#1267 - Gary Taubes & Stephan Guyenet

Mar 19, 2019

Gary Taubes is a journalist, writer and low-carbohydrate diet advocate. Stephan Guyenet, PhD, is a neuroscientist and is also the founder and director of Red Pen Reviews.

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my guests today I have two guests and they are in a heated debate over what causes obesity and it is a very complicated debate that think we got closer to understanding but man did we get in the weeds we got in the scientific weeds for if you're a dork if you're one of them low carb dorks or a dietary interest dorks you're going to love this I am one of those people so I enjoyed it and is very heavy duty I appreciate the two of them so a big shout-out to Stephen DNA and Gary taubes Stephen wrote The Hungry mind that's what's called said the name is book please call the Hungry mind who favors a

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brain-based origin of obesity and Gary taubes wrote Good calories bad calories and the hungry brain the hungry brain and Jerry Tom's real good calories bad calories what was the other boat book that Gary rub on the podcast before and when Gary was on the podcast before that's when Stephen reached out and he had some dispute with some of Gary's findings case against sugar case cancer a lot of people read that book and a lot of people quoted extensively

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I'm going to be honest it's hard being stupid person like me it's hard to figure out who is right but I really enjoyed the conversation so please give it up for Stephen DNA and Gary tops The Joe Rogan Experience

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and we locked all right so to set this up when Gary was on last Gary Tom's step by step on how do I say your last name Stephen DNA like DNA but with a G Wright got it okay when you were on last Stephen had some opposition to some of the things you were saying we talked about getting him on and you on together we finally pulled it off there's a lot of back-and-forth and we're here give me your position on this is all for proposed listening this is all about obesity and the the mechanism for obesity is that fair to say the main points that we want to talk about today all right and what causes insulin resistance was just behind a lot of

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chronic diseases that are common in society please give us your background yeah so I have a BS in Biochemistry PhD in Neuroscience after getting my PhD in Neuroscience of went on to study the Neuroscience of obesity at the University of Washington and particularly the brain circuits that regulate body fatness hopefully we'll get a chance to talk about those today and then I went on to become a science consultant science communicator and write a book called The Hungry brain that is my time to explain for a non-specialist audience what what causes obesity and my background know what is your disagreement with Gary's position yes how about how about I just can I start by explaining what I believe cause obesity I'm going to be long-winded here is that okay

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all right wheel hours Okay cool so first a little bit of housekeeping I'm going to be citing a lot of evidence today and so I wanted to bring this up to her OK Google RV siding a lot of evidence today and I want people to be able to follow along at home and so I put many of the references that I'm going to be deciding on your face okay here we go all right I put a lot of the references that I'm going Tobe siding on my website Stephen dna.com or if you don't feel like spelling my name you can go to Whole Health Source. Org and I have a numbered list of topics dare

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and imma be calling out numbers just scroll down to the number that I referred to in the references are all their second thing I want to say that I'm going to be really clear about today is that I'm not here to be the anti low carb guy I think low-carb diets are valid tool for controlling body fatness and controlling blood sugar I'm not here to talk anybody out of being on a low-carb diet what I am here to try to talk people out of this some of the mythology that has accumulated around a low-carb diet okay so I want to get started with an analogy to help people understand

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why the brain is important in obesity so imagine you're an alien coming down from outer space and you want to understand what's going on on Earth and you notice it on the highway some cars are traveling faster than other some cars go faster some cars go slower and you want to figure out why and so you go and you start studying the tires of the cars because obviously the amount of force that is exerted by the tire onto the asphalt is the thing that determines the speed of the car we know this is just physics and so you study the tires and you study the tires and study them and you never figure out why some cars go faster than others now why is that the reason is that you're studying the wrong part of the system do you want to understand the why some cars go faster than others you have to understand the part of the system that regulates speed and that is the person behind the wheel

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and so in this analogy the tires are fat cells in the person behind the wheel is the brain there has been tons of research on fat cell biology on what factors put fat in fat cells what take it out then tons and tons of research on that instituted Lee obvious that we should be studying that to understand obesity right but in fact all of that research has yielded very little insight into why some people are fatter than others that's because it's the wrong part of the system study that cells do not regulate the size of fat cells any more than the tires on a car regulate the the speed of the car the thing that regulates the size of fat cells is the brain so let's talk about first I'll give you little framework for thinking about this the brain evolved over about six hundred million years to promote the survival and reproduction of our ancestors and over the course of that time we evolved all these different brain circuits that have specialized functions DeGeneres

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hunger and are cravings and our fullness feelings that generate are eating Behavior what and how much we eat and they actively regulate the amount of fat on our bodies and that's one of things I want to talk about in all these circuits involved and these are non-conscious by the way so you don't decide you want to be hungry you don't decide that you want to have a craving these are things that Bubble Up from non-conscious part of your brain that you don't control so these circuits are calibrated to an environment of our ancestors not the environment where we're living in right now so these circuits all evolved to function optimally in the environment of our ancestors for promote the survival and reproduction of our ancestors

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so what happens when you put these brain circuits in the modern environment where you have abundant calorie-dense tasty foods rich in carbohydrates and fat is the same brain circuits push us over consumed in a push our bodies to accumulate and hold onto fat and then what you see as a result is the three Hallmarks of obesity first of all the obvious you see elevated body fat Mass second of all you see elevated calorie intake people with obesity consume more calories than people who do not have obesity after correcting for height and sex and physical activity level and third you see that people with obesity defend their higher level of body fatness against changes and so there's actually a regulatory change that happens it's not conscious defense you know they're not trying to remain obese it's these body fat regulatory circus in this is where Gary gets it right is that

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people with obesity are not just lean people who eat more calories is actually a change in the regulatory activity that regulates body fat in the body and we can get back to how that happens but I'll just leave it there for now so up until this point I've basically just been telling a plausible story right I mean I haven't actually cited any evidence yet to support that my story is correct and so let's get into that let's talk about what some of the evidence is that supports this idea that I've just laid out so I want to start with the genetics of obesity Cantina restaurant II as long as it's a very British the question I don't quite understand what the motto is if you don't understand them all how about I lay out how about I finish laying it out and then you can ask a question because I may answer your question over the course of continuance so let me just finish Okay so

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now the genetics of obesity offers us a lot of insight into the biological mechanisms that drive differences and body fatness in the general population so you get these studies like that the most interesting studies are the genome-wide association studies they get hundreds of thousands of people together and they sequence are they they measure all these markers in their genomes and they figure out what parts of the Gino makes some people fatter than other so if you have version a in this particular location you end up a little fatter than if you have version B and when you look at all the places where this is happening you can see the jeans where it's happening in and that tells you if you look at what those jeans are doing that tells you what the mechanisms are that underlie everyday differences in body fatness in the general population and so too kind of warm ourselves up let's start by talking about height genes so height has a strong genetic component so just body fatness

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and researchers has figured out a lot of the genes that underlie differences in height between people and when you look at what those jeans do they tend to be involved in the growth and development of the skeleton and the connective tissue which is what you expect right cuz growth of the skeleton determines your height so genes that determine diabetes risk type 2 diabetes are all about insulin sensitivity all about insulin secretion and the function of the insulin-secreting pancreas which is what you expect because diabetes is a disease that is all about insulin so these studies are really good at getting at the underlying biological mechanisms that are driving these phenomena so what do these Studies have to say about obesity

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if Gary's model is correct we should see a bunch of jeans popping up related to fat cells and Insulin if my model is correct we should see a bunch of jeans popping up related to the brain and in fact that's exactly what we see the genetics of obesity are overwhelmingly related to differences in brain activity between individuals

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and okay so that's one piece of evidence another piece of evidence they're five FDA-approved weight-loss drugs for of those act in the brain one of them reduces dietary fat absorption in the digestive tract there no effective fat loss drugs and I'm aware of the target insulin fat cells

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third piece of evidence if you look at some people get really unlucky in life in the end up with these horrible genetic mutations that you know knock out some biological Pathways some of these people end up with extreme obesity people and also animal to see this in mice and rats just occasionally get unlucky and get really really fat and researchers have been cataloguing what are these mutations when we find people who are genetically really obese what are these mutations that are making them fat what is the biological mechanism it's getting screwed up that's making them fat and what they've found is that all of these mutations that they've identified to date a number of them are occurring in the left in signaling pathway and this is the left in

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is the primary fat regulating hormone in the body Gary avoids this never talks about this in his writing but left in is the primary fat regulating hormone in the body and these mutations either knockout left in The Knockout leptin receptors or they knock out the left and response pathway in the brain

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and so that's the third piece of evidence okay

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so now we haven't really gotten around to talking about what it is exactly about the bad interaction that happens between our ancient brains in the modern food environment that causes us to become fat we've established that the brain is Central to obesity but we haven't really established what it is exactly about the interaction why does our modern food why does our modern environment from obesity right so basically there are three different ways that I'm going to look at this from but first I want to say that the

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probably the best way to answer this question is to start with the question what is the most fattening diet in the world what is the diet that is more fattening than any other than the answer to that is its human junk food in a variety of non-human species and humans is human junk food that is more fattening than any others and I'm going to skip over some of the research here that demonstrates this by the way I haven't been calling out numbers here okay let me call out some numbers reference number two on my website is those genetic studies reference number one is the Obesity drugs reference number 6 is a spontaneously occurring genetic mutations and now I'm talking about reference number 52 so I'm going to gloss over some of the individual research cuz I'm being long-winded here but essentially what you find is that this stuff is really fattening and animals many different species

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is it super fattening humans calorie-dense it when you put create an environment with abundant easy calorie-dense tasty foods rich in carbs and fat you see this dramatic overconsumption and fat game across many species including humans and what you find in the research is that the sugar and the carbohydrate cannot explain that they're part of the effect yes to explain part of it but you cannot replicate that effect by only feeding sugar and carbohydrate you can't replicate it in animals you can't replicated in humans when you say you can't replicate that you mean you can't replicate obesity what do you mean yeah that's right you cannot you cannot cause the same degree of fat gain the same extent of fat gain the same extent of overconsumption using only sugar and carbohydrate that you can cause with a variety of calorie-dense palatable human foods you can

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can't fully replicate it with sugar and carbs you cannot fully replicate it with fat alone either if you put those we can get deeper in this if you want the diet that causes the most obesity is what we think right this sudden human junk food diet for an sugar simple carbs bullshit bullshit. What you're saying that you can't replicate that with just sugar cannot be replicated what I mean is that if you just feed if you just increase sugar intake run animals or humans you do get weight gain but it is modest compared to what you get when you put people around a variety of calorie-dense palatable foods rich in carbohydrates and fat and similarly if you would because I'm not sure exactly what you're saying you're saying you if you give people this

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calorie Rich sugar diet of junk food you will make them gain weight but not as much weight as what so what I'm saying is that if you if you give people or animals the the actual human junk food with all the carbs and fat and everything they gained a lot more weight and a lot faster than if you just give them a diet that's high in sugar and high in refined carbohydrate and what that shows is that the sugar in their fine carbohydrate cannot fully explain the fact can't fully explain why those who the fattening you're saying if you give people the diet of American junk food

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you you get not as much of an effect if you give them just the sugar in the carbohydrate right we're saying what are you giving them when you giving them the judge that died of junk food to give me an example in animals now it's different cuz if you think about human junk Foods generally those foods contain fat and carbohydrate and salt and all kinds of other things so it's more it's more than just looks a lot so tired right now so it's just more detail so you can do this you can add sugar just sugar table sugar to the feet of animals that's one way to do it or you can add it to their drinking water sometimes it's a little bit fattening sometimes it's not it's not that fattening animals and humans you can ask them to drink sugar-sweetened beverages that are just sugar and you can see what happens and people will gain weight or you can tell them to stop drinking sugar-sweetened Beverages and you could see what happens okay people will gain weight they will

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lose weight suggesting that it that is part of the explanation but it's a much smaller effect then you see with this full pallet of these foods that contain carbs and fat and all this other stuff design saying card will obviously has more calories right if there's carbs and fat and all these other than direct if you think that calories matter then we agree it matters doesn't think it matters matters will it be wrong way to think about it what do you disagree if anything with what he said so far so far what he said he hasn't been particularly revelatory

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I think we have to

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step back for second cuz you know what the low carb Community might have a better understanding of where we disagree I think the Greater Community might not so

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fundamentally with Stefan saying with the research Community saying in the conventional thinking in this field is that the brain and correct me any point I get this wrong with the brain regulates does the fundamental job of controlling how fat we are and the way it does it is by controlling or Miss controlling our intake and our expenditure and the difference ends up in fat tissue is that fair to say for the most primarily intake but yet we go outside and we walk down in Aventura Boulevard and we see someone who weighs 400 pounds

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they clearly taken in more calories and they should have over the course of their life and it's been stored in your fat tissue and Stefan says I think would say that the problem is in their brains ability to regulate intake to expenditure is that correct yeah okay

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and let me I have to fix my headphone so I hope we going to do this I'm getting feedback when I talk getting feedback it's just weird could be the whole.

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and for those who don't know I'm hearing impaired as they say kindly my kids would say death is supposed to get a little better okay so

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what I've been arguing so I come along my background I'm a journalist I'm an investigative journalist with a science background okay that's what I do and I'm curious and I've got a lot of you know when I get my first two books for studying with her pathological science it's about people got the wrong results and science cuz a lot of time scientists do so by a very sensitive to this and as I was doing the research for my first block Wichita 5 years what I noticed in when you take a historical perspective is that the research Community starting obesity was very focused on the brand assume that that people are gluttons and I'm going to use some socially unacceptable language cuz I'm part that's how they thought about obesity literature from the 40s and 50s it's shocking the way these people talked about people with obesity and assumption was that they're gluttons are there an erotic or they're anxious

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are there to skin on her brain Centric by psychologist and psychiatrist who are trying to get people with obesity to eat less and if my favorite example is one team that was trying to get they think got the wives to stop having sex with their husbands if they didn't lose weight every week and that would motivate them I think even you pointed out that sex is a great motivator in your book then tasty Foods has greater but I said it was far

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and I'm going to just read you

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I want me to that so there was this all the Obesity research committee is focusing on the brain

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there were people studying fat metabolism and endocrinology say study hormones and hormone related disorder saying that the old fat storage and fat mobilization the burning of the human body is

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controlled by this very diverse set of hormones and enzymes in the nervous system is involved in well and our body does a very careful job of the site of basically orchestrating how we use feels after we ate location was and I think Stefan kind of stepped into this with the very first thing you said Till The Assumption was obesity is it a sort of excess fat accumulation so today when you read the literature the articles of apis obesity is a sort of energy imbalance you take in more calories than they spend

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they were still the best scientist in the field the best physician scientist with a look at it as a sort of excess fat accumulation let's look at what regulates fat accumulation the human body some people are programmed or dysregulated to store more fat and if there's store more fat they're going to their behavior is going to respond to be hungry or that we eat more than we go out and saw this thing switching the causality instead of the brain determining energy balance and that determining fat accumulation

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the idea was the sort of let's see what regulates fat accumulation that's dysregulated if I have a if I give birth to a daughter who weighs 100 pounds at age 4 I'm not going to worry about how much you turn exercises I'm going to worry about

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what's going on with fat accumulation in this young girl that her body is just as if you give a you know if you have a a child whose six-foot-eight when he's 6 years old you're not going to worry about how much she eaten exercises are going to wear that he's over secreting growth hormone so the idea basically what I've done my role in this is to say look

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vitally important in the 1960s and 1970s when obesity researchers came to understand

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the Obesity people are convinced that the problems in the brain and those obesity people eventually grew into the world that Stefan got his PhD in this neurobiological world where you study what's happening in the brain and you ignore what's happening in the fat cells and fat mobilization and fatty acid oxidation and 10 store and when you look at that

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you find a whole world of places in which people can be predetermined going to be driven to be fat self example

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Robinson High School senior in high school I weight 195 lb and I played football and my brother two years older weight 195 lb senior year and play football my brother never got more than a hundred ninety-five pounds

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and I went up to 240 we both ate as much as humanly possible and it was you could imagine that's what high school athletes do my brother was always a lien I was always try my brother stayed later became an endurance athlete I became a football player and I lifted weights I put on muscle easily and I fatten easily he didn't

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the conventional wisdom would be the reason I went to 240 and he never got the 195 was that my brain was different than his

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my argument is our bodies were fundamentally different so if I see somebody walking down the street aways 300 pounds I don't worry about that don't think about what the problem is with her brain regulating intake and expenditure I think about what's why is her body driving her to be 300 pounds and is it is it the brain that can't do the job I was at the body that can't do the job of the brain is responding to what's happening in the body is this a reduction is perspective gives me a whole list of being holistic of the human body the idea that the brain is somehow another separate from the body is the brain driving what's happening in the body or is it responding to it and you know the brand of course does respond a lot to what's happening in the body and we can talk about that and how that works but you know I think it's

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we can tell stories but the things the thing that differentiates a story that's true from a story that is not true is evidence and so you know what you talk about the difference between your brother and you this is where that genetics evidence comes back in that I was talking about your brother and you only share half of your jeans we know that genetics has a strong impact on who has the greater susceptibility to body fatness and not then others and we also know what the gene to do that under light is different than not right now I'm in the middle of saying something those jeans are primarily related to differences in brain function that is what the genetics say and so that suggests that the reason why you had a greater propensity than your brother to become fat probably has to do with differences in genetics that relate to brain function that is what the research says

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a very difficult to 17 year olds that weigh exactly the same amount like how do we know how much they consumed in calories mean we don't have any studies when I passed that I hope we both take as much as humanly possible Nation my brother would never got over 195 and I apologize for bringing you up on the air I know you don't like that used to say that he never gets stuffed it just gets bored of eating after a couple of hours okay even though like maybe if you looked at it scientifically you ate more than him or maybe you ate more shop now I made her light more car so so that's a difference of the did those are the two hypotheses one of my offices is

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my body 10 this is what's the font of Cypress I want to just the thing I wanted to read how much I'll ask you the question how much of the variation in human obesity to those jeans explain so if you look at the genetics of what you find is that from twin studies and family studies that measure the overall contribution of genetics about 75% of the differences in body fatness between individuals is due to genetic differences between those individuals so you know 1995 America if you just take a cross-section of people and you measure how much is jeans how much is environment about 75% is genetic now we've only identified a small proportion of the specific genes that underlie the propensity to obesity and

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so if you look at the percentage that we have specifically identified it's a very small and that's what I refer to my book how much it's like right now I think it's up to about 10% it was 3% my nipple first time it has 7% absolutely yeah the latest the study is under reference number two so you can you can go check that out about 10% and Mucinex that he's advancing very quickly and that's why in the three years since I wrote that we have explained a lot more than we did at the time that I wrote that and so we have a portion of these genes identified and what we're seeing is that most of that portion that we have identified relate to brain activity and so that tells us that primarily the differences between individuals that determine differences in body fatness is about differences in brain activity no one should be shot

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about this the brain generates all of our eating Behavior it generates all of our physical activity behavior and it actually regulates body fatness no one should be surprised by this

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I am and I was in the how are you surprised us agree with let's begin with

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trackback now Dion

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okay so drugs that explain Abby's to 10% with the argument that I was making in the argument I continue to make imagine if it takes the Fonz car to see Stefan he says it's okay I'm not send it but I mean I got to use the car now legit for this to tell you that I don't think this is appropriate in the 1970s aliens didn't notice that there were humans driving the car

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so now they're trying to solve the problem without the humans involved why do some cars drive faster than others and they come up with all kinds of hypotheses and some of them can explain even when they interpret the hypotheses one of the common problems that science is called intellectual phaselock so what I've been arguing is in effect the Obesity research Community left out of its research 1960s era Endocrinology the hormonal metabolic regulation of fatty acid metabolism oxidation burning and it sucks when they did that pretty much everything I've done since has been interpreted incorrectly just like the aliens and leptin is a good example

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total attendance discovered in 1993 and left them is discovered obesity become sort of a legitimate field of science and tell them it's a bunch of actually mostly psychologist studying in an hour for comes a sub-discipline of molecular biology and all the molecular biologist jump into the field and they assume that would let them does this control the brain signals how much fat is available at some kind of satiety Orefield efficiency hormone and as such

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they study the brain and they started the action of leptin in the brain noun 2002 Jeff Friedman who gets credit for discovering up then perhaps incorrectly publish the paper in the journal science a thing perhaps as much as two-thirds or more of what left and does is done in the periphery in the body and was left in does it's a hormone that sort of it is secreted in response to how much fat you've accumulated

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and then does it stimulate the brain to tell you to eat more or less depending on how much fat or it also works in liver cells which were the cells that were studying in the assumption is probably doesn't all cells to tell your cells to burn fat so it makes perfect sense if there's fat available in the fat cells now you've got a signal telling sort of influencing the other cells of the body to burn fat so now you've got a hormone that could work in the periphery and the brook in their feet below the neck or it could work above the neck but you've got a community that's almost exclusively studying and they had they don't know their human drivers down here so that's what they do so even in this world I don't I think I know the genome paper on Stephan is

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probably reference. It's been a number of them but yeah I don't remember how often with Rudy libelous I have two papers one is genes associated with obesity and one is genes associated with body type so with body type they're all below the neck they're all you know fat metabolism basically and the must get them to Gene's aspects of your body that you would expect to be controlled like when you build up muscle and you have to take an excess energy to do it that makes you hungry I don't think your brain is regulating how much muscle your building other than your drive to go to the gym they took me your body is responding to the stress on them also all the things you do when the boys left think it's all below the neck so the argument he rose again simple

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when these people looked at body type it was insulin regulated jeans for the most part growth hormone all these things when they looked at excess body fat they decided they were in the head but the question is when they looked the program to think that excess body fat it's caused by overeating so they look in the brain did they do the same kind and I was going to call the researcher involved but never got around to doing it saying if body type body shape is determined by these genes that doesn't make sense set

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excess variations of body shaper going to be determined by the same genes and did you just do the same kind of searches I don't actually know how they determine where the genes work it's the same kind of searches they just came up with different sets of genes so they didn't start with any assumptions they were just finding out if I work in the hypothalamus seems to work and every time that I respond to that you say this in your body prepared to respond whenever you're done okay in your book you say that genes work for the body is very basically puts different mechanisms to work as many places they can endure these homeostatic feedback loops in a something happened to your whole body has to respond so a gene that might work primarily on one cell is scattered all over the body cuz every cell and it'll do different jobs on different selves but if you think that the problem

► 00:43:06

in the brain that's where you look so you get this kind of intellectual phaselock wear

► 00:43:14

that's what we do that's what we study in neurobiologist studies the brain Daniel Kahneman Stephen like suicide Daniel, this concept what you see is all he's a Nobel Laureate cognitive psychologist what you see is all there is okay and basically if you're studying the brain that's what you look at if you're studying the garden until we all get trapped into that on some extent and what I'm saying is even in these studies so Stefan and Stephen wrote a book about the hungry brain that is supposed to be about obesity but in fact you never mentioned anything about the metabolic regulation of fat accumulates just not there

► 00:43:59

and I would argue it has to be there even if it's wrong if it's not there the absence of it like you can't talk about leptin without talking about what it might be doing in the you can talk then I said there's a edits put me in a very awkward position so Stephen is kind of the defender of the Orthodox and I'm the one who comes along and says locked you guys just missed it you screwed up you had psychologist and psychiatrist running the field when the endocrinologist solved and then you discovered left and it became of molecular biology problem and you're now divorced from the simplest observations about obesity

► 00:44:39

you know so we can do huge genome-wide Association studies a sound remarkable but if I were to ask a simple question like why is it I get fat here yeah the love handle thing it's in the back with me I don't snot in the front but it's here and not here I don't see what the brain has to say about okay so as you mentioned there have been different genetic studies that have looked at body fat distribution vs. total body fatness so total body fat in this is what we're talking about when we're talking about obesity body fat distribution is what we're talking about when we're talking about the fat being on your hips vs. on your wrist now what we see is different sets of genes that come up so body fat distribution we actually see insulin related genes so people that have a central body fat distribution so body fat around their waist tend to have use insulin related

► 00:45:39

things that are driving that but when you look at total body fatness the thing that causes obesity what you see is that those jeans are dominated by the brain and it really cool thing about the 10% that it rains might be dominated by the unbiased that's the really cool thing about it is that they're just this is whatever jeans are popping up you said he's do not care about what you believe about what causes obesity this is just whatever genes are popping up so it's unbiased and that's what they're saying and I want to talk about you mentioned Gary that may be left in his having important actions not just in the brain but in the body first of all I'm glad I'm flattered that you read my book and I'm glad that you acknowledge the existence of left and now this is good but now you say that researchers

► 00:46:37

focus on left and actions in the brain because we're phase locked and we can't get out of our you know we're blinders of thinking about it in terms of the brain and that's why we focus on left in action in the brain the real reason we focus on left in action in the brain is because it has been demonstrated that its effect on body fatness Arvada the brain their actual experiments demonstrating this and I'll explain how these experiments work this is all in the scientific literature so if you knock out the leptin receptor only in the brain or only in the hypothalamus you get obesity so that is what tells us that actually the brain is the key side of action and particularly the charger and it tells you everything is Terry Crews let him talk

► 00:47:29

yeah and that's it so I mean you get the same obesity if you knock let them out of the brain and particularly out of hypothalamus that you get if you knock it out of the whole body so that shows that the brain is this site of action that is causing this to happen in this is no surprise we have these mechanisms worked out we know specific groups of neurons that are receiving a left in that are controlling our appetite that are controlling our metabolic rate we have many of these neural populations worked out in my sweet understand your system so well we can control specific popular tiny populations of neurons very precisely cause them to eat a ton to stop eating to gain fat to lose fat like the animals are marionettes I mean that's the level of understanding we have right now of how these systems were so I mean all of this evidence is converging on the same thing that the brain is Central and that fat cell metabolism I'm just not seeing the evidence for that mean

► 00:48:29

if you want to cite specific evidence demonstrating that that is an actual cause of differences in body fatness between individuals in the general population I'm awaiting that evidence and I'm happy to sit here and listen to you cite the evidence that demonstrates that in proportion to the size of fat tissue so the amount of body fat you have the more fat you have the more left and you have in the circulation and basically what this is It's what's called a negative feedback loop which is really simple engineering term that works like a thermostat so with your thermostat you if you set your thermostat to 70 if it starts getting a little bit hotter your AC turns on to bring it back down to starts getting lower AC comes on or the heat comes on to bring up that's called the negative feedback system that maintains the stability of

► 00:49:29

the temperature of your house we have many negative feedback loops in the human body to regulate body temperature to regulate blood pressure to regulate all sorts of things one of the negative feedback loops we have regulates body fatness and the hormone so your thermostat measures temperature by using a thermostat sorry a thermometer your brain measure body fatness using this hormone leptin that's in the circulation and then particularly when your body fat level drops your leptin levels drop and your brain hears that and it kicks in a starvation response basically this is the main reason why weight loss is so difficult because your brain is like no I don't want to be losing fat

► 00:50:13

and it makes you hungrier and increases your craving a certain level of body fat is a general like even if you have a large person that's overweight when you're losing body fat General your body is exacerbate your hunger and this is this is a thing that's really important to understand about obesity is that people with obesity have a higher set point so it's like turning your thermostat from 70 to 80 and then your thermostat regulating around 80 people with obesity they're not regulating around 170 anymore they're regulating around 2:50 and so when you cause a lean person to lose weight you see the same things when you cause a person with obesity to lose weight you see this reaction in their brain circuits that regulate body fatness that drives and increase their cravings and their hunger metabolic rate drops evolutionary mechanism to force you to seek food correct and not just the Four Season Seafood as the main thing but it also

► 00:51:13

close your metabolic rate does everything it can to get more energy in your body and have less leaving and it keeps doing that until the fat comes back high calorie diet you will produce more fat your body will get fatter write it depends on how many calories are you if you're overeating yet to meet a lot of sugar a lot of carbohydrates your body will get fatter your body will produce more leptin correct so it comes from the diet and directly responds to the size of the fat tub in response actor to glucose mediated up take into the fat cell which is mediating park by insulin so you come back to insulin even with the left and you raise blood sugar not stick carbs you eat the cards here it's fluttering you raise insulin you raise fat storage the glucose and then you get more left then again

► 00:52:11

one of the things you have to understand about this is everything that says has two interpretations depending on which Paradigm you're looking at and these are fundamentally different paradigms so in Stevens world and again correct me if I'm wrong and I was left in a signaling

► 00:52:28

Puyallup Valley ability in the fat cells the way I would think of it and in my very small world left in is responding to fuel availability in the rest of the cells so it's basically a molecule that can tell other cells that there's fat available and you could burn that fat for fuel and then you don't have to go eat or it can tell that there isn't fuel available and it's depending on how much left in there is two cells and then that will respond by a signal to eat or not to disinhibit eating behavior on everything were talking about Stefan and I first church fell out center 8 years ago ancestral Health Symposium when I

► 00:53:13

acted improperly inappropriately but one of the problems I to the way I think you should think about this you have a hypothesis and it's the fundamental thing is it obesity caused by overeating cuz we know if your getting fatter your story more calories than you expend that's just like a room is getting more crowded more people are entering them leave and that is the simplest but it doesn't tell you why the rooms getting crowded it doesn't tell you why you're getting fatter and again what I've been arguing is the why you're getting fatter part has been left out and people decided that overeating was somehow an explanation then they went to the brain to look at white people might overheat so what I wanted the questions I asked if I'm 8 years ago and it keeps coming up as if we're going to blame obesity on the modern food environment epidemics of obesity

► 00:54:07

you know simple question to ask is can we find epidemics Applebee's today without this modern food environment and that's the sort of science 101 right and it turns out that the world is falling the first one I found in the literature was in 1902 and population of the Pima Native American tribes p.m. on living in Arizona and observer saying these people are poor they're malnourished their suffering through famines they've been suffering through a famine for 40 years and famines it's hard to overheat during a famine and yet the women of the tribe do virtually all the work they were treated as pack animals in effect or obese

► 00:54:50

so now we can disassociate obesity from the modern food environment and we could disassociated from this ultra-processed Foods we didn't start to ask a question what is it about can we find what might have driven obesity in that population despite the existence of famine say this in human genome study say that

► 00:55:18

I actually really do that my books because you can find studies at will say anything and you'll see in the studies on people misinterpreting them what was the cause of the population of women to be obese what's the one thing that happened during the 1860s put on the reservoir reservation eyes whenever they perform with day and they began eating Western foods with sugar flour and lard for the most part and sugary beverages probably so that's a reasonable hypothesis

► 00:55:55

and you can find the same thing in the Sioux Native American Sioux population living on a reservation in 1928 where you had both obese men and women living with malnourished stunted children who clearly weren't getting enough dive there on a reservation they were getting Western Foods so ultimately

► 00:56:15

yeah the question you asked in science determined to answer your cat so the question I was asking is we have this observation that any population that transitions to Western diet or Western diet and lifestyle cats will be sad diabetic they Vape developers cut metabolic syndrome which is insulin resistance and all these issues and we know that's true all over the world from January to the South Pacific Islanders to the genetics aren't that important question is what's triggering it in the environment and against Stephen would say well there's too much food available and it's too palatable and we can't say no and I had a lot of problems with the we can say no part cuz if we're laying it means they can't say no and they being the people with obesity and I don't believe that's true and then

► 00:57:10

or is it some specific item or some suspected group in this these foods that travel with Western populations and so they exist the ability and today if you look up

► 00:57:25

do a burden of obesity in malnutrition I have a Dropbox folder I can share with you that's probably 50 studies all over the world you see the same observation incredibly poor populations malnourished children are stunted which means are protein deficient in their calorie deficient and often the mothers are the ants are obese obesity tends to run in the females would suggest it has a female sex hormone related fact that I don't believe works in the brain cuz we're dealing with populations that could not have overeaten

► 00:57:57

if they could have over a reason why are the kids starving that's sort of the question in the end this was the first thing that I think we fought about Batman and it's still if you can find populations with obesity epidemics but without the modern food system without snack Wells and without Lay's potato chips on

► 00:58:21

and if you know that they're going through a famine or you know that the kids at least aren't getting enough food how do you explain obesity in the mother's without assuming that the mothers are overheat Atlas pause right there is Stephen is there a population of people that are obese that are not eating a western diet or not eating sugary Foods

► 00:58:43

that are obese in that are not eating sugary Foods probably not because generally once you have an industrialized food system that's going to include sugar but there are populations that eat a lot of sugar and are not obese and we should talk about some of these actual Gary has told a story he told his version of the Pima story let me tell the story the version of the story that appears in the scientific literature now the Pima originally they were agriculturalists they were eating traditionally a very high carbohydrate diet based on unrefined carbohydrates originally it was corn beans and squash primarily they were hunter-gatherers they were pregnant scary okay they're primarily eating agricultural Foods they were also collecting some wild Foods that's correct they were fishing at

► 00:59:43

eating Mesquite pods primarily Agricultural and they are very clear on that Gary so yes they are about to happen cuz we're going to disagree mostly fish that's incorrect okay. To the data that's how I remember you saying something about it anyway come on let's go I'm going to move on here traditionally were agriculturalists and what happened basically if you had all these Farmers moving into their area Settlers of European descent and they diverted the water from their River The Gila or Gila River not feel it and so they were no longer able to grow their crops their agricultural crops that they were primarily dependent on and therefore the government started providing them with foods to eat and these were

► 01:00:43

calorie-dense refined Foods they were like Gary said flour lard and sugar and then they became very obese there was a population of Pima right across the border from them in Mexico also very similar culturally and all that to maintain their traditional high-carbohydrate lifestyle and agricultural lifestyle and there have been studies comparing those two populations and the ones across the border with their traditional lifestyle or a lot leaner and healthier not surprisingly than the ones eating large flour and sugar okay but Gary you seem to believe that people can gain weight you kept referring to the famines and things you seem to believe that people can gain weight even if they are eating very few calories and your preferred of this many times in your writing and you know these are very casual observations that you're making kind of these casual correlations and storytelling but if you

► 01:01:43

we look at the data on this what you see is that if you just measure calorie intake and people who have obesity it is 20 to 35% higher than people who are lean after correcting for height physical activity level and that I've got that reference is going to give you any reference number seven calls you guys are these people think they have essentially the same lineage one group lives in Mexico they dare not eating these sugary Foods in the western diet the ones that live in America are the ones that live in America are becoming obese the ones that live in Mexico or not is that correct correct yeah and so now if you have someone with obesity like I said that the most accurate measures that we have suggest that they habitually consume and expend more calories and now Gary's model says that that is Downstream

► 01:02:43

the fattening affect its not causing the fattening effect it is a result of the fattening effect where is my model says that that is actually required for the fattening effect to occur is Upstream so now what happened what happened to Gary what happens if you reduce their calorie intake by that same amount 20 to 35% doesn't matter if you do it by restricting carbs or fat these experiments have been done they lose weight when you restrict their calorie intake down to consuming low amount of calories but high amounts of sugar does it doesn't make sense you can get obese that way right now to support what I just said. It's what I'd the reason I was using to do a burden example is because we have to explain how those women reading all those calories usually women

► 01:03:43

it's just off and it was dropping these studies were done by diabetes researchers it was shutting diabetes in these populations in the men had high levels of diabetes in the women had tied up with him today to give you an example where that measurement was done in Trinidad in the 1960s this is the wrong I played as I asked the question can you find populations that don't have a lot of food okay you could say that the OB 6 spend a lot of energy into a lot of calories of questions can they get obese without a lot of food and so can be fined populations like you ask can you find a population that gets herpes without sugar who's exactly the question to ask so in Trinidad in the 1960s is amount nutrition crisis the US government sent a team of researchers down to study this and the researchers come back and say to Trish in their stunting is deficiency diseases in 2/3 of the out of women are obese

► 01:04:37

and this is a medical problem in the next year and a mighty nutritionist goes down to do exactly what Stephen S4 and to actually measure the diets in obese women and lean women and to study it and it's the population with its it sound like them this is very poor Trinidad in population and reports that they I think it was 1800 calories a day with the obese women reading was actually a little lesson with the lean people seem to be eating and that it was lower than what the food and agriculture organization considered for healthy diet so again what my role in this is to point out when you have populations like that I don't see how the overeating hypothesis tells me the brain is in control of how much they tells me anything about why the women World base especially when their kids are starving this is the Paradox of the stillborn an obese mother with a starving child if they're obese mother has to eat Superfluous calories to get fat

► 01:05:35

why isn't you giving those calories to our kids because she have made him she clearly doesn't and she's got fuel so what's going on there if you positive hypothesis as I did with says that the Obesity is triggered by the macronutrient content of the diet

► 01:05:51

then you can explain I mean are plenty of animal models Hood famous quote I use in my books from Sean my ear up like that same leading Harbor nutritionist who studied an OB strain of animals in the 50 Cent my animals will get fat even when half-starved they will make fat out of their food even when half-starved these are generally animals with mutations in the left in whatever Jane by the way whatever Janet is it time to the question is if I can make fat out of my food

► 01:06:23

at levels of chloride levels at Princeton to lean person can't then I'm going to get fat eating the same amount and that fat accumulation is going to be you no means I'm taking more calories than I expected but the point is I'm throw some metabolic hormone a reason I'm taking the pill I8 and turning it at the fat and storing in the fat tissue what is responses so my responses that if you want the best answers you have to use the best methods to answer to answer the questions okay you want a question answered properly you have to use accurate methods to answer that question now as you know Gary it's very difficult to measure food intake and Free Living individuals particularly you're traveling to a country you've never been to before it's very difficult to get accurate measures so just because some guy went to Trinidad and cleaning woman actually just because some woman went to Trinidad and claimed that people

► 01:07:23

for eating 1800 calories and becoming obese does not mean that that's what actually happened now I'm responding now we have studies where researchers used accurate measures to measure calorie intake in people who had obesity many of these people were saying we're only eating 1200 calories a day when they actually measure their calorie intake what they found was that they were consistently eating more calories than lean people so this this phenomenon that Gary describes is something that is only observed when inferior methods are used to measure calories burned at malnutrition obesity this isn't one observation it's not one nutritionist the existence of The Starving Children

► 01:08:21

strongly suggest that there's not a lot of food available and we have to explain obesity in the mall. You know I like you to respond to haven't looked at these studies in particular I brought them up eight years ago we got in a fight about it we want to look there many reasons why a child could be malnourished in and non-industrial situation in this is I do a lot of work related to this what you see and non-industrial situations you see a lot of infectious disease you see a lot of malnutrition so people not getting enough essential minerals and vitamins not getting enough protein and you see a lot of children who were just barely hanging on because of this collection of really bad stuff that's happening in their lives and so yeah yeah parasites or not but I mean

► 01:09:20

diarrhea pneumonia these are the things that we all had before we had modern medicine and great sanitation in a country like the United States 30% of kids didn't even make it past childhood and so there's a lot of things that could have caused that carry it's not necessarily because you know it's not necessarily the reason that you attribute it to now I'm not the tributing Adoration I'm just as well I don't have the explanation but I'm throwing out possibilities that are alternative to the one that you're implying quite possible okay so

► 01:09:58

all right so again when you use accurate measures of calorie intake you find that these people with magical metabolisms who have obesity and don't eat very much seem to not exist anymore and furthermore I want to I want to get this to another type of study that's really going to differentiate between this Metabolic Effect driven by insulin and the effect of calories so we have a lot of studies that compared diet sandwich calories were the same but carbohydrate and fat intake differed and the ones that I really want to focus on right now that I think are key here are the studies were they increase calorie intake so they fed people that they won study in particular and see I'm going to give you a number here

► 01:10:48

see if I can get you the number here sorry why you look at that on can we bring up another issue cuz we were talking about the ultimate Laz y people get fat okay I don't want to hear I'm in the middle of something so now if we want to understand why people get fat we can look at studies that overfed people on fat or carbohydrate exclusive with so this one study the first one that I want to talk about first they figured out people's Baseline calorie intake figure out what how many calories do you need to just to maintain and then they increased by 50% by exclusively giving them fat or exclusively giving them carbohydrates okay this is Horton okay give me a number 16 so

► 01:11:40

if Gary's hypothesis is correct these people should have gained body fat on the carbohydrate overfeeding but not the fat over feeding because that increases your insulin house use Vicks on your fat cells Etc okay now these were very rigorous studies I want to emphasize that correct yes they were they had a baseline they use prisoners in Vermont state prison that's incorrect different study Baseline and did they require them to maintain the same diet and then add additional found or additional carbohydrates yes with carbohydrate that was what study did you do that was not prisoners what was the hit end of a metabolic let me just finish describing the study of irrelevant detail okay

► 01:12:40

distance to imply that I don't know what I'm talking about aren't you know what I don't actually know maybe it was in prison or so thank you all right you're welcome

► 01:12:51

but it was not the Sims overfeeding study that was done in prisoners that's what I know okay okay yeah it's on my website you can go to my website Stephen dna.com and it's reference number 16 and they're both are okay so this was what's called a metabolic word study where these people are in a research facility where the researchers could Monitor and control every morsel of food so there was no cheating no and accuracy and they were measuring changes in body fatness using a gold standard method called underwater weighing okay and so what they found was that at the end of a two-week period of overfeeding the carbon the fat groups gained the exact same amount of body fat exact same amount of body fat there was another second study that did the same thing and found the same result independent lab group very similar experiment three-week-long instead of two weeks they found the exact same thing same amount of fat game different insulin response

► 01:13:51

different amounts of carbohydrate and fat exact same amount of fat gain so this demonstrates that insulin is not in cars are not what controls what gets fat in the fat tissue calorie intake is what controls that so let me explain again remember I talked about everything to Paradigm you work and determines the question you asked and this experiment is a classic example cuz they assume that people get fat by overfeeding so then they say if we over feed them

► 01:14:21

we're just doing what happens naturally everything about the experiment is based on the assumption that they're supposed to be testing which is can people get that by overfeeding until they from the very Inception of the experiment they've built in the Paradigm that we want to test the hypothesis on top of it if it's a typical Sims experiment actually wasn't familiar with this one beside it wasn't Sims was James JC Peter James Hill was funded for the from about 1998 to. 2008 by Procter & Gamble cuz he was in olestra Shell I hate to say that Jim I apologize but I think it's a fair assessment and then when he stopped being funded by Procter & Gamble he was funded by the sugar industry and JC Peters was the head of the Procter & Gamble olestra olestra which is now

► 01:15:21

like run out room but they ain't like that but the whole idea of olestra was to replace fat in the diet so every study hall in Peter's did implicated dietary fat as a cause of obesity I don't think we could ever use I hate to say and I typically I I don't think funding influences results but I wouldn't use a James Hale study to make that pointed

► 01:15:46

because you think it's to buy a study that was in everything everything Helen Peters did James helps it works for the University of Colorado so you could actually ganna got all those documents back and forth between him and olestra I'd be happy to share them with you if you'd like their Rebel the time in him and Procter & Gamble but it basically held Procter & Gamble for ransom he would get a $500,000 on restricted gift and then he would do a study and then he would ask at the end it would conclude that fat is bad and carbs are good in there for a last resort viable product that he would ask for Procter & Gamble for more money before he then published study so it took particularly egregious example of someone who side I suspect was just as belief system he believed dietary fats bad fat cause obesity olestra is a good thing because you eat that instead of Fab you don't absorb it and they

► 01:16:46

every study he did confirm that on the point

► 01:16:52

that we keep getting away from that I haven't had an opportunity to

► 01:16:57

and Stephen knows this as well as I do if your gaining say 4 lb of fat or let's say between 20 and 40 of put on 40 extra pounds so now you're obese you're nicely and healthy young guy in 20 like many of us were done by the time you're forty you've got 40 lb of excess fat that's the equivalent of putting in about 10 calories is a story about 10 calories a day into your fat tissue that you don't burn to metabolize so you eat say 2700 calories a day half carbs do you know 35% fat 15% protein and 10 calories a day for trapped in your fat tissue less than a bites worth of food less than a sips worth of beer so the question actually trying to ask his or answer and this is against my Approach is a curious journalists do with a science background is how do we explain those 10 calories cuz when we talk about those

► 01:17:57

obese women with Starving Children all those obese women were doing was storing 10 or 20 calories a day depending on how quickly they became obese and those populations that tends to happen quickly in their twenties so we're asking this question how do we got a situation where we have to end up with 10 calories stuck in the fat cells everyday that's a 20 30 40 billion fat cells so it's divided up very small and is the brain somehow regulating that

► 01:18:28

organic sir dysregulation in the body involving pick your hormones pick your enzymes when the wind

► 01:18:37

that somehow traps fat in the fat cells or prevents the fat from being used for fuel when it's released from the fat cells and took you think about it that way like you let yourself go to seed today Joe Rogan besides I'm done I'm going to do nothing but drink beer and you might start drinking 5 beers a day and over the course of 10 years you get 20 lb and it's all here that 20 lb of the course of 10 years is still only about 20 calories you might have added 800 calories of beer to your diet and * 20 calories is fat

► 01:19:12

how does that happen and why does it go here

► 01:19:16

and not elsewhere artist Stephen said this is insulin dependent fat tissue this question could somebody get fat during a famine or can they stay fat during a fam and all they have to do is hold on to 10 calories a day extra if they're only eating 1210 gets stuck in their fat cells 1190 is excreted or expanded it's not that hard to imagine and there's nothing in the laws of physics that says it to what could be dysregulated about their fat cells even during a relative famine not a complete them but a relative famine that might be any animal experiments of which there are probably hundreds by now different animal models you can

► 01:20:04

disassociate obesity from hyper from eating too much in the animal even if someone is taking in a good amount of calories at the Smart amount of calories 2000 calories a day if you're taking in these calories in the form of sugar your body is going to take a certain percentage them even if you're getting enough food and stored as fat whereas if you were taking in just protein and vegetables and things when was once your body would not do that. So this is a gets to the mechanism question and the evidence you're saying that right so you're saying on 2000 calories of chicken and fish and vegetables and the other one is on 2000 calories of milkshakes and you know sugary drinks and pasta and bullshit that that person is going

► 01:21:04

to gain a certain amount of calories and just put them to Fat Ryan regardless that's that's does Stephen thinks it's been tested a tee time so Stephanie and

► 01:21:25

we will both tend to reject the studies that we don't like when we Define don't Life by whether or not they got the answer we think it's correct your perspective this is not the case your perspective is that like as you were saying in the study with a cozy monitor these people's diets in the added additional fat and it added additional carbohydrates that they both gained same additional amount of what it's right I mean if this is correct you have to see different levels of that game and Gary short-term study in 3 weeks insulin is the thing that gets fat in fat cells and that I mean you would see some kind of difference of insulin made any difference you should have seen some kind of some kind of difference in that game I don't want to start taking out charts but this gets into insulin Dynamics set was workouts over

► 01:22:20

I am

► 01:22:23

I promised I wasn't going to say oh boy oh boy oh boy on the show but it's my thanks to my brooklyn-born mother it's my program then

► 01:22:35

the same is true a lot of these overfeeding experiments to do the same things when they talk about overfeeding they they they literally overfeed so they kind do a reasonable way of figuring out which rating 1/7 a day measured calculated how much energy they needed to stand energy imbalance and again right there that's a problem because one of the hypotheses says that the energy balance is dependent on the macro nutrient content of the food so you're going to get a different different level

► 01:23:08

depending on what the macronutrient content is in different level of what what's necessary for energy balance my not-for-profit funded that's been very controversial where they

► 01:23:27

got their subjects this is David Ludwig and Kara I belong in there their colleagues said that that Harvard Boston Children's Hospital needed to study in Framingham and they they basically got the subjects to lose 10 or 12% of their body weight and then they randomize them to three different diets of three different macronutrient compositions and they basically calculated their energy expenditure on the three different diets which is kind of exactly what we're talking about cuz if you want to be in energy balance who know you feed people exactly what they're expanding and in that study which was published a year ago and

► 01:24:08

they saw different levels of energy expenditure depending on the carbohydrate content of the diet so the higher level of carbohydrates this is trying to keep them in energy balance the higher the carbohydrate the lower the energy expenditure the lower the carbohydrate the higher the energy expenditure so again it's just whether or not they did this study right who knows a lot of studies and we're trying to you know address exactly this point but

► 01:24:38

merely building that in theory experiment we know what their energy expenditure should be and then the point is when you increase and we have competing hypotheses multiple hypothesis and it's vitally important that you always keep the multiple hypotheses in mind when you're interpreting the study to one hypothesis of how much they eat another hypothesis says it's what they eat and that what they eat is is moderated primarily through insulin

► 01:25:11

and when you do the experiment experiment that that Steven is talking about Stephen completely confused if you overfeed them you start out with a 50% carb diet now you overfeed them if there's a threshold effect on insulin which turns out there is and you're just moving on and when you look at insulin Dynamics Moon and Sun is below a very low point the fat cells will mobilize fat and the lean tissue will burn it for few own above that point you get pretty much flat so if you start people who are eating 1500 calories or carbs and you add them pump them up to 2,500 calories from carbs are still in the plateau side of the expect to see any difference the only way you expect to see a difference in this why it helps to really interrogate those hypotheses so that you know when you're doing the experiment whether or not you're

► 01:26:11

Ashley testing something you one hypothesis you want to set up the experiment to the hypothesis predicts the two hypotheses predict something entirely different this experiment the arguably the two hypothesis predict the same thing you'll get fat game because insulin is elevated regardless and wanting someone has elevated you're going to get fat gain the question comes back to it this again always fight for the cape this is what could possibly cause a 10 or 20 calorie access that causes fat stored I have a friend that was forty four hundred pounds when he was Eighteen with a tall kid about 65 lb overweight 200 pounds overweight is roughly a hundred excess calories over 18 years stored in your fat cells you know even if you assume that you have to consume 300 calories

► 01:27:06

can I have 100 XS store in your fat cells that's in a 1/2 Coca-Cola's a day that he was drinking or 1/2 1/4 pounder a day that he was eating that is laying friends who aren't in the question would be why canti to stop doing that again Stephanie mattei cuz his brain won't let him

► 01:27:26

and I would say because his insulin is out of it doesn't matter whether he stops it or not can I underline mechanism okay alright so again it's easy to tell stories it's not easy to tell stories that are supported by scientific evidence now I want to bring people's attention to reference number 11 on my site there been 29 studies now that have measured differences and energy expenditure metabolic analysis correct there been 29 studies to date that I've measured calorie expenditure metabolic rate on diets differing in carbohydrate and fat content when you put all those studies together when you are at least the first 28 together and you look at what the overall literature says it makes almost no difference to metabolic rate whether people are eating carbohydrate or fat and in fact this very small difference that it does

► 01:28:26

actually favors High carbohydrate diets so you get a slightly higher metabolic rate when the diet is predominantly carbohydrate now this study that Gary say it is the one study out of these 29 that has reported a larger effect than any others of carbohydrate restriction on energy expenditure so this study reported in effect bigger than any of these other 28 difference and an interesting ly if you actually look at the data and data have been really analyzed by a researcher named Kevin Hall and if you look at the data you find that some of the participants some of the data that represent some of these participants are literally physically impossible they break the first law of thermodynamics is to the conservation of energy Gary knows about this he has a physics background and they literally don't add up

► 01:29:26

start subtracting the D clearly erroneous data from the pool of subjects this pig effect size starts to shrink and shrink and Shrink shrink until after you've gotten rid of all of it to study does Nola no longer reports a higher energy expenditure on a very low carbohydrate diet and it's consistent with the previous 28 studies that were done so that's my perspective on that but I want to go back to this weekend, they are you talk to her and I'm going to talk for as long as I want now I want to talk about human energy metabolism in this idea of the 10 extra calories a day I really continue to get the feeling that you do not understand human energetics because that's not how it works but now I'm just saying 10 calories stored in the fat tissue that changed dramatically I'm not done

► 01:30:26

that dude Jerry backing like you think I'm an idiot all right are you done now are you done can we be clear that we're talkin about you done now I just finish this until I am done without you how do you respond write down notes on what you want to respond to and after he's done you can tap thank you okay now what you see there's basically two things you need to pay attention to hear in terms of energetics is the imbalance between intake and expenditure and that is very small so it only takes a little bit of extra calories to cause somebody to start gaining fat however as they gain fat their bodies get bigger they're gaining fat and lean mass people that obesity have more fat more lean mass and their calorie needs go up and up and up and up the larger their bodies yet and so even though the imbalance between energy and

► 01:31:26

can expenditure is small their calorie needs end up being quite a bit higher so you're saying that someone just gaining calories eating additional cowers their body gains Lee Mass as well as you like that I didn't say it regulated by the muscle muscle muscle some of its citizens bank cards and then on top of that caring around the extra weight forces our body to grow larger presumably I'm actually not sure what the mechanism inside it doesn't have anything to do with the brain that a coincidence so so but the point is by the time the person has obesity they are consuming 20 to 35% more calories than they

► 01:32:26

were when they were leaving so that's not just one or two cokes a day that is allowing them to remain abuse their consuming 20 to 35% more calories that is with the most accurate studies are saying and so it's not just 10 extra calories or maybe just one or two cokes we're talking about a substantial amount of extra calories in a sense of generalization because we don't know what me what's the ratio of how much fat people get him out how much weight people gain and everybody gains a different amount of weight like you saying they're eating 20 to 30% more calories like who is like how many P how much are they gaining our people get fat to get 20 lb overweight people get fat to get a hundred pounds overweight because what you see is that people who are overweight so they're in the overweight Ranch you just have some extra fat they eat about 10% extra calories people who have a little bit of obesity eat about 20% extra calories people who have who are very have very very

► 01:33:26

obesity eat more like 35% is it possible what he was saying over long periods of time that will accumulate more calories are in a how much do you have to deposit is it is correct that if everyday you eat 10 calories more than what you need then yes or your body will say that your body is storing 10% tent 10 extra calories over top of what you need but the thing is that as you get bigger what you need goes up and up and up cuz you're carrying around more Water Act and its 10% on top of the elevated amount that you're already eating so you end up with these big differences in calories take so that's how that's how it really works but I want to talk about

► 01:34:26

interesting observations cuz you like to talk about you know what's going on in different dietary Trends in different cultures and I find that pretty interesting to I want to talk about the fact that sugar intake in the United States has been declining for the last 20 years so it peaked in 1999 and it is currently depending on which source of evidence you believe 15 to 23% lower than it was in 1999 this has been corroborated by number of different sources of evidence this number 17 on my blog and of course we know that obesity has increased diabetes has increased substantially over the last 20 years in the percentage of the population of Roxboro Amber's percentage and hey sugar intake has been declining for 50 years I don't believe that okay well you can argue with the date of their number 17 on my blog there about 22% lower and this is what we see

► 01:35:26

a number of different industrialized countries you see a stagnation or decline and sugar intake in recent decades as obesity rates are continuing to increase and of course that 50 year. That covers the decline in the UK covers the entire UK obesity and diabetes epidemics but there's another one I want to talk to respond to that yeah we should respond that will you respond for me cuz we had this debate with the Kato foundation so you know my yard counter argument you want to give up yeah sure absolutely I mean are you sure you want to let me give it though I don't correct it okay alright

► 01:36:06

so your counter argument is that

► 01:36:10

the amount of sugar that we consumed 20 years ago or even maybe 50 years ago maybe continuing to fatten us today and it's about the sugar that we used to eat 20 or 50 years ago and not necessarily about the sugar we eat today it's not exactly right okay I gave the bay on the Kato Foundation website and it sent right if you think about used backhoes an example so tobacco smoking per capita smoking in America Pete in 1965 right after the surgeon general's report and it took 30 years before lung cancer rates turned over okay I think we both agree that cigarettes are a major cause of lung cancer smoking so what you basically have is a system in which if there are any there's the assumption that seven is making when he closed his kind of data is that the relationship between sugar and obesity is linear

► 01:37:08

so it's sugar goes up obesity and diabetes goes up if sugar turns over they don't so here's the thought experiment they used in Cato which is

► 01:37:17

1965 or smoking per capita about 20 cigarettes a day

► 01:37:22

is it starts to come down imagine we only cut that to 17 cigarettes or 16 cigarettes a 20% reduction and smoking would you expect to see a reduction in the lung cancer rates again this is the point I made about what you would expect to see why the new thing simplistic metaphor so the question is would you like Joe we go from 2216 you expect to see the lung cancer rates turn over no now and in Sugar we went even drop I know you might the derivative might drop you might expect it to slow a tiny bit

► 01:37:58

still use it sad if there's a bunch of weird comparison because one of them is Poison the other ones food right now but in this case the food that question is how toxic is the food so when sugar we have a variety in Sugar what happened is the equivalent of going from 20 cigarettes 216 beginning in 1999 and Stephanie saying I would expect to see an immediate change in obesity rates for the rate of increase in prevalence appeared to Plateau around six or seven years later who knows whether that's relevant to get a small decrease in Sugar 25 and if it's 20% that's 2216 cigarettes and I'm sending the other fact that I talk about my book and Stephen knows this is really have maternal transmission of the propensity to obesity and diabetes so there's a generational effect this and this is studies ever done in the same on the same payment

► 01:38:58

send Native American tribe or each generation if gets more and more susceptible to whatever it is in the diet that striking in obesity and diabetes hope that's been happening in the United States and around the world you've got a generational effect that could last far longer might even keep going indefinitely even if their sugar levels drop so you have the Sugar Creek kicking off the Obesity epidemic any acceptance about to say this is a story and it is a story but it's clearly the case that mothers who are obese during pregnancy or diabetic or gestational diabetic they become diabetic during pregnancy or they have metabolic syndrome there just insulin resistant or they gained a lot of weight in pregnancy will give birth to children who are at higher risk of becoming obese and diabetic when they get older at a younger age than those children will pass it on so I can we have you know I would be nice I would love it if sugar consumption came down and with it

► 01:39:59

the Obesity and diabetes plummeted but it's not a an anyway reputation of this hypothesis which I just want to State what it is cuz people get confused about it we never got the sugar hypothesis is a little different than what we've been talking about and it's pretty simple we have obesity and diabetes epidemics worldwide as we talked with doesn't matter that you're Natick to the population you at something about a western diet to those populations Western diet and lifestyle you get these explosions V epidemics of obesity and diabetes what I'm hypothesizing in this book is that sugar is the something that has to be at it maybe it's sugary beverages for all I know maybe they were could be you know any more complex hypothesis to sing as possible one as you add sugar to any populations diet insufficient weather at South East Asians living on rice or the Inuit living on reindeer on

► 01:40:59

whatever were the Native Americans of the Great Plains or you know Caucasians living in the Upper East Side Manhattan had enough sugar and eventually through the metabolic effects of the show and the generational effects you will get explosions of obesity and diabetes and metabolic Stephanie want to respond to that sure I mean man

► 01:41:24

it's always possible to tell a story to salvage your hypothesis with that doesn't necessarily make the story correct I mean I can come up with a story that cosmic rays cause obesity by hitting my fat cells and making that you can't disprove that nobody here can disprove that but never there when experiment to protect you from okay. We don't have we don't have the data right now you don't have data supporting your hypothesis so we do you just dismiss no no no no no Vine right now. What do you think about what he's saying about sugar and increase rates of diabetes and that this is the cost

► 01:42:05

yeah I mean so let me put it this way we don't have any evidence supporting what he just said so that is a story that is not supported by evidence now does it does that mean that is definitely incorrect now I cannot say that that's definitely incorrect same way I can't say it's definitely incorrect that cosmic rays cause obesity but you know I'm going to use it Christopher Hitchens quote here that which is asserted without evidence does not require evidence to refute and that's the way I feel about this particular story but you know there are cultures that consume large amounts of sugar and do not develop a beast right now so this is reference number 21 on my blog I'm going to talk about three different cultures one of which we have not talked about Gary the first one is the hodza hunter-gatherers of Tanzania

► 01:43:05

this is a really interesting non-industrial culture they as part of their hunter-gatherer diet eat a lot of honey honey is a very common food among hunter-gatherers living similarly to our ancestors used to live and if you measure there year-round honey intake it's about 15% of their calories so this is a major calories worse than that's about as much sugar is as the average American eats and eats fruit sugar on top of this they eat a lot of fruit on top of that and so they're even quite a bit of sugar and the hodza men have about 12% body fat women have about eighteen so they correspond pretty closely to our Western ideals but it's not high for hunter-gatherers not really I mean that's harder than me have you had your body fat measured electricity of this machine will you hold onto these things stand on this platform

► 01:44:05

Physician's office of okay so done with calipers the okay so all the methods you measure that you mentioned or Not Gold Standard methods so the gold standard methods are underwater where are the underwater weighing these people on this island actually I'm not sure that they print out equipment correct okay look I can tell you that you can look at the photos I I don't remember how they'd to how they measure their body fat but you can look I am 12% as measured by dexa so I'll just tell you that so you can get a sense of what 12% is by dexa which is the gold-standard method so you can look at photos of these people they are very fit they're laying there not like a ripped you know they're not Arnold Schwarzenegger in Peak form but they are seems to correlate with a higher consumption of sugar that they seem to have a higher percentage of body fat than the average hunter-gatherer average hunter-gatherers like a friend of mine does a lot of work with the pig

► 01:45:05

he's in the Congo and they're very lean okay so you see they have six packs and that's the second culture I was going to say that you know kind of honey do they booty pic memes of the Congo they up to 80% of their calories can come from honey during the rainy season so they also eat a lot of honey and Arlene not just a correct yeah for them is part of the year the hot seat at more consistently and the hodza have low levels of body fat their cardiovascular risk markers are excellent they don't have diabetes but this is absolutely not like a controlled study in the consumption of the absolutely agree with you that's exactly the point I'm trying to make is that when you have a culture that is eating a lot of sugar but everything else is in place of doing everything else write the sugar is not enough to make them fat it's not single-handedly enough I'm not saying it doesn't contribute I think

► 01:46:05

does contribute just to be very clear I think sugar does contribute to obesity and diabetes and cardiovascular disease but it's not single-handedly responsible as Gary has argued so the third culture is pretty interesting the kuna of Panama and the reason they're interesting is that they actually aren't eating honey they're actually eating white sugar so there a culture that has primarily and non-industrial lifestyle their farmers and hunter-gatherers

► 01:46:36

and they but they do a little bit of trade and one of the things they trade for sugar and they eat sugar sweetened Foods as well so like donuts and pastries in the drink soda and Kool-Aid what what is their lifestyle and terms like what do they have at a natural lifestyle they are hunter-gatherers and subsistence Farmers so there you know living a Physically Active natural lifestyle to this is the problem in comparison with any Western Civilization that you you burn off so many more calories and trying to make is that it's more complicated than just sugar sugar but normal lifestyle it may not be the consumption didn't the thing about burning of the calories is also the the the glucose demands of glycogen demands in the muscle you're you're you're not just existing like the one of the problems with

► 01:47:36

lifestyle is it many people are just existing they're sitting in a chair they're walking to a desk there sitting in their car they're not doing anything to burn any of this shit off so you can if you have like if you get a baseline of a minimum amount of calories you required for the day I think would Gary's getting at is that if you if you have this lifestyle the lifestyle that many of us have and then with that lifestyle consume sugar that you're going to get fat I don't think you can compare that to athletes and in that respect I don't think you can compare that to hunter-gatherers because you're requiring it is a much more significant load on your body like when I was sober October fitness challenge with my friends during October and we I was working out 4 hours a day and I was fucking eating everything that moved I was drinking soda I never drink soda I was eating cookies I didn't gain any weight other than muscle I didn't get any fat at all

► 01:48:36

and I was eating a terrible fucking. But I was going crazy when you're trying to stay alive and you're running around plowing and growing foods and hunting and Gathering and fishing you're burning off insane amount of calories just the hiking that's required the amount of exercise it's required it's off the charts in comparison to a standard Western we are on the same wavelength here I mean I completely agree with you that it is more complicated than just sugar you know and but if you read Gary is written in and please correct me if I'm wrong here Gary argues that sugar is a primary cause of obesity and that physical activity does not matter calorie intake does not matter of physical activity doesn't matter now I don't think it makes a lot of difference for fat cream or talk about the cause of obesity I don't believe it because people get obese because they're sitting there to meet up put it this way so if you take

► 01:49:36

someone who's an elite athlete and they start consuming a lot of sugar but they they ramped up their exercise accordingly let's save someone does what I did during the sober October the working out 3-4 hours a day everyday do you don't think that they'd have higher sugar demands that the body would just burn that off real benefit exercise it's burning off carbohydrates you consume them then do you need less insulin to do it can I respond to the kuna get back to them for second the issues I have with my stories the stories which they are all science begins his stories on hypotheses and then what you do is go go for the evidence and then he quotes studies and refers to it as evidence about this is somehow by calling it evidence that may end of we had this discussion a year-and-a-half ago and you didn't disagree with me at the time and it had no influence I'm just going to read from the email

► 01:50:36

just a boy wreath Acuna the study cited as interesting okay sis was a study that professed to measure sugar intake of this population on an island on a Gandhi and compared to the population in Veracruz where they they had emigrated and I say but there added sugar in taken out of Gandhi According To Figure 1 is 25 teaspoons per week plus equivalent of 24 ounces of soda is it 78 grams if it's Coke 32 oz of Kool-Aid that's 96 said I'm leaving out the cup of a sugarcane because I don't know what that is menthol or how they assess it one way the other snot processed sugar so it's roughly 274 grams of sugar per week or about 32 pounds per year now that alone is very low and take me don't know how changed over the years we have no idea if it's

► 01:51:36

creasing recently I've been low for years so you just use the cooling it's an example of a population he's a lot of sugar and stated it dogmatically but that lot of sugar is 32 pounds a year and then I said I thought you did that's what I heard if we believe the study the Conan Veracruz are consuming roughly the same amount but I'm not sure I believe this study when it comes to the Veracruz population do you really think they deserve a nice kunar consuming only 3/8 Oz sodas per week so the implication was his population of Caribbean Islanders emigrates to Veracruz they move into the City and they consume more sugar back where they used to live because they trade for them when they get into the city so five glasses of Kool-Aid no candy no ice cream nothing I'd like to know more about the urban phone number for accept Section analysis is valid on top of this as they say the analysis is done mostly of women because quote the women were available to study cuz they were at home during the day on the quote so what were the men can

► 01:52:36

show me what were the children consuming when they weren't at home and with her something magical about this freak food frequency questionnaire and these researchers that they captured it accurately so this is what science is you have studied the question always is you've got competing hypotheses the sevens really speak to the hypothesis and I'm one of my issues with Stephen it's what provoked aren't our initial disc or is that he's constantly siding studies that don't actually either they only speak to one hypothesis like the overfeeding study or they're poorly constructed in poorly done to even this has the example with the honey is something we discussed any mail very kind then we went back and forth I said I don't actually think it's a reputation because of hypothesis I'm defending hear the case against sugar is you add sugar to any populations native diet and you get epidemic of obesity and diabetes so here's a population that's been eating honey for maybe thousands of years

► 01:53:36

in fact when they immigrated to this area they may I've added honey to their diet and had obesity and diabetes obesity and diabetes in a population to death sentence for the child and for the mother who gives birth so you're going to be very quickly we doubt anyone's help again it just comes back to this question of does this actually this is it a refutation the hypothesis that I found a hunter-gatherer population that eats a lot of honey and isn't fat and answer is I don't think so Steven thinks it does you could flip a coin all of this can be settled with experiment one of the experiments we did at news today

► 01:54:16

so one of the metabolic problems that goes along with obesity and diabetes is non-alcoholic fatty liver disease and it's endemic fatty if you have fatty liver disease to talk to her and you told the doctor you didn't smoke that would assume you were lying now it's so common so common in children and particularly common Hispanic children that it's clear it's not caused by alcohol in the question is what causes it cuz if you could create a fatty liver with a macronutrient you could probably create insulin resistance as well and then this whole slew of disorders including obesity and diabetes so my not-for-profit funded a pilot study where we just took 40 kid by the researchers at the UC San Diego and Emory University in Atlanta took 40 kids who had non-alcoholic fatty liver disease

► 01:55:16

so they could offer eat their hearts extant but no added sugars in their diet no sugary Beverages and the study was published in Jama four months ago and it's just it get rid of the sugar in the diet the fatty liver disease results

► 01:55:33

you know it was pretty simple I could there tells you nothing about mechanism the kids lost a little bit of weight maybe it was a weight loss the conventional wisdom would be they just ate less which I wouldn't be at all surprised cuz I probably didn't like the food as much without sugar in it but these are the kinds of ways you could test these hypotheses and problems I have with like the meta-analysis getting back to Kevin Hall there's two ways you could do science you could say let's look at all the junk that was done for 30 40 50 years let's find everything we can it even vaguely speaks to the experiment and ignore any quality of the study this question like we want to know what happened but in doing this weed switch their you know sad and take around fat and carb intake around and then we can throw all that garbage into a meta-analysis

► 01:56:33

I looked up the one with the biggest effect they mistook kilojoules 4 kilocalories so they reported that 400 kilocalorie decrease in energy expenditure on the low fat diet when was a 400 kilojoule witches what's that factor you know these numbers 8.1 and several of the other studies were Jim Hill studies we've talked about how the biggest study switch email and the way we approached the not-for-profit to say you've got to understand what the question is and you've got to design an experiment to get the right answer so when Steven dismiss this heart with three names from now I can't do it dude I just don't good names my name is Joe

► 01:57:25

hi Gary. Hi Joe

► 01:57:30

Stephen ultimately rejected the study that's about a 12 million-dollar study that was on at Harvard based on Kevin Hall so these are two names about three people out there who are convinced that everything people like me are saying is wrong about everything but most of it and they keep coming up over and over again and they were so Kevin Hall claims that he has refuted the carbohydrate insulin model in his studies who want to study comes out supporting it he works to find out why that said is wrong we all did the same thing I did the same thing right here with the conus study explaining why I don't find it meaningful but anyway that's always to do the right study cuz ultimately you got to remember what's on the line here we have obesity and diabetes epidemics I'm in tragic shit is going on out there I'm in paintball you know these are ruining lives there are overwhelming the healthcare system and the argument I made it said for the

► 01:58:30

last 50 years basically people thought a lot like Stephen is thinking now doctor DNA and that's

► 01:58:38

there appears to be another story that could be true what we have to do is find out if it is true cuz people are dying out there stuff okay the first thing I want to say is that this alternative explanation that Gary is talking about has already been investigated intensively including studies that were funded by his own organization new see two out of the three studies that have been published on that we're clear refutation of hypothesis and no no I'm representing them according to your beliefs is not representing them correctly okay now I've noticed a remarkable correlation between studies undermining your beliefs and you thinking those studies are garbage and we should talk about Jim Hill and his studies a little bit because you know to me just saying this guy has a conflict of interest and then insinuating and that makes the study bad if you

► 01:59:38

can actually find a problem with the study itself is were very rigorous studies if you cannot point out how do you say cific the problem with the assumption that you are a great design How Gary wanted it to be designed it's a problem with that study then you can't just dismiss it by making these insinuations that the person had a conflict of interest okay going to the problem now I didn't realize you're going to be able to respond in the moment now the kuna I think we should really get back to this issue this non-industrial culture because the primary basis for Gary's book the case against sugar the primary observation that underlies gears belief on this is this observational correlational thing that cultures when sugar gets

► 02:00:38

do these cultures they become fat and not as the common thread and in obesity and so what I'm doing is I'm pointing out a culture where sugar came in and it did not make them fat and that's one of the three cultures I haven't even look that hard okay you're just three cultures that I came across is probably a bunch more that are eating high levels of sugar but they're a tantrum, into our home and again Joe explanation is right on point is a lot of other things going on in these cultures and it's more complicated than just sugar that's exactly my point to talk about the Cuban economic crisis this is reference number 22

► 02:01:19

from 1989 through 1995 the Cuban economy collapsed and the price of food went way up the price of gasoline went way up and so people started focusing on these really cheap Foods Cuba I was Major sugar producer at the time I don't know if they still are and so the intake of sugar went way up intake of refined carbohydrate went way up the diet became 77% carbohydrate primarily white rice and sugar 28% sugar of their total calorie intake that's like double what Americans eat

► 02:01:58

now they're calorie intake went down and because of the lack of gasoline people got really physically active because they had to walk everywhere so now again this is this is a situation where we can test Gary's hypothesis if Gary is right and calories don't matter only refined carbohydrate and sugar matter obesity should have gone through the roof in this population over that period of time what you actually see is that the prevalence of obesity declined by half so there was a 50% decline it went from 14% to 7% over the period of this increase in sugar intake increase in refined carbohydrate intake and you might think while these people are just starving like crazy and that's why obesity rate went down actually have evidence on the rate of underweight as well and so we can check on that

► 02:02:52

the rate of underweight increase only slightly went from 8% to 10% and so we know these people weren't just totally starving and what happened then was as the diet rebounded as the economy Rebound in the diet rebounded and their diet shifted away from these refined carbohydrates and sugar and back to the normal diet that was higher in fats and lower in carbohydrate lower and sugar the obesity rate went right back up as soon as they went back to their normal diet and so I find this cuz they were they were not walking as much richer again I mean if you're eating a diet that's a very poor diet eating like white rice and sugar I mean it's not like if that's most of what if if you're sitting there on your plate his white rice and sugar you're not going to be eating a ton of that and getting fat as opposed to eating a rich or die it with more varied Foods

► 02:03:48

and so this is a case where you have an entire country testing Gary's hypothesis and finding that basically the opposite of what is hypothesis predicts let's go with this did this when he was refuting the studies and you want to go pick up that I'm going to have to read it to try and figure out what the problem is I remember looking at that studying thinking there wasn't the kind of day to your siding maybe there's multiple studies put together but the one study I looked at the kind of day to your siding wasn't in there that this is again a provinces are on my website so have at it

► 02:04:30

the beginning of his when he started talking that it was referencing some studies and you had a problem with that guy try not to get into the he-said-she-said studies cuz you never know how well they did I think we both agree that there's a reproducibility crisis in science and some huge proportion of the study's or just weather experiments or observations people sometimes aren't very good at what they do and to anyone in either business dammit but simultaneously people accuse me of writing a 600-page book with 150 pages of references that was too long to read so this clearly evidence for this observation in this hypothesis test my issue with Stephen

► 02:05:22

he said he speaks as though he knows what this Authority and so again I would like to just read a little bit from your book Because as I was prepping for this I was for you do that though he was referencing stuck human situation I don't know what the reality is referencing things that you were stating that he was saying will you saying that deal with the organization that supports him actually refused and we can chat we can get into detail on this on how does refuted Gary's beliefs and I would say Gary is about the only person who thinks they did not refuse believes the community is the unanimous didn't respond but but but could you please say what was what would the study state is in what year did

► 02:06:23

depends what you look at to depend whether or not refuted your belated are taking after understand this world to there are researchers believe one thing Kevin Hart and I ate tends to believe it'll be citizen energy balance problem and you people get back cuz they too much I hope I'm doing Kevin Justice and then there's David Ludwig and his colleagues at Harvard who can't believe what I believe and refunded them both to do studies and the Kevin Hall study if you believe with Kevin if you believe Kevin interpreted it correctly was not supportive of this model that carbohydrates are in ultimately driving insulin and insulin is driving up that accumulation and then to David Ludwig study

► 02:07:13

reported the opposite and then David has criticized Kevin study and Kevin has criticized David study in this it's a nature of science this is what you doing sign to do an experiment people critique it ideal you do another one Kevin has decided while Kevin is doing another one I think he's asking the wrong questions but I just saw the other day that he's doing another experiment tornado middle study was a tree living diet study we're done by Christopher Gardner Stanford University in the idea was original idea was 600 people randomize to either a very low carbohydrate diet or very low fat diet and then we funded in part because we hoped that Christopher would be able to get people to almost a ketogenic diet on the low-carb side and Dean ornish who promotes a low-fat diet always complaining the low fat diet wasn't bad enough so hopefully they be able to separate

► 02:08:13

what is 2

► 02:08:16

at the end of the trial they got pretty lousy did he run so low carb was about 25 to 28% carb which is by no means elope meaning ready to start. I'm pretty typical in free-living studies in the love that was about equal what they did which it's funny we've analyzed this on one side but not the other on they told the low carb proved not to eat sugars and refined grains which are by my hypothesis the most fattening carbohydrates and they also told the low-fat group that not refined sugars and refined grains so they basically remove the most fattening parts of the diet from both arms of the sudden it's funny we knew they were going to do with the low carb have to and my colleagues actually knew they were going to do with the low-fat group I didn't know that when I found out I was stunned because now you're testing to diets neither one of them have sugar or white bread

► 02:09:14

so now you see similar weight loss with relatively poor compliant why would they do that that doesn't make any sense with the their argument we talked to Christopher lot of his heart he was afraid they were two things on he wanted to die to be healthy so healthy diet in 2015 has become a diet that doesn't have sugar on White Bread in it so he wasn't going to promote sugar and white bread to 1 Dieter the knob on I take so long as the. Of time with her settings to buy they were on their way they're supposed to be on to die for you okay that makes sense in his account would you expect to see a difference I can send you an email I wrote to my new colleagues in 2015 I could read it when I found out about the slow fat thing saying this is insane he's remove the both groups are carbohydrate restricted so you could think of it as a low fat high fat carbohydrate

► 02:10:14

which could be for any reason whatsoever there's a paper I don't know if I can well I'm not going to talk about it's bad enough talking about the ambiguous studies that have been published without getting into on publish research but some people see this the New York Times for instance it to stories on it one of them said it's not about calories it's about the quality there sugar in their fine-grained because both groups restricted sugar and refined grains and lost weight the other than that was written by reporter who tends to believe what we believe and the other article said it's all about the calories cuz both groups ended up on average eating 500 calories each at the ends up from a scientific perspective being a poorly done study even though we found it at them not bitches didn't answer the question you said 500 calories each has been restricted they're cowards actually self-reported so it's not

► 02:11:14

show both sides are low in sugar both sides are not eating processed they were the two full differences in total carbohydrate intake okay so even though they were both not eating as much refined carbohydrate they were still too full differences or greater over the period of that study in total carbohydrate into if you believe now you just said but on the weather will you could be talking about vegetables you could be talking about fruits are healthy carbohydrates that they had primarily in the study that that study can be interpreted from virtually any way you want it stopped because it was a free-living definitely don't agree with that agree on agree with you on this is that fine carbohydrates and sugar are the most fattening type of carbohydrate that we can agree on

► 02:12:14

if you believe Jerry's hypothesis now any kind of carbohydrate increases insulin levels some do it more than others refined carbohydrates do it more any kind of carbohydrate increases insulin levels relative to that okay and so if that is true and these groups and that matters for fat loss these groups had two full differences in carbohydrate intake even though I was predominately healthy carbs you would have should have seen something you shouldn't have seen the exact same amount of weight loss in these two groups right right but they're not high in sugar is in your argument is always are there other part of the yard men with to take away the sugar and that was the problem with one of the problems with the end of the day I see a study that the he does the same thing he did it here we we all do if you see a study that disagrees with you you find the reason why they're not believe it in every study ever done has plenty of reasons not to do it

► 02:13:14

got to believe that's why I independent replication is something you always wanted when I get another group to do the study idea people come in getting what I was trying when we even when we started the nutrition science initiative the choice that was a non-profit the choice of the word initiative was to get nutrition researchers do in effect

► 02:13:38

using these garbage poorly designed studies to come to conclusions because they like or dislike the interpretation but try to get them to think the way harder scientist would and developing societies had to ask precisely the right question and then destroy even that pilot study that was interpreted as not supporting this hypothesis and again you could argue that for an hour and nobody's going to care that study was not randomized so non-random I study you can't infer causality it's that's why it was a pilot study one of the many reasons was a pilot study the people who think this carbohydrate model so then we talked about the carbohydrate inside model means carbohydrates are fattening That's the basis of a bread pasta potato and sugar maybe the thing that's necessary to add to the diet to make all these carbs fattening is sugar as if we talked about this year and a half ago the frog toes smell like you own

► 02:14:38

is metabolized in the liver it's linked to Fat accumulation in the liver which is linked to insulin off the way you're squeezing your stomach fat when we were talking about this experiment to poorly you know I never experiment ever done and so but we've tried to do is keep working towards better experiment is that one new version of the Ludwig experiment being done at the Arnold Foundation Laura and John Arnold funded to the tune of I think $13 and whatever that study finds

► 02:15:24

Kevin Hart will probably find a reason look in it and find a reason to question and ideally they would be working together so that you come up with the criticisms before you spent 13 million dollars is how science Works my job was to tell a good story is Stephen would say and I believe people who read the books and judge whether at their it to put in an am I convincing and arguing that do you add sugar to iced counter-evidence to everything there wasn't counter-evidence wouldn't require a journalist to come along in 20 whatever it is 19 left to make these are let me ask you this because this is something that you admit to something you said rather why are sugary carbohydrates the most fattening

► 02:16:11

well if this hypothesis is correct I think you would say that they trade our food but War. They are they create a hormonal milieu in the body that that over response to insulin and Insulin when we haven't said is if you look in the textbook for fat metabolism in fatty I hear what causes fat storage insulin is a hormone that primarily regulates fat stored in your fat cells are the ideas you raise insulin in the dust of this half of it being fructose and that mostly being metabolized in the small intestine in the liver seems to want to say peripheral explanation not that people don't love it and they don't want to get over consumed at whatever that means and the other is a central explanation

► 02:17:09

yeah so I mean sugar is a factory that makes us want to eat Foods right I mean this is one of the many food properties I would love to talk about this more that cause dopamine release in the brain and dopamine is the chemical that sets are motivational levels to do certain behaviors so the reason we become addicted to drugs is that they go in the brain and they stimulate dopamine release and that reinforces drug-seeking behaviors but this is just causing you to consume more correct but your actual amount the savior of the same amount of carbohydrates that are sugary carbohydrates is the same amount that are vegetables carbohydrates is sugary carbohydrates are going to be more fattening I didn't say it was independently of calories it's entirely dependent on calories yeah correct and we have randomized controlled trials demonstrating that so if you look at the randomized by the way we're not we're not operating in an Evidence vacuum there's tons of randomized control trials and sugar

► 02:18:09

these randomized controlled studies are they short-term it depends on how you define short-term they're not last long years and years ago isn't an issue though long-term chronic effects like that seems to be possibly but let me put it this way you know if you believe that insulin is the cause the effect of insulin on fat cells happens almost immediately so insulin I'm not aware of any mechanism of insulin on fat cells that takes more than a few hours to occur and so if you believe that insulin causes obesity this should be happening immediately you shouldn't have to wait months and months for this to occur that doesn't make any sense at all because again he's he's kind of making this up as he goes along or the idea is

► 02:19:04

explain why doesn't make sense without insulting him he's insulting your stories not you personally but what what what do you what why doesn't make sense to me

► 02:19:26

when your insulin is elevated you're storing fat right

► 02:19:30

it depends on what you mean by that that's not see you do a little bit of bait and switch here I don't know that's an until just answer the question if it's not true clarify what do you mean by store I mean your fat cells are accumulating fat when insulin is Alabama's you mean accumulate like like what stimulates lipoprotein lipase and inhibiting hormones

► 02:20:08

okay so you don't believe in choice but just give me your position and I'll let him refute it it's here but just say it and imma let you know how I hear suppression of fat mobilization by insulin and there's another graph that is

► 02:20:30

stimulation of a mobilization graduations to all of you people that are listening to the molecular mechanisms okay on the molecular mechanisms the impact of insulin on enzymes and fat cells what we disagree about is the implications of that and that's why we should talk about that stroke has nowhere in that textbook does it say that insulin regulates the total size of body fat Swift talking about have added on that mechanism would you like to have a conversation I had with the author of the text right now actually let me tell you about the car okay

► 02:21:28

Let Me Explain insulin essentially does have effects on enzymes that cause fat cells to take out more fat and to release less that so that's the part that you're right about that's what that text book talks about right now that does not mean that does not imply that insulin causes fat storage as in the accumulation of fat from day today let me explain why that is so insulin is basically a traffic cop that allows your body to burn the fuel that you just consumed so when you eat a diet that is high in carbohydrate and low in fat your insulin goes up your body restricts the fat from going out of fat cells that turns that down not off but down it causes less fat to come out of your fat cells and then your body is burning carbs that's what you just ate right now if you eat a diet that I'm fat and lower and carbohydrate you secrete less insulin does effects don't occur on your fat cells

► 02:22:28

and that allows your body to burn the fat that you just ate but at the end of the day the amount of fat that you have in your body is the amount that you ate minus the amount that you burned that's what determines the amount this is just a rhythmic take right amount that you ate my Nasim out that you burned and if you eat a low-fat diet you're not eating much and you're not burning much you're in the same place as if you're eating a diet where you eating a lot of fat and burning a lot of fat in the way we know that's true is because varying amount of carbohydrate and fat in the diet makes no difference to buy fatness in randomized controlled trial how can I tell if I know that what I just said is correct known so the first of all it's one randomized control trial with Kevin Hall again now until I tried a meta-analysis of we talked about the med analyses we decided it I think you know that

► 02:23:28

I care who does I don't like men analysis I don't like the concept of them I think it's one of the problems with modern nutritional and medical Sciences you do crappie studies generate garbage and then you ship to the garbage and second find a truth in here and the answer is do better studies answers always do better studies you can't do your med analyses takes us for everything issue is just as a simple remember talking about the 10 calories a day so when you said the difference between the fat burned and the fat store the fat consumed in the fat expand it has to be 10 calories a day that's that's were talking about 10 calories in the fat tissue okay so if it is true that if I consume 1500 calories a day and I

► 02:24:12

somehow metabolize or excrete 1490 and I guarantee that no such study was ever so carefully. I don't say that it any measure torsion study the Kevin Hall study that we've talked about one of the things they're two things that happen when you put people on a ketogenic diet among other things you generate ketones and you lose ketones in the breath in the urine and one of the things you have to do in this energy balance experiment to measure calories lost through fecal material who knows maybe you jack up the fat consumption maybe they lose more fat calories when they sit it out or maybe you check if you think Valerie's matter I think when you're measuring the fat balance what you're talkin about you have to measure the amount of fat in and out since I'm giving you an example in response to your question was cuz you give me an example in that study they didn't do either of those measurements they modeled one in the other one they couldn't get the the ass

► 02:25:12

it work after a year or two years and gave up on it and so you just don't know but getting back to this question were talking about somebody stealing 10 calories of fat in their fat self that's never get away from that are 20 cows until the question is always is this mechanism capable of explaining the 20 calories are is the what if you find him looking in that book actually what he was saying I didn't sign inhibits fat mobilization and I both agree with what's in that text book you can read it if you want something so much trans fat mobilization suppression of lipolysis in the stimulation of the re esterification of fatty acids within the ad up at Apollo

► 02:26:12

set up a note that the same process of esterification will also be simultaneously Incorporated fatty acids from circulating triglycerides all threads are released by lipoprotein lipos and Pace Pace Pace lipase into stored triazolam glycerol free flight

► 02:26:51

the argument I've been making and others is that the insulin inhibits fat loss insulin you hold onto your kind of simple Stevens absolutely right this book which is were talking about is it metabolic regulation human perspective it's written by Keith frame is retired Oxford Professor is a wonderful man and he was the world's leading Authority on metabolic regulation how your body controls its use of fuel and orchestrate storage and then oxidation and in this book Keith Frain talks about how insulin determines fat accumulation in fat cells

► 02:27:32

accumulation of fatty acid trafficking in and out of fat cells okay thank you for the first time I guess I was going for the journal science on insulin resistance and we spent about an hour in the phone and explain to me for 20 minutes all the ways insulin

► 02:27:56

traps determines fatty acid trafficking across the fat cell membrane and you raise insulin you accumulate more fat on the short-term and then we got to obesity and they said will be City's you know caused by people eating too much and I said Keith when we were

► 02:28:17

talking about wife's fat cells get fat it was all insulin mediated and when we were talking about people get fat as this eating too much thing okay and you switch mechanisms on me

► 02:28:31

so my assumption is the same reason people get fat is the same reason they're fat cells get fat and you've got a whole lot of you've got this disorder metabolic syndrome were talking about which includes not just

► 02:28:46

problems with your blood lipids But it includes getting fatter your waistline increasing and it's an insulin resistance related to sort of which means your insulin is elevated and again this is where we end up with two hypotheses about why insulin has elevated but if friends and sugar can Elevate insulin you end up with metabolic syndrome urine fat storage mode that's the terminology of diet book doctors so now you're storing that you only have to do and calories a day 20 calories a day you're going to get obese and its insulin median and Sons responding to the carbohydrate content of the diet primarily and that's it and when I sent this to Keith you know you've got one mechanism for white fat cells get fat different mechanism for why humans get sad and I'd like to talk about this over eating concept he said y'all never thought of that I mean the guy been in the field for years and maybe 5th day and then I had a long conversation with him I was back in Oxford when I did that insane Alan Aragon debate

► 02:29:46

I stopped off at Oxford on the way to Manchester and we had a long conversation with Keith I said oh but I want you to do is just

► 02:29:54

come up with a hypothesis of obesity from the fat cells perspective right shed your brain Centric energy balance Center thing and say if nothing else asks a student to do it as an experiment and I would be a great thought experiment for kid what's going to make a fat self at 9 or sumption is going to be that's what's going to make a human sad and Casey said I hate said literally said to me he was retiring and he was going off to Garden kind of envied them City I just can't I can't put energy balance aside you're telling me to not think in terms of intake and expenditure night I can't do it

► 02:30:33

tell me wonderful man he literally in this is again when I've been arguing it's all these people are so including Stephen who was you know who learned in this world are there so they locked into thinking that obesity is this energy imbalance and they can't get away from it so everything they do everything they interpret I-17 tasers study after study in their 20 randomized control studies and it turned I'm going to shovel the evidence on top of you and I'm saying like I guarantee if we go through this 20 studies I'll be just like the gym he'll study they assumed energy balance was the cause and then they wanted to see what caused energy imbalance and they started with the wrong hypothesis they're trapped in a paradigm we've all seen this and I responded so Gary I pre-ordered your book I have a copy of your book right here good calories bad calories I pre-ordered this in 2008 cuz I was so excited to read this book and I tore through it

► 02:31:33

and I was so persuaded when I initially read this 10 years ago that I ate a low carbohydrate diet for 6 months cuz I thought I was gay I thought the cars are going to make me fat and give me diabetes so I was fully immersed and convinced by your perspective when I read this book yet and you sign this book we had a very nice dinner together and this thing that caused me to go away from that perspective was when I actually started investigating evidence on my own underlying these ideas I started doing my own research I didn't take your word for it I started doing my own research in the lab as well and actually doing real scientific studies so what you were staring found it did not line up with what you were saying in your book and what I ended up realizing about good calories bad calories

► 02:32:29

is essentially your arguments primarily rely on historical narratives and speculation and there's very little of actually saying what is the most pertinent scientific evidence to answer to this question and what is that evidence have to say it's mostly historical narratives and honestly you know I'm going to try to say this in in a non insulting way but I will simply say that others who have looked at the same historical evidence have come to different conclusions than you have and that includes me in the places where I've looked at the historical evidence and so I think that you know this idea that I am like locked in some Paradigm and can't see what you're talkin about I was there Gary I am toast soak wrap this up soon so we have like 3 hours almost up here from San Diego

► 02:33:29

talking about how you are eating Behavior differed on low-carb diets versus the higher carb diet you eat now and you talked about your resistance it was easier to fast on a low-carb diet correct okay and you didn't really have an explanation for it I don't have a very two ways to look at everything so one way is a low-carb diet somehow too because of I don't know food reward issues

► 02:34:04

affects your urge to eat car and low-carb foods and because of that you don't

► 02:34:14

hunger for them as much and when you're on a higher carb diet I take the way you phrased on the sofa podcast was your body sort of tells you it's mealtime so it's condition to me better so the alternative hypothesis are the other way to think about is on the low-carb diet insulin levels are saying lower lower he's mobilizing fat and he's oxidizing that fat and then she said on the podcast 235 lb Marathon or has enough fat in his body to run for a week so the reason you're able to skip meals is because insulin is low fuel my wife is calling probably telling me I'm getting shrill on a different way to look at everything that's the point I'm trying to put every study and then can you tell me evidence that can you give me actual evidence that the lower level of insulin is the cause of not needing to eat those meals

► 02:35:14

right if your fasting for certain prolong prayer time you bought is going to go into a ketogenic State we all agree at at right now that's that's the reason why it's easier to fast once you're in ketogenic States your body starts burning off fat and misses a widely reported something I don't know that you're getting thinner on that low carb diet foods fat balance it's the amount you're eating minus the amount you're burned all but it's it's question and that's what you keep leaving out so if you hang out has been tested and it's saying it has not been tested that's what I'm saying that's why we found a new see that's why we spend 30 million dollars that's why David Ludwig is doing another $13 when you feed people whether it's over feeding or underfeeding in your cause weight loss or weight maintenance the carb to Fat ratio of the diet makes almost notify me to give you another chance

► 02:36:14

studies on the same as feeding study from the sixties which I thought when you said hard and I thought you meant Ed Horton. T J Horton so at Horton Ethan Sims it that a prisoner started they literally they they wanted to get over feed and they're using their thinking in terms of eating too much they wanted to get first get college kids to gain 25% of body weight this is in the sixties and they couldn't get the college kids to do it would suggest that college kids were different in the 60s and they are today so they used prisoners in the Vermont state prison and they over fit them and you discuss this in your book

► 02:36:50

they could get these prisoners to eat 10000 calories a day of excess carbohydrates

► 02:36:59

excess calories is calories not carbohydrate might have been calories they couldn't get him to had more than a thousand calories a fat

► 02:37:08

okay and they talked about this is some studies were crazy cuz I published in 15 different Journal so they interpret the pounds gained

► 02:37:17

per calorie added they gained more per calorie of fat than they did per calorie of carbs but if you looked at how much they could eat

► 02:37:28

they couldn't add that much fat and they could add 7000 extra calories is 10000 calories and then go to bed hungry craving more carbs so then the question becomes again is it because of carbs are doing something in the brain to increase food reward or is it the carbs are doing something in the body so that their body is figured out a way you can orchestrate deal with this massive influx of carbs vs. fat but there's always two ways to look at it and everytime Stephen says there's masses of evidence of my job as a journalist wish to go through and say this is refute that hypothesis and if it doesn't we have to hold on to it cuz remember we have an obesity and diabetes epidemic and the kind of advice where we tell people to sleep better

► 02:38:17

and eats Lasser avoid foods that they love don't have pizza and ice cream and it still implies that the reason they could fat even overeating hypothesis you think they should be eating pizza and ice cream what do you think I know I think we would both say Don't eat pizza and I don't ask questions like that thank you

► 02:38:39

is something wrong out there tragically wrong we know if nothing else I think you would agree with this at all low carb movements you set it on this podcast with that yet or what I've done if nothing else is convince people that could eat low-carb diets without killing themselves that's a good thing to ultimately these are good things that I've done my overall tires with you entirely because you're telling people that only carbohydrate matters carbohydrate calorie intake and dietary fat intake and physical activity do not influence body fatness and are not important. I'm already doing that know if you're going to look at look at the model that we publish that you contributed to and we signed off at doesn't say anything about physics says that physical activity dietary fat intake and cow

► 02:39:39

rent a car not important. I refuse to admit that somebody who's there is no harm in what you're saying because yes we all agree that these carbohydrates are fattening but you're saying that these other important things are irrelevant and that's the dangerous part I want to know what I'm saying about calories is it the wrong way to think about the way you think they do matter measure the quantity of food you're eating a could use grams you could do anything else with the question is is it the right way to think about it can you solve an obesity excess calorie intake and physical inactivity are secondary to this process and not themselves determinants of body

► 02:40:39

it's okay that's I'm not putting words in your mouth I want to read that yet but that's different than what you just tried to call you sure it is there just never seemed to be enough food to 78 Carl's growing body after school he would eat a footlong sub before his mother's home-cooked dinners even after having a hefty lunch of homemade chicken rice and vegetables in his favorite snacks granola bars and buncha crunch okay lot of calories for one person we are talking about when we see how is this going to change my problems with the hell over eating hypothesis is its tautological you don't know if someone's overeating unless they're fat right

► 02:41:30

incorrect about this fellow shopping after lunch with homemade chicken rice and vegetable

► 02:41:51

you cannot

► 02:41:53

tell if someone's fat I do have no idea how many calories I consume right I could probably get a pretty decent estimate actually based on publish formulas okay and how would you know whether I was over it and remember we're talking about 10 calories a day no offense store in the fat 2 fit how you define that but I could look at your body composition and I can tell you whether you are overeating relative to a lien person yet I have excess body fat correct so without knowing if I have excess body fat you cannot tell whether I'm overeating which is the cause of the excess body fat right circular calorie intake carbs or fat either way the game body fat there's nothing circular about my net calories increase body fat at the fellow I think someone who is currently has obesity

► 02:42:53

can you reduce their calorie intake carbs or fat doesn't make any difference they lose body fat that's so there's nothing circular about this calorie thing at all I don't understand how you can possibly think that was circular it's so simple and direct it was a lot of fun it was that much fun it was interested I don't know who to believe quite honestly I think you both make some excellent points and I think there's definitely some real legitimate concern that you have about his position and I think that your position has some Merit as well the position about insulin and about carbohydrates and sugar this is a really long conversation and I think we could probably do this for another 6 days forget about hours I think if I would recommend

► 02:43:53

people are placing people have to really keep trying to figure this out for themselves I would recommend Stephen please recommend your book what it what is your Pokemon is called The Hungry Bear hungry brain and spell boy everywhere Amazon trenda Gary calories bad calories or why we get fat or the case against sugar I think we just begun this debate has been going on a year out of evidence here that I didn't have time to say unfortunately I know it was a long one but thank you gentlemen thank you thank you Joe

► 02:44:29

notice at the beginning of the podcast I was introducing Carrot Tops I couldn't say his name right and then he couldn't say Stefan's name right what in the fuck what was that stumble all about was that I hope you guys enjoyed that podcast and I want to give a shout out to all my sponsors shout out to movement watches folks more than oh oh almost not quite almost 2 million watches worldwide bringing you quality designs

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► 02:46:33

and $5 will go to support our good friend Justin Wren fight for the Forgotten charity helping build Wells for the pygmies in the Congo

► 02:46:43

temp for today folks tomorrow my brother Bryan Callen over here I'm very excited about that and I'm sure we'll talk about some cool shit so appreciate you folks much love to you all thank you bye