Friday, October 05, 2007

Review: Good Calories, Bad Calories Gary Taubes

In the interest of full disclosure, I'll start by saying I received an advance copy of the book Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease, by Gary Taubes, to review; my acceptance of an advance copy came with no strings; I was neither asked to write a review nor was it implied if I chose to, that it be positive.

That said, it's a good thing I received an advance copy - with over 600-pages of content, notes and bibliography, it's a dense reading adventure!

That's not to say it's difficult to read or understand; quite the contrary, I found it to be well-written and a compelling page-turner. Then again, this is the genre of writing I enjoy most - content that is well researched and strongly supported with references, citations and you can imagine my excitment as I opened my copy and dug right in!

I was not disappointed.

I've held my review up until today as I was interested in watching how the media was going to play the release of the book. I wondered, would the various shows and articles encourage their viewers and readers to read the book, or would they seek to discredit Taubes to discourage any real discussion about his positions presented and the research he believes supports them?

Save for a couple of appearances and reviews, the silence around the release of the book is deafening. Taubes appeared on Good Morning America last week. The GMA website provides an excerpt from the book to read online and a video clip from the on-air segment (on same page), along with an area to leave comments. Later (same day) Taubes was featured on Nightline. The Nightline website provides a transcript of the show, a video-clip of the segment and an area for comments too.

This week, the Lifestyle: Health & Fitness section on Reuters published its review titled Count your calories.

In the Reuters article we find a glimpse of what is the at the heart of the book, "Good Calories, Bad Calories" examines an alternative hypothesis to the calorie- and fat-centric idea through decades of literature and clinical data on diet and obesity, Taubes says. It's another way to explain observations about diet and weight gain, he says, one for which strong data existed. "If we had taken this other fork in the road," he asks, "what would we have come to believe?"

The book is, in a word, a masterpiece; not because I think Taubes is right with all his conclusion, but because I feel he took the right approach to evaluate the science - he approached the research from the perspective of a skeptic; that despite his own beliefs at the start, he was going to let the data speak for itself and take him where it led from hundreds of studies published over the last century.

Before I continue with the review of the book, let me say that I believe good science requires one be a true skeptic; a good researcher, a scientist, then is not a proponent of any particular point of view, but remains cognizant of the fact that trials finding support for or refuting a hypothesis are both valuable in our quest for understanding; that seeing and believing the data, both in support of or refutation of a hypothesis, is the primary goal in scientific inquiry.

Simply put, letting the data speak for itself and remaining skeptical that your own belief in a hypothesis may in fact be wrong, is an important part of the process in scientific discovery; if one cannot remain open to the idea a hypothesis may be wrong, one cannot reject hypotheses that fail when put through the rigors of testing.

Which brings me back to the book.

Taubes tackles a number of issues in the book, notably the history of how we got where we are today with public health policies and dietary recommendations, and why, even without good science to support our policies as they developed, they were formed and promoted as fact to the population at large.

He then tackles what was two competing hypotheses at the time we hit the crossroad in our search for understanding how diet plays a role in disease: the diet-heart hypothesis and the carbohydrate hypothesis.

He asked, "If we had taken this other fork in the road, what would we have come to believe?"

The only way to begin to answer that question is to set aside what you think you know, set aside preconceived notions and dig into Taubes book.

It's rich with citations for studies lost in the noise and debate; filled with data and findings that for too long collected dust until he brushed them off for a second look; and leaves the door wide open for us to begin to really examine all the data we have.

The full weight of the evidence, Taubes contends, led him to conclusions he did not anticipate himself at the start; conclusions that are controversial but open-ended for more discussion, interpretation, analysis and trial.

Perhaps you too may find yourself in the same predicament at the end of Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease; until you read it though, you just can't know, can you?

I highly recommend the book, for those who firmly hold carbohydrate restriction is scientifically valid and for those who firmly hold limiting dietary fat is scientifically valid.

At the end of the day our quest isn't to prove what is believed right, it's to discover what is rightly to be believed.

Taubes doesn't just argue that what we're told is wrong, he provokes us to examine our beliefs about a healthy diet by providing a wealth of data from hundreds of studies reviewed in his research in writing the book to argue the validity of the scientific process. That is, he presents a compelling arguement that the supportive data used to maintain the status quo of the diet-heart hypothesis and our current dietary guidelines is not as sturdy as we're led to believe, and makes the case that for well over a century there has been, all along throughout the last century, the competing alternate theory, the carbohydrate hypothesis, that has been ignored despite compelling data.

No matter what one currently believes, this book is an eye-opening examination of the science and the history that led us to where we are today; a compelling review of the weight of the evidence from both sides; and a resource rich with citations that allow us to begin examining and questioning the validity of our beliefs in the connections between diet and health.


  1. Thanks for the review

    For anyone in the UK, like me, I'd note that the UK amazon shop do not seem to be stckign this yet, although it is possible to order the book frmo them via a third party supplier.

  2. On a related topic, In a blog posting I’ve just put up I note that I had a quick look through the latest issue of the American Journal of Clinical Nutrition. I am not an expert in such things, but in skimming through you would think that refined carbohydrates are associated with:
    loss of sight;
    increases in the so-called "bad" LDL cholesterol; and
    fructose is presented as a pretty dodgy thing to eat.

    I wonder if these articles will get as much publicity as ones that say fat is bad?

  3. Anonymous12:06 PM

    This is to Cris:

    There is a different title for the book in the UK. It is "The Diet Delusion."

  4. Anonymous12:17 PM

    Here is a link to a group that refutes Gary Taubes book. It comes as no surprise that it is the producers of high fructose corn syrup. Do you hear the jingle of coins vs good health?

  5. Anonymous11:35 PM

    Well the promoting of Mr Taubes book might be pretty quiet in the USA but spare a thought for all of us down here in Australia. There is absolutely no comment or advertising about this fantastic book & if it weren't for brilliant sites like this we would hear nothing at all. Fortunately I was able to order this great book on the internet & I am enjoying it immensely thank God for the world wide web!!!! keep up the good work. cheers helen.

  6. aphid8:38 PM

    The Diet Delusion appears to be another book and says it won't be published until January 2008. Mind you, it is nearly as long, but it's certainly got a more catchy title. They're offering a deal on the purchase of both books (more evidence that these are two books, not one in the same).

  7. I found this posting googling for reviews of Taubes' book. Unfortunately I must disagree with your reasoning.

    Your idea of how science is or should be practiced is exactly the opposite of what really happens. People do not dispassionately weigh the evidence and allow themselves to be swayed by whichever side appears stronger at the moment. That does not work for human beings. It might work for Vulcans. People are passionate and emotionally invested in their favored hypotheses. They work hard to verify them while doing all they can to destroy opposing ideas.

    There is no evidence that Vulcan science would be any better or more effective than human science. Say what you will, there is no doubt that science has made enormous progress over the past few centuries that it has been practiced exactly as I have described. Science's saving grace is that successfully championing an out-of-favor hypothesis and bringing it to the position where it is the reigning paradigm establishes its proponent as a scientific god. It is the greatest triumph possible in the field. Human vanity and pride drive scientists to adopt even relatively remote possibilities and do all they can to uncover evidence that may improve their prospects. It is the same mentality that makes people start rock bands imagining they will become superstars, or lets small businessmen imagine that they are founding the next GM.

    The bottom line is that Taubes' methodology - combing the scientific literature for papers favoring some discredited hypothesis - can be applied in field after field to produce all sorts of bizarre conclusions. The evidence in favor of psychic powers and premonitions is actually very sound. There is all kinds of documented and credible evidence in favor of UFOs. HIV does not cause AIDS according to a number of studies. The list goes on and on.

    The only reasonable policy to adopt given this reality is to trust the scientific establishment. The plain and obvious success of science as an institution gives good grounds for this policy. Attempting to go around the scientific consensus - paying attention to a careful selection of the literature and thinking for yourself - amounts to the belief that you, in a few hours of study, can learn more than brilliant researchers who have devoted their entire lives to the field. Amateurs playing the role of scientist are no more likely to succeed than panicked passengers who grab the control yoke from the pilot of a crippled airplane and try to fly it themselves.

    Trust the experts. We as a society pay them for their expertise. Refusing to listen to them is the height of foolishness.

  8. Anton8:42 AM


    You have way more "faith" in the establishment than I do.

    Science is NOT about consensus. If it is consensus, it is politics. You cannot declare fact by majority vote.

  9. Trust the experts. We as a society pay them for their expertise. Refusing to listen to them is the height of foolishness.

    Excuse me, but... What the heck are you talking about?

    Just in the field of health and off the top of my head, I can come up with:

    "Experts" pushed lobotomies for mental patients. "Experts" told us to drink milk for ulcers and refused to believe, for twenty years, that it was caused by bacteria. "Experts" used to terribly restrict heart patients' movement to not strain the heart and gave them bloodclots instead.

    Augusto and Michaela Odone simply ignored the "experts" and came up with a way of helping boys with ALD and founded the Myelin Project.

    By all means we little, humble, People with Brains can just sit around and do what the experts tell us.

    Or we can use our brains.

  10. Wow, for a minute, I thought Hal was joking - then I realized he was actually serious.

    Hal, I think you know just enough about the scientific method to be dangerous. Remember, that at one time, the scientific community thought that the earth was flat, that burning objects produced phlogiston, and that bloodletting would cure illness. How were these theories finally discredited? Precisely by noting the accumulation of evidence that does not fit the dominant hypothesis, and developing and, most important, testing alternative hypotheses that do fit the evidence. You sort of seem to know this - you say that "science's saving grace
    is that successfully championing an out-of-favor hypothesis and bringing it to the position where it is the reigning paradigm establishes its proponent as a scientific god." This is, indeed, how scientific advances are made, and I don't even disagree with you about the issue of pride and glamour - they are big motivators. Then you go on to suggest that we all ought to trust the scientific establishment, even though the great advances of science come from noticing that there are just too many discrepancies in the data for the dominant hypothesis to be considered tenable. This is how it happens that we no longer think that the sun revolves around the earth - there was too much data that didn't fit the hypothesis.

  11. Janice Harayda2:48 PM

    Just want to say how refreshing it is that you said that you got an advance reading copy of "Good Calories, Bad Calories." You almost never see bloggers acknowledging that they have received copies of books, though many, many do.

    I've read only about 100 pages of "Good Calories, Bad Calories." But as I mentioned in a post earlier this week, I liked what I read a lot. I especially admired Taubes's brief -- but damning -- analyses of Jane Brody's Personal Health columns in the New York Times. His basic point is that Brody has sometimes kept writing what she believes long after scientific evidence has ceased to support it. Taubes's book should foster a healthy skepticism of much of the advice that appears in the media. Thanks for your post.
    Jan Harayda
    One-Minute Book Reviews

  12. Oh Hal,

    I am married to a research scientist (biochemist in basic science, not nutrition or clinical) and you should have heard him laughing when I read your comment. He is the first to say that hypotheses are there to topple, unless one wants knowledge to grind to a halt. Science is about pursuit of knowledge, though you are right that humans tend to confuse that with their passions and professional reputations.

  13. Anonymous2:43 PM

    How do you expect anyone to take seriously a comment in which you refer to Vulcans? lol

  14. Hal is just joking.

    Nobody would post something that absurd and expect to be taken seriously. I think he's being ironic. He posted a logical fallacy.

    In his post at the start he is saying that science is flawed and that somehow bias works in favour of progress, but then on the other hand hs is saying that we should therefore place our trust in what is incorrect, flawed and biased.

    That's like saying: Something is incorrect, Being incorrect is a positive thing, and then finally you should blindly trust these folks that are incorrect, because being wrong is good.

    If he is being serious, then he is the biggest idiot on the planet, or quite possibly insane. Therefore I conclude he is joking.

    Thanks for the review Regina!

  15. I'm on page 79...

    and I'm loving it!

    I'm a big reader anyway, so 600 pages will not pause me. I would urge anyone to give it a try thought, because Mr. Taubes is an excellent writer; clear, well-organized, and insightful.

    And the facts he reveals are nothing short of amazing!

  16. Marcus Shapiro10:33 PM

    I just watched the Larrry King special that featured Taubes. Oz, the cardic physician did not seem as convincing as Taubes and here is why. Taubes actually went back and reviewed much of the research that has shaped current paradigms and treatments. Oz, I suspect, has formulated much of his theory based upon research REVIEWS (or research CHOSEN for publication in his medical journals). And, he has formulated his theories based upon what he was taught. Unfortunately doctors don't have the time to review research like Taubes does. Unfortunately Taubes is not a doctor and therefore can not prescribe treatment. So, the consumer/patient might never receive effective care. I hope all doctors and nutritionists read the book and there is an true examination of current treatment courses. This is the only way to effectively curb the medical crisis we face in this country (USA).

  17. Marcus, waiting for doctors and nutritionists to come on board will take a generation.

    If we really want to curb medical costs, we are on our own.

    Did you hear the cardiologist who called in? After Taubes asked him, so what WOULD you say to a patient about obesity, the doctor said he would not recommend diet changes at all. Because he's not sure of a safe treatment.

    Remember that docs and nutritionists have a higher standard to perform to, than we individuals working only on ourselves. They can be sued for going against standard treatment.

  18. Marcus9:01 PM

    You are right. And, maybe it is even optimistic to think that it will only be a generation. Yes, I do believe personal responsibility is the way to go.

    Not enough people are taking care of themselves. This means that private enterprise, still and always has had, the opportunity to create change with compelling messages, ideas, products and services. What company or companies will it be that foment huge change?

  19. Anonymous4:54 PM

    Oz is an Ass.

    Cock-sure pompous ass.

    He knows not of science....

    Nor did he bother to read Taubes' book before the interview.

  20. I have been wondering about saturated fat for awhile. All of the studies or peer research has focused on trans fat and saturated fat together and not separately. Trans fat makes sense why that is bad for you, but I was never convinced of saturated fat. Why? Because humans have been eating it for thousands of years. I have not read the book yet, but have researched much about Taubes and the previous articles he has written (I also saw him on CBC). I'm glad that Taubes has put two things in the forefront for medical researchers:
    1. Quality research: There is very little quality, one-variable research out there for nutrition. Most nutrition studies have about 5 different theories going on with them.
    2. Saturated Fat: not the evil it was made out to be

    I am curious about a couple of things:
    1. Does anyone know how old Taubes is?
    2. Has anyone seen anything Taubes has written about pasterization of dairy products (especially milk)?

  21. Anonymous1:28 AM

    I think this books sounds interesting and I plan to read it. However one should be skeptical of everything - conventional wisdom and non-conventional wisdom...

    But the problem with a book like this one, which goes on and on in great detail about experiments new and old in areas ranging from heart disease to cancer to diabetes, is that it can be hard to know what has been left out. For example, Taubes argues at length that people get fat because carbohydrates in their diet drive up the insulin level in the blood, which in turn encourages the storage of fat. His conclusion: all calories are not alike. A calorie of fat is much less fattening than a calorie of sugar.

    It’s known, though, that the body is not so easily fooled. Taubes ignores what diabetes researchers say is a body of published papers documenting a complex system of metabolic controls that, in the end, assure that a calorie is a calorie is a calorie. He also ignores definitive studies done in the 1950s and ’60s by Jules Hirsch of Rockefeller University and Rudolph Leibel of Columbia, which tested whether calories from different sources have different effects. The investigators hospitalized their subjects and gave them controlled diets in which the carbohydrate content varied from zero to 85 percent, and the fat content varied inversely from 85 percent to zero. Protein was held steady at 15 percent. They asked how many calories of what kind were needed to maintain the subjects’ weight. As it turned out, the composition of the diet made no difference.

  22. Anonymous11:28 AM

    I just finished reading the book through once and am about to start reading it a second time. It is indeed quite dense and involved. But after my first reading I was telling my mother (now in her 60's) about what Taubes was suggesting and she had some interesting things to say as well. She is from the Middle East. She said that years ago, when someone went to the doctor for issues connected with overweight, etc. this is what would be recommended: Eat mostly grilled meats, eggs, fish, cheese. Avoid bread, rice, and potatoes, and re-include them only in minute portions once the weight is off.

    Hmmmm... Sounds a lot like what Taubes' is suggesting got lost in the shuffle in the US in the past several decades.

    I think it is urgently necessary for researchers to investigate whether a low-carb approach is safe on an indefinite basis and also whether it is safe for pregnant women. Many people lose weigh on low-carb diets but may fall off the wagon because 1) they end up restricting calories way too much; 2) They become anxious about staying low-carb long-term; and 3) Most women who don't have weight issues pre-childbearing will develop them in conjunction with pregnancy.

    Thanks for a great blog!

  23. Anonymous5:40 PM

    "Hal is just joking."

    he seems to want to say that even though scientists are often dogmatic and mistaken, scientific results tend to be reliable, or at least they are the best we've got to go on.

    its best to make some distinctions here. some sciences are more reliable, less foggy, more coherent (etc) than others. e.g brain researchers are still confused(except about some of the basic 'low level' workings), though they aren't severing the frontal lobes from the rest anymore. some are even honest with themselves, and the public, on this point.

    the question of what to trust should probably be decided case by case. blind trust is out of the question - there is no 'scientific world view' even if you tried to adopt the dominant attitudes of each scientific community, and ignored the dissenters, you would wind up a confused soul with many inconsistent and clashing attitides (including beliefs).

    and can one judge well without full time study? sometimes - scientists often speak beyond their means. e.g. when a particle physicist tells you about the absolute nature of reality, or a neuroscientist (or anthropologist, biologist etc) declares what the necessary, innate human identity is - what you are, and what the world is - it often doesn't take that much research to understand their mistake. they've gone beyond their area of expertise.

    if i say 'years of study have led me to conclude that there is no such thing as a solid surface' - at the very least, i've mispoken.

  24. I also read the NYT review, and found it interesting.

    I am still in the heart-disease section of the book so I have not read the things the reviewer is criticizing. But I have found myself constantly wondering "What has he left out? What is he ignoring?" As a lay-person, I hope that some doctors and scientists examine this book closely and add, agree with, debate, and/or refute the things it says, as necessary.

    The most exciting thing I can say is "Hooray for science!" If Taubes is not omitting or ignoring based on bias, then I'm completely ashamed of the health science community for their shoddy science. If he is biased, that's fine. We need more people to look at the science, all of whom will have different biases, and maybe eventually we will find some facts we can rely on.

    Is anyone else out there tired of having our health played with as though we were unimportant? I want to live a long healthy life. I want my doctors to tell me the truth about how to do it, not lie to me for political reasons!

  25. Anonymous2:26 PM

    I am still reading Taubes' book but one item he cited really made me stop: "the prinicpal fat in red meat, eggs and bacon is not saturated fat but the very same monosaturateed fat as in olive oil." Page 168.
    This is quite eye-opening. Hurrah for butter!

  26. lpdwyer11:28 AM

    After switching to a low carb diet four years ago, I was able to lose 25 pounds in approximately six months. As my weight decreased, my energy level increased immensely and I feel twenty years younger. I got into low carbs after reading Atkins and the South Beach diet.

    Knowing first hand that low carb diets work, I was interested in Good Calories, Bad Calories the minute I heard about it. Gary Taubes book has provided a wealth of information lacking in the two other books mentioned. After reading Good Calories, Bad Calories I no longer consider myself to be on a diet, instead I consider myself as having gone through a life style change. I eat carbs only sparingly now.

    Just about everyone I know is either overweight or obese and diabetes is so common now. It’s a shame that with the science we have today, so many people are unhealthy.

    I’m 53 years old now and have taken up hiking. Five years ago, I would have thought of this as an impossibility given the way I felt. All I can say is educate yourself on this subject to improve your quality of life.

  27. Anonymous9:42 PM

    Just read the NY Review, and tried to follow up the study cited. Found this blog post:
    which, in my opinion, pretty much blows Gina Kolata out of the water.
    David T. Shaw

  28. I'm not a nutritionist or really old enough to truly log in on a debate that's been gong on since the 70's (I'm 24).

    But I do know that I was an obese teenager who was never taught anything about nutrition whatsoever, my parents only knew the three-squares-a-day, vegetables are good, etc. They also let us eat alot of sweets and didn't know why dinner consisted of what it consisted of, I have a feeling it was really influenced by the status quo.

    After joining the Army I started losing weight, which quickly became a fascination. I exercised more and more while getting lay-knowledge of nutrition from men's fitness, runner's world, etc. The sad thing is that I've been exercising harder than most people I know for several years now, while sticking with the high carb-ratio/low fat diet that most fitness sources recommend. I've been increasingly frustrated with the fact that you can only see my hard earned abs under a layer of stubborn fat, along with slight spare tire on my sides. If I work out so hard and eat so healthy, why do I look so bulky when all is said and done?

    I've just started reading Taubes book, and as an aspiring Microbiologist I find his hard look at the misinterpreted clinical studies to be believable and refreshing. Atkins and south beach seem like a joke to me because they're more about hype than an understanding of nutrition. Living as our incredibly fit and thin ancestors did makes much more sense to me, and I will follow this low carb/high fat diet to see if I can get results. I've already noted positive changes, and I thank him for possibly giving the very nice body to a young man who's been trying way too hard without results for years now. Thanks at the very least for your courage to stand up to the medical establishment in the face of contradictory evidence.