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Comment by matthewdgreen | Hacker News Reader

There's a ton of very new research on this. The big exciting candidate right now is Akkermansia muciniphila, which seems to emit a glucagon-like peptide that moderates appetite [1] (similar to drugs like Wegovy, only maybe without the side effects.) The western high-fat/carb diet also seems to cause Akkermansia populations to drop precipitously, which may be either cause or a separate side-effect of the obesity epidemic.

Apparently supplementing Akkermansia in obese mice has extremely beneficial effects on weight and all sorts of health measures. I tried some from the only supplier in the US and (unfortunately) noticed absolutely no difference, N=1. Still, I am eagerly awaiting the day when someone conclusively nails the obesity epidemic down to something as simple as gut dysbiosis.

[1] https://www.nature.com/articles/s41564-021-00880-5

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The western high-fat/carb diet also seems to cause Akkermansia populations to drop

The West, typically, eats a tiny, tiny fraction of the fat it used to. And also far less animal fat.

Do you know what went in soups, stews? Bones, with fat, for flavour, and energy, and nutrition.

What were pies made of? Pies, made to allow older apples and such, to be used past their best date?

Loads of animal fat in the crust.

And, especially in Canada, our pork is now leaner than beef was 50 years ago! And our beef is silly lean.

We eat far, far less fat than our ancestors, who would never throw away such valuable, nutritious calories.

If the simple metric is, why were we thin before, and overweight now? And if the answer is "our diet changed", then this logic means we should all be eating about 10x the calories we currently do, in animal fat, and tapering off the rest.

What if all those craving are just simply "the body needs more nutritious fat". Just like our ancestors ate.

What if we crave salty snacks, coated in vegetable oil (potato chips), because our body desperately wants salty fat?

Being overweight is far, far more unhealthy than eating more animal fat daily.

What if the cost of low fat diets, is an irresistable urge which causes weight gain?

If so, low fat diets are, therefore, very unhealthy... because being overweight is far worse.

I’d focus on getting fruit, vegetables, legumes, fiber, and everything that comes with it back into the western diet before I’d look at animal fat as the silver bullet we’re missing.

Too few animal products doesn’t seem like the thing the SAD is missing, either.

Indeed. All this talk about a proper diet without ever mentioning anything but animal flesh and fat.

Can't be the excess food intake. Like too much sweets and meat. No. Fat people are not eating enough fat. It's so simple.

I mean I lost 80 pounds literally eating cheap hot dogs and kimchi for 6 months. It might be that simple.

That's almost zero carbs (if we're talking about "sausage" hodogs, and not "sausage-in-bread-bun" hotdogs)... fat makes you feel full faster and longer, and kimchi add vitamins and almost zero calories, so no wonder you're losing weight :)

Replace those with potato chips and chocolate, and you'll be fat very soon :)

I think the upshot of much of this research is that sugar and fat aren’t directly the issue. That gut bacteria actually have a much bigger impact on both energy expenditure and appetite than we thought. Insofar as diet has a major effect on obesity (in the epidemic sense we’re seeing in the US) it might be due to diet having a harmful effect on gut bacteria. Or it might not. It’s an intriguing hypothesis, and it’s disappointing to see it devolving into an argument about “not eating too many sweets.”

Then there’s the classic lean chicken and tequila diet[1] (plus green vegetables). It’s physically impossible to gain bodyfat on that diet because the storage form of protein is muscle and other lean tissue and the storage form of alcohol is there isn’t one. The body preferentially metabolizes ethanol for immediate energy needs over all other macronutrients. So if you have fat or carbohydrates in your diet they will get stored as adipose tissue, but if you stick to protein and ethanol you’re good.

The above is a joke. However it’s useful to know if you’re cutting and planning to attend an event where you’ll be consuming alcohol. Just skip all carbs and fat that day and eat protein and dietary fiber and you won’t set yourself back at all.

[1] Any lean protein source will do, including bison, grass fed beef, some fish, some pork cuts, and so on. Same for the ethanol, has to be pure spirits, no sugar mixers.

"and the storage form of alcohol is there isn’t one."

Do you have a source for this? I would think at least secondarily it could cause fatty liver or beer belly, even if it's technically using the calories from other sources.

It’s been a while since I Google scholared this and I’m not interested in being an unpaid research assistant. I have no reason to lie, but if you want to check my claims you’ve got the tools at your fingertips.

The essence is that there is no metabolic pathway to convert dietary ethanol into lipids or glycogen. Any unused ethanol is excreted through the lungs or kidneys. Granted ingesting enough ethanol such that it’s too much for your immediate energy needs is a life limiting decision.

I'm 99% sure you're correct on the alcohol reference. From what I've read, alcohol cannot be stored but gets prioritized as caloric fuel for the body. Regarding lean protein, I'm also sure that protein gets broken down into glucose for fuel, and can be stored as such in fat. It's why the keto community is really big on such a relatively low percent of protein and high percent fat in their diet.

That diet probably works wonders because if you have ever tried to eat a bunch of lean meat, it's difficult to get through an entire chicken breast, let alone excess calories it would require you to put on weight.

> Regarding lean protein, I'm also sure that protein gets broken down into glucose for fuel, and can be stored as such in fat.

Glycogenesis is certainly a thing. However every metabolic ward study I read found that there was never a glycogenesis -> lipogenesis pathway observed. Instead excess protein was discarded renaly.

Alcohol is metabolised to ATP and unused ATP will of course be stored as glycogen later. When glycogen storage are full, fat is deposited. Glucose is needed + ATP. High Protein intake will lead to gluconeogensis and create the glucose.

Please link to a metabolic ward study showing ethanol observably being converted into bodyfat through a glycogenesis to lipogenesis pathway. I only found ones saying it never happened, so I’m very interested in any counter example.

You just went from answering someone that asked you for a source with "I’m not interested in being an unpaid research assistant" to asking someone else "please link to a metabolic ward study showing..." in the same thread. Maybe people would feel a bit more generous with their time if you were willing to do the same?

Note that it's called "beer belly" and not "alcohol belly". Beer has a not insignificant number of calories even if you don't factor in potential overeating from intoxication. If by "secondarily" you mean overeating while intoxicated I guess you could also factor in organ damage from drunk driving accidents or fights.

Not just overeating. If the body performs to use the alcohol as energy as claimed, then the normal amount of calories that you already ate would be stored instead of used. Alcohol and it's metabolites can directly cause organ damage.

that's a recipe for gastric cancer

"sweets" are the alternative to fat. That's the point.

There was a concerted effort to reduce fat intake in the United States throughout the latter half of the 20th century, and the timing of this effort lines up pretty well with the beginning of the obesity epidemic.

I enjoyed the documentary Fed Up which claimed that when the low fat craze was beginning, the industry had a lot of excess fat, so you also see a rise in cheese advertising around the same time.

Yeah but it replaced fat with refined sugar. That doesn't mean adding animal fat back is an unconditional improvement

Sure but, to my understanding, the human perception of satiety (“being full”) is far more sensitive to animal fats than refined sugar.

> Can't be the excess food intake. Like too much sweets and meat. No. Fat people are not eating enough fat. It's so simple.

There can be second order effects. For example, it's not that eating a bunch of animal fat will magically get or keep you thin. Instead, it's likely that eating fat you'll not eat as much of it, and even better: eat little to no sweets or other "junk".

I'm not convinced that eating too much meat gets people fat. By that, I mean the meat itself. What I've noticed when eating out, is that meat is often drenched in some kind of syrupy sauce. And I notice that whenever I eat such a meal, I'm left hungrier, or get hungry quicker afterwards, compared to if I eat the same quantity of meat but with just a few spices. Most of the times, I'll find there's too much meat, and not even finish it. But with the sauce? I'll only stop when I'm physically bursting.

Another poster touches on this, talking about satiety. It's very clear to me that some foods just give me the impression of being hungry and wanting to keep on eating them. And it requires a great deal of will power to not indulge. Bonus points for these foods being "bite-sized", when you figure "just one won't make a difference". Only issue is, "you can't eat only one", as the ad says.

Maybe exercise is a component too. We traded manual labor for sedentary desk jobs.

Protein too. Americans used to consume considerably more animal protein, especially red meat. For example the typical Union Civil War field ration included 20 ounces of meat. I don’t have any non military data, but I’d bet that the rations were modeled on the civilian diet.

Yeah but that was for guys marching 10-20 miles per day.

Field rations are hardly representative of normal diets. Meat consumption has gone up since we invented industrialized meat farming, because meat got so much cheaper.

> Americans used to consume considerably more animal protein, especially red meat.

This is not true.

Per capita meat consumption has increased over the last century, with red meat consumption peaking in the 1970s. It looks like total meat consumption has increased about 40% since the early 1900s.

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/

[1] https://www.thedailymeal.com/how-american-diet-has-evolved-o...

If you're going to falsify my claim that 19th century Americans ate more protein and red meat, you may want to find some sources that aren't talking about the 20th century.

Years ago I read about the massive amount of grease (food waste from kitchens) in the London sewer system and thought ~what went wrong in our (my/Western/Euro-centric) culture where we don't use the fat?

Also, if animal fat is important for our health, that's another reason we don't scale well as a species. Seven billion humans and life on the planet continues to groan.

Ties in with the thread about how comicbook stores aren't kid-friendly; we (the relatively wealthy, globally) have been growing accustomed to having whatever sideshow we want as the main course in life. It's an easier life for a few of us in the short run, and an interesting experiment. [0]

[0] https://www.worldcat.org/title/ultimate-hitchhikers-guide-to...

From my perspective:

Pork raised on a small farm has ridiculously pure white fat. Heritage bacon fat turns clear as it is cooked. It's delicious, even unseasoned, and the texture is firm and pleasing. The flavor is nutty.

Industrially raised pork fat is disgusting. It is pinkish gray, milky, and stringy. It does not properly render during cooking (seems like too much connective tissue). It is mostly flavorless, or even acrid, and the texture is more chewy than firm.

The problem with the US farm system is that our food should be more expensive. Eggs, poultry, pork, beef, but also many vegetables. breads, etc, just don't have the dietary benefit that we had in the past. Garden grown celery is almost inedible raw - the flavor is so intense a single stalk can flavor an entire stew. Garden grown carrots are hearty and flavorful.

The quality of the food we are producing tends to be abysmal.

We can can unsaturated fat from olive oil and omega3 from walnuts/flax- or chiaseeds.

<add> ~70% of mankind lives close to water, ie have acces to fish (O3). There are tribes that that don't. When they shoot an ape, they eat the brain (O3) and intestines (unsaturated fats). The meat gets thrown away.

"What if all those craving are just simply "the body needs more nutritious fat". Just like our ancestors ate."

Not necessarily fat, but most produce has lower nutritional value than it did 100 years ago, at least for some nutrients. It sounds like there are a variety of potential causes - soil depletion, synthetic macro fertilizer ignoring micronutrients, selection or genetic modification for larger/faster varieties with plants unable to move enough of certain nutrients to the larger fruit load, longer storage times due to modern supply chains, etc.

People seem shocked when they find out that high-fat diets can be hugely beneficial for weight loss. I couldn't lose weight if it wasn't for keto. And the plus side is once you're used to eating high fat foods, you're just not as hungry. I've been finding myself kind of forcing to eat just to get enough calories now. Although I will say, some of these low carb ice creams are delicious and pack a ton of calories and fat.

> The West, typically, eats a tiny, tiny fraction of the fat it used to. And also far less animal fat.

We dont do the exercise of previous generations.

One study conducted around the early 1900's got ordinary people off the street to carry out a set of physical tasks. What stood out for me was the tasks and time it took to complete, todays special forces people would struggle to keep up with the physical exercise of those from the 1900's.

Yes our diets have changed, we can grow food more quickly, the nutrition of the food is different to that seen in the early 1900's and arguably less nutritious but satisfies the short term needs of an over populated planet.

One example, muscle density is in decline, for example US special forces know that black people have higher muscle density that Caucasians, this means Black people cant tolerate the cold or swim because they dont have the layers of fat seen in Caucasians. To the point Black US special forces have successfully sued the US military over Arctic deployments because they fail in this environment and the US military knew this before deployment.

What the science doesnt tell, is Caucasians used to have the same muscle density and limited amount of fat in/on their body as seen with Black Americans generally.

Carnitine is one of those chemicals which increases muscle density and its similar to Choline, main food source Beef Steak! Even ground beef has substantially lower levels, the mechanical processing removes some of it. Now this shows how science can obfuscate, look at the studies which show Choline aiding exercise and weight loss, Carnitine is structurally similar but studies on Carnitine generally dissuades people from using it for exercise enhancement. So if you didnt know about the structural similarity of the two, you wouldnt link their biological properties together.

There are a lot of chemicals like this and some chemicals which are generally seen as the best FORM to take are not always available in a unadulterated form of bulk consumer amounts, but only as a consumer end product adulterated with other chemicals you dont really wont and in some cases working against the chemical in question.

Diet is a very expensive absolute mind field, fortunately even the medical experts dont know it all because of their instance on injecting some chemicals still!

> The West, typically, eats a tiny, tiny fraction of the fat it used to. And also far less animal fat.

This is false, or at least not supported by any data I've seen.

Fat consumption increased 39% from 1909 to 2000 [0].

Meat consumption increased about 40% from 1909 to 2007 [1].

You are right that many of the fats have changed from animal fats to seed oil fats mostly from the 1970s onward.

[0] https://www.beatalewismd.com/blog/fat-fads-changes-in-fat-co...

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/

Still, I am eagerly awaiting the day when someone conclusively nails the obesity epidemic down to something as simple as gut dysbiosis.

That's unlikely to happen. Nutritional content of produce has gone down, people eat fewer home-cooked meals and we drive more and walk less, among other things. So it's not likely to boil down to "This one simple trick!" that can be solved with a simple product one can buy for cheap.

If you look at the timing of the obesity epidemic you notice that it has a very sharp “knee” in the US around the 1970s. It does not coincide with the introduction of fast food or the automobile or sedentary living, and contemporary people exercise more in many cases than they did in the 60s and 70s, with vastly higher BMI as a result. The same pattern occurs in other countries just at later times. And the effect size is huge. Much larger than anything we can achieve with diet and exercise (durably) or even the best weight loss drugs. I don’t know what’s causing it, but “gosh people eat poorly” doesn’t seem like a good explanation. I thought this was a good (amateur, but accessible) summary of some of the stats: https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-p...

I don’t know what’s causing it, but “gosh people eat poorly” doesn’t seem like a good explanation.

I'm not sure what your point is because what I said boils down to "There seem to be multiple factors, not any one thing."

I've lost multiple dress sizes by improving my health when losing weight wasn't a goal at all. Among other things, that experience informs my views and I don't really know how to engage whatever point you are trying to make that seems to not really engage with anything I actually said.

But thank you for the link. It's got a take I hadn't previously seen.

Me too. But fundamentally I’ve never consistently long-term kept my weight below where my body seems to want it. Enjoy that link. I think they’re right in the early parts but maybe they don’t quite land it at the end.

Available calories went way up (and so did disposable income):

https://academic.oup.com/ajcn/article/91/5/1530S/4597478

Of course availability is not a perfect proxy for consumption, but they are probably somewhat related.

And people got more sedentary over the same period.

That’s exactly when health experts and the government started to heavily promote the low fat diet.

> “gosh people eat poorly” doesn’t seem like a good explanation.

Maybe they drink poorly? One guy shown in Super Size Me drank 8 litres of soda a day IIRC. The body has no use for fructose, it can only be converted in the liver to fat. You can even get a fatty liver from it, like with too much alcohol. Soda is usually sweetend with HFCS (high fructose corn syrup) no?

Fructose is converted into glycogen in the liver, which is then converted into glucose or fat, the body uses fructose just fine.

Regularly consuming 5000 calories of anything sugary or starchy is going to be a problem for most people.

This is a startling and very interesting article. Thank you!

> Nutritional content of produce has gone down

I doubt doubt the findings, but I haven't heard of an epidemic of micronutrient deficiencies. With a lot of micronutrients, you only need so much, and then your body dumps the rest. What you're saying might be true, but I'm not convinced it's a problem.

But there does seem to be an epidemic of "mystery ailments" with no real explanation.

What if that's not some bizarre coincidence and is actually related in a cause and effect manner?

While I'm fairly convinced that a lot of dysfunction gets a helping hand from microbiota imbalance, including such faraway targets as pulmonary, cardiac, and even neurodegenerative disorders [1], I think there's a simpler culprit: sugar. Metabolism of simple sugars changes biochemical gears, and we as a culture and society are heavy on its use.

[1] https://news.ycombinator.com/item?id=29882347

Sugar definitely seems bad, but doesn't explain why simple fecal transplants are able to replicate many of the health effects of a low-carb diet without the actual diet, at least in some obese mice [1]. (PS I am definitely not an expert in this area, just someone who is tired of eating low-carb to maintain weight, and wondering why other people can just eat normal food.)

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199268/

The whole thing about fecal transplants is that the resulting changes in your microbiome make it so your pull to sugar is weakened. Your diet changes because your cravings change. Imagine how easy it would be if you craved food that was "good for you", or that your cravings for bad food were severely weakened. That's kinda what having a healthy microbiome is like

Grain Brain is an interesting read that covers in a pop-sci way some of the various research being done.

> Still, I am eagerly awaiting the day when someone conclusively nails the obesity epidemic down to something as simple as gut dysbiosis.

On average, what is the daily caloric surplus (calories in - calories out) for Americans vs. the rest of the world? I suspect going for exotic/complex explanations for obesity may not be necessary, therefore think change is gut bacteria is an effect, not a cause of obesity.

Lot's of other places have a high-carb diet (staples are rice- or corn-based), and yet do not have obesity crises because those areas also have low mechanization, high levels of menial labor and walking

what does a non western diet include that is so much more healthy? In my limited experience it doesn't seem that way or atleast you can pick and choose what you want. Rice is a big thing and white rice has a high glycemic index. or cooking with ghee, or coconut milk or fatty cuts of meat

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