A Roadmap to Obesity

In this post, I'll explain my current understanding of the factors that promote obesity in humans.  

Heritability

To a large degree, obesity is a heritable condition.  Various studies indicate that roughly two-thirds of the differences in body fatness between individuals is explained by heredity*, although estimates vary greatly (1).  However, we also know that obesity is not genetically determined, because in the US, the obesity rate has more than doubled in the last 30 years, consistent with what has happened to many other cultures (2).  How do we reconcile these two facts?  By understanding that genetic variability determines the degree of susceptibility to obesity-promoting factors.  In other words, in a natural environment with a natural diet, nearly everyone would be relatively lean, but when obesity-promoting factors are introduced, genetic makeup determines how resistant each person will be to fat gain.  As with the diseases of civilization, obesity is caused by a mismatch between our genetic heritage and our current environment.  This idea received experimental support from an interesting recent study (3).

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Seed Oils and Body Fatness-- A Problematic Revisit

Anthony Colpo recently posted a discussion of one of my older posts on seed oils and body fat gain (1), which reminded me that I need to revisit the idea.  As my knowledge of obesity and metabolism has expanded, I feel the evidence behind the hypothesis that seed oils (corn, soybean, etc.) promote obesity due to their linoleic acid (omega-6 fat) content has largely collapsed.

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Food Palatability and Body Fatness: Clues from Alliesthesia

Part I: Is there a Ponderostat?

Some of the most important experiments for understanding the role of food palatability/reward in body fatness were performed by Dr. Michel Cabanac and collaborators in the 1970s (hat tip to Dr. Seth Roberts for the references).  In my recent food reward series (1), I referenced but did not discuss Dr. Cabanac's work because I felt it would have taken too long to describe.  However, I included two of his studies in my Ancestral Health Symposium talk, and I think they're worth discussing in more detail here.

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I Made Bread! It Was Easy. You Can Too.

You know when it's August, but your iPod thinks it's December, and it plays "Do They Know it's Christmas," and you find yourself silently mouthing "Tonight thank god it's them, instead of YOUUUUUUUUUUUUUU" at a nice Asian man who clearly thinks you're about to steal his bag of lychees?

I love that.

I also love bread, but have never in my whole puff attempted to make it until this summer, assuming it was roughly as complicated as re-wiring the Hadron Collider. Then, it dawned on me that, a few years ago, Mark Bittman  published a recipe for five-minute, idiot-proof, no-knead artisan bread. It's since been updated and refined by half the population of Guam, but the essentials are there: four ingredients, a bowl, a pot, and time. So I tried it myself, and whaddayaknow? It's the best. Seriously. In all seriousness. Squared. I will eat this and nothing else until I die, presumably, of choking on bread.

Here's how you make it. (Do it! We'll have a bread party.)

First, gather your ingredients. They are:
  • 3 cups of bread flour

  • 1 little packet of active dry yeast

  • 1 1/2 teaspoons salt

  • 1 1/2 cups lukewarm water

If you plan on making this baby a lot in the future, bite the $4 bullet and purchase a package of yeast from CostCo or something. It is approximately four billion times cheaper than buying it envelope by envelope, a.k.a What I'm Currently Doing.


Second, you get a large, non-reactive mixing bowl and combine your dry ingredients, a.k.a. The Ingredients You Didn't Get From the Tap.


Third, add water and stir until it becomes a spongy, dough-like mass, a.k.a. Mr. Squishy. Don't overstir, or something bad will happen. I'm not exactly sure what, but aren't you scared now?


Fourth, cover that baby. With plastic and rubber bands. Then, leave it out for at least four hours, but for as long as several days, refrigerating after those first 240 minutes. (Note: The longer it sits, the better it will taste. I've gone up to three days.) If you have a cat that's prone to eating dough (er, not that I know any cat like that) ...


... hide it somewhere, like the Cave of Caerbannog, where it will be guarded by a rabbit so foul, so cruel, that no man (or cat) has yet fought with it and lived.


A cabinet will also be sufficient.

Eventually, your dough will expand like crazy, to about three times its former size. It will also appear softer and slightly wetter. (Note cat in lower part of photo, stalking wet dough for potential lunching. His lobotomy is scheduled for tomorrow.)


Fifth, cover a clean cooking surface (a counter, mayhaps) with a thin sheen of olive oil. Turn the dough out on to the surface, and fold it over two or three times. Cover everything with plastic wrap, and let it sit at least 30 minutes, but for up to 2 hours. If it's been refrigerated, it must be given enough time to come to room temperature. It must!


Sixth, while the dough lounges around, move your oven rack to the lower third of your oven. Then, preheat that sucker to 450 degrees F. Grab a pot or Dutch oven, cover it, and stick it in there, to warm along with the oven.

This is mine. It's a 3-quart hard anodized piece of Calphalon, but I'm fairly sure any sizable, oven-safe covered pot will do. (Have doubts about yours? Look it up on the interwebs.)


Seventh, once everything is good to go, CAREFULLY remove the hot pot from the oven and VERY CAREFULLY place the dough into it. SUPER CAREFULLY cover it, and COLOSSALLY CAREFULLY place it back into your oven. Bake for 30 minutes. I CAN'T EVEN EXPRESS HOW CAREFULLY YOU SHOULD remove the cover. Bake an additional 15 minutes, or until the top of your bread is nicely browned. If you see it starting to burn, get it out of there.

Eighth, flip the bread out on to a wire cooling rack. It should look something like this:


And one more time, in black and white, for posterity:


Ninth, once it's cool enough to handle, eat that bread. It may seem like a big loaf at first, but I promise on all that is good and pure, none of it will go to waste. Here's the above loaf, 30 seconds later:


And finally:


Happy baking!

I Got Boinged, and Other News

The reaction to my post "The Carbohydrate Hypothesis of Obesity: a Critical Examination" has been overwhelmingly positive, particularly among the scientists I've heard from. 

On Saturday, the inimitable maker and writer Mark Frauenfelder posted a link to my post on the variety blog BoingBoing.  BoingBoing has been on my sidebar for three years, and it's the place I go when I need a break.  It's a fun assortment of science, news, technology and entertainment.  BoingBoing was originally a zine started by Frauenfelder and his wife in 1988, and it has been on the web since 1995.  Today, it has multiple contributing authors and it draws several hundred thousand hits per day.  I'm thrilled that Frauenfelder posted my article there.  Apparently he likes my blog.  Thanks!

I added a new section (IIB) to my original post.  It discusses what human genetics can teach us about the mechanisms of common obesity.  It is consistent with the rest of the evidence suggesting that body fatness is primarily regulated by the brain, not by fat tissue, and that leptin signaling plays a dominant role in this process. 

The Carbohydrate Hypothesis of Obesity: a Critical Examination

Introduction

I'd like to begin by emphasizing that carbohydrate restriction has helped many people lose body fat and improve their metabolic health.  Although it doesn't work for everyone, there is no doubt that carbohydrate restriction causes fat loss in many, perhaps even most obese people.  For a subset of people, the results can be very impressive.  I consider that to be a fact at this point, but that's not what I'll be discussing here. 

What I want to discuss is a hypothesis.  It's the idea, championed by Gary Taubes, that carbohydrate (particularly refined carbohydrate) causes obesity by elevating insulin, thereby causing increased fat storage in fat cells.  To demonstrate that I'm representing this hypothesis accurately, here is a quote from his book Good Calories, Bad Calories:

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Ancestral Health Symposium

Last weekend I attended the Ancestral Health Symposium at the University of California, Los Angeles, organized by Aaron Blaisdell, Brent Pottenger and Seth Roberts with help from many others.  It was a really great experience and I'm grateful to have been invited.  I was finally able to meet many of the people who I respect and admire, but knew only through the internet.  I'm not going to make a list because it would be too long, but if you take a look at the symposium schedule, I think you'll understand where I'm coming from.  I was also able to connect with a number of Whole Health Source readers, which was great.  I recognized some of them from the comments section.  Now I know it wasn't just my mom with 57 Google accounts.

The symposium was the first of its kind, and represented many facets of the ancestral health community, including "Paleolithic" diet and exercise patterns, low-carbohydrate diets, Weston Price-style diets, traditional health-nutrition researchers as well as other camps.  For the most part they coexisted peacefully and perhaps even learned a thing or two from one another. 

I was very impressed by the appearance of the attendees.  Young men and women were fit with glowing skin, and older attendees were energetic and aging gracefully.  It would be hard to come up with a better advertisement for ancestrally-oriented diets and lifestyles.  I saw a lot of people taking the stairs rather than the elevator.  I like to say I'll take the elevator/escalator when I'm dead.  I think integrating exercise into everyday life is healthy and efficient.  Escalators and elevators of course make sense for people with physical disabilities or heavy suitcases.

The first talk was by Dr. Boyd Eaton, considered by many to be the grandfather of the paleolithic diet concept.  I was very impressed by his composure, humility and compassionate attitude.  Half his talk was dedicated to environmental and social problems.  Dr. Staffan Lindeberg gave a talk titled "Food and Western Disease", which covered his paleolithic diet clinical trials as well as other evidence supporting ancestral diets.  I like Dr. Lindeberg's humble and skeptical style of reasoning.  I had the great pleasure of having dinner with Dr. Lindeberg and his wife, Dr. Eaton, Pedro Bastos, Dr. Lynda Frassetto, Dr. Guy-Andre Pelouze and his son Alexandre.  Pedro gave a very nice talk on the complexities of traditional and modern dairy.  The following night, I was able to connect with other writers I enjoy, including Chris Masterjohn, Melissa McEwen, John Durant, and Denise Minger

Dr. Pelouze is a french cardiovascular surgeon who strongly supports the food reward/palatability concept of obesity.  We had a conversation the evening before the conference, during which he basically made the same points I was going to make in my talk.  He is particularly familiar with the research of Dr. Michel Cabanac, who is central to the food reward idea.  He eats an interesting diet: mostly raw, omnivorous, and extremely simple.  If I understood correctly, he mostly eats raw meat, fish, fruit and vegetables with little or no preparation.  He sometimes cooks food if he wants to, but most of it is raw.  He believes simple, raw food allows the body's satiety systems to work more effectively.  He has been eating this way for more than twenty years, and his son was raised this way and is now about my age (if I recall correctly, Alexandre has a masters and is studying for an MD, and ultimately wants to become an MD/PhD).  Both of them look very good, are full of energy and have a remarkably positive mental state.  Alexandre told me that he never felt deprived growing up around other children who ate pastries, candy et cetera.  They woke up early and ran six miles before the conference began at 8 am. 

I gave my talk on Friday.  Giving a talk is not like writing a blog post-- it has to be much more cohesive and visually compelling.  I put a lot of work into it and it went really well.  Besides the heat I got from from Gary Taubes in the question and answer session, the response was very positive.  The talk, including the questions, will be freely available on the internet soon, as well as other talks from the symposium.  Some of it will be familiar to people who have read my body fat setpoint and food reward series, but it's a concise summary of the ideas and parts of it are new, so it will definitely be worthwhile to watch it.  

We have entered a new era of media communication.  Every time someone sneezed, it was live tweeted.  There are some good aspects to it-- it democratizes information by making it more accessible.  On the other hand, it's sometimes low quality information that contains inaccurate accounts and quotes that are subsequently recirculated. 

It was a great conference and I hope it was the first of many.