March 11, 2026

Carbs vs Fat - Metabolic Health, Weight Loss & Gold Standard Science | Ep 24

Carbs vs Fat - Metabolic Health, Weight Loss & Gold Standard Science | Ep 24

Does eating fat actually make you fat? Or has modern nutrition science gotten the story backwards? In this episode of Unconditional, Norbie Schickel explores one of the biggest debates in modern nutrition: low-carb vs. low-fat diets and whether fat loss really comes down to “calories in, calories out.” The episode revisits the rise of the low-carb movement after Gary Taubes’ influential 2002 article, “What If It’s All Been a Big Fat Lie?”, which challenged decades of dietary advice by arguing...

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Does eating fat actually make you fat? Or has modern nutrition science gotten the story backwards?

In this episode of Unconditional, Norbie Schickel explores one of the biggest debates in modern nutrition: low-carb vs. low-fat diets and whether fat loss really comes down to “calories in, calories out.”

The episode revisits the rise of the low-carb movement after Gary Taubes’ influential 2002 article, “What If It’s All Been a Big Fat Lie?”, which challenged decades of dietary advice by arguing that carbohydrates and sugar—not dietary fat—may be the real drivers of obesity and metabolic dysfunction.

But when proponents of the carbohydrate-insulin model put their theory to the ultimate test in a gold-standard randomized controlled trial conducted by NIH researcher Kevin Hall, the results appeared to contradict the low-carb hypothesis. Headlines quickly declared victory for low-fat diets.

Norbie breaks down what the study actually found—and more importantly, how it was designed. From the surprisingly small sample size to the six-day dietary intervention and calculated fat loss measurements, this episode explores the details that rarely make it into headlines.

Along the way, the conversation raises a bigger question: How should we interpret nutrition science—and what counts as real evidence when it comes to health and fat loss?

If you’re interested in nutrition science, metabolic health, keto and low-carb diets, the food pyramid debate, and the limits of “following the science,” this episode is a fascinating deep dive.

CHAPTERS

00:00 Intro: Fat vs Carbs & Gold Standard Science
06:04 Science & Nutrition - The Stakes & Context
06:42 Calories In Calories Out Is At Stake
07:50 The Role Of Dietary Fat & Weight Gain is at Stake
08:45 The Role of Science in Nutrition is at Stake
11:34 Humans Have Historically NOT Relied On Science For Nutrition
17:29 Gary Tuabes vs Kevin Hall - The Big Fat Debate
27:18 The Actual Study
37:46 The Validity of Fat Burn Measurements
40:09 Study Design and Its Implications
42:22 The Role of Science in Nutrition

#metabolichealth #fatloss #ketodiet #lowcarbdiet #weightloss

RESOURCES

Kevin Hall Paper

BBC Article

WEBVTT

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Every now and then, a radical idea comes along and completely flips what we know or what we thought we knew upside down.

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The Earth isn't the center of the solar system.

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The world isn't flat.

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Hand washing will prevent childbed fever.

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There are many such examples across the universe of human knowledge.

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In the realm of health and fitness and nutrition, that's no different.

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With the recent inversion of the food pyramid, the rising concern around seed oils and say the emergence of the carnivore diet, you might say that we're living through many such inversions right now.

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What we knew or what we thought we knew has been completely flipped on its head.

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Now there are many takeaways each time one of these revolutions comes along.

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In addition to the specific change, they serve as an important reminder of the need for humility, or of the harm of hubris, and the willingness to hear people diametrically opposed to your perspective.

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As you know, I have been fascinated by all things health and fitness for as long as I can remember.

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And one of the first of these revolutions, these completely inversions, these paradigm flips, if you will, happened with respect to what would appear to be an obvious question.

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Does eating fat make you fat?

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And for most people, including myself at the time, they knew the answer to this question.

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Of course it did.

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In addition to the fact that all of the experts agreed, or at least the ones we heard from, well it's self evident, right?

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It's correct by definition.

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Of course fat makes you fat.

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It's like saying is a dog a dog or is a bird a bird.

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It's true by definition.

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Only for some people, noting what was an early uptick in obesity, despite worldwide knowledge, quote unquote, of what was making us fat, the answer didn't appear to be so obvious.

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And the real truth may have been diametrically opposed to the conventional wisdom.

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Eating fat was not only not making us fat, eating fat was quite possibly the only thing that could save us from becoming fat.

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In 2002, a science writer and journalist named Gary Taubs published an article in the New York Times magazine titled What If It's All Been a Big Fat Lie?

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An article which rocked the world of health and nutrition, in which he argued that the conventional understanding and government official dietary recommendations, it should be pointed out, were essentially upside down, that the consumption of dietary fat was not a driver of obesity and heart disease.

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But in fact, sugar and carbohydrates were actually to blame.

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By now, we're used to things like paleo diets, low carb diets, keto diets, even carnivore diets.

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But at the time, I have to impress upon you, this was radical, okay?

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As insane and as upside down as anything you could imagine within the space of health and nutrition.

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And as always, the stakes and the context matters.

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This was a very, very different time, okay, almost 25 years ago.

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I remember.

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Okay, I'm in high school at the time, but keep in mind, very limited early social media, right?

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Probably talk in my space, very limited alternative media.

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You know, we're talking something like blogs, right?

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Maybe the Drudge Report.

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This is a very, very different time.

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But despite the massive pushback from the establishment on this idea, on Taubs' idea, the chorus of the low carb movement started to form, first as a whisper and then as a roar.

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And in the space of about 10 years, this improbably radical idea, one fueled by incredible before and after photos of weight loss stories, of real people, the health turnarounds by millions of Americans, right when it seemed that low carb was poised to take over as the new normal, science stepped in, real science here, gold standard science, and it punched the challenger right in the mouth.

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With that, I'd like to welcome you to another episode of Unconditional with Norby Shickle.

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We have a very exciting episode this week.

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This is a topic I've teased a bit in the past.

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And if you are a health and fitness nerd like me, I think this is a conversation you're really going to enjoy.

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Now there is a sentence that gets thrown around a lot in the health, fitness, and nutrition space.

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And it's something like this.

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Where's your study?

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Or show me the science, or something to that effect.

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And while often this can be a legitimate attempt to use the tool of science to get to the truth, it can at times be a means of shuddering debate and discussion.

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There is no debate about the fact that the tool of science and the scientific method has delivered some incredible results for humanity, including within the space of health and fitness.

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But is it the only tool?

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The most appropriate tool?

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Well, even asking the question feels like heresy.

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But it's a question we should ask, because doing so may shed light on some things that are very confusing within the world of health and fitness right now.

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And to further unpack this question, we're going to dive into a single chapter within the history of human health and nutrition, one that happened recently, one involving gold standard science, and a few questions that are as important now as they've ever been.

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Does eating fat make you fat?

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Is fat loss truly as simple as calories in, calories out?

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The law of thermodynamics, if you will.

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And trust me, if you're into health and fitness like I am, you're going to find this very, very fascinating.

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Okay, now always we got to talk stakes, we've got to talk context, we got to talk why does this matter?

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Okay, why is this important?

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And for me, what it really comes down to is the fact that this topic and this study that we're going to talk about, we'll go into some depth on it, have broad implications for a whole lot within the realm of health and fitness.

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Let's just reflect on a few of these for a moment.

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Okay, we'll start specific and then we'll radiate out from there.

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Okay, and I think you'll start to see why I find this small chapter in human health and fitness just so compelling.

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Okay, so first, one of the most important claims from the perspective of science and nutrition, it's at stake here within this chapter.

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Okay, do calories matter?

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Or has the quote law of thermodynamics, as often as invoked in this case, been thrown out?

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Or at a minimum, is it in need of significant revision?

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Again, this would be a major, major departure from the conventional understanding of health, nutrition, and fat loss.

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How often have you heard some form of a calorie is a calorie, calories in, calories out, law of thermodynamics, right?

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Said all the time.

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Not just by those within the scientific community either, but by those in the public, general fitness, bodybuilders, fitness trainers, right, as well.

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If it's possible, as had been claimed by many in the low carb community, that they are able to eat more calories, yet somehow burn more fat, and this is proven out scientifically, this is a massive, massive departure.

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This is enormous.

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We've spoken a bit about the food pyramid before, and we are living through the complete inversion of the food pyramid, or at least from an optics perspective.

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Okay, we did an entire episode on the food pyramid, the new one.

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So if you haven't given that a listen, definitely worth doing.

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Okay, as always, there's a lot missing from the headlines on the new food pyramid.

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And if you want to know the real, real, check out that episode.

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Okay, the change is maybe not quite what you think.

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But given that the original food pyramid recommends six to eleven servings of grain, whole grains per day, right?

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It's the very base of the pyramid, and that obesity rates continue to climb despite a reduction in the consumption of dietary fat and saturated fat.

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If Gary Taubs in the low-carb community are right, the official government dietary recommendations for Americans are at least somewhat responsible, right?

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The original ones.

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But as I've said, there's an even bigger question that is at play here.

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And honestly, it's a more meta question.

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And it's what the nerds in the group, no judgment, myself included, would refer to as a question of epistemology.

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How do we know what we know?

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Or more precisely, how do we know what we think we know?

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Now just bear with me for a minute here.

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Okay, if you're thinking I'm about to start going into simulation theory and the multiverse, you know, don't hit the pause button just yet.

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Okay, we're gonna bring this back in.

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We're talking about something much more tangible and much more direct.

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It may be another way to think about it is what do we accept as proof in the case of nutrition, in the case of health and fitness?

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What do we accept as evidence that would support a claim?

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And this is one of those questions that sounds like it has an obvious answer.

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But the more that you start thinking about it, I don't know.

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You might be surprised.

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For most of us, at least in the United States, 2026, and I guess most of the developed world, quote unquote, at this point, I think you could say have a very strong affinity for the scientific method as a means of assessing the validity of a claim.

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Does X drug cure Y disease?

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We've sort of followed the steps of the scientific method in order to establish whether the drug is effective or not effective, right?

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We're all familiar with this.

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For most of us in the developed world, when it comes to questions of food, of nutrition, and of health, we turn to the experts.

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And when we say experts, let's be clear, we mean scientists, right?

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We mean people who perform experiments or at a minimum study the results and review the results.

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That's what we mean.

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We don't, for the most part, we're not out consulting tarot cards, trying to read Oracle Bones or the Bible.

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Other areas of human knowledge, such as history, anthropology, or say religion, these might be interesting.

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They might even present some interesting sort of hypothetical what if type questions.

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But for the most part, for most of us, the final arbiter, it's science.

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And for the record, I'm not saying this is wrong, but it's important to realize that this is certainly not the only system developed by humans for assessing truth from falsity.

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In fact, most humans, throughout all of human history, never looked to science for anything in the realm of health or food or nutrition.

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They ate the way that their parents and their grandparents did.

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Well, let me point something out.

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The study which is most often described as the first study in human nutrition occurred in 1747 by a guy named James Lind.

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Okay, Lind was a Scottish naval surgeon.

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And this study looked into whether the consumption of certain foods might be effective at treating scurvy, right?

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And Lind discovers, lo and behold, it's citrus fruits.

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Now, this is 300 years ago, which seems like an incredibly long time ago.

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But in the grand scheme of human history, that's a blink of an eye, right?

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And that's just one study in one country.

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It would be many, many more years before science had anything meaningful to add on the perspective of nutrition in general.

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And so an obvious question is, well, how did people know what to eat before?

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And how did they assess what was working, promoting vitality and good health, or disease and decline?

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And while we know the answer is varied, right, from religious beliefs to necessity imposed by nature to tradition, the list goes on and on, including things that we likely don't know and maybe never will know.

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But one thing we do know is that it wasn't science.

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I find that just fascinating, right?

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That this paradigm, the ultimate authority that we all look to in order to sort truth from falsehood, it's a very new invention.

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And this is not a negative judgment about the scientific method, again, I will emphasize, or of studies on nutrition or health or any of that, I am very glad to be living in a world with all of the incredible innovations and technologies that have come as a direct result of the scientific method.

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But is it the only way?

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Is it the only tool in the toolbox, so to speak?

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Well, of course not.

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And when you look back at tribal and ancestral people, from, say, the work of Dr.

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Weston A.

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Price, a name that if you listen to the show, you'll be very familiar with, it's very obvious that these people enjoyed incredible health and vitality, all in the absence of science.

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They didn't rely on a study to tell them how to eat or what food would develop and grow healthy bodies.

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And I think you could make the case that they were much more vital as a society than we are today.

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Actually, I think it would be difficult to make the case that they weren't.

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But either way, there's no denying that science and those connected to science, say doctors, medical professionals, nutrition scientists, etc., are held in an elevated position in society.

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And of course, you might say this is for good reason.

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But it's also important to remember that this is only one method of attempting to get to what will build health and vitality in our own lives.

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And of course, science is not static.

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It's ever changing.

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And it's important to remind ourselves that is a feature, not a bug.

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Science evolves and should evolve.

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But these two factors, right, the high esteem, the sometimes unquestioning, uncritical attitude that we adopt towards quote science, I'm speaking very generally here, and the fact that the state of current scientific knowledge can and will change.

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In my opinion, it helps to explain these times in history when we look back and think to ourselves, how could they not see it?

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How did anyone go for that?

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Let's talk about the harm of seed oils for a second, something that's becoming increasingly mainstream.

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You know, there are people alive today who grew up as children eating butter.

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And at some point in time, they were informed that butter was the cause of heart disease, of obesity, of a whole host of other diseases, and they should switch to vegetable oils, to margarines, and they did, right, out of trust, respect, and competence for those in science.

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And even though many of them started to develop health issues, even the very conditions that the switch was supposed to prevent, most continued to pay for their own poison, so to speak.

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If you buy that seed oils are toxic and harmful, as I know many of you do, there's an obvious question.

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How did these people, many of whom you know, how did they not see it?

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Especially when their parents and their grandparents never ate that way, never consumed any of these seed oils or margarines or vegetable oils, and never had any of those problems.

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And I think that we have an answer.

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And it has to do with faith in science.

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Now, am I painting with a broad brush here?

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Of course I am.

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The debate around seed oils in the scientific community and research community, it's ongoing.

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And this is just one example, right?

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There are many that we could point to, from the benefits of a glass of wine per day, something I certainly heard as a child, to the lack of evidence between smoking and lung cancer, right?

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Something that our parents probably heard as children, if you're around my age, or the six to eleven servings of grain recommended in the food pyramid, which we've seen within the past few months has been completely flipped upside down.

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If you are simply attempting to follow the science, the science has and will continue to change.

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Which, of course, is why we cannot, as individuals, simply outsource our rational faculties, no matter how compelling, powerful the track record, to anybody else.

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Okay, it's just my two cents here.

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And that is at the core of this episode.

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Okay, so we, as always, have beaten the context of this episode to death.

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We have the stakes, we've got why this is important.

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I've given you my perspective as to why this small chapter in the history of human nutrition is just so compelling.

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And so we should go ahead and get into it.

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Now, to tee up this study correctly, let's recall the setting, right?

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The conventional wisdom, as evidenced by the food pyramid, is that the primary food at the base of the pyramid that we should be consuming as Americans, let's just say six to eleven servings of grain per day.

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That consuming fat, dietary fat, is what's making us fat, and that reductions in fat consumption and saturated fats, especially, will lead to better health outcomes for all Americans.

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Now, of course, there's this radical guy named Atkins, you know, and he made some kind of wild claims about carbohydrates and that sort of thing.

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But for the most part, he was ignored.

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But along comes this guy, Gary Taubs.

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And this time, you know, this low carb thing, it really starts to stick, right?

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It goes mainstream.

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And I remember this very well.

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Okay, I was in college at the time, right?

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The article came out in 2002.

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I think I started college in 2004.

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And certainly by the time I was partway through college, it was in full swing.

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Okay.

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It really became big.

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And for those who were not around or weren't just paying as close to attention at the time, the way that I would describe it is it was very similar to the hype that we're living through right now with GOP ones.

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Right?

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Social media wasn't quite the same.

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You still had Facebook, you know, you had other people that you knew.

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And it seemed like everybody knew someone or multiple people who had struggled with weight for years, only to hear about and then to do the exact opposite of what the official dietary guidelines suggested, and finally see the weight melt away.

00:19:42.319 --> 00:19:48.640
All while seeming to eat more food, no counting calories, no exercise in many cases.

00:19:48.880 --> 00:19:57.039
I mean, this is a complete revolution with Gary Taubs, the chief revolutionary, and riding high on the success.

00:19:58.319 --> 00:20:08.799
In fact, Taubes was so confident that he had discovered the truth, that he discovered the root cause of what today we might describe as metabolic dysfunction and obesity.

00:20:09.599 --> 00:20:12.079
He and the co-founder of his company, Dr.

00:20:12.160 --> 00:20:20.480
Peter Atia, yes, same Peter Atia, longevity guy, Epstein guy, yep, the very same.

00:20:21.039 --> 00:20:28.160
They recruited one of the most influential and well-respected skeptics of the low carb movements, right?

00:20:28.240 --> 00:20:37.119
One of their critics, to put their ideas to the test in the gold standard of scientific inquiry, a randomized controlled trial.

00:20:37.519 --> 00:20:38.960
It's just incredible.

00:20:39.200 --> 00:20:43.279
And the guy that they recruit is a man by the name of Kevin Hall.

00:20:43.519 --> 00:20:48.880
And he's arguably the most important researcher on nutrition at the National Institutes of Health.

00:20:49.119 --> 00:20:56.000
He's been the lead author on what are considered to be some of the most important studies on nutrition of our lifetime.

00:20:56.640 --> 00:21:10.720
Marion Nestle, a professor in nutrition at NYU, called Hall's studies on ultra-processed foods, one that we'll talk about in a future episode, quote, the most important concept to come in nutrition since vitamins, end quote.

00:21:11.920 --> 00:21:16.720
So this guy is no lightweight, okay, and he's a critic of low carb diets.

00:21:17.279 --> 00:21:24.160
And to Taub's and Atias credit, despite the forward momentum of the low carb movement, they are not punching down.

00:21:24.319 --> 00:21:33.279
They are putting this model, what's referred to as the carbohydrate insulin model, right up against the stiffest competition they could possibly face.

00:21:33.680 --> 00:21:36.960
And I believe they even funded some of the research, maybe even all of it.

00:21:37.119 --> 00:21:39.359
Okay, that's how confident that they were.

00:21:40.559 --> 00:21:53.519
And when the results of the study finally came in, I think it's fair to say the results were devastating for the proponents of the carbohydrate insulin model for Tabs and ATIA.

00:21:53.839 --> 00:21:59.759
Despite the millions of people who'd lost weight following a low carb diet, despite the literal cottage industry.

00:22:00.319 --> 00:22:03.200
Of food products, supplements, cookbooks.

00:22:03.680 --> 00:22:15.119
When this model was finally put to the test using the gold standard of science, randomized control trial, using a study design that was signed off on by Taubes and ATIA.

00:22:15.759 --> 00:22:27.039
The study found that when protein and calories were equalized, people actually lost more fat on a high carbohydrate diet than a low carbohydrate diet by quite a bit.

00:22:27.359 --> 00:22:30.799
Absolutely devastating for the low carb advocates.

00:22:31.599 --> 00:22:42.160
Hall's paper is titled Calorie for Calorie Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity.

00:22:42.559 --> 00:22:46.559
And for anyone interested, it's publicly available for free download.

00:22:46.799 --> 00:22:51.200
But let's be honest, most people never read the study directly.

00:22:51.440 --> 00:23:21.440
They learned about the results from articles like this, which ran in the BBC, August 14th, 2015, titled Low Fat Diets Better Than Cutting Carbs for Weight Loss, in which the article says that the study found, quote, those reducing fat intake lost an average 463 grams of body fat, 80% more than those cutting on carbs, whose average loss was 245 grams.

00:23:23.519 --> 00:23:27.119
The article goes on devastatingly to say, quote, Dr.

00:23:27.200 --> 00:23:32.880
Hall said there was no metabolic reason to choose a low carb diet, end quote.

00:23:34.240 --> 00:23:35.359
So what now?

00:23:36.240 --> 00:23:45.039
On the one hand, you've got millions of people who've reported substantial weight loss following a low carb diet, including many people you know.

00:23:45.759 --> 00:23:57.200
But on the other hand, you've got the gold standard of science stepping in, arguably the most important and influential nutrition researcher the country has to offer.

00:23:57.519 --> 00:24:00.160
Saying no, there's nothing there.

00:24:00.400 --> 00:24:08.720
And in fact, if you want to actually lose weight, six to eleven servings of grain is probably where you want to be.

00:24:09.680 --> 00:24:10.960
What are we to believe?

00:24:11.119 --> 00:24:12.960
How do we make sense of this?

00:24:13.519 --> 00:24:18.480
Now we've discussed briefly the conclusion of the study, the punchline, if you will.

00:24:18.720 --> 00:24:29.440
And like me, although you're probably not a nutrition researcher, you probably have some ideas in your head about how the researchers came to these conclusions, right?

00:24:29.519 --> 00:24:31.200
What the study looked like.

00:24:32.240 --> 00:24:39.200
Or maybe said differently, let's say you decided as a lay person that you were going to try to assess this question.

00:24:39.359 --> 00:24:40.799
You know, how would you do it?

00:24:40.960 --> 00:24:47.759
How would you assess whether people lost more weight following a low-carb diet or a low fat diet?

00:24:48.160 --> 00:24:49.680
Just in your own head.

00:24:50.640 --> 00:24:54.799
And if I had to bet, I'd bet it looks something like this.

00:24:55.680 --> 00:25:01.279
Take two groups of people, similar body weights, similar body composition.

00:25:01.759 --> 00:25:07.680
At the beginning of the study, let's measure their body fat percentage, maybe a few other biomarkers.

00:25:08.400 --> 00:25:17.359
We'll split the group, we'll put one group on a low carb diet for a period of time, and we'll put another group on a low fat diet for a period of time, right?

00:25:17.519 --> 00:25:26.480
Match for calories, match for things like protein, and then as best we can try to control for as many other possibly related factors, right?

00:25:26.559 --> 00:25:31.039
Things like sleep, exercise, maybe alcohol consumption.

00:25:31.440 --> 00:25:32.720
Does that sound about right?

00:25:32.880 --> 00:25:35.440
Is that pretty close to what you have in your head?

00:25:36.240 --> 00:25:38.400
But let's go a little further, right?

00:25:38.559 --> 00:25:42.640
If you had to just swag it, how long should we run the study for?

00:25:43.200 --> 00:25:50.160
How long before we would see results in a study that's focused on diet and fat loss, right?

00:25:50.319 --> 00:25:52.960
Before we're confident in our results.

00:25:53.680 --> 00:25:54.799
And I get it, right?

00:25:54.880 --> 00:26:03.759
We're not scientists, but we are somewhat familiar, most of us, with the idea of diets, fat loss, right, from a personal experience perspective.

00:26:04.000 --> 00:26:10.079
So if you had to guess, if you had to throw something out there, how long should we set this study for?

00:26:10.799 --> 00:26:17.039
A couple of weeks, a couple months, maybe, see whether there's a difference in these two dietary patterns?

00:26:17.680 --> 00:26:22.319
Speaking of knowing whether it's working or not, how are we gonna measure it?

00:26:23.119 --> 00:26:25.759
Weight loss is relatively straightforward, right?

00:26:25.839 --> 00:26:27.039
We've got to scale.

00:26:27.359 --> 00:26:28.799
But how about body fat?

00:26:29.039 --> 00:26:35.279
If we're interested in that, if you care, probably a DEXA scan, right?

00:26:36.000 --> 00:26:40.640
And I think it's fair to say that different bodies respond to interventions differently, right?

00:26:40.720 --> 00:26:43.359
So we gotta have more than just a handful of people.

00:26:43.920 --> 00:26:45.440
So how many in each group?

00:26:45.519 --> 00:26:46.960
You know, what's reasonable here?

00:26:47.119 --> 00:26:48.160
And keep in mind, right?

00:26:48.240 --> 00:26:49.759
This is the gold standard, right?

00:26:49.839 --> 00:26:52.319
These are this is the best that we have in science.

00:26:52.799 --> 00:26:56.240
I don't know, 20, 30 people minimum in each group?

00:26:56.559 --> 00:26:57.119
More?

00:26:57.839 --> 00:27:00.240
I don't know, something to think about, right?

00:27:00.480 --> 00:27:09.279
And based on my description of the results of the study, I'm guessing that you probably had something like this in mind as the design, right?

00:27:09.440 --> 00:27:12.559
Something pretty straightforward, pretty ironclad.

00:27:13.599 --> 00:27:17.680
But if that's your perception, you'd be wrong.

00:27:18.319 --> 00:27:20.640
Let's talk about the actual study.

00:27:20.960 --> 00:27:24.960
Now, in the actual study, we have a total of 19 participants.

00:27:25.119 --> 00:27:27.759
Okay, and we'll get how these break down in a moment.

00:27:28.079 --> 00:27:33.680
But of these 19 participants, 10 are male, nine are female.

00:27:34.160 --> 00:27:36.960
They have an average BMI of 36.

00:27:37.200 --> 00:27:39.359
Okay, now what does this translate to?

00:27:39.599 --> 00:27:52.079
For reference, a 5'9 male, which as of this recording is the average height for a male in the United States, this would translate to a weight of about 244 pounds.

00:27:52.880 --> 00:28:04.160
For a 5'3 female, which is about the average height for a female in the United States at the time of this recording, this would translate to close to 200 pounds.

00:28:05.440 --> 00:28:11.119
Okay, so we've got 19 people, close to 20 people.

00:28:11.599 --> 00:28:13.599
Is this 20 people in each group?

00:28:14.079 --> 00:28:15.920
Well, not really.

00:28:16.319 --> 00:28:20.079
Or at least not the way that you or I would probably think.

00:28:20.480 --> 00:28:25.519
Okay, they take these 19 people and they split them into two groups.

00:28:26.160 --> 00:28:34.559
And for an initial period, they feed each group a fairly balanced baseline diet of about 2,700 calories.

00:28:36.000 --> 00:28:49.200
Now, after this baseline period, they take one group and they feed them a reduced carb diet for a period of time, and the other group follows a reduced fat diet for a period of time.

00:28:49.359 --> 00:28:49.680
Okay.

00:28:49.920 --> 00:28:56.559
But in each case, each group is put on a calorie deficit of around 800 calories per day, right?

00:28:56.720 --> 00:29:02.160
Going from 2,700 calories per day down to about 1900 calories per day.

00:29:02.319 --> 00:29:04.880
Okay, total calories cut by a third, right?

00:29:06.160 --> 00:29:08.079
That is a significant drop.

00:29:08.319 --> 00:29:10.799
And already that strikes me as a bit odd, right?

00:29:10.880 --> 00:29:12.640
Why the calorie deficit?

00:29:13.039 --> 00:29:19.039
And at the end of that period, measurements of body weight, body fat, and other biomarkers are taken.

00:29:19.200 --> 00:29:22.000
And we're going to dive into these in more detail.

00:29:22.400 --> 00:29:33.440
But perhaps not surprisingly, given the initial BMI of the participants and the sharp calorie deficit, each group, based on our calculations, loses some fat.

00:29:34.720 --> 00:29:39.839
Now, when you read about the duration of the study, I've seen it described completely differently.

00:29:40.000 --> 00:29:47.039
Sometimes it's four weeks, sometimes it's two weeks, I've seen even as long as six weeks or as short as six days.

00:29:47.279 --> 00:29:48.799
So what's up with that?

00:29:50.400 --> 00:29:55.599
Well, I said this before, but there are a couple things that strike me as odd.

00:29:56.160 --> 00:30:01.279
Remember, there are 19 people in this study, and it is a randomized control study.

00:30:01.599 --> 00:30:09.119
So all the participants are essentially living in a facility for the duration of the study to ensure 100% compliance, right?

00:30:09.200 --> 00:30:12.640
This is one of the powers of randomized control trials.

00:30:13.039 --> 00:30:20.319
You have control, much, much more control over the inputs and to ensure that we're not talking about self-reporting here.

00:30:20.480 --> 00:30:21.680
There's no cheating, right?

00:30:21.839 --> 00:30:22.480
None of that.

00:30:22.960 --> 00:30:27.119
We know that this is what they ate because that's all they had access to.

00:30:27.359 --> 00:30:27.599
Right.

00:30:27.759 --> 00:30:30.079
And on that front, completely makes sense.

00:30:30.240 --> 00:30:31.039
And I agree.

00:30:31.200 --> 00:30:35.839
It's one of the reasons why randomized control is the gold standard.

00:30:36.960 --> 00:30:46.079
And a nutrition study of six weeks, I think, yeah, okay, that's probably what most of us had in mind, something like that from a duration standpoint.

00:30:47.119 --> 00:30:52.000
But remember that balanced baseline diet fed to each group for a period of time?

00:30:52.880 --> 00:30:54.400
Well, that was five days.

00:30:54.559 --> 00:30:56.319
Okay, so five days.

00:30:57.039 --> 00:31:02.160
And then some of the participants were fed a reduced fat diet, and then some a reduced carb diet.

00:31:02.640 --> 00:31:04.480
The total period for those?

00:31:05.440 --> 00:31:06.640
Six days.

00:31:07.599 --> 00:31:09.200
Yeah, you heard that right.

00:31:09.519 --> 00:31:10.880
Less than a week.

00:31:11.200 --> 00:31:15.200
Six days is what these results are based on, right?

00:31:15.359 --> 00:31:26.240
Five days of essentially establishing a control, being fed this baseline diet, 2,700 calories, taking some body weight measurements, body fat, et cetera, right?

00:31:26.480 --> 00:31:28.480
At the end of that baseline.

00:31:29.279 --> 00:31:40.559
And then after six days of being on either a reduced fat diet or a reduced carbohydrate diet, that is what our final measurements are based on.

00:31:41.119 --> 00:31:42.960
Let that sink in for just a minute.

00:31:43.200 --> 00:31:51.599
We're talking about around 10 people in each group on a dietary intervention for six days.

00:31:52.400 --> 00:31:57.839
And while the body weight numbers are fairly straightforward, right, we know what the numbers on the scale say.

00:31:58.400 --> 00:32:07.759
I think we can all agree that given the duration of the intervention, six days, we could just be measuring changes in water weight.

00:32:08.319 --> 00:32:11.200
But that's where fat loss is supposed to come in, right?

00:32:11.279 --> 00:32:16.480
The final arbiter here to make sure that we're really measuring something that's meaningful.

00:32:17.279 --> 00:32:19.839
And as we've seen, this is what the BBC reported.

00:32:20.000 --> 00:32:24.880
Actually, interestingly enough, the title of that article refers to weight loss.

00:32:25.119 --> 00:32:29.839
But what the study actually claims is that there is a delta in fat loss, right?

00:32:29.920 --> 00:32:34.319
So even the article, there's sort of a loss in translation here.

00:32:34.960 --> 00:32:44.400
What the BBC reports in the article, not the title, is that 80% more fat loss was realized by those following the high carb diet.

00:32:44.880 --> 00:32:48.400
But let's pull those numbers back up and take a look at them again.

00:32:48.799 --> 00:32:52.160
How much fat did each participant lose on average?

00:32:53.039 --> 00:33:00.480
And for those cutting fat, right, eating the higher carb diet, they lost 463 grams of fat.

00:33:01.039 --> 00:33:08.160
And for the Americans in the audience, like myself, 463 grams of fat, that's about one pound.

00:33:08.240 --> 00:33:10.000
Okay, about one pound of fat.

00:33:10.720 --> 00:33:16.559
For those cutting carbs, I think it was 245 grams, that's about a half a pound.

00:33:17.119 --> 00:33:22.720
Okay, now this is not a massive amount of fat, right, on somebody who's 244 pounds.

00:33:22.960 --> 00:33:25.759
But then again, we're only talking about six days, right?

00:33:25.920 --> 00:33:30.319
Spread that across a month or a year, you know, and you've really got something.

00:33:32.160 --> 00:33:34.480
But let's hang on for just a second.

00:33:34.799 --> 00:33:37.519
How exactly did they measure the fat loss?

00:33:37.920 --> 00:33:43.119
And if you've ever had your body fat tested, you know there's a tolerance with these machines, right?

00:33:43.200 --> 00:33:44.720
There's a margin of error.

00:33:45.759 --> 00:33:48.799
There's a margin of error with a DEXA scan.

00:33:48.960 --> 00:33:50.960
And these are pretty small differences.

00:33:51.200 --> 00:33:55.680
I mean, could they really use a DEXA scan to note the differences?

00:33:56.720 --> 00:33:59.839
Now, if that's your sense, you'd be right.

00:34:00.079 --> 00:34:13.440
In fact, although DEXA scans were performed, the authors write that, quote, DEXA was not sufficiently sensitive to detect significant difference in fat mass change between the reduced carb and reduced fat diet.

00:34:13.679 --> 00:34:14.639
End quote.

00:34:17.199 --> 00:34:24.079
Okay, so again, probably a little bit different than what you assumed if you were just reading headlines about the study.

00:34:25.119 --> 00:34:29.519
No, if it wasn't a DEXA scan, then how did they measure fat loss?

00:34:30.320 --> 00:34:33.360
Well, technically, they didn't.

00:34:33.599 --> 00:34:45.039
The paper reads quote, body fat loss was calculated as the difference between daily fat intake and net fat oxidation while residing in a metabolic chamber.

00:34:45.360 --> 00:34:46.320
End quote.

00:34:47.119 --> 00:34:52.400
The key word here in case you missed it is calculated, not measured.

00:34:52.639 --> 00:34:56.239
Okay, this is a small but very meaningful difference.

00:34:56.639 --> 00:35:08.960
The method for quote calculating fat loss involves adding up all the dietary fat consumed and then subtracting out the fat that was burned by that participant.

00:35:09.599 --> 00:35:14.320
Now, how do they know how much fat was oxidized, how much fat was burned?

00:35:14.480 --> 00:35:24.079
Well, there's quite a bit that goes into it, but in short, it involves measuring the ratio of various gases that are exhaled while resting in a metabolic chamber.

00:35:24.239 --> 00:35:25.599
Or you fog out here.

00:35:25.840 --> 00:35:26.960
Hang in there for a second.

00:35:27.119 --> 00:35:29.280
Okay, let's just go sequentially.

00:35:29.840 --> 00:35:32.320
What we're trying to do is measure fat loss.

00:35:32.559 --> 00:35:37.039
And what we want to do is compare fat loss between the two different groups.

00:35:37.360 --> 00:35:41.679
But we can't because the difference is too small to pick up with the DEXA scan.

00:35:42.719 --> 00:35:49.920
So we have this other method that measures fat burn, which we assume leads to fat loss.

00:35:50.239 --> 00:35:52.159
But that is a bit different, isn't it?

00:35:52.320 --> 00:35:54.400
It's not exactly fat loss.

00:35:55.280 --> 00:36:02.480
And while already this strikes me as odd, is this accepted within the research space as a valid approach?

00:36:03.039 --> 00:36:06.639
Well, from what I understand, yes and no.

00:36:07.360 --> 00:36:15.039
While most would accept fat oxidation, right, this fat burn measurement that they're able to pull based on a metabolic chamber, right?

00:36:15.199 --> 00:36:22.800
Looking at the composition of gases that are exhaled, most would accept that as a proxy for fat loss.

00:36:23.199 --> 00:36:26.079
The duration, right, the six days.

00:36:26.559 --> 00:36:36.719
Well, there are many who would argue that this is not valid, in part because of the short duration, but also due to the nature of the claim that's being investigated here.

00:36:37.039 --> 00:36:58.000
Because part of the argument behind a low-carb diet, or let's just take even say, like a ketogenic diet, right, something that we're more familiar with now, is that in a state of restricted carbohydrates, the body will eventually switch to burning fat as a fuel source as opposed to carbohydrates, right, or sugars.

00:36:58.719 --> 00:37:01.760
Now, how long does it take for the switch to happen?

00:37:02.320 --> 00:37:05.920
For the body to adapt to burning ketones as fuels?

00:37:06.320 --> 00:37:10.480
Well, it's generally recognized to occur within two to four weeks.

00:37:13.440 --> 00:37:23.920
Again, given that you'll find descriptions of the duration of the study ranging from six days to six weeks, let me share an additional detail of the study design.

00:37:24.079 --> 00:37:35.519
So, what I described as the initial baseline diet of five days, followed either by a six-day reduced carb diet or a six-day reduced fat diet.

00:37:35.840 --> 00:37:37.519
That was only the first part.

00:37:37.840 --> 00:37:51.679
Okay, after the 19 participants completed the first phase, right, this baseline period followed by an intervention, one of two, after which they had a two to four-week washout period, at which time they went home.

00:37:51.920 --> 00:38:06.000
And when they restarted the study, they checked back in, they restarted with a new baseline period of a new five days, same 2,700 calories on the baseline diet.

00:38:06.320 --> 00:38:09.199
And then this time the two groups were flipped.

00:38:09.519 --> 00:38:16.480
So those following the reduced carb diet the first time were now placed on the reduced fat diet, and vice versa.

00:38:16.719 --> 00:38:22.400
And then the results of both of these six-day interventions were aggregated together.

00:38:23.440 --> 00:38:26.239
Now, if you're confused by all this, you're not alone.

00:38:26.400 --> 00:38:35.039
And again, just compare this to what you probably had in your mind as a very straightforward experiment with a very straightforward set of results.

00:38:35.920 --> 00:38:38.800
I'll say it again, it just strikes me as odd.

00:38:39.360 --> 00:38:46.800
Why not simply allow the initial phase to continue for another week or two, as opposed to ending it at six days?

00:38:47.039 --> 00:38:51.679
Why the washout period, in which the study was paused and then restarted?

00:38:52.079 --> 00:38:53.840
Why flip the groups?

00:38:54.320 --> 00:38:57.199
You know, and I want you to think for just a second here, right?

00:38:57.360 --> 00:39:01.760
We've heard that randomized controlled trials, this is the gold standard, right?

00:39:01.840 --> 00:39:12.800
We haven't talked much about epidemiology and some of the criticisms of epidemiology and drawing conclusions from nutritional studies that look back over periods of years.

00:39:21.440 --> 00:39:27.679
Put one group on one intervention, stop the intervention, then flip the two groups?

00:39:28.079 --> 00:39:28.800
I don't know.

00:39:28.960 --> 00:39:31.039
It just strikes me as very odd.

00:39:31.280 --> 00:39:32.719
I don't think it would.

00:39:34.000 --> 00:39:41.599
And while the paper itself is clear that this is not a long-term study, and any longer-term predictions are based on modeling, right?

00:39:41.760 --> 00:39:47.679
Extrapolating out what these initial findings are over a period of months or years.

00:39:47.840 --> 00:39:50.960
You know, most people, they're never going to read the study.

00:39:51.199 --> 00:39:54.880
At best, they're going to get what's reported about the study, right?

00:39:54.960 --> 00:39:57.440
Let's dig back up that BBC article.

00:39:57.679 --> 00:39:59.039
Quote, Dr.

00:39:59.199 --> 00:40:04.000
Hall said there was no metabolic reason to choose a low carb diet.

00:40:04.960 --> 00:40:07.039
That sounds pretty definitive to me, right?

00:40:07.199 --> 00:40:08.480
Sounds pretty long term.

00:40:09.440 --> 00:40:29.119
And in light of the fact that subsequent studies, longer studies too, I might add, have discovered the opposite, that when it comes to fat oxidation as measured by a metabolic chamber, reduced carb diets tend to edge out reduced fat diets after two to say eight weeks.

00:40:30.239 --> 00:40:32.239
What exactly are we to make of this?

00:40:32.480 --> 00:40:38.480
And that's to say nothing about this small but very important line in the study.

00:40:38.800 --> 00:40:50.320
Quote, the subjects exercised on a treadmill for one hour each day, at a clamped pace, and inclined to maintain relatively constant physical activity.

00:40:50.719 --> 00:40:51.519
End quote.

00:41:07.840 --> 00:41:12.719
And just to be 100% clear, I am not saying that this study is invalid.

00:41:12.880 --> 00:41:20.239
I'm not saying that it's not interesting, or that it's not a helpful addition to the body of scientific knowledge on nutrition.

00:41:20.800 --> 00:41:43.840
What I am saying is that this study, a gold standard study performed by arguably the most esteemed nutrition researchers of our time, from the perspective of actual, real-world choices that you and I might make with respect to our health, to our family's health, it's limited.

00:41:44.239 --> 00:41:48.079
Does this mean that there's no place for scientific research and nutrition?

00:41:48.400 --> 00:41:49.440
Absolutely not.

00:41:49.679 --> 00:41:51.280
I'd like to see more of it.

00:41:51.519 --> 00:42:04.960
But what it illustrates to me, and again, feel free to agree, feel free to disagree, I could be totally off here, is that what I said from the very beginning stands, science and studies are one tool.

00:42:05.599 --> 00:42:09.440
And like all tools, they are by definition imperfect.

00:42:09.679 --> 00:42:16.400
And for those touting the latest study, it might not be the slam dunk that you think it is.

00:42:17.519 --> 00:42:25.119
In addition to that, if you are getting results in the absence of a study, it might be that science hasn't caught up yet.

00:42:25.280 --> 00:42:35.039
And when it comes to reclaiming your own radical health and fitness, the very guiding principle of this show, if you will, it's important to keep that in mind.

00:42:35.920 --> 00:42:37.920
That's going to be it for me today.

00:42:38.239 --> 00:42:40.239
As always, thank you for the listen.

00:42:40.400 --> 00:42:42.000
I always enjoy these episodes.

00:42:42.159 --> 00:42:43.679
Get to nerd out a little bit.

00:42:43.840 --> 00:42:48.960
If you are enjoying the show and you've yet to subscribe, go ahead and remedy that right now.

00:42:49.039 --> 00:42:58.480
Okay, Apple Podcasts, Spotify, YouTube, wherever you enjoy listening to podcasts, won't cost you a cent, and you'll never miss another episode.

00:42:58.800 --> 00:43:01.360
Thanks again, and I'll see you next week.