If you have to lose weight all of the above. Everything has to go into the hopper and you have to hope you are mostly right. It is not a settled science or a one-size-fits-all.
The real challenge is cutting calories over the long run.
Related to this, the cost to repair a P2 leaflet of the Mitral valve (1 leaf out of 3 on that valve, and you have 4 valves) in a minimally invasive way (robotic, sternum intact) was just a touch over a half million dollars. So glad I have insurance!
No indication this was diet related or lifestyle related, but your choice of diet and exercise can have real costs!
EDIT: Looking over explanation of benefits. Billed was $514,000. Insurance paid $153,00, I paid $3,300. I find that absurd. Just how much does our system screw people that do not have insurance?
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Right on! The solution is to eat less but that is not easy. You have to eat stuff that kills the hunger pangs. Supposedly fat does that but fat does not work for me. Protein does. Hard boiled eggs work great. I now have two of them at hand all the time, just in case. Cheese, while high in fat is also high in protein. I love Brie!
As for drinks now itâs mostly just plain water. Coffee in the morning and an occasional beer. Donât give up all your vices!
You have to find what works for you.
The Captain
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The Law of Unintended Consequences. There was nothing wrong with animal fat, butter, lard, and tallow. But Procter and Gamble had invented Crisco and the competitors had to be gotten rid of. Religion also had a lot to do with it. Look up the history of Corn Flakes.
BTW, blenders to make smoothies and juicers are also part of the problem. Juice and smoothies are forms of âpre-digestionâ which accelerate the digestion of the sugars inceasing insulin spikes. Eat the whole fruit! Better than as juice.
An important thing to keep in mind, the body has lots of ways of protecting itself so it can withstand a certain amount of abuse. But the modern American diet, the result of religion, industry, and government, exceeds those limits.
The Captain
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Diterpenes are lipids that are extracted from coffee grounds by hot water. The amount of lipids extracted depends on how finely ground the coffee is and the length of brew.
Paper filters absorb some diterpenes and also block most of the grounds. Metal filters only block the grounds. Therefore, paper filters are better than metal filters.
On a side note, diterpenes have nothing to do with caffeine.
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Who knew what when regarding âsimple carbsâ?
I suspect General Mills and other millers knew by the 1920âs, and that they kept that knowledge from the public while using it to market what they knew to be addictive substances, shades of the Tobacco industry.
My maternal grandfather was a key executive at General Mills for its northwest region, HQâd in Portland, Oregon, where he was the chief surveyor and buyer of grain from all of Oregon, Washington, Idaho, and western Montana. In my motherâs childhood home under his tutelage white bread was strictly prohibited and bread was never put on the table, except in the form of toasted whole wheat bread at breakfast and whole wheat bread sandwiches. White flour treats such as muffins, pies, and cakes were only allowed on birthdays and special holidays. My mother brought my siblings and me up under the same rule.
david fb
[My maternal ancestors were âcarbohydrate farmersâ, primarily wheat, from 1845 on the Willamette River, and from the 1880âs in the mighty Palouse district
and so carbohydrates are literally âin my bloodâ.]
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Here is the original USDA food pyramid from about 1960:
It doesnât seem that bad based on what was known at the time.
We now know that certain oils are healthy so that stuff like olive oil should not be classified with sweets. The pyramid also overemphasized carbs (pyramid base), although I think for an active population where people are burning a lot of calories, it probably isnât that bad a recommendation. Farmers and miners probably could use 6-11 servings of carbs.
I donât think the pyramid was the big problem for obesity. I think it was more that the population became sedentary. If all one does is sit, fiber should be a higher diet priority than calories.
The pyramid didnât push sodas, oreos, and Cheetos We did that on our own.
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Well, in reality, there was probably quite a lot wrong with those animal fats when eaten in the quantities that so many Americans were consuming them. For sure, substituting the alternatives in the same amounts⌠or possibly more since they were perceived as healthier by folk who were willingly seduced by deceptive marketing (i.e. folk who believed what Dr Paul Mason portrayed as popular myths in the video you seem to have found persuasiveâŚnot just the cartoon Food Pyramid but also the cartoon cigarette ad with the drawing of a guy wearing a white coat used to suggest that doctors supported smoking.)
Did anyone actually think this was true back when they lit their first ciggie (assuming there are no centenarians reading this)âŚand continued to do so even when warnings were commonplace on every pack? Smoking for health reasons? Historical revisionism at its finest
This 
⌠and the fact that so many were eating about 3 pyramids worth of rations a day! So, although proportionately they couldâve claimed a low fat diet, the actual amount was likely at least as much as the pre pyramid eating habitsâŚand with a heck of a lot more carbs on top!
But WHY were they eating so much??? Because for a large majority of people, carbohydrates donât lead to that âfullâ feeling, so they needed to eat more and more and more until they felt full. Proteins and fats, on the other hand, make most people feel full after a much lesser quantity is ingested.
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At that time it seemed fine to me but I was clueless. 
But that does not mean it was good science.
The Captain
true
The NPR report ran the two topics together along with all sorts of facets on the topic.
I still donât get it. Given what was known at the time, what did the USDA get wrong?
So what could you have possibly known in 1960 that would have changed your diet? We are all limited in our decision making by what information is available.
Looking at that first food pyramid, I honestly donât see why it should be blamed for todayâs obesity problem.
This is an interesting study that analyzed changes in US occupations over the past 50 years and their impact on average calorie use. It found that on average, occupations today result in an over 100 calorie reduction in expenditure per day, explaining much of the obesity problem we see.
Over the last 50 years in the U.S. we estimate that daily occupation-related energy expenditure has decreased by more than 100 calories, and this reduction in energy expenditure accounts for a significant portion of the increase in mean U.S. body weights for women and men. Trends over 5 Decades in U.S. Occupation-Related Physical Activity and Their Associations with Obesity - PMC
We simply arenât as physically active as past generations yet our meal portions have increased. There is no need to assume corporate conspiracies or government malfeasance. Obesity is inevitable if you move less and eat more.
And thatâs true enoughâŚstimulation of cholecystokin and all that âŚand for those folk who really did attempt an ultra low fat and low protein diet (misguidedly thinking really low fat was better than low-ish) and who have problems managing a low satiety diet, thatâd certainly stimulate appetite.
However, in reality I doubt this scenario held for a large majority. My first exposure to American eating habits on home turf was in 1980 when dh and I spent a yearâs sabbatical in NYâŚnot generally recognised as the nationâs epicenter of obesity. Our first foray into a local deli within a few days of arriving clued us in as to why there were so many fat Americans around. We didnât know what to order so we copied the two guys ahead of usâŚâcomfortably upholsteredâ, the pair of 'emâŚham and cheese hero for me and roast beef for dh. I realised our mistake as soon as they got their order. Massive quantities that would have fed a whole team of lumberjacks.
Took our food back to our apartment and set about dismantling these door stopsâŚdiscarding one half of the bread roll, scraping off about half a pound of butter and throwing it away, and put well over half of each of our servings of meat away which lasted as cold cuts for lunch for a few more days. We effectively rendered our lunch low fat in proportion to what was originally served. No way was it lacking in satiety valueâŚbut, for sure, those two blokes ahead of us wouldnât have last on that approximately 500-600 Cal meal if they were routinely guzzling the 2000Cal option that was the original format.
Overeating has been a US phenomenon long before the food pyramid provided a convenient excuse.
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Are you seriously claiming that you followed the US Food Pyramid to the letter? Havenât you stated in the past that you routinely guzzled Viennese pastries and other scrumptious desserts available to you?
For sure, no one can be blamed for not knowing what they didnât know until they didâŚbut itâs self deceptive to imagine that it was information that was distorted or withheld or wrong simply because you didnât know at the time or ignored because you werenât actually concentrating on healthy lifestyle habits in quite the way you recall.
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Basically, they knew it was bogus for decades before making changes due to lobbying from the processed food industry.
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Because free markets are extremely good at finding out what people want, or in this case finding out what tastes good.
Soda tastes better than water. Potato chips taste better carrots. Put salt on something and people will eat a lot of it. The free market does what it does. It provides products people wantâsweet or salty and convenient.
The other side of the freedom equation is that people have to act responsibly. You know, all that âBuyer Bewareâ stuff. If people canât act responsibly and curb their impulses, then we have to become a ânanny stateâ and do stuff like tax fructose or prohibit âBig Gulpsâ.
Or go bankrupt paying health costs for an increasingly infirmed population.
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If you want to hold the food pyramid blameless thatâs fine by me. In the interest of humanity I would like to know what caused the obesity and allied ailments epidemics. We know itâs bad nutrition. Where did it come from? How can we avoid a repeat? Why did the medical profession not learn about nutrition?
I see no reason not to investigate. To call all who donât like the food pyramid DENIERS is not science.
The Captain
This is EXACTLY it. Exactly. There are essentially two things that make food taste good right now, fat and sugar. Yes, there are other things, spices/umami/etc, but those take longer for the good taste to penetrate, and donât add the good texture that fats and sugars add. So once fat was thoroughly vilified, the âfree marketâ had to find something to make food taste good RIGHT NOW, so you are tempted to buy it RIGHT NOW, and they ended up adding sugar. To nearly everything. Baked goods, sauces, processed meats, snacks, etc all had sugar added, sometimes large amounts of it. I think the crescendo of sugar laden foods/snacks was the Starbucks Frappuccino (among other similar items), a massively sugar-laden drink, almost like drinking down pure liquid sugar in large quantity, and because it is cold, flavorful, and rather pleasant, it goes down really well.
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What specifically about the pyramid was known to be bogus at the time? Got any details?
Remember, this was the 1960s. Consumers were interested in convenience as prosperity increased disposable income. Canned foods, fast foods, TV dinners and the like. Processed foods were just becoming a big deal.
I think âthey knew it was bogus for decades beforeâ is mostly revisionist history. I know of no official recommendation from the government or medical organizations for adding Fritos and french fries as part of a healthy diet.