Good Calories, Bad Calories

In two of these studies—Foster et al. 2003, and Gardner et al. 2007—the investigators also included a comparison of weight maintenance at the end of a year. In the former, those randomized to the Atkins diet maintained a greater weight loss than those assigned to the low-calorie, low-fat diet (4.4 © 6.7 vs. 2.5 © 6.3 percent of initial body weight), but the difference was not “statistically significant.” In the latter, those randomized to the Atkins diet maintained, on average, a 10.4-pound weight loss, compared with 5.7 pounds for a “lifestyle” program that included both a low-fat, low-calorie diet and exercise. The difference between these numbers and the larger numbers that Kemp reported could be due to the fact that these modern studies were more rigorous in following up on patients and measuring weight. It could be because the modern studies provided no counseling after the first two months of the trial, whereas Kemp categorized patients as having “defaulted” if they did not continue to appear at his monthly counseling sessions. Perhaps for this reason, the carbohydrate restriction after the first couple of months in the modern trials was at best modest. In Gardner et al. 2007—see p. 973 (table 2)—the subjects randomized to the Atkins diet consumed, on average, 30 percent of their calories from carbohydrates at six months, and 35 percent at twelve. This problem was particularly significant in the one trial I omitted: Dansinger et al. 2005:46 (table 2). Here the subjects randomized to the Atkins diet consumed an average of 137 grams of carbohydrates per day (32 percent of calories) after only two months of the trial, and 190 grams (over 40 percent) at six months and a year—the equivalent of four to five large baked potatoes every day—effectively identical to subjects randomized to low-fat, low-calorie diets. Thus, the similarity in weight loss on the different diets in this particular trial may simply reflect the similarity in carbohydrate consumption.

“first published synthesis…”: Bravata et al. 2003.

“Calories are all alike…”: Quoted in Berland 1983:7. “the effect of specific…”: Rubner 1982:36.

Bistrian and Blackburn instructed: Palgi et al. 1985. “thousands of patients…”: Interview, Bruce Bistrian.

Paradox relating to hunger: Leith 1961 (“nagging discomfort”); Peña et al. 1979; Hanssen 1936; Krehl et al. 1967 (“more than amply satisfied”). “Isn’t the proof…”: Interview, Bruce Bistrian.

Sims’s overfeeding experiments: Goldman et al. 1976:167.

Bloom’s articles on starvation therapy: Azar and Bloom 1963 (“At a cellular level…”); Bloom and Azar 1963.

“little hunger”: Bloom 1958. “In total starvation…”: Keys, Brozek, et al. 1950:829. “The most astonishing aspect…”: Drenick et al. 1964. “The gratifying weight loss…”: Anon. 1964c.

“mighty stimulant…”: Pennington 1954. “Many individuals spontaneously…”: Dwyer 1985:185.

“The fact remains…”: Anon. 1973.

“If you put a restaurant-size…”: Mayer 1975a:30–31. Fallback for the NIH recommendation: Ernst and Levy 1984:733–34; interview, William Harlan.

“Yudkin showed that…”: Interview, George Bray. Two papers: Yudkin and Carey 1960 [six subjects]; Stock and Yudkin 1970 [eleven subjects].

Yudkin explained: Yudkin 1958 (“The irrefutable, unarguable…,” 59; “much of the extra fat today…,” 141; fat calories will come down, 149).

Experimental evidence: Yudkin and Carey 1960.

Subjects losing weight consuming considerable calories: Milch et al. 1957; Werner 1955; Rilliet 1954 (“numerous and encouraging”).

“all-you-can-eat diet[s]…”: Brody 1981c. “The best definition”: Keys, Brozek et al. 1950:32.

“persistent clamor of hunger”: Keys, Brozek, et al. 1950:835. “nonappetizing nature”: Cahill 1975:58–59.

“token” amounts: Keys, Brozek, et al. 1950:74.

“their appetite-depressing…”: Spark 1973. “Substances called ketones…”: Brody 1996.

The existing research refutes ketone hypothesis: Drenick et al. 1964 (“It is not clear…” “…did not reappear”); Sidbury and Schwartz 1975. See also Kinsell 1969.

“these foods digest…”: Brody 2002. Even those investigators: Werner 1955; Kinsell et al. 1964 (“There is a good reason…”).

Yudkin had struggled: Yudkin and Carey 1960 (“for reasons…” “It would seem…”).

“It is better…”: Bernard 1957:37. “inevitability”: Yudkin and Carey 1960. “Claims that weight loss…”: White and Selvey 1974:48.

Physicians who took Pennington seriously: Thorpe 1957; Taller 1961.

Pennington set out: Pennington 1954 (“voluminous…,” “meager…,” “These tended…”). See also Pennington 1951b.

Something Benedict suggested: Benedict 1925:57. And Du Bois believed: Du Bois 1936:254–55. “index of calorie nutrition…”: Pennington 1953b.

“static phase”: Rony 1940:47. “His caloric intake…”: Pennington 1952.

Diet-induced decrease: Benedict et al. 1919:694–95; Strang and Evans 1929; Brown and Ohlson 1946. Lusk suggested: Lusk 1928:173. “their tissues are not…”: Pennington 1952.

A conundrum: Pennington 1953d. Stetten reported: Salcedo and Stetten 1943.

Applying the same law of energy conservation: Pennington 1952.