Why We Get Fat: And What to Do About It – by Gary Taubes
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We’ve previously reviewed Taubes’ “The Case Against Sugar“. What does this one bring differently?
Mostly, it’s a different focus. Unsurprisingly, Taubes’ underlying argument is the same: sugar is the biggest dietary health hazard we face. However, this book looks at it specifically through the lens of weight loss, or avoiding weight gain.
Taubes argues for low-carb in general; he doesn’t frame it specifically as the ketogenic diet here, but that is what he is advocating. However, he also acknowledges that not all carbs are created equal, and looks at several categories that are relatively better or worse for our insulin response, and thus, fat management.
If the book has a fault it’s that it does argue a bit too much for eating large quantities of meat, based on Weston Price’s outdated and poorly-conducted research. However, if one chooses to disregard that, the arguments for a low-carb diet for weight management remain strong.
Bottom line: if you’d like to cut some fat without eating less (or exercising more), this book offers a good, well-explained guide for doing so.
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What Flexible Dieting Really Means
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When Flexibility Is The Dish Of The Day
This is Alan Aragon. Notwithstanding not being a “Dr. Alan Aragon”, he’s a research scientist with dozens of peer-reviewed nutrition science papers to his name, as well as being a personal trainer and fitness educator. Most importantly, he’s an ardent champion of making people’s pursuit of health and fitness more evidence-based.
We’ll be sharing some insights from a book of his that we haven’t reviewed yet, but we will link it at the bottom of today’s article in any case.
What does he want us to know?
First, get out of the 80s and into the 90s
In the world of popular dieting, the 80s were all about calorie-counting and low-fat diets. They did not particularly help.
In the 90s, it was discovered that not only was low-fat not the way to go, but also, regardless of the diet in question, rigid dieting leads to “disinhibition”, that is to say, there comes a point (usually not far into a diet) whereby one breaks the diet, at which point, the floodgates open and the dieter binges unhealthily.
Aragon would like to bring our attention to a number of studies that found this in various ways over the course of the 90s measuring various different metrics including rigid vs flexible dieting’s impacts on BMI, weight gain, weight loss, lean muscle mass changes, binge-eating, anxiety, depression, and so forth), but we only have so much room here, so here’s a 1999 study that’s pretty much the culmination of those:
Flexible vs. Rigid Dieting Strategies: Relationship with Adverse Behavioral Outcomes
So in short: trying to be very puritan about any aspect of dieting will not only not work, it will backfire.
Next, get out of the 90s into the 00s
…which is not only fun if you read “00s” out loud as “naughties”, but also actually appropriate in this case, because it is indeed important to be comfortable being a little bit naughty:
In 2000, Dr. Marika Tiggemann found that dichotomous perceptions of food (e.g. good/bad, clean/dirty, etc) were implicated as a dysfunctional cognitive style, and predicted not only eating disorders and mood disorders, but also adverse physical health outcomes:
Dieting and Cognitive Style: The Role of Current and Past Dieting Behaviour and Cognitions
This was rendered clearer, in terms of physical health outcomes, by Dr. Susan Byrne & Dr. Emma Dove, in 2009:
❝Weight loss was negatively associated with pre-treatment depression and frequency of treatment attendance, but not with dichotomous thinking. Females who regard their weight as unacceptably high and who think dichotomously may experience high levels of depression irrespective of their actual weight, while depression may be proportionate to the degree of obesity among those who do not think dichotomously❞
Aragon’s advice based on all this: while yes, some foods are better than others, it’s more useful to see foods as being part of a spectrum, rather than being absolutist or “black and white” about it.
Next: hit those perfect 10s… Imperfectly
The next decade expanded on this research, as science is wont to do, and for this one, Aragon shines a spotlight on Dr. Alice Berg’s 2018 study with obese women averaging 69 years of age, in which…
In other words (and in fact, to borrow Dr. Berg’s words from that paper),
❝encouraging a flexible approach to eating behavior and discouraging rigid adherence to a diet may lead to better intentional weight loss for overweight and obese older women❞
You may be wondering: what did this add to the studies from the 90s?
And the key here is: rather than being observational, this was interventional. In other words, rather than simply observing what happened to people who thought one way or another, this study took people who had a rigid, dichotomous approach to food, and gave them a 6-month behavioral intervention (in other words, support encouraging them to be more flexible and open in their approach to food), and found that this indeed improved matters for them.
Which means, it’s not a matter of fate or predisposition, as it could have been back in the 90s, per “some people are just like that; who’s to say which factor causes which”. Instead, now we know that this is an approach that can be adopted, and it can be expected to work.
Beyond weight loss
Now, so far we’ve talked mostly about weight loss, and only touched on other health outcomes. This is because:
- weight loss a very common goal for many
- it’s easy to measure so there’s a lot of science for it
Incidentally, if it’s a goal of yours, here’s what 10almonds had to say about that, along with two follow-up articles for other related goals:
Spoiler: we agree with Aragon, and recommend a relaxed and flexible approach to all three of these things
Aragon’s evidence-based approach to nutrition has found that this holds true for other aspects of healthy eating, too. For example…
To count or not to count?
It’s hard to do evidence-based anything without counting, and so Aragon talks a lot about this. Indeed, he does a lot of counting in scientific papers of his own, such as:
and
The effect of protein timing on muscle strength and hypertrophy: a meta-analysis
…as well as non-protein-related but diet-related topics such as:
But! For the at-home health enthusiast, Aragon recommends that the answer to the question “to count or not to count?” is “both”:
- Start off by indeed counting and tracking everything that is important to you (per whatever your current personal health intervention is, so it might be about calories, or grams of protein, or grams of carbs, or a certain fat balance, or something else entirely)
- Switch to a more relaxed counting approach once you get used to the above. By now you probably know the macros for a lot of your common meals, snacks, etc, and can tally them in your head without worrying about weighing portions and knowing the exact figures.
- Alternatively, count moderately standardized portions of relevant foods, such as “three servings of beans or legumes per day” or “no more than one portion of refined carbohydrates per day”
- Eventually, let habit take the wheel. Assuming you have established good dietary habits, this will now do you just fine.
This latter is the point whereby the advice (that Aragon also champions) of “allow yourself an unhealthy indulgence of 10–20% of your daily food”, as a budget of “discretionary calories”, eventually becomes redundant—because chances are, you’re no longer craving that donut, and at a certain point, eating foods far outside the range of healthiness you usually eat is not even something that you would feel inclined to do if offered.
But until that kicks in, allow yourself that budget of whatever unhealthy thing you enjoy, and (this next part is important…) do enjoy it.
Because it is no good whatsoever eating that cream-filled chocolate croissant and then feeling guilty about it; that’s the dichotomous thinking we had back in the 80s. Decide in advance you’re going to eat and enjoy it, then eat and enjoy it, then look back on it with a sense of “that was enjoyable” and move on.
The flipside of this is that the importance of allowing oneself a “little treat” is that doing so actively helps ensure that the “little treat” remains “little”. Without giving oneself permission, then suddenly, “well, since I broke my diet, I might as well throw the whole thing out the window and try again on Monday”.
On enjoying food fully, by the way:
Mindful Eating: How To Get More Nutrition Out Of The Same Food
Want to know more from Alan Aragon?
Today we’ve been working heavily from this book of his; we haven’t reviewed it yet, but we do recommend checking it out:
Enjoy!
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Chai-Spiced Rice Pudding
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Sweet enough for dessert, and healthy enough for breakfast! Yes, “chai tea” is “tea tea”, just as “naan bread” is “bread bread”. But today, we’re going to be using the “tea tea” spices to make this already delicious and healthy dish more delicious and more healthy:
You will need
- 1 cup wholegrain rice (a medium-length grain is best for the optimal amount of starch to make this creamy but not sticky)
- 1½ cups milk (we recommend almond milk, but any milk will work)
- 1 cup full fat coconut milk
- 1 cup water
- 4 Medjool dates, soaked in hot water for 5 minutes, drained, and chopped
- 2 tbsp almond butter
- 1 tbsp maple syrup (omit if you prefer less sweetness)
- 1 tbsp chia seeds
- 2 tsp ground sweet cinnamon
- 1 tsp ground ginger
- 1 tsp vanilla extract
- ½ tsp ground cardamom
- ½ tsp ground nutmeg
- ½ ground cloves
- Optional garnish: berries (your preference what kind)
Method
(we suggest you read everything at least once before doing anything)
1) Add all of the ingredients except the berries into the cooking vessel* you’re going to use, and stir thoroughly.
*There are several options here and they will take different durations:
- Pressure cooker: 10 minutes at high pressure (we recommend, if available)
- Rice cooker: 25 minutes or thereabouts (we recommend only if the above or below aren’t viable options for you)
- Slow cooker: 3 hours or thereabouts, but you can leave it for 4 if you’re busy (we recommend if you want to “set it and forget it” and have the time; it’s very hard to mess this one up unless you go to extremes)
Options that we don’t recommend:
- Saucepan: highly variable and you’re going to have to watch and stir it (we don’t recommend this unless the other options aren’t available)
- Oven: highly variable and you’re going to have to check it frequently (we don’t recommend this unless the other options aren’t available)
2) Cook, using the method you selected from the list.
3) Get ready to serve. Depending on the method, they may be some extra liquid at the top; this can just be stirred into the rest and it will take on the same consistency.
4) Serve in bowls, with a berry garnish if desired:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Grains: Bread Of Life, Or Cereal Killer?
- Which Plant Milk?
- If You’re Not Taking Chia, You’re Missing Out
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Sweet Cinnamon vs Regular Cinnamon – Which is Healthier?
Take care!
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Metformin For Weight-Loss & More
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Metformin Without Diabetes?
Metformin is a diabetes drug; it works by:
- decreasing glucose absorption from the gut
- decreasing glucose production in the liver
- increasing glucose sensitivity
It doesn’t change how much insulin is secreted, and is unlikely to cause hypoglycemia, making it relatively safe as diabetes drugs go.
It’s a biguanide drug, and/but so far as science knows (so far), its mechanism of action is unique (i.e. no other drug works the same way that metformin does).
Today we’ll examine its off-label uses and see what the science says!
A note on terms: “off-label” = when a drug is prescribed to treat something other than the main purpose(s) for which the drug was approved.
Other examples include modafinil against depression, and beta-blockers against anxiety.
Why take it if not diabetic?
There are many reasons people take it, including just general health and life extension:
However, its use was originally expanded (still “off-label”, but widely prescribed) past “just for diabetes” when it showed efficacy in treating pre-diabetes. Here for example is a longitudinal study that found metformin use performed similarly to lifestyle interventions (e.g. diet, exercise, etc). In their words:
❝ Lifestyle intervention or metformin significantly reduced diabetes development over 15 years. There were no overall differences in the aggregate microvascular outcome between treatment groups❞
But, it seems it does more, as this more recent review found:
❝Long-term weight loss was also seen in both [metformin and intensive lifestyle intervention] groups, with better maintenance under metformin.
Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect.
Long-term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects.❞
Source: Metformin for diabetes prevention: update of the evidence base
We were wondering about that cardioprotective effect, so…
Cardioprotective effect
In short, another review (published a few months after the above one) confirmed the previous findings, and also added:
❝Patients with BMI > 35 showed an association between metformin use and lower incidence of CVD, including African Americans older than age 65. The data suggest that morbidly obese patients with prediabetes may benefit from the use of metformin as recommended by the ADA.❞
We wondered about the weight loss implications of this, and…
For weight loss
The short version is, it works:
- Effectiveness of metformin on weight loss in non-diabetic individuals with obesity
- Metformin for weight reduction in non-diabetic patients: a systematic review and meta-analysis
- Metformin induces weight loss associated with gut microbiota alteration in non-diabetic obese women
…and many many more where those came from. As a point of interest, it has also been compared and contrasted to GLP-1 agonists.
Compared/contrasted with GLP-1 agonists
It’s not quite as effective for weight loss, and/but it’s a lot cheaper, is tablets rather than injections, has fewer side effects (for most people), and doesn’t result in dramatic yoyo-ing if there’s an interruption to taking it:
Or if you prefer a reader-friendly pop-science version:
Ozempic vs Metformin: Comparing The Two Diabetes Medications
Is it safe?
For most people yes, but there are a stack of contraindications, so it’s best to speak with your doctor. However, particular things to be aware of include:
- Usually contraindicated if you have kidney problems of any kind
- Usually contraindicated if you have liver problems of any kind
- May be contraindicated if you have issues with B12 levels
See also: Metformin: Is it a drug for all reasons and diseases?
Where can I get it?
As it’s a prescription-controlled drug, we can’t give you a handy Amazon link for this one.
However, many physicians are willing to prescribe it for off-label use (i.e., for reasons other than diabetes), so speak with yours (telehealth options may also be available).
If you do plan to speak with your doctor and you’re not sure they’ll be agreeable, you might want to get this paper and print it to take it with you:
Off-label indications of Metformin – Review of Literature
Take care!
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Willpower: A Muscle To Flex, Or Spoons To Conserve?
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Willpower: A Muscle To Flex, Or Spoons To Conserve?
We have previously written about motivation; this one’s not about that.
Rather, it’s about willpower itself, and especially, the maintenance of such. Which prompts the question…
Is willpower something that can be built up through practice, or something that is a finite resource that can be expended?
That depends on you—and your experiences.
- Some people believe willpower is a metaphorical “muscle” that must be exercised to be built up
- Some people believe willpower is a matter of metaphorical “spoons” that can be used up
A quick note on spoon theory: this traces its roots to Christine Miserandino’s 2003 essay about chronic illness and the management of limited energy. She details how she explained this to a friend in a practical fashion, she gave her a bunch of spoons from her kitchen, as an arbitrary unit of energy currency. These spoons would then need to be used to “pay” for tasks done; soon her friend realised that if she wanted to make it through the day, she was going to have to give more forethought to how she would “spend” her spoons, or she’d run out and be helpless (and perhaps hungry and far from home) before the day’s end. So, the kind of forethought and planning that a lot of people with chronic illnesses have to give to every day’s activities.
You can read it here: But You Don’t Look Sick? The Spoon Theory
So, why do some people believe one way, and some believe the other? It comes down to our experiences of our own willpower being built or expended. Researchers (Dr. Vanda Siber et al.) studied this, and concluded:
❝The studies support the idea that what people believe about willpower depends, at least in part, on recent experiences with tasks as being energizing or draining.❞
Source: Autonomous Goal Striving Promotes a Nonlimited Theory About Willpower
In other words, there’s a difference between going out running each morning while healthy, and doing so with (for example) lupus.
On a practical level, this translates to practicable advice:
- If something requires willpower but is energizing, this is the muscle kind! Build it.
- If something requires willpower and is draining, this is the spoons kind! Conserve it.
Read the above two bullet-points as many times as necessary to cement them into your hippocampus, because they are the most important message of today’s newsletter.
Do you tend towards the “nonlimited” belief, despite getting tired? If so, here’s why…
There is something that can continue to empower us even when we get physically fatigued, and that’s the extent to which we truly get a choice about what we’re doing. In other words, that “Autonomous” at the front of the title of the previous study, isn’t just word salad.
- If we perceive ourselves as choosing to do what we are doing, with free will and autonomy (i.e., no externally created punitive consequences), we will feel much more empowered, and that goes for our willpower too.
- If we perceive ourselves as doing what we have to (or suffer the consequences), we’ll probably do it, but we’ll find it draining, and that goes for our willpower too.
Until such a time as age-related physical and mental decline truly take us, we as humans tend to gradually accumulate autonomy in our lives. We start as literal babies, then are children with all important decisions made for us, then adolescents building our own identity and ways of doing things, then young adults launching ourselves into the world of adulthood (with mixed results), to a usually more settled middle-age that still has a lot of external stressors and responsibilities, to old age, where we’ve often most things in order, and just ourselves and perhaps our partner to consider.
Consequently…
Age differences in implicit theories about willpower: why older people endorse a nonlimited theory
…which explains why the 30-year-old middle-manager might break down and burn out and stop going to work, while an octogenarian is busy training for a marathon daily before getting back to their daily book-writing session, without fail.
One final thing…
If you need a willpower boost, have a snack*. If you need to willpower boost to avoid snacking, then plan for this in advance by finding a way to keep your blood sugars stable. Because…
The physiology of willpower: linking blood glucose to self-control
*Something that will keep your blood sugars stable, not spike them. Nuts are a great example, unless you’re allergic to such, because they have a nice balance of carbohydrates, protein, and healthy fats.
Want more on that? Read: 10 Ways To Balance Blood Sugars
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Are You Making This Alcohol Mistake?
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The famous “small glass of red per day” is, as is quite well-established now in science, but not so much in popular culture, known to be not a good idea.
What most people don’t know
Rethinking “One Drink a Day”:
- Outdated beliefs and flawed studies:
- The idea that “one drink a day is healthy” stems from flawed associative studies that included…
- unhealthy former heavy drinkers in the zero-drinks category, and
- healthy older individuals who continued light drinking due to good health, not because alcohol contributed to it, in the drinkers category
- In other words, they looked at former alcoholics whose health was ruined by drinking and said “aha, non-drinkers have bad health”, and looked at the survivors of survivorship bias and said “aha, light drinking is the key to good health”. Which of course is terrible science propped up by terrible abuse of statistics propped up by shoddy methodology.
- The idea that “one drink a day is healthy” stems from flawed associative studies that included…
- New research findings:
- A 2022 UK Biobank Study showed that even one drink a day leads to brain shrinkage, neuron death, and cognitive decline.
- Another study on CVD disproved the notion that light drinking benefits heart health once confounding variables were removed.
- There are plenty more, and at 10almonds we’ve done a main feature about it, but for now, you get the idea.
Some other things you should know:
Ethanol and acetaldehyde damage neurons responsible for impulse control, judgment, motor coordination, and memory formation, leading to cognitive decline. The feeling of being drunk results from the suppression and damage of these neurons. But while the drunk feeling wears off, the damage to neurons does not.
Alcohol causes cumulative DNA damage in neurons, accelerates brain aging, and prevents the formation of new neurons, similar to a slow, gradual stroke.
Broader Health Impacts of Alcohol
We’ve said it before, and we’ll say it again: alcohol is bad for pretty much everything.
Here are some examples mentioned in the video:
- Neurodegenerative diseases: heavy drinking increases the risk of Alzheimer’s, particularly in those genetically predisposed.
- Sleep disruption: alcohol reduces deep, restful sleep and hampers the brain’s natural detox process overnight, contributing to morning grogginess.
- Inflammation and immune suppression: alcohol increases inflammation, exacerbates autoimmune diseases (like psoriasis and arthritis), and weakens immune function.
- Cancer risk: alcohol is classified as a Group 1 carcinogen by the International Agency for Research on Cancer, linked to various cancers, especially breast cancer. Even light drinking increases breast cancer risk.
- Hormonal imbalances: in women, alcohol heightens PMS symptoms, reduces fertility, and increases testosterone. In men, it lowers sperm quality and disrupts hormones.
For more on all of these and more, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Can We Drink To Good Health? ← this is mostly about red wine and heart health
- How To Reduce Or Quit Alcohol ← this is about the more general reasons to quit, and how to do so
- What Happens To Your Body When You Stop Drinking Alcohol ← a realistic timeline of recovery
Take care!
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- Outdated beliefs and flawed studies:
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Diet Tips for Crohn’s Disease
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Doctors are great at saving lives like mine. I’m a two time survivor of colon cancer and have recently been diagnosed with Chron’s disease at 62. No one is the health system can or is prepared to tell me an appropriate diet to follow or what to avoid. Can you?❞
Congratulations on the survivorship!
As to Crohn’s, that’s indeed quite a pain, isn’t it? In some ways, a good diet for Crohn’s is the same as a good diet for most other people, with one major exception: fiber
…and unfortunately, that changes everything, in terms of a whole-foods majority plant-based diet.
What stays the same:
- You still ideally want to eat a lot of plants
- You definitely want to avoid meat and dairy in general
- Eating fish is still usually* fine, same with eggs
- Get plenty of water
What needs to change:
- Consider swapping grains for potatoes or pasta (at least: avoid grains)
- Peel vegetables that are peelable; discard the peel or use it to make stock
- Consider steaming fruit and veg for easier digestion
- Skip spicy foods (moderate spices, like ginger, turmeric, and black pepper, are usually fine in moderation)
Much of this latter list is opposite to the advice for people without Crohn’s Disease.
*A good practice, by the way, is to keep a food journal. There are apps that you can get for free, or you can do it the old-fashioned way on paper if prefer.
But the important part is: make a note not just of what you ate, but also of how you felt afterwards. That way, you can start to get a picture of patterns, and what’s working (or not) for you, and build up a more personalized set of guidelines than anyone else could give to you.
We hope the above pointers at least help you get going on the right foot, though!
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