Why We Get Fat: Food Toxins

Erich asked about the link between omega-6 fats and obesity. It’s a good question and also a good way to introduce the first step of the Perfect Health Diet weight loss program:  removal of toxic foods from the diet.

Vegetable Oils With Fructose or Alcohol

These toxic foods are particularly dangerous in combination. We discuss this mix of toxins in the book (pp 56-59).

If you feed lab animals high doses of polyunsaturated fat (either omega-6 or omega-3 will do) along with high doses of either fructose or alcohol, then fatty liver disease develops along with metabolic syndrome. Metabolic syndrome is a major risk factor for obesity, and it’s not very difficult to induce obesity on these diets.

Both sugar and vegetable oils are individually risks for obesity:

  • Stephan did a nice post a few years back, “Vegetable Oil and Weight Gain,” discussing a couple of studies showing that both rats and humans get fatter the more polyunsaturated fat they eat.
  • Dr. Richard Johnson and colleagues did a review of the evidence for sugar (fructose) as a cause of obesity in the American Journal of Clinical Nutrition a few years ago. [1]

What the animal studies show us is that when fructose and vegetable oils are consumed together, they multiply each other’s obesity-inducing effects.

Here are a few pictures illustrating the correlation between polyunsaturated fat consumption, fructose consumption, and obesity.

Here is the Johnson et al chart showing historical fructose consumption in the UK and US [1]:

Here is Stephan’s chart showing historical polyunsaturated fat consumption in the US:

And here are obesity rates in the US:

Cereal Grains

It’s a common observation that the toxic grains, especially wheat, can produce a potbelly or “beer belly.” Rice doesn’t seem to do that.

There is epidemiological evidence for this effect. Here, for instance, is obesity prevalence by country from the World Health Organization Global Infobase:

Note the low obesity prevalence in the rice eating countries of China, India, Japan, Indonesia, and southeast Asia; and in sub-Saharan Africa, where a diversity of starch sources are eaten, including manioc/cassava, sorghum, millet, rice, maize, and wheat. The highest obesity prevalence is found in wheat-eating countries.

This correlation persists within countries. In the China Study, the correlation of wheat consumption with BMI was 56%, whereas the correlation of total calorie intake with BMI was only 13%. (Since total calorie intake is correlated with muscle mass, total calorie intake may be completely uncorrelated with fat mass. It’s not how much you eat, but how much wheat!)

Similar outcomes occur in mice. I can’t find any mouse studies comparing wheat to rice, but I did find one comparing wheat to rye [4]. Wheat was far more obesity-inducing than rye:

Body fat percentage was 20.2% in the wheat group, 13.7% in the rye group; fasting insulin was 126 pM in the wheat group, 90 pM in the rye group; and fasting cholesterol, triglycerides, and free fatty acids were higher in the wheat group.

In short:  wheat made mice fatter, more insulin resistant, and more dyslipidemic than rye.

Just for fun here’s a picture comparing fat tissue in the rye (left) versus wheat (right) fed mice:

I believe that rice would have done even better than rye, but I was unable to find a paper directly comparing rice vs wheat or rye.

Why We Get Fat

This brings me to a point of difference with Gary Taubes. Although glucose is toxic in high doses, the body has an extensive machinery for disposing of excess glucose. As we discussed in our last post, all tissues of the body participate in glucose disposal. Dietary glucose is not likely to do much damage unless the body’s glucose-disposal machinery has been damaged by other toxins first.

Obesity is caused not by carb calories per se, but by natural plant toxins. Plants, not carbs, make you fat!

It’s possible, by the way, that differing toxicities among grains could be responsible for epidemiological evidence favoring “whole grains” over “refined grains.” In America, products made with refined grains are usually 100% wheat; but products made with whole grains are often of mixed origin (“7 grain bread”). Since wheat is the most obesity-inducing grain, dilution of wheat content may be masking the toxicity of whole grains.

Conclusion

Certain toxic foods seem to be very effective at causing obesity:  vegetable oils, fructose, and wheat. Along with malnourishment (for instance, by choline deficiency) and infectious disease, food toxins are why we get fat.

The first step in any weight loss effort, therefore, ought to be removal of these toxic foods from the diet. Removing these toxins may not cure obesity; but without this step a cure is unlikely.

References

[1] Johnson RJ et al. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr. 2007 Oct;86(4):899-906. http://pmid.us/17921363.

[2] Andersson U et al. Metabolic effects of whole grain wheat and whole grain rye in the C57BL/6J mouse. Nutrition. 2010 Feb;26(2):230-9. http://pmid.us/19647415.

Leave a comment ?

84 Comments.

  1. Hey Paul,

    What would you say is the upper limit of fructose or sugar intake? I have a huge fear of fructose and haven’t consumed fruit in months because of it. I also didn’t realize that many vegetables have fructose, hahah. I suspect I have some sort of fructose malabsorbation, and I want to limit my intake as much as possible. What is in your opinion a safe amount of fructose?

    Thanks

  2. Hi Robert,

    It’s hard to pick a particular amount because the damage done by fructose depends on many factors. It’s much safer on a low-carb diet than a high-carb diet because it can be turned into glycogen; it’s much safer in combination with saturated fats than with polyunsaturated fats, since it can’t peroxidize saturated fats; it’s much safer in people who don’t have gut infections because fructose feeds pathogens; it’s safer in people who don’t have GI cancers and safer in people who don’t have fructose malabsorption.

    We support eating moderate amounts of fruit and vegetables, but counsel avoiding fructose-containing sugars otherwise.

    In your case it sounds like you have special reasons to avoid it. Fructose malabsorption is more dangerous when you have gut infections, since it’s so available to whatever is in your gut.

    I guess I would say, listen to your body. If you do best with minimal fructose, then minimize it.

  3. I hope someone beats me to it, but I sure would like to do a graphic with wheat, fructose, PUFA, and obesity on the same time scale. I suspect it’d be as fascinating as this: http://weightmaven.org/2011/01/02/obesity-and-food-deserts/

    Note that a synonym for “food desert” is really “plant toxin utopia” — all those convenience and fast food vendors pushing wheat, veggie oils, and added sugar!

  4. Beth, that is really something! I think you’re on to something there.

  5. Did you notice: It looks like the obesity-curve of the first chart fits better with the PUFA-curve of the second chart! Much better!
    So my personal toxicity ranking (worst to best) for now goes:

    1. PUFA
    2. Wheat
    3. Fructose
    4. Sucrose
    5. Glucose/starch

    Btw, in my quest to find “safe” fruits (those with more overall glucose then frutcose) I found bananas to be ok (Paul, you eat bananas yourself, right?) and virtually all stone fruit (cherry, peach, apricot, nectarine, plums – albeit the last have some sorbit problem) to fit.
    Incidently(?) all fruits I always liked (bananas and cherries especially) whereas I never cared about apples. Always gave me stomacch cramps, oranges too.
    Both are high in fructose (and fiber).

  6. Dr. Kurt Harris also lists wheat, linoleic acid, and fructose as neolithic agents of disease. He points out in his most recent interview with Jimmy Moore that these may be the drivers for insulin resistance. With the high carb SAD, the glucose that we should be burning off gets stored as fat.

  7. gunther gatherer

    The map you posted not only shows the highest wheat-eating countries in red, but also the highest protein-eating countries (including Argentina with their famous grass-fed steaks). Let’s be fair and consider the idea that China, India and those other skinny countries are also not eating a lot of protein. This is a major contributor to weight gain as well, IMO. Thanks for this!

  8. gunther gatherer

    Come to think of it, protein intake has also increased over the century along with all the other toxins as living conditions have gone up in western countries. So it runs alongside the increase in weight nicely. I’m thinking overabundance of protein in the diet could be a factor too, though not the whole reason.

    I hear the Inuit arguments already, so I’ll suggest that given their activity levels and the fact that they don’t always have any food at all and that a large part of this is fat anyway, maybe they don’t see obesity for this reason. Just thinking out loud…

  9. Paul, I don’t believe you and Gary are really that far apart. Gary has backpedaled a bit with the “all carbs are bad” and now admits that it may mainly be the fructose in HFCS and in refined sugar. Also, my understanding is he’s still open to other causes of metabolic syndrome (vegetable oils, wheat, infectious mechanism, etc), but once our metabolism is broken, it’s the carbs that are responsible for putting on weight in bulk, which I believe you’d agree with as well. And that’s why he pushes the carb angle, because carbs on a broken metabolism IS what makes us fat (it might not be what broke the metabolism in the first place, but it’s what’s making us fat).

    Plus, two of the prominent “causes” you list (fructose and wheat) are carbs! So, you two are more in agreement than disagreement, IMO.

    At the moment, I differ in that I think wheat and obeisity, as far as is causes, is a correlation and not causation. Wheat comes after the damaged metabolism, IMO. The real danger in eating wheat is immune related (I believe, possibly erroneously, that wheat has a staring role in the development of all auto-immune diseases).

    What if leptin resistance had an auto-immune element to it…wouldn’t that make it interesting?

  10. Actually, the Inuits is not a high-protein diet. They preferred fat. They considered lean meat dog food, and as such, fed it to their dogs. So, I don’t think you have to explain the Inuits away. However, I’m not sure you can explain the French away without using the word “paradox.”

    And the map is just a correlation. As is: food for thought. As in: take it in conjunction with the other information presented.

  11. Ok, this was done in rats, but last year a brazilian nutricionist, Fabiola Lacerda, did her master thesis on gluten and obesity. Rats feed a diet with gluten had 25% more fat, 33% more visceral fat. She intend to do his PHD studing the effect of gluten in humans.

    http://translate.google.com.br/translate?js=n&prev=_t&hl=pt-BR&ie=UTF-8&layout=2&eotf=1&sl=pt&tl=en&u=http://www.ufmg.br/boletim/bol1695/4.shtml

  12. gunther gatherer

    I live in Normandy, and if you take a look at the fat content of the cheeses and meats they eat here, they are all very high fat. So I’m not sure traditional French lifestyle was ever so high-protein here. Goose fat, butter and duck fat are prized to the point that you save it after cooking and keep it next to the stove in a jar for use next time. Ditto for creme fraiche. Vegetable oils and margarine have only started to be used in the last 10 years or so.

    The problem here is bread and sugar, and now margarine, which have gone up tremendously as the French have cut fat due to official recommendations. Even my neighbors all say they “get fat when they eat lots of desserts”. Never when they eat what their grandparents ate! I think the traditional lifestyle here actually approaches the Inuit in many ways: They are both high fat, not really high protein! No paradox in either case, IMO.

  13. @Poisonguy et al. – interesting thoughts, however how much overfeeding can a normal metabolism take before excess adipose causes obesity physiology. Color me skeptical. I think Paul is on to something with his food toxins, but I have no doubt that behavior has a key role. What triggers or maintains behaviors may have to do with toxins as well.

    It seems clear to me, that overfeeding with any macro-nutrient leads to energy storage. I’ll grant your set points and compensation by increased activity and thermogenesis. Maybe you can compensate for a couple of hundred calories of overfeeding with those mechanisms. And, I agree that the body will decrease hunger in most normals. But, we can easily overcome that with hyperflavored foods and habit. Still, the fate of any macro that doesn’t go to energy or heat or structure is to sit on your gut.

  14. GG, I don’t doubt the French eat plenty of fat. Good for them. I do too. They also eat plenty of meat. See:

    http://www.allcountries.org/uscensus/1370_per_capita_consumption_of_meat_and.html

    I live in Greece, so I could state my personal experience with the diet here, but it wouldn’t necessarily reflect the true nature of the Greek diet.

    Mario, that link isn’t working for me, but the tidbit you posted sounds interesting.

    Robert, I have no disagreements with you. Actually, I see things through a similar lens. However, if a “normal metabolism” allows one to overfeed, should it really be considered a normal metabolism in the first place? I’ve never experience any animal species in the history of the world (okay, an unprovable exaggeration for effect) that has ever overfed (that had no links to humans and hibernating species excepted, that is).

    I think Paul is on to many things. I’ve even been caught doing a double take at the whole infectious disease origin stuff. Just pointing out that he and Gary may not be polar opposites after all.

  15. Peter Silverman

    If it were as simple as plants make you fat, vegetarians would be obese, but you can eat for months in a vegetarian restaurant before you see anyone even remotely obese.

    Also, I’ve read that the rice eaters in southern India have three times the heart disease rate of the wheat eaters in the north. I don’t know if this is true, or if it is what other factors separate the northerners from the southerners.

    I would love to see a friendly panel discussion with you, GaryTaubes, and Stephan Guyenet discussing the question: Which carbs are safe?

    Love your book.

  16. I recently saw a report on tv about pacific islands (don’t ask me which ones exactly, I didn’t see it from the beginning).
    There are some families still sticking with the traditions (living close to the beach, fishing and growing taro – eating taro, fish, coconut and not much more). They looked lean and fit, some men really muscular, some younger girls really beautiful – going bare breasted (we got to see such things on tv in europe) even into older age (albeit I suspect the “old” guys to be around 55).
    But when they went to the next bigger village on the same island(!) it was shocking to see how much different the picture became and much more fat people(and I mean really fat – especially the females – luckily also not going half naked anymore) then slim ones where on the scene!

  17. gunther gatherer

    Poisonguy, I highly doubt the French eat more protein than the Inuit. However, I don’t know how much protein in the diet starts to become a detriment to health. Maybe also it’s the percentage of protein out of daily calories that is the detrimental factor, not the overall amount per lb or per year. For instance, the Pacific Islanders eat anywhere from 3% to 10% protein in their daily calories and are in very good health, no signs of malnutrition and no diseases of civilization, etc. Both the French and the Inuit have too many confounding factors to make a good guess whether high protein is causing or preventing disease.

  18. Paul, one other comment re PUFAs and weight loss. I had come across a post a while back that suggested that stored body fat was ~15% PUFA, with most of that omega-6 (something I later confirmed via email with Dr. Bill Lands).

    I don’t know for sure (don’t come across it often), but suspect that this may be something to be somewhat concerned about during weight loss. If it has a role in insulin resistance for example, could possibly be a factor in weight loss stalls. For now, I’m going with minimal dietary omega-6 and upping my omega-3 (via diet and supplements).

  19. BTW, one other thought re French and other diets. I think that it’s not just a problem that omega-6s in excess are bad, it’s that they displace healthy fats with their vitamins and minerals.

    I don’t agree with everything Art DeVany promotes, but this Twitter comment of his makes lots of sense to me:

    “The brain is the main organ we have to feed. Obesity starves the brain.”

    I too would put wheat further down on the toxicity scale, mostly based on how long we’ve been eating it. That said, there’s a difference between the wheat my grandma ate and the wheat that’s in all the industrial food we Americans eat today.

    Poisonguy has a point re wheat and auto-immune problems, but I wouldn’t be surprised if the combination of nutrient-poor diet with lots of wheat opioid peptides are a disaster for normal appetite control!

  20. Could you post more on the connection between alcohol and obesity? Is it just lumped in with fructose as a toxin, or are there other factors at work?

  21. Interesting study about wheat versus rye! Not all gluten grains are created equal?

    I still drink the occasional beer, which are generally made with barley. However, I avoid wheat beers and have no interest in them. I will take this study as possible/probable support for my intuitive avoidance of the wheat beers.

  22. I’m confused – i’m getting very little omega 6 and a smaller amount of omega 3’s. Yesterday my omega 6 was 9.3g and omega 3 9.1g. The omega 3’s came mostly from Flaxseed oil. I put a tablespoon in my smoothie to get a better ratio of 6 : 3’s. Should i take any at all if my omega 6 stays real low because the total PUFA was 19g after i added the omega 3. So is it better to have a lower overall PUFA or add to the total with supplements?

  23. Is it possible that the toxicity of Omega-6 fats is simply only a problem when the fats are consumed as oils rather than as their natural seeds and nuts? Humans have been consuming seeds and nuts far longer than the highly refined oils from their seeds. Some cultures prepare them with toasting or soaking and sprouting yet other simply eat them raw. I wonder if there isn’t a danger in isolating negative elements of nuts and seeds (or any food for that matter)– in this case that would be Omega-6 or phytates/oxalates, etc — as a rationale to avoid or limit nuts and seeds while ignoring other elements in the nuts and seeds that are quite beneficial. The idea that walnuts, hazelnuts, almonds, pumpkin seeds, sunflower seeds are nothing more than toxic little fat balls best avoided seems incredible when one looks at healthy cultures who have been eating these things for a long time. It’s also curious that the pairing of fruit (high fructose or not) and nuts is something found in many healthy cultures. I don’t doubt the evidence that omega-6 oils are prone to rancidity and certainly not necessary as refined oils but I don’t want to throw the baby out with the bathwater.

  24. Lisa, two things. First, from what I understand,* it’s good to keep dietary omega 6 to under 4% of your calories. And in general, you want your ratio of omega 6 to 3 to be as close to 1 as you can get (1 to 1 or 2 to 1 is ideal, 4 or 5 to 1 is better, 15 to 20 to 1 is what we get on the standard American diet.

    If you’re just worrying about it for health, you can do fairly well by avoiding dietary omega 6s and eating fatty fish (salmon, tuna, sardines) a few times a week. Me, I’m supplementing in addition to eating lots of fish because I believe I’m having to deal with additional omega 6s through fat loss (my back of the envelope calculation is that 2lbs/week fat loss is equivalent to ~15g of dietary omega 6/day).

    Second, flaxseed oil is not really the best source of omega 3s. If you’re vegetarian, I guess you have to do what you can, but the omega 3 in flax is in a form (alpha-linolenic acid) that needs to be converted to what we use (EPA and DHA). Unfortunately, we don’t seem to be particularly efficient at this conversion, especially as we get older.

    * http://wholehealthsource.blogspot.com/2009/05/eicosanoids-and-ischemic-heart-diseas.html

  25. Annie, here’s someone from the paleo community who agrees with your take on omega 6s in nuts: http://donmatesz.blogspot.com/2010/03/paleo-diet-basics-why-i-eat-walnuts.html

    Me, I think that as with other things (like grains), there’s also a question of where you are. If you’re otherwise healthy, then eating nuts for their other benefits seem like a win. But if you’ve got existing health issues (obesity, metabolic syndrome etc), then avoiding some of these potentially problematic foods/foodstuffs may be prudent.

  26. Oh, and one other thing re omega 3s. Robb Wolf promotes a short period of hefty omega 3 supplementation for unhealthy folks — on the order of 1g/10lbs of body weight per day.

    Yowsa! To me, 20-30 (or more?) grams of omega 3 as a supplement seems excessive, but it sounds* like he theorizes that doing this for a short time enables the body to swap out some of the stored omega 6 PUFA. I’m sure I’m understand this, but thought I’d mention it to see if others had a clue.

    * http://livinlavidalowcarb.com/blog/the-llvlc-show-episode-433-%e2%80%98encore-week%e2%80%99-2011-interview-with-robb-wolf/9683

  27. Paul, do you think malnutrition triggers an obesity response in the body?

    I believe food toxins play a role, but anecdotally, I see lots of women who balloon up after having children.

    So, I wonder, does trying to build a baby without adequate nutrients break a feedback loop in the body and contribute to obesity in women?

  28. Hi everyone!

    Franco, yes I also eat bananas and stone fruits and tend to avoid apples and pears.

    Gunther, I’m not sure about that. When I looked into the evidence when writing the book, it was hard to find evidence for protein toxicity below 600 calories per day. Also, epidemiologically nearly every country eats close to 15% protein. So there’s not a lot of variability to justify linking disease to protein.

    Poisonguy, Gary is a smart guy and a good scientist/journalist, and he makes a lot of great points. I haven’t read his latest book so I’m reacting mainly to the marketing themes. Having been persuaded to go very low-carb myself and then having run into problems, I suspect that many people might be persuaded by Gary’s work to replicate that experience. I’m sure he’s helping many more people than he’ll hurt, but he may he missed a chance to advance the science.

    You may be right that wheat’s influence on obesity could be mediated through autoimmunity. However, rye also contains gluten and is less obesogenic. I think the issue of mechanisms is open.

    Mario, thanks! That is interesting. Her finding that gluten specifically is obesogenic supports Poisonguy’s idea.

    Poisonguy, I added up the PORK+POULTRY+BEEF in Excel and sorted them. Just eyeballing it, it seems like meat consumption is strongly correlated to income, weakly correlated to obesity. Hong Kong was at the top of the list, US second, Denmark 3rd.

  29. Peter, thanks! Most definitely it is not simple. I would love to have a discussion with Gary and Stephan, with or without an audience.

    Franco, it seems like many late-to-agriculture peoples are poorly adapted to toxic foods and get disease much faster than Eurasians. There must have been some recent genetic changes to help us detoxify grains. But the traditional Pacific Islander diet is the best!

    Beth, we discuss that in the book. It takes ~5 years to completely normalize omega-6 levels. Best to get started early!

    Great point about opioid peptides!

    PGuy, that’s a great idea. I’ll certainly try to work up a post on that.

    Mike, I’ve given up beer and adopted wine, but like you I give wheat beer a bigger detour than regular beer!

    Lisa, I think you’re doing OK. That’s at the upper end of our recommended omega-6 intake, but better than most everyone, and it is hard to go lower with omega-6 everywhere in modern foods. The omega-3 is a bit high but the shorter 18:3 fat is less dangerous in excess than other omega-3s.

    We personally skip the plant omega-3s and eat salmon every week, but there’s more than one way to skin a cat.

    Annie, it’s conceivable, but I doubt it. We do support eating both fruit and nuts, but we don’t think they should be a large share of calories. Less than 10% of total calories between them would be my recommendation. I’m not sure any traditional cultures exceeded that.

    Beth, I definitely would not support such a huge influx of omega-3s at once. I think Robb went astray on that one.

    Michelle, yes, absolutely malnutrition contributes to obesity. I think this is why yo-yo dieters generally get heavier over time. Also famines sometimes induce obesity later.

    Malnourishment definitely stimulates appetite until the needed nutrients are recovered. So definitely, micronutrient deficiencies could contribute to postpartum weight gain. It’s a very interesting idea! Thank you.

  30. Paul, thanks will go re-read the book ;). That said, any chance you’ll have a Kindle version? Hard copy is a must for some books, but I also like being able to search and highlight … and the Kindle apps for the PC and Mac rock!

  31. Yes, I’m working on the Kindle version! I know it’s late … I’ve been busy … the dog ate my homework.

  32. You may want to look at the history of the Pacific Islands, and how the introduction of rice, as a carbohydrate staple (along with canned meats and other processed foods of course) led to a epidemic of obesity and diabetes

  33. Thank you, Dennis, I had forgotten that post which is very interesting. It’s a clever idea to think of regulation of protein intake as a lever for total calories! I will have to read the papers and ponder that one.

    Hi dougie,

    Do you know where I could find sources on that?

  34. Since we’re on the topic of n6 etc., has anyone heard of Elevation Burger? It’s a new franchise for “better” fast food. They claim that they use grass fed beef. They use olive oil for making French fries, but their buns are the usual fast food type, and they serve the usual Heinz condiments. They advertise their veggie burgers as “guilt free”. The whole thing kinda seems duplicitous to me.

  35. Here’s what the popular press says about the Pacific Islands’ obesity problems.

    http://www.telegraph.co.uk/news/worldnews/1578329/Spam-at-heart-of-South-Pacific-obesity-crisis.html

    Reminds a little bit of what happened to the Pima Indians when they traded their traditional diet for White Men’s rations.

    And another publication here:

    http://www.who.int/nutrition/publications/obesity/9290610441/en/index.html

    I read the first few pages and it became clear to me that an increase in use of imported vegetable oil plays a major role in the crisis, although the authors seem more amenable to blaming it on an increase in the saturated fat that accompanies processed meats (spam, turkey tails, etc.).

    I think the Traditional Pacific Island diet that Paul identifies as beneficial predated the introduction of many different Western processed foodstuffs. It seems that it wasn’t so much the introduction of rice (that probably happened much earlier from contact with Asian peoples), but rather the addition of, you guessed it, wheat, oil, and probably sugar and/or HFCS that happened much more recently.

  36. The WHO report is really interesting, Maggy! Thanks for that find.

    It does seem like the major imported foods were not rice, but sugar and prepared fats.

    Some passages:

    The 1954, 1962 and 1966, surveys showed that much of the higher carbohydrate consumption of the urban dwellers appeared to come from sucrose. Fat consumption was similar but there had been a change from coconut-based (vegetable) fats to animal fats. The diet in Rarotonga showed an increasing reliance on imported foods. The population was consuming more sugar, salt and animal fat, and less bulky, starchy foods and fibre. (p 10)

    The author found little evidence of malnutrition before the Second World War, since which the national diet had changed considerably from local to imported foods high in fat, sugar and salt. Simultaneously, increasing vitamin A deficiency (VAD) and chronic diseases had emerged. (p 12)

    There had been an increase in the consumption of fat, carbohydrate and protein, with the additional carbohydrate intake being in the form of sugar, rice and wheat starch. (p 13)

    For example, bread was being consumed for breakfast and roti (flat bread made from coarsely ground white flour) was being taken to school instead of the traditional root crops. (p 13)

    The Tokelauans’diet was rich in fish, pork and poultry. Almost every family had one or two pigs and some poultry, so eggs and chicken were being widely eaten. Toddy or coconut sap, either fermented or fresh, was a speciality of the Tokelau Islands. Coconut sap is also used to make a kind of molasses. Later, in 1979, McKenzie and colleagues (109) confirmed that the traditional diet was very low in both zinc and copper.
    Naylor visited Tokelau in 1989 to review health services (110). One of the review’s findings was that the dietary habits of Tokelauans were undergoing considerable change. Fresh fish, traditional root and leaf vegetables were being consumed less often, while highly refined processed foods with salt and sugar additives were being used more frequently. (p 28)

    The 1998 study also found strong associations between the source of fat in the diet (local vs. imported) and obesity and diabetes. Table 6 shows that participants were 2.19 times more likely to be overweight or obese if they ate imported fat sources compared with traditional fat sources such as coconut…. The individual foods providing the fat in the urban diet were identified as oil, margarine, butter, meat and chickens … (p 32)

    Table 7 on p 35 gives food changes in Fiji 1965-2000. Vegetable oil consumption increased 173%.

    The increase in availability of vegetable oils and cereals, especially bread and rice, also suggests changes in cooking methods – from fat-free earth-oven cooking to frying. This was first documented in 1973 by Parkinson, who identified urban life as not conducive to traditional (umu) cooking because of lack of space and time for city people (133). Therefore, many families have changed to frying foods that are accompanied by rice and bread (that is again spread with margarine, thus adding more vegetable oil). (p 36)

    All in all I think it absolves rice and is consistent with omega-6-rich vegetable oils, margarines, wheat, and sugar as the main culprits.

  37. How is rice absolved from those passages?
    It is clear that the only change was not rice
    But the 47 references to rice in that document
    http://www.wpro.who.int/NR/rdonlyres/…/diet_food_supply_obesity.pdf
    suggest that rice played a role

  38. Hi dougie,

    Certainly nothing in the document absolves rice.

    I think other evidence indicates that rice is benign, and that the other recent additions to the Polynesian diet are not.

    So I’m merely noting that the WHO report is consistent with our thinking, not that it is probative.

  39. Hi Paul, totally OT but I want to ask you about the following: I have increased my starch intake via potatoes an it seems that every time I eat them I have cloudy urine,the cloudiness clears away if I add vinegar to it (phosphaturia?), It happens quite often, but stops when potatoes are eliminate.
    Could this indicate a kidney issue? or is this normal?

    Best,
    Carl

  40. Hi Carl,

    It could be a kidney issue, but it could be something else.

    Is it only potatoes? Or is it other starch sources like rice too?

    A common cause of cloudy urine is a urinary tract infection, and that could be stimulated by high blood sugar. Another common cause is kidney stones or dissolving material of stones, like oxalate or phosphate. Perhaps the oxalate in potatoes is forming crystals when excreted. Does eating spinach cause something similar?

    I don’t know why the vinegar helps. Is that vinegar added to potatoes, or to urine? If adding the acetic acid to the urine clears it, that might suggest an alkaline urine, perhaps indicating renal tubular acidosis.

    I would recommend having a doctor check it out. They can take a urine sample and figure out what’s causing the cloudiness. That’s better than us trying to guess.

  41. Thanks paul!. it is only potatoes..haven´t eaten spinach for a while so I dont know. The vinegar is added in the urine, I did it just to see if phophates where the cause of the cloudyness.
    I think I would check with my doc.
    Thanks again for taking time to answer!
    Best,
    Carl

  42. Dougie, maybe it was everything else that got layered on top of rice consumption rather than replacing it.

    Just anecdotal, but I have a friend who is from South America and she told me they always have rice with a meal, even if that meal happens to be spaghetti with meatballs. A meal isn’t complete unless there is rice on the table. The same may be the case in the Pacific cultures, where rice is considered the staple grain at each meal, but it doesn’t get removed once bread, macaroni, or other (less benign) carbs are adopted.

    This is also what happens in the Middle East (where my family’s from), where bread (flat pita type bread in Lebanon and Syria) is present at every meal, even if the meal is grain-based. Economically disadvantaged folks who don’t have access to meat all that often will become fat (but never really obese they way it happens here in the US) from eating a mainly grain and legume based diet (e.g. mujaddara made with lentils and bulghur), but will continue to eat bread as well. The advice they receive for reducing is to stop eating bread. People who are diagnosed with metabolic disorders, high blood pressure, etc., are told to take marrow bone broths and plain white rice.

  43. Hi, perhaps this sounds a little dumb but just wondering why it is that types of food, are seen as correlated with obesity, instead of the kinds of lives people are leading on a whole that differentiate these kinds of health problems. What if these kinds of health problems have nothing to do with food itself? How can we know the difference?

    • Hi Jenna,

      It’s not at all dumb. In fact it’s been one of the most controversial issues in obesity research for the last century. Much of Gary Taubes’ books are spent criticizing the idea that exercise and eating less are the keys to preventing obesity.

      Our book tangentially addresses the question when it discusses how food toxins and malnourishment lead to obesity.

      I think it’s clear that food matters. We see this clearly in animal studies, where mice living in the same cages with the same lifestyle have radically different obesity outcomes depending on the types of food they are given.

      Whereas lifestyle modifications have a rather poor record of curing obesity. Nor do they obviously cause it: there are plenty of sedentary thin people, and athletes who become obese. Moreover there is credible evidence that obesity leads to lifestyle modifications like sedentariness, rather than the other way around.

      Ultimately, the proof will be if diets like our Perfect Health Diet routinely cure obesity. That will show that it’s definitely food toxins and malnutrition that are the keys.

  44. That’s strange; I also noticed occasional severely cloudy urine after increasing white potato consumption over the last few months.

    I’ll try the vinegar if I see it again.

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