to reduce refined sugar content by 20 to 30 per cent in the next five years. “This is not an anti-sugar programme,” says Chris. “There is no question that drinking sugary drinks will make you fat but whether it is the sugar that is toxic or it is just the calories is not so clear.

“People will be surprised by what happened to our bodies during the experiment. The important element that emerges is that we need to teach a bit of critical thinking so we do not take every sensational new diet or piece of health advice at face value.

“If you find yourself worshiping one nutritional god you may find you need to change churches in a few months as you rise and fall on the tide. Processed foods are delicious and we eat a lot of them so it may be a painful conclusion that we have to remove a bit of deliciousness from our lives but you can find healthy stuff that is delicious.”

The 35-year-old twins put themselves through their Angels and Demons dietary mangle in the name of science and both emerged with a greater understanding of how the body performs and how to help it survive.

“It is about creating an environment at home and work where you can have something delicious without every meal being packed with processed foods. Our goal is how we help people make changes to have healthy lives without being totalitarian about their diets.”http://www.express.co.uk/life-style/diets/456134/Sugar-vs-fat-Twin-brothers-take-radical-steps-to-show-the-real-impact-of-our-fad-diets

[ojoj]

I shall be watching!!

Jo xxx

[teaser]

Let's try repeating the experiment with identical twins with more obvious signs of metabolic syndrome. Twins whose idea of a good time isn't


push[ing] themselves to extremes on expeditions to the Arctic and the jungle

Also, if they continued to lose weight--the mixture of fat/glucose burned would be changing more for the sugar-eating brother than it would for the fat-eating brother.

I don't doubt the "foods designed to derail satiety" message. I think Heinlein said something about prudes thinking sex was the only thing that went on between people.

If sugar makes fat more appealing, and fat makes sugar more appealing, should we make a choice between the two? I know my choice. Sugary treats that aren't fatty seem kind of hollow. Fatty treats without sugar are delicious.

[bike2work]

I doubt they gave one twin time to become adjusted to a low carb, high fat diet. This will probably end badly.

[M Levac]

I was going to write a long post, then I got tired. I prefer Feltham's experiment, it's more comprehensive.

http://forum.lowcarber.org/showthread.php?t=453297

[rightnow]

There were 8 sentences about the twins' experiment and then endless yapping from everyone else in that article.

There have been other research done on twins, I seem to recall Taubes covering some of that in his Good Calories, Bad Calories book didn't he? I know Dr. Jeffrey Friedman at Rockefeller mentioned twin studies once also.

I think Teaser's point that time would change the body reactions is important. Whatever one is testing, not only do the subjects obviously matter, but the effect it has short term vs. long term is a major thing. I also suspect that people who are very healthy to begin with, their organs actually 'deal with' a lot of the toxins/problems early on, so you're really not seeing all the damage, only the 'result' after a healthy body processes and heals daily. But give it to someone already metabolically challenged, or look at the effect after a year instead of a month, and it might be a radically different story.

I had forgotten that about Heinlein. Funny and true.

PJ

[coachjeff]

This poorly written news story about twin brothers, one who did an LC diet while the other did a very low-fat diet, should provide ample fodder for debunking.

Low Carb vs. Low Fat Twins (http://shine.yahoo.com/healthy-living/twin-brothers-act-guinea-pigs-sugar-v-fat-190600102.html)

A quote from the article that made me want to pull my hair out of my head.

"Nutrition expert Angela Lemond explained to Yahoo Shine, that high protein diets produce chemicals called ketones, which promote weight loss but can lead to kidney failure. "We recommend staying above 100 grams of carbohydrates per day to avoid going into ketosis," she said and added, "We know people cannot sustain this way of eating and therefore, they re-gain the weight."

And Jesus wept.

[M Levac]

Same story here: http://forum.lowcarber.org/showthread.php?t=457872

I think that latest article just confirms the stupidity and ignorance of the medical profession and the news. Low-carbers know how to avoid the problems cited by Xand, and they're not docs or nutritionists or experts, but they did read a goddamn book written by docs who know all about those problems and how to avoid them. Incidentally, the problems cited by Chris have been known at least since the Minnesota Semi-Starvation experiment, more than 60 years ago. I get the impression these two guys went in believing they knew everything, and came out believing they learned everything there was to learn about diet, physiology and health. Goddamn it, I've been reading and discussing that for several years, and I barely touched the surface, and my own personal experience with diet has been going on for just as long, much longer than just a month. I should listen to those two nitwits? No.

[ojoj]

I wasnt impressed. The conclusion was that it wasnt fat or sugar that were bad, but a 50/50 mixture of the two.

Their results from their two opposing diets were that the high fat diet caused insulin resistance and muscle wastage and the high sugar diet was better??????

I didnt "buy" a lot of what was said, but my husband pointed out that these guys are doctors, as were those testing them - I'm not!!!!

Jo xxx

[Ken66]

Sugar v Fat? It's easy. One will rot your teeth and the other won't.

[Demi]

From The Independent
London, UK
30 January, 2014

Sugar vs Fat, TV review: Binge twins make a meal of it

Last night's Horizon (BBC2) pitted the two best food types against each other in "Sugar vs Fat", a battle which – as I flounce towards a chubby middle age – I'm calling as a score draw. They're both brilliant.

Alas, thanks to a backlash in the fructose-bloated US, sugar is 2013's diet bête noire. I spent a fun lunchtime this week with my colleagues dissecting the sugar content of my Appletiser (31 per cent of your daily allowance, FYI), but in the UK it's fat that has traditionally been the nutritional bogeyman. But which is worse?

Well there's only one way to find out – employ a pair of high-achieving scientist twins to binge on both for a month and find out whose innards take the bigger shoeing.

And so it was. Identical hunky docs Chris and Xand van Tulleken were our guinea pigs. Xand went on a high-fat, low-sugar diet; Chris did the opposite. Cue shots of lots of lovely pastries.

You may remember Chris and Xand from The Secret Life of Twins and Channel 4's Medicine Men Go Wild. Their schtick here was that their identicalness makes them perfect as a point of comparison for this food-based face-off. At the start of the film, the pair looked like the kind of blokes who would smash a full set of lights in the first round of Take Me Out; by the end, well, they appeared much the same but – like Morgan Spurlock after a month of Big Macs – felt a bit grubby.

Chris's carb-heavy blowout meant he could eat more calories but still feel hungry, whereas Xand's high-protein diet made him feel fuller because, we learned, fat and sugar have different effects on ghrelin, the hunger hormone. Fat, then, suppresses hunger, to a point. So get the bacon out. Or at least the eggs and the rest of the polyunsaturated/monosaturated mob. However, a gram of fat has twice as many calories as sugar and our bodies turn them into body fat more easily. So is that one-all?

The experiments continued with a bike race up Box Hill in Surrey with Team Sky's Nigel Mitchell fuelled by a tab of butter and an energy bar. Sugar won, easily.

The results of some of their tests were a bit odd. In fact, Chris's no-sugar diet almost led him to diabetes as it made his body less resistant to insulin. My punt before I watched the show was that it might conclude: don't have too much of each. And, quelle surprise, the twins' summing-up: "We know our enemy and it's the delicious combination of fat and sugar." http://www.independent.co.uk/arts-entertainment/tv/reviews/sugar-vs-fat-tv-review-binge-twins-make-a-meal-of-it-9094370.html

[Demi]

Sue’s Morning Stretch: Twins right about one thing, ditching processed foods

There’s a lot of buzz on the Internet about these twin doctors in Britain — Chris and Alexander “Xand” van Tulleken — and their weight-loss challenge and it was picked up by “Good Morning America.” The two decided to go on what many are describing as opposite diets to see who lost the most weight in a month. One cut out fat (Chris), the other (Xand) sugar (AKA carbohydrates, including fruit). Otherwise they could eat as much as they wanted. They followed the same fitness regime each day.

Xand lost the most weight, but both said they felt miserable. Xand said his breath stank and he couldn’t keep up with Chris in exercise. Chris said his food tasted horrible without fat. Both decided that the combo of fat (usually not the good fat you should be eating) and sugar in processed food is what they should be avoiding.

ABC’s chief health and medical editor, Dr. Richard Besser, weighed in, recommending people go for real food (translation, things that are grown or born), keep a food diary to see where food weaknesses/excesses may be, and exercise. When “GMA” anchor Robin Roberts asked Besser, how much, he said “any,” explaining his answer by saying too many people don’t do anything. “Do something,” he implored, and don’t start out with something grandiose, like going to the gym every day for two hours. He said people often start out too big and fail. “Get up and walk around the block,” Besser said.

While the twin docs’ experiment is interesting, it’s lacking real science. And they did this for one month. Their bodies were just getting used to things when they stopped. Personally, I follow an extremely low-carb diet because I am a Type 2 diabetic. And I know it takes a while to get used to it. Here’s one thing people often miss on this diet; you are to eat until you are full and then stop. No non-stop eating. After stuffing our faces with abandon for years, sometimes it takes time for us to recognize the difference between being full and wanting to eat on because it tastes so good.

And neither twin talked about vegetables. Following a low-carb plan, I eat lots of fresh vegetables. I still make pasta sauce, but now I serve it over sauteed spaghetti. I eat a huge salad at lunch with homemade, full-fat dressing, some protein and another vegetable. I am full and satisfied. And I have no trouble keeping up with exercise.

Like I said, there is actual science that shows the wisdom in a low-carb diet. Watch Dr. Robert H. Lustig talk about what he’s learned about sugar. Hear Dr. Peter Attia discuss why he believes the answer to the obesity epidemic is not our lack of discipline. Once you do maybe you’ll be like me and will change what you eat.

The twin docs from Britain are right about one thing: we need to avoid processed foods as much as possible. Eat food as close to its natural state as possible.http://voices.suntimes.com/arts-entertainment/the-daily-sizzle/sues-morning-stretch-twins-right-about-one-thing-ditching-processed-foods/

[leemack]

I have this recorded and will watch it tonight. However I do recall reading somewhere about the metabolic effects of high sugar/carbs becoming apparent at about 10 weeks, and I'm not sure how long it takes to keto adapt for exercise. Can't remember where I read about the length of the studies, but I remember it saying that was why industry financed studies were less than 10 weeks - because after 10 weeks, the results go against them.

So a four week trial tells us nothing.

[Demi]

From Dr Briffa's blog:


My take on the Horizon documentary ‘Sugar v Fat’

By Dr John Briffa on 30 January 2014

Last night a BBC documentary aired called ‘Sugar v Fat’. If you’re in the UK, you can watch it here (http://www.bbc.co.uk/iplayer/episode/b03t8r4h/Horizon_20132014_Sugar_v_Fat/). The show charted the experiences of identical twin doctors in their (I think) mid-30s, who were put on very different diets for a period of 30 days. One ate a very fat-rich diet, while the other ate on rich in carbs (sugar and starch). From now on, I will refer to them as ‘High-fat’ and ‘High-carb’ for ease.

A basic premise behind the show is that identical twins have identical DNA. So, having twins eating different diets is akin to testing two diets in the same person at the same time.

The twins underwent experiments over the course of the month. At one point, for instance, the twins’ mental powers were put to the test through a simulated stock trading exercise. ‘High-fat’, apparently, fared much worse than ‘High-carb’ here.

The men were fed breakfasts consistent with their new diets, and equal in calories. 3 hours later ‘High-carb’ seemed hungrier than his sibling, and ate more at a free buffet too.

The men were exercised on bikes and then made to race up a hill. ‘High-fat’ was given a pat of butter before the race, while ‘High-carb’ got a carbohydrate gel. ‘High-carb’ won the race by a country mile.

At the end of the experiment, ‘High-fat’ had lost about 4 kg, about 1.5 kg of which was fat. ‘High-carb’ lost 1 kg in weight, about half of which was fat and half lean tissue (muscle).

Finally, the men underwent a ‘glucose tolerance test’. From what I could make out, ‘High-carb had maintained blood sugar control as a result of increased insulin secretion. ‘High-fat’ was told his glucose tolerance was worse, and that he was not far from being ‘pre-diabetic’. Much was made of this.

In the end, the conclusion was (basically), that it’s not either fat nor sugar that causes obesity, it’s overeating. We were told that foods with a combination of fat and sugar that are highly palatable and rewarding that drive people to overeat.

The fundamental problem with this programme is that it essentially dressed up anecdote as science. It’s not a good idea to judge the impact of different diets by testing them on a limited number of people in this way. It’s not much different from someone could claiming that ‘smoking never did me any harm’. And they might be right, but I’d hesitate before using that observation as the basis for advice I might give about the health effects of smoking.

The programme did point out that we cannot necessarily extrapolate the twins’ experience to the general population. That’s right, but unfortunately, I expect that is what literally millions of people may do asresult of viewing this programme.

Even the idea that testing different diets in identical twins is especially insightful is flawed. That’s because other factors beyond the twins’ DNA may have impacted on their physiological functioning. For example, ‘High-fat’ underwent mental testing in New York, while ‘High-carb’ was in London. A ton of potential factors that have nothing to do with ‘macronutrient ratios’ in the diet may have accounted for any differences in performance, including jet-lag, hydration status and the type and amount of light in the room.

‘High-carb’ stated with absolute certainty that it was his carb-fuelled breakfast that gave him the edge over his fat-munching brother. In reality, though, there is absolutely no way he could know that at all.

After the glucose tolerance test (about 38 minutes into the show) ‘High-carb’ is told he he’s making more insulin and handling sugar better. When the person officiating over the tests (Dr Richard Mackenzie from the University of Westminster in London) is pressed (by ‘High-fat’) as to whether this is a good thing, he conceded that in the long term, this could lead to problems. Of course it could, because producing more insulin to regulate blood sugar sounds likes ‘insulin resistance’ is here or on its way. Insulin resistance, by the way, is usually the key underlying factor in type 2 diabetes.

Yet, the boys end up almost rejoicing in this result, somehow. And Dr Mackenzie gives ‘High-carb’ a clean bill of health.

He had stern words for ‘High-fat’, though. He is told he is dire straights and close to being ‘pre-diabetic’. Why, because his fasting blood glucose had gone from 5.1 mmol/l to 5.9 mmol/l. But is this difference statistically significant? And could anything else have caused the rise? Stress? Running down the street on the way to the appointment? Being a bit sleep deprived?

But none of this could stop Dr Mackenzie telling ‘High-fat’ that he must stop his diet and that if he continues his pancreas is going to stop producing insulin. Curiously, ‘High-fat’s glucose tolerance test results were not described at all. If he seemed to be in such bad shape, how come we only got to hear about his fasting test result?

I have to say, I got more of a sense of anti-fat bias through this show. The glucose tolerance testing episodes is a case in point. Also, when nutritionist Amanda Ursell was talking the boys through the diets at the start, we heard all about the bad breath and constipation ‘High-fat’ would inevitably suffer. In contrast, we heard not a peep about the potential adverse effects of a diet rammed full of sugar and fast sugar-releasing starches (such as blood sugar dysregulation and its tendency to induce mood instability, fatigue, sweet cravings and to disrupt sleep).

If the twins and the producers and Dr Mackenzie wished to genuinely gauge the impact different diets have on health, they could have looked to an abundance of published studies. This review (http://authoritynutrition.com/23-studies-on-low-carb-and-low-fat-diets/) of 23 relevant studies show quite clearly that, overall, low-carb diets produce better results regarding weight loss and disease markers (including those for type 2 diabetes).

This programme did not draw on this research, and was essentially a piece of theatre. While I found the twins very funny at times, I reckon the show was actually a tragedy.http://www.drbriffa.com/2014/01/30/my-take-on-the-horizon-documentary-sugar-v-fat/

[M Levac]

I have this recorded and will watch it tonight. However I do recall reading somewhere about the metabolic effects of high sugar/carbs becoming apparent at about 10 weeks, and I'm not sure how long it takes to keto adapt for exercise. Can't remember where I read about the length of the studies, but I remember it saying that was why industry financed studies were less than 10 weeks - because after 10 weeks, the results go against them.

So a four week trial tells us nothing.
It depends which metabolic effect they measured. For example, Taubes cited an experiment where they tested plasma lipids for both high-sugar and high-fat diets for only 1 week each. I'm paraphrasing, but the researcher apparently showed the two vials, and in one the plasma was clear (high-fat), and in the other the plasma was milky white (high-sugar). 1 week, and this metabolic effect was plainly obvious. It's interesting that this particular experiment wasn't done for those two clowns. Maybe they didn't want to show any difference, maybe they wanted to prove a point about something else, or maybe they're just clowns who don't know f'all.

[ojoj]

From Dr Briffa's blog:


http://www.drbriffa.com/2014/01/30/my-take-on-the-horizon-documentary-sugar-v-fat/

I dont like Amanda Ursell. I did a days photoshoot with a popular UK national newspaper because of my weight loss and she interviewed me. I told her how marvelous the Atkins diet was, how it had transformed my life, both thru weight loss and removing all of my symptoms IBS, eczema, arthritis, lethargy..... I went on and on... However, the following week when it was in the paper, my weight loss was down to her guidance, diet advice, exercise program - no mention of atkins - the nearest it got was to say that I didnt eat sugar!!!!! I was livid. http://livinlavidalocarb.blogspot.co.uk/2008/02/real-jo-heeley-low-carb-weight-loss.html

And as for that other professor Susan Jebb - I believe she has interests in the flour industry in the UK!!?

Anyway, Dr Briffa is right. The whole program was biased and reading his comments reminded me!!

Jo xxx

[RawNut]

It's on Youtube here: http://www.youtube.com/watch?v=9D-XL-zkNIY

It wasn't long enough and they should know better than to draw conclusions from an OGTT given to a low carber. How about giving the high carb twin an oral fat tolerance test?

[leemack]

http://www.dietdoctor.com/sugar-vs-fat-on-bbc-which-is-worse?utm_source=rss&utm_medium=rss&utm_campaign=sugar-vs-fat-on-bbc-which-is-worse


Sugar or fat, which is worse? That’s the question in the BBC documentary “Sugar vs. Fat” that aired the other night. And it’s been a long time since I got so many e-mails asking me for comments!

It’s an interesting setup. Two identical twin brothers – both of them doctors – go on a diet for a month. One on an extreme low fat diet, one on an extreme low carb diet (not even vegetables are allowed!). Here’s some background information:

MailOnline: One twin gave up sugar, the other gave up fat. Their experiment could change YOUR life

You can watch the show online here if you’re in the UK or watch a lower-quality copy on YouTube if you’re not.

Unfortunately they end up mostly “confirming” their preconceived ideas. Ready? Here comes the spoilers:



Result

Obviously when there is only one person on each diet, chance plays a big role. But I think the findings were more or less what could be expected, it’s mostly the ignorant (or TV-drama) explanations I have objections to.

Weight

First thing first. Even though both brothers were at a fairly decent weight to start with, the low-carb brother lost the most weight: 4 kg (9 pounds) vs only 1 kg (2 pounds) for the low-fat brother.

As study after study show more effective weight loss on a low-carb diet, this should be no surprise. The loss of fat was 1,5 kg on low-carb (a good result in a month) and 0,5 kg on low-fat. Most of the rest was probably fluid. On a very strict low-carb diet you quickly lose a kilo or two of glycogen and water weight.

How much – if any – muscle mass the participants lost is impossible to know as the BodPod test only measures fat mass vs. non-fat mass (including water).

Brain function

For testing the brain function of the brothers the producers chose to make them do stock trading with fake money.

This shows that the producer is ignorant or just interested in a dramatic show. Why? Because short-term stock trading – without insider info or other illegal tricks – is a game of pure chance. It’s been convincingly shown that a trained monkey has a 50% chance of beating a well-educated stock broker. Why? Because it’s all chance.

In other words this test is rubbish, but the low-fat brother wins.

More interesting and relevant is that the low-carb brother complains of feeling “thick-headed”. I’m sure he’s honest. Going on an extreme low-carb diet – without even vegetables – can absolutely result in problems concentrating etc. for a week or even more, before the body and brain adapts to burning fat and ketones.

This problem can often be partially avoided by increasing the intake of fluid and salt. And after a week or two it’s normally gone.

Exercise

For testing their exercise capacity the brothers do “long sessions of uphill cycling”. The low-carb brother predictably loses badly.

Why? Two things: the body needs weeks or sometimes even months to adapt to high-intensity exercise, using mostly fat and ketones. And even then you might need a little bit of carbs for explosive and anaerobic sports like this.

I’ve interviewed Dr Peter Attia who successfully races his bicycle for hours on a very low-carb diet. Even he uses a little bit of slow-release starch for maximum performance on his long training sessions:

YouTube: Very Low Carb Performance

Diabetes

Finally the icing on the (diabetes) cake. The doctor claims that the low-carb brother has become “almost” pre-diabetic by eating low-carb! The word “almost” should actually be interpreted as “not”. I wonder if the doctor knows the first thing about low-carb and diabetes. In fact I wonder how much he knows about diabetes at all.

The low-carb brother has a fasting glucose of 5,1 before the diet (normal) and a fasting glucose of 5,9 after the diet (normal). Did you catch the word “normal” twice? Yes, thats right, a fasting glucose of up to 6,0 mmol/L is considered normal, at least in Sweden. It also varies significantly from day to day. If we tested the doctors’s own fasting blood glucose it might be 5,9 today and 5,1 tomorrow.

The result could be due to chance but sometimes the fasting glucose level actually gets slightly higher on an LCHF diet, while the glucose levels during the day (after meals) is way lower. This is probably because the body is adapted to burning fat and so the need for burning glucose when fasting is lower. Thus you don’t get the same fasting “dip” in sugar levels.

They also did glucose tolerance tests – a much more relevant test. But the result of the low-carb brother is never mentioned. I guess it was normal.

The fact that diabetes is effectively treated with a low-carb diet should tell us everything we need to know. You don’t get type 2 diabetes by eating a diet that can cure diabetes. And you certainly don’t get type 2 diabetes (strongly correlated to obesity) by losing 4 kilos of excess weight in a month.

Summary

The documentary concludes that it’s not about fat or sugar, it’s about avoiding processed food with both fat and sugar in it. I’m sure that strategy would work fine for these two fairly fit brothers. It’s an excellent start. But it’s not enough for everybody.

In people with obesity and diabetes studies convincingly show that low-carb diets are more effective.

Finally, while a super-strict low-carb diet is not necessary for everyone and has possible side-effects (especially during the first week or two) it certainly do not result in diabetes. That’s just ignorant.

[leemack]

Watched this last night, and along with all the other issues noted, I was rather concerned to see the supposed high sugar brother's dinner at one point which looked like (you only saw it for a second or two) a piece of fish and small amount of rice and veg - low fat maybe but high sugar no way.

The title of the show is very misleading and should be low fat versus high fat - I would very much like to see how much sugar the low fat brother's diet actually contained, especially in comparison to his normal intake.

[dan_rose]

Their results were that the high fat diet caused insulin resistance and muscle wastage.

Must say, I got a bit worried by these results. Don't care much about the low fat diet and comparison to it, but these results were contrary to what I would have predicted. I'm open minded, can we be sure that there isn't a minimum level of carbs that we require to keep muscle and the insulin system ticking over?

Other notes:
1) First time I've heard mention of low-carb affecting memory.
2) The tests may have been done early on before either had adapted.
3) Out of a poor choice, I would have gone for the donut with cream and dusted off the flour. My favourite donut is the 'dough ball' that we have in the UK with sugar crystals on the outside and cream and red jam on the inside.
4) Don't glazed donuts have sugar on as well?

[leemack]

Must say, I got a bit worried by these results. Don't care much about the low fat diet and comparison to it, but these results were contrary to what I would have predicted. I'm open minded, can we be sure that there isn't a minimum level of carbs that we require to keep muscle and the insulin system ticking over?

Other notes:
1) First time I've heard mention of low-carb affecting memory.
2) The tests may have been done early on before either had adapted.
3) Out of a poor choice, I would have gone for the donut with cream and dusted off the flour. My favourite donut is the 'dough ball' that we have in the UK with sugar crystals on the outside and cream and red jam on the inside.
4) Don't glazed donuts have sugar on as well?

As has been pointed out, the 'bod pod' used to measure fat loss does NOT measure muscle loss, but only fat loss and non fat loss, so in saying the rest of weight lost was muscle was idiotic, it was in all probability water loss, but without measuring muscle loss specifically there is no way of knowing if there was any muscle loss.

A deliberate lie!

[ojoj]

Must say, I got a bit worried by these results. Don't care much about the low fat diet and comparison to it, but these results were contrary to what I would have predicted. I'm open minded, can we be sure that there isn't a minimum level of carbs that we require to keep muscle and the insulin system ticking over?

Other notes:
1) First time I've heard mention of low-carb affecting memory.
2) The tests may have been done early on before either had adapted.
3) Out of a poor choice, I would have gone for the donut with cream and dusted off the flour. My favourite donut is the 'dough ball' that we have in the UK with sugar crystals on the outside and cream and red jam on the inside.
4) Don't glazed donuts have sugar on as well?

I'd have gone for the donut covered in thick icing AND cream inside lol!!!

Those other things, the memory and muscle thing - well, without doubt neither of these things are something I've experienced in 11 years of low carbing - and I do very little exercise. I'm always amazed that when I need to, I have copious amounts of energy. I can beat my colleagues up the steps at work and I can certainly out-dance my teenage daughter. As for my memory?? Well its no worse than it ever was!? But of course, this is just anecdotal, as was that twins experiment!


Jo xxx

[dan_rose]

As has been pointed out, the 'bod pod' used to measure fat loss does NOT measure muscle loss, but only fat loss and non fat loss, so in saying the rest of weight lost was muscle was idiotic, it was in all probability water loss, but without measuring muscle loss specifically there is no way of knowing if there was any muscle loss.

A deliberate lie!

Thanks for this, I checked it out and you're spot on - I've sent a complaint to the BBC.

I was wondering how they get the percent fat from a single density number and came across these (bodyologypps.com.au/pdf/bod/BOD%20POD%20Density%20Equations.pdf) equations that they use based on cadaver research and they don't take account of water mass. For instance, assuming everything else is constant, the results will be different if you're carry 1kg (2.2lb) of water one day and not the next.

[teaser]

Must say, I got a bit worried by these results. Don't care much about the low fat diet and comparison to it, but these results were contrary to what I would have predicted. I'm open minded, can we be sure that there isn't a minimum level of carbs that we require to keep muscle and the insulin system ticking over?

Two twins, both running their brains on mostly glucose, go on diets. One switches to ketones, and needs to adapt, one sticks to glucose, and doesn't. So he performs better on physical/mental exercises. And you can't separate the two, the brain needs to coordinate the muscles, attention needs to be focused during a race, etc.

One thing that needs to be pointed out--the low carb twin is the one who describes himself as having gotten quite fat--much fatter than at the beginning of this "experiment" (it wasn't that, I'm quite certain they knew, or at least very strongly expected the results they got. If they didn't, they didn't do their homework. This was a demonstration, not an experiment.)

There's no mention of the other twin ever having been obese. So going in, even if the brothers started around the same body composition, one of them got there by never having been obese in the first place, and the other one was dieted down. We can't know for sure that the dieted-down brother would have done as well on the high-carb diet as the never-obese brother did.

[QUOTE]I'm open minded, can we be sure that there isn't a minimum level of carbs that we require to keep muscle and the insulin system ticking over?


No, we can't. Do I think we have any reason to think that this is true? No.

In the sixties, they did a number of experiments with obese subjects where they fed them nothing, sometimes over a year. These patients, after losing most of their excess weight, were entirely capable of getting fat again when they went back to eating. Their bodies did not forget how to make insulin. The Inuit ate very few carbs for many generations--the insulin system kept ticking. Recovering anorexics seem to be able to still do insulin.

Warning somebody on a low carb diet that their temporarily compromised glucose tolerance is an early harbinger of diabetes is a sign of gross incompetence. Glucose tolerance only matters if you actually eat the stuff.

[OregonRose]

Warning somebody on a low carb diet that their temporarily compromised glucose tolerance is an early harbinger of diabetes is a sign of gross incompetence. Glucose tolerance only matters if you actually eat the stuff.
Brilliant. I'm stealing that. :)

[dan_rose]

Glucose tolerance only matters if you actually eat the stuff.

Agreed, but for those of us that do occasionally have carbs e.g. at parties etc. then it could be more detrimental than if we were eating a background level of carbs all the time. I've heard similar said about drinking alcohol. They mentioned in the program the body up-regulates when faced with a continuous stimulus.

[jmh]

Agreed, but for those of us that do occasionally have carbs e.g. at parties etc. then it could be more detrimental than if we were eating a background level of carbs all the time. I've heard similar said about drinking alcohol. They mentioned in the program the body up-regulates when faced with a continuous stimulus.

Good point.
When I think about it, the body adapts to alcohol consumption. A regular drinker can finish half a bottle or more of wine without it having much affect. A non-drinker feels drunk after half a glass. And if you body gets used to constant alcohol consumption you can get withdrawal symptoms when you stop. That doesn't mean that you should keep on drinking to excess though!

[teaser]

Agreed, but for those of us that do occasionally have carbs e.g. at parties etc. then it could be more detrimental than if we were eating a background level of carbs all the time. I've heard similar said about drinking alcohol. They mentioned in the program the body up-regulates when faced with a continuous stimulus..

If it really is occasional, then no, it doesn't matter. You don't develop complications of elevated blood glucose from occasional indulgences. It's the day in, day out elevation of blood glucose and insulin that does the damage.

[M Levac]

Good point.
When I think about it, the body adapts to alcohol consumption. A regular drinker can finish half a bottle or more of wine without it having much affect. A non-drinker feels drunk after half a glass. And if you body gets used to constant alcohol consumption you can get withdrawal symptoms when you stop. That doesn't mean that you should keep on drinking to excess though!
The same analogy with tobacco. The smoker will tolerate smoking because he's used to the effects. A non-smoker that tries for the first time will find himself coughing and sputtering and puking. Once he's used to the effects (which means once he's smoked enough to get used to the effects), he'll tolerate them just as easily as the smoker, because, well, he'd have become a smoker himself.

You have to smoke regularly. Otherwise you'll fail the OSTT, or Oral Smoking Tolerance Test.

[tomsey]

Two doctors, identical twins, decide to test 2 diets, for one month.

One ate a high fat/meat diet with no sugar or starch or anything but high fat/meat while the other at a very, very low fat diet and could eat anything else.

The result is the low fat diet doctor lost 2 pounds. The high fat meat diet doctor lost 8 pounds, and became pre-diabetic. In one month.

http://www.cnn.com/video/data/2.0/video/bestoftv/2014/02/04/newday-van-tulleken-twins-diet-experiment.cnn.html

[Demi]

http://forum.lowcarber.org/showthread.php?t=457872 ;)

[tomsey]

http://www.sciencedaily.com/releases/2011/04/110411121539.htm

[tomsey]

The same analogy with tobacco. The smoker will tolerate smoking because he's used to the effects. A non-smoker that tries for the first time will find himself coughing and sputtering and puking. Once he's used to the effects (which means once he's smoked enough to get used to the effects), he'll tolerate them just as easily as the smoker, because, well, he'd have become a smoker himself.

You have to smoke regularly. Otherwise you'll fail the OSTT, or Oral Smoking Tolerance Test.

That's a poor analogy. Smoking is extremely addictive and part of that response has to do with the body dealing with a very addictive toxin, nicotine. Also, the body adapts within a few days and is then addicted, showing little to no ill effect from that point on (for a while) and then you smoke regularly. You are still getting hurt from smoking, though the body has found a way to temporarily cope better.

The body does something similar with alcohol, a super-toxin/carcinogen and top killer of a very large age group through drunk driving incidents and other health effects. Generally, a light weight remains a relatively light weight and the heavy drinker usually always has had a high tolerance and starts heavy/ier. But like with cigarettes, that doesn't mean the body is not being harmed because the person has stabilized with its effects and adapted (some might say have become addicted in some measure). With heavier regular (alcoholic) drinking, some adaptation does take place which has the effect of protecting the brain. This is why binge drinkers (5-8 beers or more in one sitting - just once a week or once a month), damage their brains much quicker than the all day binging alcoholic. Due to glutamate storms. Both are unhealthy though. Drinking a half bottle or full bottle of wine regularly is destroying the body, setting it up for cancer and a host of ills.

Regarding carbs, the longest lived people in the world traditionally have had relatively high carb diets and consume sugar to some extent. They were not eating meat and broccoli. The biggest low carb proponent was Atkins, and he did not appear based on available info to be particularly healthy, his tragic slip and death and lack of longevity aside. Perhaps what some would argue as only initial bad effects of low carb diets (poor endurance, poor memory and cognitive function, poor blood sugar control with normal human omnivirous diet challenge, stalled weight loss, poor metabolism, constipation etc) that lasts for say for a month or 2 months or whatever works for your argument against any timed trial that shows it, until you "adapt", is a warning that behind the scenes bad things are happening after adaptation. Are there any known long lived low carbers? Any non-starch eating peoples known for longevity and health? Or known at all? If it was so healthy, with the added benefit of believing in it so strongly to the point that a diet became identified with them, then why did the bear and others have their very serious health issues?

[*Caz*]

Regarding carbs, the longest lived people in the world traditionally have had relatively high carb diets and consume sugar to some extent. They were not eating meat and broccoli. ……...Are there any known long lived low carbers? Any non-starch eating peoples known for longevity and health? Or known at all? If it was so healthy, with the added benefit of believing in it so strongly to the point that a diet became identified with them, then why did the bear and others have their very serious health issues?

I'd be really interested to hear more about this, and what others responses are.

[RawNut]

I'd be really interested to hear more about this, and what others responses are.

Of the long-lived societies, the only one to have their diets examined individually rather than a whole has been the Seventh Day Adventists. Of those, the fish-eaters lived longer than the vegans and other vegetarians.
http://www.huffingtonpost.com/2013/06/04/vegetarians-death-premature-longevity-live-longer_n_3380781.html


The nut eaters lived the longest of all, vegetarian or not:

http://img706.imageshack.us/img706/3161/n4bf.png

http://archinte.jamanetwork.com/data/Journals/INTEMED/11988/ioi00635.pdf


They don't give us macronutrient breakdowns but is nut consumption a proxy for total fat consumption? People who eat nuts shouldn't be afraid to eat other sources of fat. It may not be an argument for low carb but it certainly isn't an argument for low fat, vegan either.

[Demi]

How the TV bout Sugar vs. Fat was rigged

Just how accurate and informative was BBC2’s Horizon program on Wednesday that aimed at scientifically answering the question: which is more deadly: Eating lots of sugar or lots of fat? The format was to feed two doctors who were also identical twins – Alex and Chris – unlimited amounts of one or the other. Alex got a low carb/high fat diet while Chris followed the traditional low fat/high carb diet with added the sugar.

Officially the result was an undramatic draw. Neither is to blame for making us sick and overweight individually. It’s only when they join forces do the twins become evil – think ice cream or glazed donuts. In fact the program’s headline message was the familiar, but still welcome, advice to avoid most processed food.

Dieticians don’t understand the diet

But few viewers will have been left in any doubt that as a lifestyle choice the low carbohydrate diet is a bad thing. This is a highly misleading conclusion for reasons that will become clear. A charitable explanation would be that those setting up the experiment didn’t understand how this diet actually works or how the body responds to it.

Less charitably it might be that the 40-year-old low fat diet lobby is very influential and has been under considerable attack recently from those who point out that demonising fat isn’t supported by good evidence and that there are good reasons why feeding people a heavy diet of carbohydrates can lead to metabolic problems.

So HealthInsightUK asked some of our expert contacts and contributors to give us their response to the program. Read the full article here: http://healthinsightuk.org/2014/01/30/how-the-tv-bout-sugar-vs-fat-was-rigged/

[WereBear]

The biggest low carb proponent was Atkins, and he did not appear based on available info to be particularly healthy, his tragic slip and death and lack of longevity aside.

Dr. Atkins was still playing tennis in his seventies, when he slipped on the ice because he was still walking to work at that age. As someone with a self-confessed weight problem, he adhered to his own program, staying at a normal weight for decades and being quite active. I guess you hang around with 72 year old ultra-marathoners or something.

Regarding carbs, the longest lived people in the world traditionally have had relatively high carb diets and consume sugar to some extent. They were not eating meat and broccoli.

In Good Calories, Bad Calories, Gary Taubes demonstrated quite clearly, and over and over, that concentrated sugar is what flipped traditional diets from healthy to deadly. As soon as the indigenous peoples started eating any industrialized foods, they developed the chronic metabolic illnesses of cardiovascular disease, diabetes, and cancer. Some traditional diets contain carb sources... some do not. None of them were "high" in anything close to the proportions in the standard industrialized diets of the US and British Isles.

In fact, in the recent book Death by Food Pyramid, Denise Minger describes many of these traditional diets in ways which utterly refute your argument. There is no sugar in them whatsoever. The mountain Swiss ate rye bread... which was covered with an even larger slab of full fat cheese. The Celtic islanders ate oats... in porridges which were greatly supplemented with oily Northern fishes.

In fact, Minger added up the health consensus on these not-nearly-Paleo societies, and found the best health markers came from abundant marine input, and all were characterized by lots of "nose to tail" animal eating. Neither of those sources contain much carbohydrate, at all.

I'm not getting any sense from your arguments.

[teaser]

Originally posted by tomsey; Regarding carbs, the longest lived people in the world traditionally have had relatively high carb diets and consume sugar to some extent.


As a Canadian, I know that being an American increases your chances of going home from the Olympics with a gold metal. Strike that--make that, being on the American Olympic team vs the Canadian Olympic team increases your chances of going home with a medal. This isn't to say that the average American is more athletic than the average Canadian. They have a larger pool of citizens from which to choose 1-in-a-million athletes from.

http://www.medalspercapita.com/

Small countries don't stand a chance.

In a world where most people traditionally have had relatively high carb diets and consume sugar to some extent individuals and small populations with exceptional lifespans are mostly likely to be in the category you outlined in that quote. John McDougall makes similar claims that successful populations must eat carbs. No. But you do need carbs to take over the world--it's just the easiest way to sustain a very large population. Ten health-compromised farmers can kick the butt of one hunter gatherer in perfect health. I'm not saying all farmers were unhealthy, and all hunter gatherers healthy, just that this is a game of numbers.

We're asking a lot if we hope for the longest-lived people in the world to be found among current groups eating Inuit-like diets. Before Europeans got here, their population is estimated to have been around sixty thousand.

[Demi]

Another good blog article on the programme:

My take on the BBC’s ‘Horizon – Sugar v Fat’

http://www.liveasimplelife.co.uk/eatwell/take-bbc-s-horizon-sugar-v-fat/

[dan_rose]

Apologies for the bump, I've just come across this (http://healthinsightuk.org/2014/01/30/how-the-tv-bout-sugar-vs-fat-was-rigged/) criticism by Hannah Sutter: "How the TV bout Sugar vs. Fat was rigged"

[M Levac]

Regarding carbs, the longest lived people in the world traditionally have had relatively high carb diets and consume sugar to some extent. They were not eating meat and broccoli. The biggest low carb proponent was Atkins, and he did not appear based on available info to be particularly healthy, his tragic slip and death and lack of longevity aside. Perhaps what some would argue as only initial bad effects of low carb diets (poor endurance, poor memory and cognitive function, poor blood sugar control with normal human omnivirous diet challenge, stalled weight loss, poor metabolism, constipation etc) that lasts for say for a month or 2 months or whatever works for your argument against any timed trial that shows it, until you "adapt", is a warning that behind the scenes bad things are happening after adaptation. Are there any known long lived low carbers? Any non-starch eating peoples known for longevity and health? Or known at all? If it was so healthy, with the added benefit of believing in it so strongly to the point that a diet became identified with them, then why did the bear and others have their very serious health issues?
As far as I'm aware, there's no evidence for the high-carb diet itself. Rather, the only evidence is a food questionnaire and observation of the association between this food questionnaire and the apparent health of the population. There's no experiment to demonstrate either way. However, let's take equal evidence and compare: Weston Price's observation of traditional populations and their diets. With this particular evidence, we see that few, if any, of those populations ate any significant amount of refined carbs, if at all.

We could use two logical extrapolations. First, those HC long-lived populations are the norm, and Price's observation is the exception. Second, Price's observation is the norm, and those HC long-lived populations are the exception. Again as far as I'm aware, there's far more traditional populations like Price observed than there are who ate a HC diet, so I'm going to go with the latter extrapolation.

Finally, we have ample experimental data to support this latter extrapolation by way of those LC experiments like the A-TO-Z study for example, which shows that LC (Atkins in this case) is best for all things measured. In terms of likelihood, it's much more likely that whatever diet does best in all things measured also does best in longevity. The alternative is that somehow the worst (or a mediocre) diet tested in such experiments manages to allow us to live the longest - an apparent paradox.

We could also use a third logical extrapolation - that humans are fully adapted to either LC and HC diets, and this is why we find both LC and HC populations that are in equal health, and most likely live equally long. However, if that was true, then experiments like the A-TO-Z study would show different results.

[Demi]

Apologies for the bump, I've just come across this (http://healthinsightuk.org/2014/01/30/how-the-tv-bout-sugar-vs-fat-was-rigged/) criticism by Hannah Sutter: "How the TV bout Sugar vs. Fat was rigged"See post #36 above ;)