I got an email today about the upcoming 2010 USDA Nutritional Guidelines and Food Pyramid from Richard Feinman, Ph.D., who asked me to pass it along to the readers of this blog. The US Department of Agriculture updates the nutritional guidelines every five years – the last time was in 2005. You can find the link below to get the executive summary of the 2005 guidelines. In a few days the scientific group that works on these guidelines will be selected. Please write and voice your opinion that scientists who are experts in the low-carb arena should be members of this panel.
A few years ago I was on the O’Reilly Factor on Fox News (I don’t know how to get the tape of the show. If anyone knows how, please give me a heads up, and I’ll get it and post it) discussing the Nutritional Guidelines and the Food Pyramid. I said my piece, and Bill O’Reilly said something along the lines of: Ah, Doctor, who cares what the guidelines say? Nobody pays any attention to them anyway.
I explained that although he may not pay attention to them, plenty of other people do. The law that established the guidelines mandates that every bit of food or money for food that the government doles out has to follow the Nutritional Guidelines. Approximately 54 million people are fed daily by the government, and they all have to be fed according to the guidelines. Who does the government feed? The military, people in the prison system, school lunch programs, numerous people who receive commodities from Uncle Sam, Federally funded daycare centers, the list goes on and on. So the Nutritional Guidelines are not a meaningless, harmless little bit of government doodling – they are of great importance. It would be nice to see them move away from a diet that composed primarily of carbohydrate. The only way this will happen is to get some low-carb advocates on the panel.
Here is a copy of the email. Due to my computer ineptness I couldn’t get it to copy over with the links included, so I stuck them in below.

The links from the above email are below:
Metabolism Society
Support Truth in Science
Join Today
USDA Dietary Guidelines
Nutrition & Metabolism Journal
New Diabetes Articles of Interest
First Article
Second Article
NMS (Nutrition & Metabolism Society) Scientific Board Members
Below is a sample letter that you can personalize:
Sample Letter

Nutrition Promotion Staff Director

Co-Executive Secretary of the Dietary Guidelines Advisory Committee
Center for Nutrition Policy and Promotion
US Department of Agriculture
3101 Park Center Drive, Room 1034
Alexandria, VA 22302

Dear Ms. Davis:
I am writing you about the recent announcement about the establishment of the Dietary Guidelines Advisory Committee for the 2010 Food Pyramid. I understand that the selection process is currently underway to determine what voices will be part of the discussion about the framework for the American diet. Some aspects of the current food pyramid are not a reflection of the needs that most Americans like myself have in order to maintain health. I encourage you to ensure that researchers who have performed extensive studies on the benefits of adjusting variables in the diet, like Dr. ___________ be included on the panel.

I have many reasons for wanting to make sure that the panel includes experts on the science behind different kinds of diets, such as diets low in carbohydrates.
[insert your own personal story – 1 or 2 paragraphs – about the results you have achieved by lowering the carbohydrates in your diet. Write about how these results have made you feel. What health effects have you seen?]

Facts about the science of low-carb diets are important to the discussion about the new food pyramid. I urge you to make sure the Dietary Guidelines Advisory Committee includes scientists who are well-informed about these issues.
[Your name]
Cc: www.NMSociety.org

(your senator)
(your congress person)
Both MD and I belong to the Nutrition & Metabolism Society and urge you to join as well. A number of people have written me asking if there is a scientific association supporting low-carbohydrate dieting. The Nutrition & Metabolism Society is it. You can join as a non-professional for a mere $25. All the funds go toward disseminating information about the advantages of carbohydrate restricted diets.


  1. You don’t see that many obese or even fat people on the military or in correctional facilities… so, so much for that theory.
    Most are relatively young and active, both of which go a long way toward minimizing the immediate effects of a high-carbohydrate diet. I ate carbs like they were going out of style when I was young, and I was thin. But it ultimately caught up with me, and it’s been a struggle since.

  2. Did you read the ad below that says, “Fat=Death & You Know It”.
    Do you subscribe to such a theory?
    I’m hoping that you screen the ads that are placed on your blog and allow them to be there, if they have merit.
    The ad you mentioned wasn’t there when I checked. I don’t screen. Google puts up whatever ads that are in rotation, I guess. I’m not even sure how it works or how I could screen it. I have to rely on the fact that my readers are smart enough not to fall for a scam that styles itself Fat = Death.

  3. Thanks. That eases my mind considerably. I should have known Google had a hand in this. Now it says “Fat=Parasites” Really.
    Actually, the optimal strategy is to click on such ads because I make a penny (or maybe a fraction of a penny), and the advertiser gets gigged for having Google place its ads on an inappropriate site.

  4. “It would be nice to see them move away from a diet that composed primarily of carbohydrate. The only way this will happen is to get some low-carb advocates on the panel.”
    And to undo the population explosion and extinction of large animals that allegedly caused the need for agriculture in the first place. I don’t see how. Carbs are here to stay, until the world can feed 7 billion people the diet you espouse (or 95% of them die). It’s obvious simply looking at grocery shelves that there isn’t enough meat, eggs, fish, low-carb, and veggies to provide enough calories for all of the people in the store. Most of the space in the grocery goes to refined carbs, junk food, grains, and processed vegetable oils.
    Re “Fat = Death”
    I think that ad was for plastic surgery (liposuction), not saying that all fatty foods were bad.
    I agree and I disagree about carbs verses the population explosion. It needs to be dealt with in a long post, however, not in the comments.

  5. Besides the fact that the military screens out recruits who are already fat and can boot out those who get fat, so it’s hardly a representative population or proof that a military-style diet makes fat people thin. Surely any reader of this blog knows a causation/correlation problem when he sees one.

  6. Dr. Mike,
    The comment about prisoners in correctional facilities ignited my curiosity, as I’ve often wondered how alot of inmates manage to get so muscular on what i imagine would be regarded as a poor diet by most bodybuilding authorities. From the books i’ve read and the documentaries i’ve seen, inmates typically eat a diet very high in carbs and low in protein. Perhaps a book on the workout behaviours of some inmates is warranted…
    I’ve received letters from inmates telling me that they are following a Protein Power type diet by having family members send them cans of tuna and other potted meats. So I guess there is a way to get around the dietary restrictions in correctional facilities (a euphemism if I’ve ever heard one).
    Interestingly, the famous Simms overfeeding studies were performed on inmates in the Vermont State Prison.

  7. He lives….we could fashion some kind of socio-political movement around your re-birth had it not already been done.
    Afore you went swimming in the sea just off the manuscript coast you were threatening to post about fat loss and fat cals in as i recall;is it still on the agenda pleasum ?
    Should be the very next post.

  8. To the first commenter: Obesity is only one of the health problems caused by a carb-centered diet.

  9. I live near a US Navy station. Plenty o’ sailors walking around with muffin tops and wheat bellies, especially the mid-career ones. The Navy has always seemed to me to be the military branch to have members most inclined to excess weight gain, for some reason. The nearby Marine base doesn’t seem to have as many with pounds to lose, though. Just a casual observation.

  10. That’s not an image of current food pyramid.
    If you are going to criticize it, at least be current.
    What difference does it make? The old one was as broken as the new.

  11. What’s up with the contentious ( almost disrespectful ) tone of these posters, since you’ve come back online, Doc?
    Quite a few of them seem badly misinformed.
    Maybe a standard response should be: “Go read “‘Good Calories, Bad Calories’, and then we’ll talk – if you still need to.” Sheesh!
    Hey John–
    I really didn’t notice a change in tone. Maybe it’s just because I’m so happy that the book manuscript is behind me that I’m seeing the world through rose-colored glasses.

  12. Instead of writing for lo-carb advocates to be put on the panel – I prefer everyone write in and propose that the whole useless program be completely scrapped.
    If you are to believe the “obesity epidemic” scaremongers – then the program is an abject failure.
    If the “science” of food and nutrition guidelines are so tenuous that they need to be revised every five years – why have them at all? Millions of people have been duped into “healthy eating” and then every 5 years a new panel say “OOPS! We were wrong – you should do this instead of that”. Why are millions of dollars of taxpayer money being spent on pure speculation?
    I agree. The government doesn’t belong in the nutrition-recommendation business. But it’s there anyway. Consequently were better of at least trying to make the recommendations reasonable.

  13. How we can feed people with enough meat (healthy meat, at that!) and even preserve/renew the planet at the same time? Yes, it’s possible and you can check it here:
    I agree there are too many people on this planet. That’s what happens when one species, Man, doesn’t have any natural enemies. It is not a nautral situation and Nature will always find a good way of correcting such unnatural things. Since we have nobody else to destroy us, we are making a good job of destroying ourselves. We made this planet and our bodies toxic, we are rapidly making the ozone layer fall apart, at this rate of spending we will probably run out of energy sometime soon, we might also run out of food or it will become too expensive for many of us, and meanwhile, we are killing ourselves with stupid high carb, high sugar, high artificial junk diets.
    Vegetarianism, especially veganism, is not only unhealthy, it is also an ellitistic way of eating, possible only as long as no more than 20 % of World population subscribe to it. More than 20 %, and we will die of famine even sooner. These people are not aware that a large percentage of land worldwide is only suitable for raising sheep, cattle etc. (think New Zealand, Switzerland, Scottland and other hilly areas where agriculture is not possible). Take that away, and how will you feed the world?
    Also, take cattle dung away, and how will vegetarians fertilize their precious monocultures? With even more toxic chemicals? Are we not poisoned enough as it is? Also, if you don’t eat/raise meat, you take away another large chunk of daily calories, namely the satiating, healthy animal fats.
    So no, the answer is not to go vegetarian. The answer is to strive for sustainable, non invasive, humane farming for raising healthy meat, healthy vegetables and healthy fats. Grains are man fabricated foods that were never intended to feed our genes. And the sooner USDA (and everybody else) recognizes that, the better.
    Hey Xenia–
    Thanks for the great link. I agree that the Polyface farm strategy is the way to go.

  14. There’s a Scientific American interview with the author of a review paper/commentary on the nutrition guidelines here: http://www.sciam.com/podcast/episode.cfm?id=13BE8F96-CC52-62E0-362994556CDDD508. They conclude in the paper that the government has no business making dietary recommendations, given that there’s no consensus on what constitutes a really safe healthy diet and the current guidelines have clearly contributed to a public health crisis.
    Thanks for the link. I pretty much agree except for his glorification of Jeffrey Rose.

  15. Hi Doctor , not to get off topic but I saw this article and remember you once posting on MSG I believe and thought I would send this link to you it has a PDF at the bottom of the article that is awesome . http://homodiet.netfirms.com/otherssay/letters/food_additive.htm , I did not know MSG caused obesity in lad rats when injected with it , it caused an insulin secretion three times the norm and it lowers ketones . I was floored .
    Hi Cindy–
    Thanks for the link, but I’m not all that concerned about msg in humans. The Japanese consume msg by the ton as do most people in other Asian countries, and the Japanese, despite smoking like stacks, have the greatest longevity of any society. It’s difficult for me to believe that msg could be as bad as its critics say when it doesn’t appear to affect those who consume it the most.

  16. The food pyramid is based on economic pressure from growers. It’s only logical to put pressure on those growers by explaining how we would eat more of those foods we want. There’s only two persons to speak to in a giant corporation. The person at the very top, and the person at the very bottom. It hasn’t worked at the top. Time to speak to the farmers.

  17. Professor Stephen Simpson, a biologist at Sydney University, was quoted this week on Yahoo Australia as saying:
    ” “If you feed locusts a low-protein, high-carbohydrate diet they will gorge themselves until they reach their ‘protein target’,” he said.
    “So they over-eat carbohydrate and fat in an effort to get enough protein.”
    The same may be true of humans who were eating more fat and carbohydrates and less protein than ever as more highly refined foods hit the market, he said.
    “This research suggests that we should be focusing more on our intake of protein and that humans may also have a protein target that, once achieved, will lead to feelings of fullness.”
    Prof Simpson said he was not advocating the dangerous high-protein, high-fat Atkins-style diets, but one that includes around 20 per cent of total kilojoule intake from protein.
    And, he said, this must be accompanied by a drop in high-fat and refined carbohydrate foods.
    Dr Peter Clifton, a co-author of the CSIRO’s high-protein diet, said the theory was interesting and needed further testing in humans.
    But Dr Tim Crowe, a nutritionist at Deakin University in Melbourne, said the theory had already been disproved.
    “We know that longer-term, high-protein diets, low-carb diets and low-GI diets don’t give a weight loss advantage,” Dr Crowe said.
    “It sounds good in theory, and it might work for locusts, but the relevance of this research for humans in the real world is almost zero.”
    Statistics show more than seven million Australian adults are overweight or obese, up 16 per cent from the late 1980s.”
    I challenged Dr. Crowe in an e-mail on his statements referring to the longest term controlled test on the Atkins-diet, reported on in the March 2007 issue of JAMA, that did show a positive weight loss advantage of the Atkins diet as compared to other diets. He came back by saying that I had mentioned only one study whereas he knew of at least six recent ones that showed the opposite.
    He also claimed that he knew of many long term ‘observational’ studies that did show the deleterious effect of a high protein low carbs diet on CHD.
    Yet he didn’t give one reference.
    I don’t know the literature well enough to judge his claim but I trust you do.
    Hi Arie–
    I do know the literature, and I can tell you that Dr. Crowe is incorrect. I’m familiar with Dr. Simpson’s work and have a few slides on his protein-leverage hypothesis that I use in talks that I give on protein intake. He has indeed done studies on human subjects showing that his hypothesis holds. But his work mainly involves changes in protein in the context of a more ‘normal’ diet, meaning one relatively high in carbohydrate. In my opinion the reduction in carb is more potent in bringing about weight loss than is a small increase in protein, although on low-carb diets protein intake generally increases, so you get a two for one effect.
    The problem with the studies Crowe is referring to is that these subjects went off their low-carb diets, allowing their weight to creep back up to the same as those on low-fat diets. When subjects remain faithfully on their low-carb diets, the results shame those of subjects on the low-fat arm of such studies.

  18. I posted on this earlier but the comment seems to have disappeared.
    Professor Stephen Simpson, a biologist at Sydney University, came up with a possibly interesting parallel between locusts and human beings.
    Yahoo Australia reported this week that he believes that overeating in locusts happens because they have to reach a certain protein target. In the process they ingest too many carbohydrates. He surmises that the same could be the case in humans and was planning to present his views at the conference of nutritionists that takes place at the Australian Gold Coast this week.
    He took care to say that his views did not imply that he recommended the dangerous Atkins diet. Oh dear.
    A co-author of the CSIRO-report on high-protein diets called his view interesting and thought that further research was warranted (the CSIRO is a prestigious Australian governmental research institute).
    But a Dr.Tim Crowe, a senior lecturer at Deakin University in Melbourne, commented as follows:
    “We know that longer term, high-protein diets, low carb diets and low GI diets don’t give a weight loss advantage.”
    I challenged him on this in an e-mail referring to the March 2007 study in JAMA which shows that over a term somewhat longer than a year the Atkins diet does have a weight loss advantage as compared to other diets.
    He came back to this by claiming he knew many studies to the contrary. He also called Taubes myopic in his views and claimed that he selectively quoted from studies to buttress his point of view.
    After some to and fro he came up with the following list of references of which the first eight allegedly show that there is indeed no weight loss advantage in a high protein diet and the last two that the Atkins diet is in fact dangerous.
    I will have to read through these myself but having no background in science (my doctorate is in the social sciences) I wonder what you think of these.
    Brinkworth et al. Int J Obes 2004;28:661-70
    Stern et al. Ann Int Med 2004;140:836-7
    Foster et a.. New Eng J Med 2003;348:2082-90
    Nordmann et al. Ann Int Med 2006;166:285-93
    Franz et al. J Am Diet Assoc 2007;107:1755-67
    Dasinger et al. JAMA 2005;293:43-53
    Truby et al. BMJ 2006; May 2006
    McAuley et al. Int J Obes 2005;1-8
    Long-term health effects:
    Lagiou P et al. J Int Med 2007;261:366-74
    Trichopoulou et al. Eur J Med 2006;1-7
    Hey Arie–
    I’ve read ahead and noticed that you’ve dug these papers out yourself and critiqued them in other comments. I’ll add my comments there.

  19. Thus far I have tracked down three of the references Dr.Crowe gave me to back up his charge that the low carbohydrate diet was ineffective and dangerous to boot.. My preliminary conclusion is that if he has to base his case on these materials he better gives it up altogether.
    The Brinkworth article reports on a comparison between a ‘standard protein diet’ (15% protein with 55% carbohydrate) and a ‘high protein diet’ (30% protein and 40% carbohydrate) administered to obese subjects with hyperinsulemia.
    Well, the first remark that can be made here is that this is not a test of a LOW carbohydrate diet. But even if it were the results would do nothing for Crowe’s case because the patients achieved weight loss on both diets but noticeably more on what is here called a high protein diet (S.P. -2.9+/-3.6 % HP -4.1+/5.8%). However, it seems to have been a poor test altogether because the authors report that after an initial period the protein intake decreased in the HP-diet and increased in the SP-diet so that at week 68 there was little difference. Adherence in both groups was poor.
    Yet with both diets there was an improvement in cardiovascular risk factors.
    The Foster article also reports on a comparison, this time of a low carbohydrate, high protein and high fat diet and a low calorie, high carbohydrate diet. Both diets were administered over a year. The low carbohydrate diet showed greater weight loss after six months but not after twelve months.
    It should be remarked however that of the high carbohydrate diet was said that it was low calorie whereas this was not the case with the low carbohydrate diet. So was this a fair comparison? Also, the low carbohydrate diet was associated with greater improvement of some risk factors for coronary heart disease (greater increase in HDL cholesterol and decrease in the triglyceride concentration). A fact that does nothing for Crowe’s assertions about the dangers of a low carbohydrate diet for CHD.
    The Franz article finally seems to have nothing to do at all with a low carbohydrate diet. The abstract says: “Result shows that weight loss intervention utilizing a reduced energy diet and exercise are associated with moderate wqeight loss at 6 months. Although there is some regain of weight, weight loss can be maintained.”
    I will report on the other ones when I have tracked them down.
    Good analysis of the studies. One of the tricks foes of the low-carb diet use is to quote studies where the authors of the study purport to study low-carb diets but in reality study diets that are minimally diminished in carbohydrate. Those of us who are familiar with low-carbohydrate diets realize that carbs have to be restricted to at the most 50 g per day. Dropping carbs to 175 g per day from 250 g per day doesn’t do the trick, yet these minimal reductions are reported as low-carb diets.
    In the same issue of the NEJM in which the Foster study appears, there is another article by Samaha that shows a significant reduction in weight in the group following the low-carb diet. Incidentally, if you look at the references in this article you will note that the low-carb diet used was that found in our book The Protein Power LifePlan. In the Foster study subjects on the low-carb diet were instructed to increase the carbohydrates as they lose weight, a strategy doomed to failure.

  20. I will discuss here five more articles cited by Dr.Crowe:
    The McAuley reference could neither be tracked down in Proquest nor in Ovid Medline . At the pagenumbers indicated (pp.1-8) there appeared in fact a different article that year. There was however a McAuley article in the following year for which the correct reference is:
    McAuley K.A. et al. (2006), Long-term effects of popular diet approaches on weight loss and features of insulin resistance, International Journal of Obesity, Vol.30 Iss.2 p.342.
    This article reports on a comparison between a high-protein, a high-fat and high-carbohydrate diet administered over a year to a total of 93 insulin-resistant overweight women.
    The abstract says: “During the second 6 months the HF group had increases in waist circumference …, triglycerides … and 2 h glucose … . Overall there was substantial sustained improvement in waist circumference, triglycerides and insulin in the HP group and sustained but more modest changes on HC. Dietary compliance at 12 months was poor in all groups.”
    So at 12 months the high protein diet was superior to both the high fat and high carbohydrate diet as far as waist circumference was concerned. It was also superior as regards triglycerides and insulin. Thus if the low-carbohydrate diet (the object of Dr.Crowe’s strictures) is defined as a high protein diet these strictures miss the mark. If, however, it is defined as a high fat diet he has a case here. Altogether a rather ambiguous result as far as his thesis is concerned.
    I could not track down the Nordmann article either whatever I tried until I found out that it didn’t appear in the Annals of Internal Medicine, as indicated by Crowe, but in the Archives of Internal Medicine. The rest of the reference is the same.
    This article deserves to be taken a bit more seriously because it utilises a Cochrane Search Strategy to report on five trials involving a comparison of low-carbohydrate diets versus low-fat diets. As far as weight loss is concerned the abstract states: “After 6 months, individuals assigned to low-carbohydrate diets had lost more weight than individuals randomized to low-fat diets …. This difference was no longer obvious after 12 months …”
    And regarding blood pressure and lipid profile it stated: “ There were no differences in blood pressure. Triglyceride and high-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-carbohydrate diets … but total cholesterol and low-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-fat diets …”
    Thus here it appears that a low-carbohydrate diet doesn’t offer any weight loss advantages over one year compared to a low fat diet but once again it seems that there are no risks engendered for CHD as far as the lipid profile is concerned – rather the opposite.
    It took me also some time to track down the Stern article because here too the reference was faulty. In this case as far as the page numbers were concerned ( I hope for Dr.Crowe that none of his students get to see this post otherwise they would have a case to cite against him next time he marks them down for poor referencing). The appropriate reference is:
    Stern L. et al. (2004), The effects of Low-Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One Year Follow-Up of a Randomized Trial, Annals of Internal Medicine, Vol.140 Iss.10, pg.778, 8pgs.
    This is what the abstract said:
    “Stern et al review the 1-year outcomes between a low-carbohydrate diet versus a low-fat weight loss diet in severely obese adults with a high prevalence of diabetes or metabolic syndrome. They found out that participants on a low-carbohydrate diet had better results overall than those on a low-fat, restricted-calorie diet. Furthermore, weight loss was the same in the 2 groups, but patients on the low-carbohydrate diet had less atherogenic dyslipidemia and better glycemic control.”
    So here too the low-carbohydrate diet seemed to have no advantage as far as weight loss was concerned but was distinctly superior in its health outcome.
    The Truby article dealt with a comparison over a six month period between four diets:available in the UK: Atkins, Slim-Fast Plan, Weight Watchers pure points program and Rosemary Conley’s Eat Yourself Slim diet. The average weight loss was 5.9 kg. The abstract says further: “The Atkins diet resulted in significantly higher weight loss during the first four weeks, but by the end was no more or less effective than the other diets.” So here too Crowe seems to be scoring a point about a low-carb diet not offering any weight advantages as is also the case with the following Dansinger article (which I found equally hard to track down because of poor referencing – Crowe spelt the name Dasinger).
    This Dansinger article also reports on a comparison, in this case that between Atkins, Zone, Weight Watchers and Ornish. The test was conducted for over a year on 160 overweight or obese adults with known hypertension, dyslipidemia or fasting hyperglycemia, varying in age between 22 to 72 years. Weight loss varied between 4.8 kg (Atkins) and 7.3 kg (Ornish) but the authors take care to say that the amount of “weight loss was associated with self-reported dietary adherence level … but not with diet type …”
    So this also seems to confirm Crowe’s point about low-carb diets not offering any weight loss advantage, but once again clearly not as far as his warning about CHD risk factors is concerned because the authors distinctly state in their conclusion that “each popular diet modestly reduced body weight and several cardiac risk factors at 1 year.”
    So what is the score as far as Crowe’s double thesis on the low-carb diet not offering any weight advantages over one year and the risk factors for CHD are concerned.
    Concerning the first factor five of the eight references cited seem to support his view and one is ambiguous. Concerning the alleged risk factors for CHD he appears to be totally wrong. In so far as these risk factors have to do with lipid profile the low-carb diet had in all cases a favorable outcome.
    Crowe has also given two references concerning long term health hazards. I will discuss these in my next post.
    Hey Arie–
    As you can see, these articles aren’t really all they’re cracked up to be in terms of denigrating the low-carb diet. I’ll address just the first one. In this study subjects were divided into the following three groups:

    Dietary targets for the HF group were to consume no more than 20 g carbohydrate/day in the first 2 weeks, increasing up to 50 g/day by 8 weeks and continuing thereafter on an amount that maintained initial weight loss. The target for the HP group was to consume 40% of total energy from low glycaemic index carbohydrates, 30% from fat (predominantly unsaturated) and 30% from protein. The HC group were asked to consume at least 55% of total energy from carbohydrates, less than 30% from fat (less than 8% from saturated fat), 15% from protein and to aim for a dietary fibre intake of 25–30 g/day. At the end of 4 months all participants were instructed to continue their allocated diet without supervision until the 6- and 12-month visits.

    The subjects were advised to diet to achieve weight loss in the first two months and to strive for maintenance during the second two months, which means that the dieters tended to regress to the mean during the 2nd two months.
    Interestingly, during this study caloric intake wasn’t controlled. In other words, subjects were advised to follow their particular diet protocol without regard to calories.
    You probably had only the abstract to go by in your analysis so you didn’t get all the pertinent info. The abstract reported only the changes in metabolic parameters, but if you get into the results section of the paper you find that those subjects on the HC diet lost 9.7 lbs over the year while those on the HP diet lost 14.5 lbs and those on the HF lost 11.9 lbs. Even more amazing, when you look at the table showing caloric intake you find that the HC subjects lost their 9.7 lbs on diets containing 1474 kcal while those on the HP lost their 14.5 lbs on diets of 1585 kcal. Best of all, those who followed the HF protocol lost their 11.9 lbs on 1781 kcal/day, a little over 300 kcal per day more than those who lost only 9.7 lbs on HC. Metabolic advantage anyone? The abstracts never tell the whole story.

  21. I have never been a fan of the low carb diet. Since that is the highest percentage of what your body needs for energy Its makes little since to extremely reduce carbs.
    Uh, you don’t need any carbs at all for energy. You can get it from fat, and without the negative metabolic consequences that come along with the carbs. Spend some time with a medical biochemistry textbook.

  22. Crowe referred to two studies that allegedly point to the long term negative health effects of a low-carb diet. The first of these is Lagiou P et al. ( 2007), Low carbohydrate-high protein diet and mortality in a cohort of Swedish women, Journal of Internal Medicine, 261 (4), pp. 366-374;
    This study purported to trace the correlation between protein intake and mortality in the population of the Women’s Lifestyle and Health cohort study, 42,237 women in all, over the intial period 1991-1992 with a twelve year follow up through linkages to national registries. The original material was provided by an extensive questionnaire.
    The results seemed to show that a decreasing carbohydrate and an increasing protein intake were associated with higher mortality, and particularly cardiovascular mortality, among women.
    The weak spot of this study as acknowledged in the text is of course that there is no guarantee that the lifestyle respondents indicated at the beginning of the study was maintained over the next twelve years. Also, I wonder whether the concomitant variables of a lifestyle marked by a high consumption of meat were really kept constant.
    Also as long as there is no non-controversial medical explanation provided for the alleged link between protein intake and higher cardiovascular mortality there remains an argument open that this statistical link could possibly be spurious. In the studies cited above we have seen that in all cases a low-carb diet led to an improvement in lipid profiles – so why the cardiovascular mortality?
    One of the the contributors of the Lagiou et al. study, A.Trichopoulou, also led a study which I didn’t find in the European Journal of Medicine (Crowe’s indication) but in the European Journal of Clinical Nutrition. The complete reference is :
    Trichopoulou A. et al (2007), Low-carbohydrate-high-protein diet and long-term survival in a general population cohort, European Journal of Clinical Nutrition, 61, pp.575-581.
    The abstract says: “ Follow-up was performed from 1993 to 2003 in the context of the Greek component of the European Prospective Investigation into Cancer and nutrition. Participants were 22 944 healthy adults, whose diet was assessed through a validated questionnaire. Participants were distributed by increasing deciles according to protein intake or carbohydrate intake, as well as by an additive score generated by increasing decile intake of protein and decreasing decile intake of carbohydrates. Proportional hazards regression was used to assess the relation between high protein, high carbohydrate and the low carbohydrate–high protein score on the one hand and mortality on the other.”
    The results seemed to suggest that higher intake of carbohydrates was linked to a significant decrease in mortality whereas higher protein intake was correlated to a nonsignificant increase in mortality. The combination of low carbohydrate-high protein seemed to be particularly fatal with regard to both cardiovascular and cancer mortality. So the conclusion was that ‘prolonged consumption of diets low in carbohydrates and high in protein is associated with an increase in total mortality’.
    The same strictures relevant to the Swedish study apply here.
    The results of both the Swedish and Greek study are, as far as cardiovascular disease is concerned, flagrantly contradicted by a study published in the New England Journal of Medicine which I believe to be superior to these other studies, because of the size and the nature of its population (nurses), because of the regular updating through questionnaire of food data and because of the period involved (twenty years).
    The reference is:
    Halton Th. et al. (2006), Low-carbohydrate score and the risk of coronary heart disease, New England Journal of Medicine, 355(19).
    It concerns here an analysis in the context of the Nurses Health Study, with a total of more than 82,000 respondents who every two years filled out a questionnaire about their food intake and were followed for a period of twenty years. The resullts suggested that there was no correlation between low carbohydrate intake and cardiovascular disease and that in fact, if vegetable sources of protein and fat were consumed, there was a negative correlation. There was, by contrast, a mild link between total carbohydrate intake and coronary heart disease and a strong link if this food contained a high glycemic load.
    One critic of this study held that there were not enough respondents in this study who consumed less than 30 % carbohydrates to come to positive conclusions.
    Overall I would say however that Dr.Crowe’s case on this point has not really been confirmed.
    I did a pretty thorough analysis of the Swedish study that I never got around to writing up and posting. Basically the results of that study are worthless as far as having any predictability to the longevity effects of low-carb diets for a couple of reasons. First, it’s an epidemiological study, which, as I’ve posted on countless times, can’t show causality. Second, the relation between carbs and protein and longevity are within a range of protein and (especially) carbs that are not found in low-carb diets and, therefore, can’t be extrapolated to them.
    I agree that Dr. Crowe’s conclusions have not been substantiated.

  23. I guess that even Mr. O’Reilly can have a blooter 😉 moment.
    We all can.

  24. Thanks for your comments, Doc. It struck me that another reason why the nurses’ study is superior to that Swedish one is that in nurses you are dealing with people who, roughly, belong to the same socio economic group. In the Swedish study no attempt seemed to have been made to control variables having to do with differences in lifestyle between (possibly more affluent) high protein consumers and those who habitually ingest high quantities of carbohydrates. I am not sayin that that would have weakened its conclusions. It could have reinforced them but the attempt should have been made.
    As a flagrant example of not taking co-variables into account I remember a bit of research done by an Amsterdam GP at the beginning of last century. He had come to the conclusion that being under the sway of socialist ideas was probably a matter of having been poisoned by white bread. He had noticed that in the Amsterdam neighborhoods where there were most votes for the socialist party there was also the highest consumption of white bread.
    Interesting. I wonder where the votes for Obama will come from?

  25. Dr. eades, my son and i have been following the high fat, moderate protein lifestyle for some time now, and my son has an issue with his face breaking out. He keeps asking me if the fat is doing it and I keep reassuring him that the fat is good for him.
    Am I on the wrong track?
    Is the fat contributing to his breaking out?
    it’s basically around his mouth, chin area.
    Do you have a better answer for him, than I have?
    Is it the fat, or just hormones?
    Hi Eve–
    I can’t say in your son’s case since I haven’t evaluated him, but I can say that the medical literature implicates carbohydrates as the villain in this condition. I don’t think it’s the fat.

  26. The diet should be high fat , not high protein because ,a high protein diet(lean meat) is dangerous without fat.There where many observations on this matter at the beginning of the last century ,see “Adventures in diet” by anthropologist Vilhjalmur Stefansson trying the duplicate his experince with the innuits and the experience of american indians with “rabbit starvation”.
    So I’ll put at the base of my piramid ,butter ,lard ,coconut oil,palm oil, fatty meat,fatty fish, fatty cheese.

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