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*74 If the surgery is done to rodents during hibernation, they will somehow slow the rate at which they draw on their fat supplies for fuel so as to compensate for the loss.
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*75 The diet constituted roughly 400 calories a day of protein, 270 calories of fat, and 900 calories of carbohydrates.
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*76 Though Stunkard’s analysis has widely been perceived as a condemnation of all methods of dietary treatment of obesity, the studies he reviewed included only semi-starvation, calorie-restricted diets.
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*77 Physical activity is the primary determinant of the variation in energy intake in human populations, as Walter Willett and his Harvard colleague Meir Stampfer note in the 1998 textbook Nutritional Epidemiology:“Indeed, in most instances, energy intake can be interpreted as a crude measure of physical activity….”
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*78 When Mayer wrote about this research, or when he spoke to reporters about it, he would often give the impression that it included multiple studies in animals and humans—“J. Mayer has since demonstrated, in both animal and human studies…,” as he would write in Science in 1967. This was technically true, in that he had performed studies of both humans and animals—one study of each.
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*79 Tanner did believe that William Banting’s French predecessor Jean-François Dancel had finally provided a “more sure basis” for the treatment of obesity, and that Banting himself deserved credit for “bringing the subject before the public in a plain and sensible manner.”
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*80 It also assumes that the ingestion of food greater than that required by the body won’t lead to a compensatory increase in energy expenditure, which is a point we’ll discuss at length in the next chapter.
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*81 This left von Noorden explaining that the detection of a retarded metabolism seemed to require “special knowledge and acumen on the part of the observer,” and he acknowledged that even he lacked sufficient expertise. Hence, the only way to diagnose a retarded metabolism was by implication: if the patient’s weight could not be “brought under control through intelligent regulation of diet and exercise,” then the patient probably had a retarded metabolism. The circularity of this argument was evidently not apparent to him.
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*82 This notion has survived in the suggestion that weight gain in children is exacerbated by the refusal of parents to allow their children to walk or ride to school, for fear they will be kidnapped or abused by strangers.
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*83 The common response to confronting this dilemma, as Bennett noted, “is to ignore it,” which is what happened to Bennett’s commentary, even though he discussed this issue at a 1986 obesity conference hosted by the New York Academy of Sciences and attended by many of the prominent authorities in the field.
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*84 That the toxic-environment hypothesis is deeply immersed in moral and class judgments is evidenced by the observation that few or none of the condemnations of fast-food restaurants include a coffee chain such as Starbucks, despite the copious excess calories it peddles. A “grande” (sixteen ounces) Tazo ® Chai Crème Frappuccino, ® for instance, with whipped cream has roughly 510 calories, equivalent to a quarter-pounder with cheese at McDonald’s. The same judgments are made when discussing physical activity: If we sit around all day watching television, we’re condemned as couch potatoes, and our obesity is only a matter of time. If we sit around studying or reading books, this same accusation is rarely voiced.
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*85 These observations do not contradict Magnus-Levy’s. Magnus-Levy compared lean and obese subjects. These latter observations compare those who gain weight to those who don’t; this difference, as we’ll see, is critical.
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*86Obesity and Leanness was the first serious book on obesity published after 1900, when von Noorden published Die Fettsucht. In the years since, there have been only half a dozen similar attempts (out of the innumerable professional texts and proceedings now available) to present a comprehensive and balanced analysis of the evidence, and only three come close to Obesity and Leanness in critical analysis—the chapters on obesity and undernutrition in the 1933 English translation of Eric Grafe’s Metabolic Diseases and Their Treatment, Hilde Bruch’s Importance of Overweight, and, a distant fourth, John Garrow’s Energy Balance and Obesity in Man.
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*87 A hormone also secreted by the pancreas that tends to counteract the effects of insulin.
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*88 This phenomenon led to the notion of low-protein diets for weight loss. Regrettably, the ability to burn off excess calories when consuming a protein-deficient diet appears to be specific to young animals, and maybe even young pigs. When researchers tried to replicate this result in other animals—rats, sheep, cattle, or even older pigs—they noted that the animals eating the lower-protein diet got considerably fatter. They had more fat and less muscle, even if they weighed the same as the control animals.
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*89 Although, as we discussed in Chapter 16, the total energy expenditure of obese individuals is likely to be greater, because they have, simply put, more pounds to expend energy and generate heat.
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*90“The mean diet for Japanese people,” Nishizawa et al. reported, citing a 1972 survey by the Ministry of Health and Welfare, “consists of 359 g of carbohydrate, 50.1 g of fat, 82.9 g of protein and a total of 2,279 calories.”
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*91“Obesity itself,” as the National Academy of Sciences noted in 1989, “has not been found to be associated with dietary fat in either inter-or intra-population studies.”
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*92 The Duke University pediatrician James Sidbury, Jr., who would go on to become director of the National Institute of Child Health and Human Development, made the same observation about the obese children he treated in the early 1970s: “A pattern of constant nibbling was consistently found. Most common snack foods are predominantly carbohydrate: crackers, potato chips, french fries, cookies, soft drinks, and the like.”
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†93 Evans’s first test diets “called for no carbohydrate whatever” only later did he settle on twenty grams of carbohydrates to address nitrogen balance.
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*94“Wheat contains all of the essential amino acids,” explained the Columbia University nutritional anthropologist Marvin Harris, “but to get enough of the ones that are in scarce supply a man weighing 176 pounds (80 kilos) would have to stuff himself with 3.3 pounds (1.5 kilos) of whole wheat bread a day. To reach the same safe level of protein, he would need only .75 pounds (340 grams) of meat.”
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*95 These included Graham Lusk and Eugene Du Bois from Cornell and the Russell Sage Institute of Pathology; Russell Pearl and William McCallum from Johns Hopkins; the Harvard anthropologist Earnest Hooton; and Clark Wissler of the American Museum of Natural History.