August, 2013:

Wrapping up the series, which began here.

By far, the most contentious issue in weight loss these days has nothing to do with carbs or fat. It’s about the sheer quantity of the stuff that we eat. In one corner are the people who say that one calorie is exactly like every other calorie, and the only thing you have to do to lose weight is to eat fewer calories. In the other corner are people who say that if you eat the right stuff (typically protein, fat, and green vegetables) you can hork down as much as you want and not gain weight.

Who’s right? We don’t know.

We don’t know a great many things about human health. In my view, the ad lib diet question is the biggest single unknown in the whole weight-loss arena. This may be because both sides assume that they’re right (settled science!) and insist that no further research is necessary. Alas, I’m appalled at how little good research there actually is.

But I have noticed something: Carol and I tend to pick up weight when we travel. Part of this may be the fact that we often go home to Chicago on holidays, when there’s loads of snackable sugar around. But it occurs almost any time we’re away for a week or more. When we get home, the weight vanishes over the next several weeks.

Hmmm. When we’re away, we eat at restaurants a lot. When we’re home, we hardly eat at restaurants at all.

I was boggled to learn that many people eat at “sit-down” restaurants four or five times a week. Carol and I eat at restaurants perhaps two or three times a month. Good stats are hard to come by, but this graph (possibly skewed by the nature of the site and its patrons) says a lot. 25% of the respondents confessed to eating out or doing takeout 6-11 times per week. Not per month. Even cutting that in half in an effort to back out selection bias, we still have a quarter of Americans eating restaurant food 12-22 times per month.

Wow.

Note well that I’m not talking about fast-food here. Fast-food meals are fairly small compared to sit-down restaurant meals, and I think their primary contribution to weight gain is unlimited refills on sugared drinks. Writer Tom Naughton tried to get fat eating at McDonald’s for a month and failed. He published his food logs. Morgan Spurlock of Super Size Me fame did the same thing and claimed all kinds of health problems as a result. Spurlock has steadfastly refused to release his food logs (if he indeed ever kept them at all) and so to me his research is “research” and very likely bogus.

Looking carefully at sit-down restaurant meals reveals two things: The portions are very large, and the meals are carb-heavy. Been to Macaroni Grill lately? Egad. You’re looking at a couple of pounds of pasta. Carol and I have also noticed that restaurant pizza has gotten crustier in recent years. Baked potatoes, which I remember as smaller than my fist decades ago, now seem as large as wing-tip shoes. Carbs are cheap. Wheat in particular is cheap, and there are special issues with wheat, as I explained earlier in the series. There is also the natural tendency to eat the whole thing at the restaurant rather than take two-thirds of it home.

If any experiment is possible relating to portion size, it’s this: Stay out of restaurants for a month and see what happens. If you lose some weight, try to do it for another month and see if the trend continues. If it does, don’t panic. It doesn’t mean you have to stay out of restaurants forever. It may mean that you have to cut back, to perhaps one meal a week or so. Say five a month.

My thought on the portion control issue is that portion size does matter, but because it’s so difficult to separate the portion size issue from the carbs issue in restaurant meals, it’s tough to put real numbers to in any reasonable experiment. Eating out less may simply mean eating carbs less, and that’s almost certainly a win.

They don’t state it explicitly, but having looked at the methods of weight-control programs like Jenny Craig and Weight Watchers, I’d say they work because they’re portion-training systems. No, their pre-packaged meals don’t look all that appetizing. They are, however, modest in size and contain enough energy not to shock your body into fat-storage mode. Eating a little less on a regular basis works better than starving yourself for a couple of months and then giving up. Do that and you will gain weight.

Eating smaller portions at home is easier because you control the portions. One trick I’ve seen is just to use smaller plates, so that less food looks like more. Beyond that, it’s just planning. Don’t cut portions in half when you’re getting started. Ramp down slowly. Don’t stop when you feel full. Stop when you no longer feel hungry.

And that’s pretty much all I had in my notes about weight loss. I’ve lost 20+ pounds since 1997, almost all of it from my gut, which is where you want fat the least. I eat low-carb, which for me is mostly low (or no) sugar. I eat high-fat by conventional standards: Butter? Love it. Meat? Lots! Eggs? Every day. By experiment I’ve determined that modest quantities of wheat, potatoes, and rice don’t seem to have the effect on me that they do on many people.

But that’s been the whole point of this series: You cannot generalize about human metabolism. We’re all over the map. You have to do the science to find out what works for you. So do the science. Keep good records. Don’t starve yourself. Be patient. Believe your findings. (That can be tricky when you’re nostril-deep in diet books that all claim to know The Way.)

It’s a peculiar and surprising business. If you learn anything interesting, do let me know.

Hypothesis: Eating fat gooses your metabolism, burning body fat.

Experiment: Eat more fat.

Some time back, I reviewed a very old book: A Letter on Corpulence, Addressed to the Public, by William Banting. It was published in 1865, and you can get it for free from Google Books. It’s the earliest I’ve ever seen anyone publish what amounts to an experiment in losing weight. An overweight man got advice from his doctor, tried it, and lost weight. Better still, he published what he ate, and passed out the book (which is more of a pamphlet) to anyone who wanted it. Banting’s diet proved so popular that “to bant” became a Victorian term for what we now call “going low-carb.”

Fast forward to the late 1950s. A physician named Herman Taller, like Banting, got impatient with his own weight. He’d tried the fashionable remedy of his time (counting calories and avoiding fat) without any success. Then, at the encouragement of a fellow researcher, he did something remarkable: He started consuming what could have been as much as 5,000 calories a day, most of it fat. He lost weight.

Also, like Banting, he wrote a book. Calories Don’t Count was published in 1961. Again, like Banting, Taller and his book have been pretty much forgotten. Forgotten, of course, until Gary Taubes redisovered them, and described them both in his 2008 book, Good Calories, Bad Calories.

Taller’s book is mostly of historical interest these days. His science is now 55 years old, and we’ve learned a lot in the meantime. (There are hazards in polyunsaturated fats that we had no clue about in the 50s.) So I don’t recommend it. Taubes’ book picks up the science that Taller began with, and brings it up to the current day. I do recommend Taubes, enthusiastically, and have several times. If you want to know anything at all about human metabolism, he’s your go-to guy.

For this entry, the point I want to make is something that Taubes explained: Going low-carb is an excellent first step. But you can’t just eat protein, or you risk mal de caribou, which is liver overload due to eating almost nothing but protein. You have to eat fat as well. If you’ve reduced your carb intake, eating fat begins a remarkable process: fat mobilization. Your body runs out of convenient carbs in the bloodstream, and begins to burn stored fat for energy. Your metabolism ticks up sharply. You generate more heat. It’s a weird concept, but I did the experiment. It works.

Here’s how: I banished all carbs from my breakfast. No sugar, no grains, no juice, no fruit. What I began eating (and have eaten most days since) is an egg fried in butter, sometimes two. Coffee with cream. Some days (not always) full-fat unsweetened yogurt. An odd thing began to happen. Within twenty minutes to half an hour, I started to sweat under my arms.

I added up the calories, and it was about a wash compared to a bowl of Cheerios. But when I ate Cheerios, I didn’t sweat. I got a little sluggish, in fact, an hour later, in what was literally a Cheerios crash. The key is that I hadn’t eaten any carbs since the previous evening’s meal, and had gone all night without eating anything. By the morning, I was out of carbs. There was nothing to stoke the fires but protein and fat.

As with everything I’ve suggested in this series, it may not work this way for everyone, but the biochemistry seems legit, and it certainly worked for me. Try it. Lose your fear of fat. There’s nothing to it. When I ate more fat, I lost weight, and both my bad cholesterol and triglycerides went through the floor. By conventional measures I’m healthier than I was when I was 45. I credit that to eating more fat. (The kidney stone just pushed me in the right direction.)

Tomorrow: Wrapping up.

Hypothesis: Wheat sensitivity makes you gain weight.

Experiment: Go gluten-free.

(Quick note: This is a series. If you haven’t been reading it from the beginning, please go back and do so.)

Wheat is a weird business. Furthermore, the current emotional furor about GMO foods has muddied the water horribly. When people think “GMO,” they imagine legions of scientists in blinding white labs teasing DNA strands out of organisms and inserting artificial genes with nanogrippers. Or scanning-tunnelling electron microscopes. Or black magic. People forget that homo sap has been doing GMO for ten or fifteen thousand years. Selective breeding and hybridization (not the same thing) have turned wolves into dogs, grass into corn, and (different) grass into wheat. Nanotechnology not required.

The mud in the water comes from a widespread impression that if a food plant is “natural” (i.e., untouched by high tech) it’s completely safe to eat. GMO is fine as long as you leave the DNA intact.

Alas, hybridization does not leave the DNA intact. This is new knowledge for me, and a lot of what I know comes from an excellent 2011 book called Wheat Belly by William Davis . The publisher appears to have wanted a diet book, but what they got was heavy on the science. Some of that science is disturbing, to say the least:

Analyses of proteins expressed by a wheat hybrid compared to its two parent strains have demonstrated that, while approximately 95 percent of the proteins expressed in the offspring are the same, 5 percent are unique, found in neither parent. Wheat gluten proteins, in particular, undergo considerable structural change with hybridization. In one hybridization experiment, fourteen new gluten proteins were identified in the offspring that were not present in either parent plant. Moreover, when compared to century-old strains of wheat, modern strains of Triticum aestivum express a higher quantity of genes for gluten proteins that are associated with celiac disease. [pp 25-26; author’s emphasis]

To make a long and unnerving story short, 10,000 years of meddling have made wheat’s genome very odd. Accelerated hybridization in the last 100 years has accelerated its oddification in tandem. Now we’re finding that more and more people just can’t digest the stuff well. A small but growing cohort (celiac sufferers) can’t digest it at all.

I don’t have this problem myself. However, a number of close friends do. In addition to digestive difficulties, wheat sensitivity makes people put on weight, particular around the waistline. Two of my friends have cut back on wheat gluten and by doing so have lost a great deal of weight. They also feel a lot better.

It’s a difficult experiment to make, more difficult than cutting back on sugar. Sugar is in a lot of things. But a lot of other things are wheat and little else. The bulk of the grain carbs we eat are wheat, and the cheaper the wheat, the more likely it is to be a modern hybrid. Gluten-free baked goods and pasta exist, but they’re not common and they’re relatively expensive.

Worse, there are no generally accepted lab tests for non-celiac wheat sensitivity. The only thing you can do is cut out wheat and see what happens. Again, Carol and I don’t have the problem, but we’re aware of the issue, and we try to buy imported pasta that isn’t as likely to be hybridized to the extent that mass-market pasta is. I’m trying to move my carb intake (reduced as it’s become) to corn and potatoes. This is bitchy because I’m sensitive to corn bran. But it does give me an excuse to stick with potato chips.

It’s not obvious to everybody, but beer is a wheat product, and going wheat-free means going beer-free. There are gluten-free beers. I don’t drink beer and don’t know if they’re any good. If you just want the buzz, red wine is better. If you’re really attached to beer, you may have to do some hunting.

I’ve been asked an excellent question: How do I know if weight loss experienced after going gluten-free is due to gluten exclusion and not simply reduced carbs? Answer: I don’t know. It is true that wheat’s ubiquity makes it hard to go gluten-free without cutting carbs drastically, and that makes single-factor experiments tricky. I guess you could boost your consumption of other starches in compensation, but starches are still carbs and do affect insulin regulation. My suggestion: Hold your non-wheat carbs steady and try gluten-free for a month. If you lose weight, keep at it. Weight loss is good even if you’re not sure precisely how it happens, and this is one instance where controlled experiments may not be possible.

So. Sugar and wheat are the first things to go after in your metadiet experiment. Next: The Magic Ingredient. (I may need to post an Odd Lots first.)

Hypothesis: Sugar makes you fat.

Experiment: Stop eating sugar.

I came upon this whole business when I threw a kidney stone in late 1997. It was very unpleasant, and my urologist told me to drink nothing but coffee and water until the stone was recovered and analyzed. I did as he said. The biggest change was to stop drinking two (sometimes three or four) Snapple sweetened iced teas every day. Tea is a known factor in kidney stones, though not the only one. I did not expect what happened next: I lost weight in a big damned hurry.

The weight went fast enough that, fascinated, I continued the experiment long after the stone report came back. I gave up both sweetened and unsweetened iced tea almost entirely, for obvious reasons. I gave up sugared sodas generally. (This was when I began a love affair with Diet Mountain Dew that lasted ten years.) I stopped snacking on cookies and other sweet things. I did other experiments over the next several years, and I’ll describe them in coming days. In my case, sugar was the big one.

For most people, it may also be the hardest. I admit that there could be a Fox and Heron effect in play for my own situation: I’ve never really loved sweets, so giving them up was no huge effort. Most people I’ve talked to and read about report that giving up sugar is tough. Whether sugar is addictive is still being debated. However, there is an enormous amount of research indicating that most individuals gain weight eating sugar. I know at least one person who doesn’t, and I suspect that there is a smallish human cohort who just handle sugar and carbs better than most of us. Everybody else is going to have to go cold turkey, whatever it takes.

The case against sugar is most clearly made in Gary Taubes’ book, Good Calories, Bad Calories . It’s long, and technical, and can be a slog in spots, but I’ve read it twice and will read it again in the near future. It’s the best description of sugar metabolism I’ve ever seen. It’s how I learned that fructose is metabolized in a completely different way than glucose. Read the book, but here’s the short form: Glucose messes with your insulin levels. Fructose messes with your liver and your triglycerides, which are fat precursors. Either will put fat on you, and sucrose contains an equal measure of both. Whether fructose is worse than glucose is still being debated, but there is clear evidence that overdosing on fructose can destroy your liver. (This may also be why we lost celebrity fruititarian Steve Jobs decades before we should have. Fructose appears to be the food of choice for malignant tumors.)

Giving up sugar is doubly hard because it’s in almost everything, even a lot of things that don’t taste particularly sweet. That said, most of the sugar we ingest these days comes in through sweet drinks, particularly sodas and fruit juice. Dry wine contains almost no sugar. Beer contains very little simple sugar, but may be fattening through a completely different mechanism, which I’ll get to in coming days. Milk contains a little sugar in the form of lactose, probably too little to be a serious fat-factor.

A few researchers say that sweet tastes are enough to make you fat, and that non-sugar sweeteners won’t help you. This cooks down to insulin sensitivity, which varies hugely across the human species. Some people’s insulin systems are so sensitive that sweet tastes of whatever source cause an insulin pulse. However, like the people who can ingest all the sugar and carbs they want without putting on weight, this is a minority trait, on the opposite extreme of the sugar-metabolism spectrum. I’ve known a number of people, some of them quite well, who lost an enormous amount of weight simply by switching from sugared sodas to diet sodas.

So if you really can’t eliminate all sugar from your diet, at least get rid of the obvious sources: Sugared drinks and sweet snacks. Give it a month, and if the trend is in the right direction (even if it’s not a huge trend) give it another month.

Note well that I only mean sugar here, not carbs generally. Carbs are not all the same. This is a point that I’ll come back to later on.

To begin: Everything you think you know about dieting is wrong. Put it all out of your head. You’re going to have to start from scratch. This is work. It’s also a species of science. You’ll have to be rigorous and consistent, which involves four important first principles:

• Keep good records. This suggests a calendar, but all those little squares on calendars just aren’t big enough. I’ve been tempted to write an eating-specific database utility in Lazarus, and I may if time ever allows. In the meantime, an ordinary diary in a text document will do.
• Change only one thing at a time. Jumping feet-first into a whole new way of eating may lose some weight for you, but it won’t teach you anything about losing weight. Learning what works is the whole idea here.
• Record consistently. Weigh yourself on the same scale at the same time every day. Ditto blood pressure, if you choose to record it.
• Don’t give up. Individual metabolisms have inertia. The process may take some time.

Here’s what I call the Jeff Duntemann Metadiet: You’re going to try a number of relatively narrow changes to your daily diet, one at a time, and record what happens with each. Some will work. Some won’t. Continue with any change that works. Abandon any changes that don’t. Repeat until you’ve lost the amount of weight that gets you where you should be.

The above paragraph comes in at under 100 words, so it’s what I call a picobook. If it had come in at 10 words, it would have been a femtobook. IBM published an attobook once. It was a runaway bestseller. Anybody ever read it?

If at all possible, get some fresh blood numbers before you begin. If you’ve had a recent physical, that’s perfect, and it doesn’t have to be yesterday, just within a year or so. If you’re lacking a recent physical, I’ve had good luck with a chain called Any Lab Test Now. You don’t need a prescription or a doctor appointment. Also, their phlebotomists are among the best I’ve ever experienced. Other such labs are all over the place, and they’re not horribly expensive. Weight is only one indicator of health. Get your cholesterols and triglycerides at bare minimum. Record your blood pressure as you go, on a daily basis.

A sidenote: Exercise doesn’t really help you lose weight directly. It has lots of other benefits, especially training that builds muscle. Since muscle consumes energy 24/7, exercise helps indirectly by goosing metabolism. But we don’t burn calories like we burn charcoal in a grill. Calories don’t count. (Doctors knew that in 1964. By the late 1970s, they’d forgotten.) The type of calories counts critically.

Another sidenote: The BMI is bullshit. It doesn’t distinguish between fat and muscle. If you’re in the process of losing fat and gaining muscle, it’s less than useless, and I will no longer discuss it. Don’t even bring it up.

Still another sidenote: There are other causes of overweight beyond diet. Genetics is big, as is the state of your endocrine system. You may not be able to eat your way skinny. My experience and research suggest that you can eat your way healthy.

The last sidenote (for today, at least): Don’t starve yourself. Eating less generally is a good thing, considering how much we eat, but taper off slowly. Going off a calorie cliff kicks survival mechanisms into gear that you don’t need, and over the long term will only make you gain weight again.

Tomorrow: The Biggie. I suspect you already know what it is. I suspect that you’re right. Get that calendar ready. And put down that doughnut.