Nutrition & Metabolism meeting

MD and I just got back from the Nutrition & Metabolism meeting in Phoenix. I’ve been dilatory in posting and in putting up comments because the meeting and the pre- and post-meeting socializing (most of which was discussion of one another’s work and the status of the low-carb diet in academia) took up all of my non-sleeping time. And all the pre- and post-meeting socializing included both film and podcast interviews.

The Nutrition & Metabolism meeting is held in conjunction with the annual meeting of the American Society for Bariatric Physicians (ASBP). We skipped the ASBP meeting because we couldn’t take the time away from the book project we’re working on. As a result we missed a terrific presentation by Robert Wolfe, formerly of the University of Texas Medical Branch in Galveston, now at my alma mater, the University of Arkansas. Dr. Wolfe has done much of the work on protein metabolism and has shown in a number of papers that good things happen when protein is substituted for carbohydrate in the diet. When MD and I got there, Dr. Wolfe was in the hall trying to escape from a barrage of questioners. I listened in and learned, among other things, that his work with glucogenogenesis has shown that the newly minted glucose (made from protein) goes first into glycogen and from there into the circulation. I always thought it went directly into the blood stream from the liver, but work with carbon 13 tracing shows that it goes into glycogen first.

Before I had to get suited up for the first interview, Richard Feinman and I were able to slip off and have a cup of coffee.

And a joke or two. Richard has a great dry sense of humor. That’s probably why Anthony Colpo doesn’t like him.

Putting on my game face for the film interview. Note the lack of socks. The producer promised me I would be shown from the waist up only.

Doing a podcast interview with Jimmy Moore.

A dinner conversation with Gary Taubes, Mary Vernon and a tired Nicolai Worm, who had just flown in from Germany.

There were a number of informative presentations during the course of the meeting, a number of which I plan on posting about as time allows (the book deadline draws near). Casual conversations during the breaks, however, were often more enlightening. One of the commonest conversational subjects was how so many incredibly smart people could fail to see the obvious and ignore or even bash carb-restricted diets when so much data is out there showing their superiority. During one of these discussions, one of the scientists at the table (one who does not want to have this statement attributed to him/her, so I won’t) said:

It’s really pretty easy to see why if you understand academia. If, as an academic, you go down the low-carb rabbit hole, your chances of survival in that dog-eat-dog world are about 5 percent. If you follow the herd and pooh pooh low-carb diets, your chances of survival are about 95 percent. The smartest of the academics figure this out quickly and follow the path that leads them to survival and promotion.

It’s a sad commentary, but I’m not all that sure that I wouldn’t have done the same thing (gone with the 95 percent chance of survival) had I gone the academic route instead of the clinical practice route. It would have been a difficult call.

MD and me with Gary Taubes and Nicolai Worm

Gary Taubes gave two good talks. The first was the same one you can find all over the internet (I posted on it earlier). The second was a presentation on the history of the idea that cholesterol and saturated fat are risk factors for heart disease. This was Gary’s first go at this presentation, and it was beyond excellent. I thought the first presentation was good, but the second was exceptional. It’s difficult to believe what a bunch of chicanery and smoke and mirrors went into this idea that is accepted by virtually the entire mainstream right now. Simply mind boggling. All of this information is in Gary’s book (which I’ve read three times in its various iterations), but it’s even more unbelievable seeing it presented in slide form. I don’t think anyone made a video of the presentation, but I’ll check and let everyone know. If so, it’s not to be missed.

Mary Vernon, MD and me.

Mary also gave a wonderful presentation. She stated it better than I’ve ever heard it stated when she told the group of physicians about the power of a low-carb diet, and how they needed to carefully monitor their patient’s medications. She said:

Nothing in your medical training will have prepared you for how quickly this is going to work.

Mary is an absolute ball of fire. I don’t know where she gets the energy. If you ever have a chance to meet her or hear her speak, take it. I think MD talked Mary in to coming to her (MD’s) big performance of the Carmina Burana at the end of May.

The last lunch. Gary Taubes, Richard Feinman, me, and Jay Wortman. I’m holding a copy of Jay’s video My Big Fat Diet made with the First Nation people in Alert Bay. Jay is going to let me know how readers can obtain the video. As soon as I hear from him, I’ll pass the info along. He showed the entire video as part of his lecture at the meeting. And, lest I forget, the object in front of Richard Feinman is his award as the Nutrition & Metabolism honoree of the year.

For those of you waiting for comments that you’ve written, I’ll get to them as soon as I go through the giant pile of mail that awaits me.

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52 thoughts on “Nutrition & Metabolism meeting

  1. Hi Dr. Mike:

    Thanks for the report and the photos. Very much appreciate your blog, as always. And just wanted to mention that my spouse and I have just completed one full year of a low carb nutritional lifestyle and it has worked out better than we could have imagined at the beginning of the journey last April. The weight reduction, enhanced energy level and overall sense of well-being that we now enjoy has been…….extraordinary.

    We owe a lot to you and MD for your books (both PP and PPLP) and your blog for helping us to get there and to stay on the path; and for educating us in the history and science of how and why it all works. We are never going back to that food pyramid nonsense. Looking forward to the new book.

    Best,

    W

    Hey Wil–

    Thanks for the kind words. Congratulations to you and your other half on your combined success! It’s something to be proud of. And you guys did all the work.

    Here’s to another year.

    Cheers–

    MRE

  2. Is that bread on the table?!?!? 🙂

    Did you notice that the bread was still on the table – not in us. It was a banquet, and the hotel provided not only bread but desserts as well. And to top it off, the steaks were floating atop a pile of mashed potatoes. But we good low-carbers all avoided the bread, dessert and potatoes, however.

    Cheers–

    MRE

  3. Is that a plate of bread sitting in the middle of the table?? 😀

    Thanks for the update, Dr Eades. Perhaps next year someone will record the conference. There are thousands of us who can’t attend but would love to be able to watch.

    I think the conference is audio recorded and can be purchased, but I’m not sure. I’ll see if I can find out.

  4. dr Eads, 60 yrs old, 80lbs of fat, male, quit smoking in 97 went from 160 to 238 over yrs,and need to lose. i’ve tried low carb several times, but just don,t seem to make much progress. i have pp, atkins, kk, and read and still reading a host of others, question is i think i eat to many cal, using fat liberly to modest amounts you tally quit alot of cal without alot of volume of food. i am a big eater constantly snacking, always craving carbs, doing low-carb. lost about 12 lbs doing kk, but stopped, gained it back, so whats the best low fat, low carb, highfat, lowcarb or either of these with low cal. feel better in many ways on low carb, acid reflux, bloating, brain fog, etc, , i have hypoglycemia, high bp, insulin ressistent, i;m a sad case ha ha. had less cravings on kk, but stayed on kk longer than most of the others, don.t know if it was lack of fat or greater amount of protein, by being low fat is was also a lower cal way, woould like to hear you thoughts. tks Rick Stewart

    Hey Rick–

    Stay tuned. I plan on posting on your situation very soon.

  5. It was great seeing you and MD in Phoenix, Dr. Mike! THANK YOU for your gracious time to sit down with me for an interview. I look forward to sharing that real soon at my podcast show. Yes, the meals were atrocious for breakfast and lunch and let’s not even talk about that box lunch they served on Friday. OMG!

    The ASBP has both audio and video of the conference available on their web site, but it’s not cheap. I believe the CD was $130 for the Nutrition & Metabolism sessions. It should be available from ASBP if people want to contact them about it.

    Here’s my blog post about the conference:

    http://livinlavidalocarb.blogspot.com/2008/04/still-on-cloud-nine-after-asbpnutrition.html

    THANKS again! Meeting you and Dr. Mary Dan was such a thrill and an honor.

    Hey Jimmy–

    It was great seeing you again. Thanks for the info about the video and audio. I now at least know that they exist.

    Somehow I missed the box lunch on Friday – sounds like it wasn’t a great loss.

    Cheers–

    Mike

  6. Dr. Eades,

    You, your wife, Richard Feinman, Gary Taubes all look terrific! Poster boys and girl for the effectiveness of LC diet!
    I work in academic, and I understand the 5/95 or its variations. Imagine if you claim climate change has nothing to do with humans! Even if you show solid data, you’d just be dismissed as a right wing redneck.

    Mike

    Hey Mike–

    After my discussions with numerous academics at this meeting, I can tell you that you’re not alone.

    Cheers–

  7. Dr. Eades,

    As noted by one of the other posters, you, Mary Dan, and several of the others look great. But some do not, including at least one physician who is known as an obesity and diabetes expert in low-carb circles. Do you have any explanation for this? Forgive me for sounding like a jerk, but most low-carb critics would look at these overweight folks in the same way that low-carbers looked down at Dr. Weil (at least before he read Gary Taubes book).

    What are your thoughts on this?

    It’s an interesting and difficult question. I have a couple of thoughts. First, I try to listen to the message and not the messenger. It’s hard to do sometimes when the messenger sends opposing signals to the message, but it’s the message that’s important. If I weighed 300 pounds it wouldn’t change the truth (or lack thereof) of my message. It would simply demonstrate that I didn’t follow my own advice, not that my advice was wrong. Second, when I see an overweight person I don’t know where that person started weight-wise. Maybe he/she, though moderately overweight now, was enormously overweight a year or two ago and is simply a work in progress.

  8. Wow. Seeing all these people that you hear about all in one place makes you realize just how much is going on in the field. It sounds kind of exciting.

    And I’m looking forward to your podcast on Jimmy Moore’s site!

  9. Dear Dr. Eades,

    I’d like to echo Mike’s compliment – you all do look terrific and it’s so fun to see pictures of the LC “heroes”!! Thank you for sharing pics!

    By the way – the HEADLINE of our newspaper this morning was about the results of the DASH diet on high blood pressure. Have you heard of this? Any thoughts? Ever since my husband and I went LC I skip anything I come across in newspapers or magazines (or the cooking section of the newspaper for that matter) since they always parrot the party line. Apparently the DASH diet strongly emphasizes fruits, vegetables, whole grain and protein from non-meat sources. This is going to be news to my husband. His high blood pressure could not be brought under any significant control (after his doctor tried a couple of different medications) until he went LC. He now has blood pressure in the mid to high normal range. It didn’t occur to us that a LC diet might affect his blood pressure, but after a couple of evenings this past winter my husband mentioned he couldn’t get warm, which is unusual for him. Then a lightbulb went off in my head and I got out the blood pressure cuff. Sure enough a blood pressure reading that caused us both to look at each other and say, “ok, maybe we used the cuff improperly because these can’t be your blood pressure numbers!” But they were his new numbers and solely due to LC eating.

    Thanks again for your good work!

    I know all about the DASH diet. It’s basically a sodium-restricted diet to help reduce blood pressure. Your husband’s experience with a low-carb diet is pretty typical as far as blood-pressure lowering is concerned. It’s been my experience that 70-80 percent of people with high blood pressure will reduce it to normal with a low-carb diet. The other 20-30 percent will reduce it somewhat but not into the normal range. These folks have causes of high blood pressure that aren’t totally responsive to the diet. An interesting feature of the low-carb diet as compared to the DASH diet is that people on a low-carb diet need extra sodium. I recommend that my patients salt their food and/or eat a couple of dill pickles or drink bouillon daily to replace the sodium lost in the urine while on the diet.

    Tell your husband congrats from me for his success.

  10. Hey Dr.Mike,

    I am very interested in reading your reply to Rick Stewart’s query, as i know many people who find it damn difficult to adhere to a low-cabr diet. The most common problem i encounter is an inability to concentrate. More specifically, people i know complain that when they avoid carbs even for a meal or two, they begin to feel jittery, anxious and have an inability to concentrate. Among these people, there is a general consensus that the ingestion of carbs immediately causes these symptoms to subside. For instance, they report a calming effect and far greater concentration.

    There is an adaptation period required for people switching to a low-carb diet. These symptoms must be endured for this adaptation period. When carbs are low, the body, especially the brain, turns to ketones for fuel. When one is adapted to a low-carb diet this transition doesn’t pose a problem – for those who aren’t adapted, the conversion to the use of ketones sometimes produces the symptoms you mention. If folks will hang in there for a day or two they’ll find that the symptoms go away.

  11. Vitamin pills ‘increase risk of early death’
    By Kate Devlin, Medical Correspondent
    Last Updated: 12:01am BST 16/04/2008

    Popular vitamin supplements taken by millions of people in the hope of improving their health may do no good and could increase the risk of a premature death, researchers report today.

    Vitamin pills are no substitute for healthy diet
    Have your say: Do we rely on vitamins too much
    They warn healthy people who take antioxidant supplements, including vitamins A and E, to try to keep diseases such as cancer at bay that they are interfering with their natural body defences and may be increasing their risk of an early death by up to 16 per cent.

    Antioxidants, including vitamins A, E, and C are said to mop up free radicals, which cause disease

    Researchers at Copenhagen University carried out a review of 67 studies on 230,000 healthy people and found “no convincing evidence” that any of the antioxidants helped to prolong life expectancy. But some “increased mortality”.

    About 12 million Britons supplement their diets with vitamins and the industry is worth £330 million. But little research has been done on the long-term health implications.

    The Department of Health said yesterday that people should try to get the vitamins they need by eating a balanced diet and advised care in taking large doses of supplements.

    A spokesman said: “There is a need to exercise caution in the use of high doses of purified supplements of vitamins, including antioxidant vitamins, and minerals. Their impact on long-term health may not have been fully established and they cannot be assumed to be without risk.

    advertisement”Anyone concerned about their diet should speak to their doctor or dietitian.”

    Antioxidants, including vitamins A, E, C and beta-carotene and selenium, are said to mop up compounds, called free radicals, which cause disease. It is this action that researchers believe may cause problems with the defence system.

    The Danish research, released by the influential Cochrane Library, applied only to synthetic supplements and not to vitamins that occur naturally in vegetables and fruit.

    It found that vitamin A supplements increased the risk of death in healthy people by 16 per cent. Taking beta-carotene was linked to a 7 per cent increased risk, while regular users of vitamin E supplements increased the risk of an early death by four per cent.

    Although the review found no significant detrimental effect caused by vitamin C, it found no evidence that it helped ward off disease. Millions take it in the hope of avoiding a common cold.

    Goran Bjelakovic, who led the review, said: “We could find no evidence to support taking antioxidant supplements to reduce the risk of dying earlier in healthy people or patients with various diseases.

    “If anything, people in trial groups given the antioxidants beta-carotene, vitamin A, and vitamin E showed increased rates of mortality.”

    But Patrick Holford, a nutritionist who has formulated supplements for the company Biocare, said: “Antioxidants are not meant to be magic bullets and should not be expected to undo a lifetime of unhealthy habits.

    “When used properly, in combination with a healthy diet full of fruit and vegetables, getting plenty of exercise and not smoking, antioxidant supplements can play an important role in maintaining and promoting overall health.”

    A spokesman for the Health Supplements Information Service said: “People should get all the vitamins and minerals they need from their diet, but for the millions who are not able to do that, vitamins can be a useful supplement and they should not stop taking them.”

    However, Catherine Collins, of the British Dietetic Association, said: “This study is deeply worrying and shows that there should be more regulation for vitamins and minerals.

    “The public can buy vitamins as easily as sweets. They should be treated in the same way as paracetamol with maximum limits on the dosage.”

    Have your say

    My say is that I agree that vitamins and minerals should be obtained from the diet. But there are those supplements that can’t be had in high enough quantities in food – CoQ10 and lipoic acid come to mind – and must be gotten in supplement form if one needs them. Like with all things, the situation is much more complicated than the article would have us believe.

  12. Dr. Eades, What is the significance of protein-made glucose being stored as glycogen before going into the blood stream?

    Nothing, really. It’s just a step I wasn’t aware of. If anything, it means that the protein to sugar conversion requires a little more energy than I though, giving yet another reason to believe in the notion of a metabolic advantage.

  13. Wow, I wish that there was some way that the gods could have sent me there. This low carb “fad” is increasingly impressing me. Although I am not a doctor, I am medically trained. This is now a very serious hobby for me. I contemplate about how many diseases would fall off the face of the earth if people would just stop, step back and really look at the truth.I am going to show the pics to my husband and remark at all the “big, fat, low-carbers”. Just showed it to him and he said. “They’re not fat, what are you talkin’ about? Oh I getit.Ha ha ha ha.” ( if that makes sense 🙂 )

    I was hoping to see Dr. McCleary hangin out with all of you. Nevertheless, I look forward to hearing what other info you gleened from the event.

    Take care Doc,
    Mary

    Yep, unfortunately Dr. McCleary missed this one. Dr. McCleary puts on a ski week for kids with cancer in Aspen every spring, and he just got through with that and so couldn’t make it to the meeting.

  14. Dr. Eades,

    I have often pondered the problem of academic conformity. Page 133 of Snowball Earth by Gabrielle Walker contains an interesting quote by Mott T Greene, biographer of Alfred Wegener, a German climatologist and geophysicist who hypothesized continental drift and plate tectonics. At first, most of the scientific community ridiculed the concept. Here’s the quote:

    “Throughout the entire course of the debate [about Wegener’s theory] neither his supporters nor his detractors seemed to have the clear grasp of a theory which comes from having read it carefully. The reason for this is a kind of guilty secret: most scientists read as little as they can get away with anyway, and they do not like new THEORIES [Greene’s emphasis] in particular. New theories are hard work, and they are dangerous – it is dangerous to support them (might be wrong) and dangerous to oppose them (might be right). The best course is to ignore them until forced to face them. Even then, respect for the brevity of life and professional caution lead most scientists to wait until someone they trust, admire, or fear supports or opposes the theory. Then they get two for one – they can come out for or against without having actually to read it, and can do so in a crowd either way.”

    Apparently, when a controversy arises, few there are who are both curious enough and persistent enough to delve deeply into the subject matter.

    Matters become even more complicated when commerce and ideology are factored in as in the case of nutrition science. For example, the edible oils industry, sugar producers, soy producers, corn producers, agribusiness, food manufacturers, and vegetarian activists have been variously motivated to vigorously endorse the idea that saturated fat is a health hazard. It would be naive to suggest that these interests have not also influenced the content of textbooks and policies set by government agencies. Perhaps the problem in academia is not so much academic as political.

    Dave

    Great quote. I think it hits the nail on the head. Thanks for providing it.

  15. Very interesting with “newly minted glucose (made from protein) goes first into glycogen and from there into the circulation.” – Bound with the glycogen there goes like a factor 5 of water, right? Could this explain weight fluctuations during the day? Or is the glycogen form very temporary?

    The glycogen form should be very temporary as the glucose is needed in the blood.

  16. Hi Dr. Eades,

    Great blog, thank you. I’ve only recently found it and I’m really enjoying going through all your articles. Fantastic stuff!

    This is off topic for this post, but I’ve just seen the BBC has reported on research from Copenhagen that found that vitamins A, E, and beta-carotene can actually shorten life-span.

    My question is what would you consider to be key steps we can each individually take to assess whether there is any potential downside of nutritional changes (eg: adding vitamins, changing our diets — eg: increasing protein as you recommend etc). It seems to me that some studies are flawed — and you can only know if you have some expertise in the area — and some of the more accurate long-term studies only come out after many years (or even decades) or long-term follow up (in practical to wait for those studies).

    The BBC link is:

    http://news.bbc.co.uk/2/hi/health/7349980.stm

    If you feel it is worth your time posting about that, would you do so please?

    If you have other issues of more importance, I fully understand.

    Many thanks,

    Michael

    Hi Michael–

    I’m glad you’re enjoying the blog.

    I agree that it is best to get most of your supplements via food, but I think there are some that to be effective are required in larger doses than food can provide. I haven’t read the study in question yet, so I can’t really comment on it intelligently until I do.

  17. re academic conformity:

    Reminds me of something Schopenhauer said: “The expert hits a target that others can’t hit, but the genius hits a target that others can’t see.”

    John

  18. Hi again Dr.,

    This is sort of an addendum to my previous post. As i said, i know people who find it very difficult to adhere to a low-carb diet, though they continue to try, given the wealth of evidence demonstrating the efficacy of this stlye of eating. Some of these people appear to function fantastically well on a high carb diet, in that they are lean, energetic, and intelligent people. They also don’t experience the blood sugar high and lows after eating meals very high in carbs, like a couple slices of bread topped with plenty of honey, and perhaps some peanut/almond butter. The opposite occurs, though, when they eat low-carb, in that they experience sluggishness; i witnessed this the other day as i cooked one of the people in question some eggs scrambled in butter. I’m curious, do you think such people should bother even making the effort to eat low-carb? Put another way, do you think certain people are better off following a high rather than a low-carb diet?

    I actually don’t think anyone is better off eating a high-carb diet. Though some people seem to be able to tolerate a high-carb diet better than do others, this doesn’t mean these people should necessarily follow such a diet. It takes anywhere from a few days to a week to adapt to a low-carb diet when one has been on a high-carb diet for a lifetime. All the metabolic processes require specific enzymes to function properly. Although we all have the codes for these enzymes in our DNA, we don’t necessarily have them made and circulating in any quantity if we don’t need them. The enzymes required to operate the metabolic machinery smoothly and efficiently when fueled by a low-carb diet are different than those required for a high-carb diet. When one switches from high-carb to low-carb it takes a while for the body to synthesize these enzymes in the required quantities. During the switchover phase the person going from high-carb to low-carb will experience fatigue, lethargy and sluggishness. All too many people use these uncomfortable feelings as an excuse to go back to their high-carb diet. If they hang in there, they adapt and find the fatigue, lethargy, etc. go away.

  19. From the Wikipedia entry on Glycation:

    Endogenous glycations occur mainly in the bloodstream to a small proportion of the absorbed simple sugars: glucose, fructose, and galactose. The balance of the sugar molecules is used for metabolic processes. It appears that fructose and galactose have approximately ten times the glycation activity of glucose, the primary body fuel[6].

    The important fact is that galactose (milk sugar) is a damaging as fructose. It would appear that the potato which is primarily starch which is derived from glucose is better than say fruit juice. Milk would still be better than fruit juice due to its fat and proteinand mineral content. This may not be as relevant to committed low carbers I meant to add another comment on AGE but it was apparently closed, although I’ve since seen other comments posted on that entry.

    On the 5/95 rule, you’ve heard of Aldous Huxley, but probably not the Reverend Samuel Wilberforce who debated against Huxley on evolution. The same is true of Coopernicus or Einstein but not their critics. The mediocre scientists want to be on the safe side. The great scientists want to be on the right side, since this is how they will attain any lasting recognition. This roughly corresponds to a quote by the great Science Fiction writer Theodore Sturgeon. Sturgeon’s Law which states that

    “Ninety percent of SF [science fiction] is crud, but then, ninety percent of everything is crud.”

    It is clear that there is an emerging low carb community of scientists and that they need our support, financially and otherwise.

    As always, thanks for the time and space to comment.

    I have heard of Wilberforce – he was one of the great orators of the 19th century. He got killed when he fell off a horse, which led Huxley (Thomas, not Aldous) to comment that Wilberforce’s brains had at last come into contact with reality, and the result had been fatal.

    Don’t know why you had trouble commenting on the AGE post – it shouldn’t be closed. I’ve recently updated the blogging software, so God only knows what kind of gremlins are going to jump up and bite me until I get all the kinks worked out.

  20. The finding that protein is first converted into glycogen in the liver makes a lot of sense in terms of my own response to protein ingestion. If I eat a lot of protein in one sitting, it seems to feel similar to eating a lot of carbs in terms of the “pumped up” feeling that glycogen provides (of course without all of the resultant blood sugar/insulin issues). When I eat less protein on a more consistent basis, along with an increase in fat (more of a ketosis state), water loss is ramped up and I don’t ever feel this glycogen response.

    Questions: Would excess protein ingested require a small squirt of insulin to be stored as a substantial amount of glycogen and/or fat? Could a person “protein up” the same way some athletes “carb up?” Or is the gylcogen storage only temporary w/ protein?

    The bushmen of the Kalahari have been know to eat very little for several days and then procure a giraffe or gemsbok or other large game. They then literally gorge on protein and fat (although I noticed in one documentary, it was primarily the protein they were after). Bite after bite after bite of meat. Following this feast — within a day or so — their butts swell up. Are they storing the excess protein as fat or glycogen? Or a mixture of both?

    The storage of protein as glycogen during gluconeogenesis is transient. It converts to glycogen then quickly to glucose. And you can’t really ‘protein up’ the way you can carb up because there is really no short term storehouse for protein (other than glycogen).

  21. I am from Germany,living a half year in the US and a half year in Germany.The low carb diet ,through the book of Dr.Worm was helping me loos 18 German KilosAs soon as I come to the States and want to go out for dinner,ask them for a chicken and salat,they bring next to the chicken a big slab of horrible tasting noodles.The chicken breast was tiny the salad really tiny ,but the carbs very big.Every time I go out they put hidden carbs,like breadening into a vegetable-dish.I feel horrible to always be so picky and thats why I cook from now on at home.But is that not sad.I immediately gaine pounds here, even I move more in the States than in Germany.The worst thing is that I realised I gane more around my belly if I am here in the US.
    I will read all your books and I am very happy to have read the article about your convention in Phönix.The comments are incredible interesting too.Thank you
    Sorry about my English-spelling.
    Halina

    No problem with the English spelling. You do a lot better than I would do writing in German. I’m glad your enjoying the blog and books. Welcome aboard.

  22. I wonder how much the higher death rate among vitamin takers has to do with the fact a lot of the vitamins are made in China these days.

    Interesting thought. I don’t have an answer.

  23. “…jittery, anxious and have an inability to concentrate…” sound like withdrawal symptoms. So in addition to the body’s enzymes and whatnot changing to accommodate ketones, people have to go through drug withdrawal when switching from high carb to low carb diets. No wonder some don’t stick with it long, they think something is seriously wrong with them when they feel like that. Forget marijuana, sugar is the gateway drug, IMHO.

    Addiction is evident looks of terror and the rationalizations that follow when I tell people about low carb, even after I’ve explained to them that their bodies can make glucose. “Oh no, I can’t give up carbs!” “I’ll exercise more to lose weight!” And my favorite, “I tried it and it didn’t work for me!” And “trying it” meant eating candy, bread, sweet fruits, pancakes and syrup…that carb addiction is hard to shake! It’s as bad as quitting smoking.

    Glad you had a great time at the conference, sorry about the crappy hotel food!

    The food wasn’t all that crappy. Other than one planned lunch we typically ate at a nearby restaurant where the food was great.

  24. Re: biblelife.org
    I read their low-carb part of the website and while I think it contains some valuable information there is quite a missionary twang to it. I then went to their homepage and – lo and behold – here they are telling everyone to take the bible literally and denying the science about evolution. Which just goes to show that people who believe in low-carb are not necessarily open-minded in other ways…
    Re: breakfast in hotels
    Oh dear – I know what you have been through…Being European I have never been able to regard sickly-sweet Danish and lightly-brown coloured liquid as breakfast, and as for the “lunch”-boxes provided – they were left untouched (1 green apple that needed a power drill to get a hole into, 1 sandwich that was somewhere between soggy and tasteless, something sweet and tasteless) – the carton it came in looked wonderful.

    Hurray for low-carb and anything that will take people and hotels back to quality!

  25. I don’t remember you mentioning sodium in your book, but given your response to a comment above you feel that some “supplementation” is necessary. How much sodium do you hypothesize that our paleolithic ancestors consumed and is that relevant to you?

    Thanks.

    I can’t tell you offhand how much sodium Paleolithic man consumed, but I would imagine it would be a fair amount. I do know that I have my own low-carb patients add a couple of dill pickle spears and/or a cup or so of bouillon to their daily fare (along with a potassium supplement) to keep their electrolytes in order. Reducing insulin levels by reducing carb intake sends a signal to the kidneys to release excess fluid. As this excess fluid leaves the body as urine it takes along with it sodium and potassium. If you don’t replace the sodium you can get light headed and dizzy if you stand up too fast, and if you don’t replace the potassium you can get fatigued and have muscle cramping. I, myself, go the dill pickle route for the sodium and occasionally (much to MD’s disgust) will actually drink the pickle juice, which I’ve done since I was a kid. I really love the stuff.

  26. “It’s a sad commentary, but I’m not all that sure that I wouldn’t have done the same thing (gone with the 95 percent chance of survival) had I gone the academic route instead of the clinical practice route. It would have been a difficult call.”

    I certainly can understand that!

    But you’d think eventually some of these guys would have trouble sleeping, looking at themselves in the mirror, etc. I mean they are, essentially, responsible for the unnecessary suffering of, what, thousands? Tens of thousands? Hundreds of thousands? That I cannot understand.

    I am a RN, graduated over 30 yrs ago. I’m currently working for a company that develops software for case management, utilization review, disch planning, etc. I am a QA Analyst. I’ve thought about going back to clinical work, or case management (my REAL love), but I just don’t think I can live with myself telling people to watch their fat intake, eat lots of grains, and don’t forget the drugs they don’t need. Oh and yea, then having to arrange for the care they need as a result of my instructions? Nah, I don’t think I’d sleep too well. (And I would “only” be following MD orders, not the one doing the ordering!)

    You wrote:

    But you’d think eventually some of these guys would have trouble sleeping, looking at themselves in the mirror, etc. I mean they are, essentially, responsible for the unnecessary suffering of, what, thousands? Tens of thousands? Hundreds of thousands? That I cannot understand.

    Ah, but that’s why they have a confirmation bias. It prevents all that guilt.

  27. I noticed a few comments about the effectiveness of low-carb diets to reduce high blood pressure and reduce edema. One thing I’ve noticed is that if I’ve fallen off the low-carb wagon for a bit and then get back on — I sometimes notice several days of no weight/water loss. In fact, I seem to temporarily retain water. This eventually subsides and the weight loss begins.

    I was rereading Dr. Yudkin’s excellent book last night and came across a possible explanation for those like myself who seem to need a few days and/or weeks before any weightloss or water loss begins while low-carbing. He says that for some, the metabolic changes brought about by the switch to low-carb “often” — he uses the word often — cause some temporary water retention. I am going to provide the direct quote here so that others who are embarking on low-carb and not getting the immediate scale gratification of weightloss (water) during the first week or so will not get disheartened:

    Page 168 of Yudkin’s Lose Weight Feel Great

    “When we are losing weight however we are changing our metabolic pattern a bit, during the time that the unwanted fat reserves are being depleted. This may well alter, for a short time, the way in which we balance our water. Often we retain more than the normal amount while we begin to lose wieght. So although we are in fact losing fat, we are not at first losing the corresponding amount of weight. If the water retained is as much as the fat lost, we don’t in fact change weight at all. But, in a little time, such people get back into normal water balance, and lose this extra water.”

    He also explains how female hormonal fluctuations also cause water balance fluctuations which may hide fat losses on the scale.

    So for those of you out there who are feeling a tad bloated during the first few days to weeks of a low carb regime and/or not losing any weight — rest assured this too shall pass.

    Hope this is helpful to all those out there (especially gals) who tend to retain water and/or not lose quickly at the beginning of a low-carb regime.

    Thanks for the excerpt. Yudkin’s advice is almost always invaluable.

  28. Off topic, didn’t you post on ferritin levels and anemia? If so, can you please provide a link to the post?

    Thanks!

    I don’t think I posted on them. We did write about them in the PPLP, however. Maybe that’s where you saw it.

  29. Low Carb ?
    Something occurred to me – today – I started my weight loss at 260 eating only lettuce and one can cooked peas daily – got down to 220 or so doing this – I probably lost a bit of muscle doing this –

    I lost another 15 pounds eating only raw summer squash during the summer –

    What I realized just today is that I was actually eating low carb – although I was only eating carbs –

    I lost another 10 pounds eating high protein two days a week and low calorie the other days of the week – getting down to 195 –

    At 195 my body fat is around 12% – I want it under 8% –

    So – maybe what I’ll do is go the two high protein ( 200-300 grams ) – days per week and the other days eat a minimum of protein ( 100-120 grams ) – and two heads of no net carbs lettuce -and one egg per day – tuna – whey protein for the protein – and a little coconut – peanut butter -2 tablespoons flax seed – a few sunflower seeds and a bit of cheese and butter –
    and although I do not like eating oil period – less than a teaspoon of olive oil or just some olives -preferably –

    Whats the big deal ?

    I’ve been stuck at 192 pounds for three months now – I’ve been in ketosis the last 16 days ( under 30 grams carbs ) – the fat on my lower stomach has shrunk quite a bit during this time – but my fat intake and calories have been so high my weight is still near 192 –

    Eating two to three and three quarters pounds of cheese and a whole 16 oz jar of peanut butter is no big deal while in ketosis – at least the days before and after are in ketosis –

    The problem is I don’t lose any weight – doing this

    I seem to be able to control fat intake if I eat enough lettuce or eat enough protein – but I have to do one or the other or both to do this –

    Since I’m losing belly fat regardless – while being in ketosis – I’d thought it will speed things up a bit by doing two high protein days per week and the other days going big on the lettuce and not so much protein allowing low enough calories for weight loss to occur –

    It’s relatively easy to get down to 12% body fat – but to go lower than this requires a bit of doing –
    It might seem easy and perhaps it is – if done correctly –

    Of course the purist might suggest I eat 50/50 – protein and fat and 1200 calories to do the same thing –

    Ridiculous or insane this would be – fat has the same effect on me as sugar – the difference being I can control my fat intake if I stop at 25% or so – where-as with sugar/fructose almost 0% is necessary – otherwise a snowball effect occurs and I end up eating 3 pounds of cheese – and a jar of peanut butter – if I eat more fat than this – not every day but often enough to prevent weight loss –

    My only other option is to eat high protein every day and lots of lettuce and keep fat under control – and let ketosis whittle the fat away –

    I suppose either option is workable – providing fat intake and therefore calories are carefully controlled –

    Small amounts of fat are as satiety effective as large amounts for me – I feel just as full eating either way – the only difference being calories ingested – a hundred calories cheese or seven thousand calories cheese – I feel just as full either way –

    On the other hand – I find large amounts of lettuce or high protein or both to be the only effective way of eating big and getting full – while still staying in ketosis and controlling calories

    I’ve also added one or to tablespoons granulated kelp to my diet to suppress estrogen and two tablespoons flax seed for the same reason –

    I suspect the remaining fat I have is a store house for estrogen – I also suspect that many low carbers never fully get rid of this fat – many of them never losing that last five and in some cases sixty pounds of the stuff – this estrogen saturated resistant fat

    Kelp – from personal experience – seems extraordinarily effective at shutting down estrogen or controlling it – granulated kelp at one to two tablespoons for the amount –

    You’d think with only needing to go from 12% body fat to 8% percent that all this fuss would be un-needed –

    Well – apparently not

    Thanks for the specific nutritional history. I can tell you categorically that you won’t lose if you are consuming cheese and peanut butter by the pound. I plan my next post on this very subject.

  30. Regarding all LC-people not looking as great as you guys do, another idea is that “it’s when you’ve already been struck with poor health that you begin to look up an alternative lifestyle”, and maybe not all damage is repairable? Myself, I have psoriasis (or “had”) and it’s been pretty well cured by the diet, but my skin still looks dull compared to any person without psoriasis. I guess it always will, but it’s also a million times better than it used to be.

  31. Seeing the photo with Gary Taubes reminded me to send you this link of a humorous article by Mr. Taubes in the latest Prevention magazine on the social aspects of being a low-carber:

    http://www.prevention.com/cda/article/diary-of-a-carb-phobe/d69f12b73d8e8110VgnVCM10000013281eac____/news.voices/in.the.magazine/may.2008.issue

    The most amusing thing to me is the fact that Prevention magazine follows the media herd about nutritional advice and articles (monthly Q&A’s with Dr. Oz, etc.), and Taubes’ article is only included as a backhanded slap at low-carbing, since I don’t imagine they’d ever use any of his nutritional articles. It is quite a funny piece. I wonder, did Mr. Taubes have any comments on his reception from publications like this?

    I hadn’t seen this until you sent the link. I spent several hours with Gary at the NMS meeting, and he didn’t mention it. I’ll ask him about it next time we talk.

  32. Nice to see you got a chance to chat with Jay Wortman. He occasionally stood in for a local radio celebrity talkshow Dr. when the usual Dr. was out of town. On the radio he was very vocal about the downside of carbohydrates, and he was very critical of the latest Canadian & US Food Guides ignoring the “significant and growing body of evidence” demonstrating how unhealthy carbs are.

    Sadly, he hasn’t been on air much recently. I hope it’s just because he’s too busy.

    Keep us posted on that video of his. His story is fascinating. Thanks!

  33. Dr. Eades,,

    Lots of very interesting reading here, thanks!

    Regarding the old discussion on the shorter life expectancy of the Inuits (http://www.proteinpower.com/drmike/ketones-and-ketosis/ketosis-cleans-our-cells/#more) and your blog entry on Longevity and membrane saturation where decreasing the amount of vulnerable polyunsaturated fatty acids in cellular and mitochondrial membranes would make them less prone to oxidation (http://www.proteinpower.com/drmike/uncategorized/longevity-and-membrane-saturation/ )

    Taubes says on page 250 of his “Good Calories, Bad Calories” on human fat regulation; that “The colder it gets, the more unsaturated the fats”

    Could this be an explanation of the shorter life span of the Inuits?

    It could be or it could simply be more hostile living conditions. The Inuit of today have for the most part taken to the Western diet, which is no doubt leading to a substantial decrease in longevity for them. I don’t really know how the longevity of the Inuit leading traditional lives compared to other primitive societies.

  34. With respect to protein-made glucose being stored as glycogen before going into the blood stream: is it possible to consume so much protein and, therefore, store sufficient glycogen so that all energy requirements are met by using glucose? If so, would this, then, shut down the fat breakdown process? Does this argue for a higher dietary fat intake percentage (vs. protein)?

    Protein doesn’t drive the conversion to glucose. Glucose is made from protein when needed, not because protein is consumed. People with type I diabetes have a problem with protein intake because they can’t make insulin and therefore can’t signal that there is plenty of glucose available. They do convert protein to glucose when they eat protein. Those of us with plenty of insulin don’t have that problem.

  35. Dr. Mike,

    Just curious, do you know if there is a limit to the amount of fat a person can properly digest in one meal?

    I don’t know. I’ve never really thought about it. I would bet that all the satiety signals that fat intake induces would stop one from eating long before the digestive limits were reached.

  36. Dear Mike:
    Thanks for bringing up “pickle juice” My mom made home-made pickles and used salt and water instead of vinegar. The best part was the juice which we all fought over as the pickles started running out. Ymmm.

    Pickle juice sounds gross to the uninitiated, but, as you’ve discovered, it’s pretty good.

    Cheers–

  37. Also…can excess protein keep one in hyperinsulinemia hypothetically ?

    I wouldn’t think so. Protein stimulates the release of both insulin and glucagon. The glucagon ends up blunting the effects of insulin.

  38. I definitely would like to see Gary Taubes’ presentation on the history of the idea that cholesterol and saturated fat are risk factors for heart disease on video.

    I would like to report one observation I made with regards to the role of exercise in a low carb lifestyle. For months, I’ve been eating less than 20 gm of carbs a day (primarily in the form of nuts and veggies), and my weight has remained stable and my ketostix tests showing mild ketosis. Recently I decided to hire a personal trainer and start working out heavily in the gym. Now, I get large amounts of ketones in my urine even though my diet hasn’t changed (my wife prepares our low carb meals). I wonder if anyone has done a good study measuring the effect of heavy exercise on fat metabolism in the absence of significant carbohydrate intake. I know that Taubes has said that there is no evidence that exercise makes you lose weight, but I’m still curious about it.

    Hi Doc–

    Gary Taubes has been terribly misunderstood about his writings on the role of exercise in weight loss. The common prescription given by many physicians, nutritionists and dietitians to people seeking to lose weight is to eat less and exercise more. Often people are told to ‘just get out and move a little. Take a walk. Climb the stairs instead of taking the escalator.’ Stuff like that. The medical literature is pretty clear that these types of exercise don’t help people lose weight – the body simply compensates for them. That’s what Gary has been saying, i.e., the average recommendations to ‘move more’ are pretty much worthless.

    He would be the first to acknowledge that an intensive exercise program coupled with a low-carb diet would accelerate weight loss. I’m sure that your heavy workout is burning fat, as evidenced by your increase in ketosis.

    Best–

    MRE

  39. Dr. Mike,
    I am a firm believer in low carb living and have been doing this for about four years now. Initially I lost weight very quickly (a total of about 28 pounds), while eating large quantities of low carb food. Over the years it has become very difficult to even maintain my weight loss. Although I’m not great at tracking my food intake, I do believe I am eating smaller quantities now than when I first started the low carb diet. Intermittent fasting lead to some weight loss for me (I was definitely not eating a day’s worth of calories in my food window), but I found that difficult to maintain. I also exercise quite a bit (over an hour a day, every day). I run marathons and ultra marathons, as well.

    My question is…does your body adjust to the low carb diet after some period of time? Does excessive exercise make this worse? I’m not going to give up the low carb diet, as I believe it is the best for my health. Here’s some stats on me: female, age 42, 5’8″, 175, blood glucose and blood lipid levels are excellent. I do have a family history of diabetes (both type I and type II) and obesity. I’d love to hear your thoughts, but I know you can’t really offer medical advice over the internet.

    Thanks,
    RK

    Hi RK–

    I’m going to do my very next post in the next day or two on this very subject. It should answer all your questions.

    Cheers–

  40. Mark Levin: “It appears that fructose and galactose have approximately ten times the glycation activity of glucose, the primary body fuel[6].”

    That study is based on refined purified fructose. It is illogical to assume that the same would happen with, say, fresh fruit or unheated (comb) honey. I think the problem with all of these sugars comes from the extensive refining and heating they undergo. Their lack of nutrients is causing the glycation. I bet if you put protein in raw honey or fruit juice, it would not hardly any glycation. This is the problem with a lot of low-carb proponents, IMO. They talk about a study using refined sugars, as if it implies something for fresh, raw, natural, unrefined sugars. Let’s see some studies using unheated honey and raw fruit juice. I bet they don’t cause even one percent as much glycation as the refined processed sugars do.

    Also, the term glycation is a misnomer, because a lot of the protein damage blamed on sugar actually comes from lipids. Advanced Glycation End products (AGEs) are coming to be known as Advanced Lipoxidation End products (ALEs), too, meaning that the damage comes from the oxidation of PUFAs (which are abundant in modern diets, and build up in the body with age).
    http://www.jbc.org/cgi/content/full/271/17/9982

    Hi Bruce–

    I disagree about the idea that the lack of nutrients in refined sugars as the driving force for glycation. Plain old glucose – blood sugar – causes plenty of glycation, and it is just a sugar. I suspect that protein incubated in a solution with fresh honey would glycate just as readily as with a comparable mixture of refined fructose and glucose.

    Best–

  41. Ok, here you hve it. My, forgive me, ex-wife and I used the Hp/Lc way of eating in 1996. We both ate that way for over nine3 months. Exercised and followed your plan to a tee. She lost almost 60 pounds and me 48 and felt great. Then for some reason we stopped. Didn’t take long to put the weight back on. Anyway, now in 2008 I’ve been diagnosed with diabetes. I wanted to start using your plan again simply because I know people who were on the pill and just a few weeks later they were off. I’ve always been skeptical of the medical proffession believing that a majority of doctors only want to treat systems not cure them. Being 58 years old I’ve read many reports of things that could make and keep you healthy. AMA always turns against these studies. Why? If we were all healthy we wouldn’t need them nearly as much as we do now. What would that cause? Lost of income and devistate the drug companies. I’m not totally anti-doctor. When I had my accident, if it wasn’t for the quick thinking of a doctor I would have lost my leg. Now to the point. I started on your plan. I told my daughter, which had tried your way once, she said she felt awful, probably because of a carb crash. Anyway, she turned totally against lc way of life. She has done nothing but research the internet for the negative. She even found one nutritionist that said the lc is absolutely the most dangerous diet a diabetic can do. She sent me all kinds of sites to go to to prove you wrong. That there is proof you are wrong. That being on your diet long term causes premature death. I have one web site, it,s in my e-mail. Oh, his name is Ornish. According to my daughter, he claims to have the ONLY studies that prove the lc is not good for you.. I tried to tell her her that thousands of people have been using your way for years and that you have thousands of case studies and years of research and refinement. But, the biggest problem with her, she absolutely trusts the AMA and I guess she absolutely refuses to search for the possitives. I read about the guy who theorized about the tetonic plates. How true in this case that so many would not see the light. Simple answers: being backed by drug companies, no need for their services, lost wages. Thank you DR. Eades and your wife for doing what you do so well. HeeHee. I hope this isn’t too long to make it to you. Barry Bennett

    Hi Barry–

    No, it’s not too long. It’s just sad. I’ve discovered that there is no way to make someone who is hellbent on another way of eating to change. These people have to come to it themselves. I wish your daughter well.

    Best–

  42. Very interesting and thank you for sharing.
    PS I find it a little amusing that there is a platter of what appears to be bagels or some kind of rolls, in front of what might as well be the mount rushmore of the low carb world (you, taubes, feinman).

    Notice that the bread is still in the platter and not in us.

    Cheers–

    MRE

  43. Dr. Eades, this is off the subject but I have come across some information concerning an Italian oncologist named Dr. Simoncini. He says that cancer is caused by a fungus and has treated tumors by flushing them with sodium bicarbonate . Have you heard of this and if so, what is your opinion?

    Hi Patty–

    I have never heard of Dr. Simoncini or his methods, so I can’t give an intelligent answer. Maybe other readers can shed some light.

    Best–

    MRE

  44. Dr. Eades, I look forward to what Gary Taubes says about the “Prevention” article. I read it on a low carb site where I am a regular poster. As a matter of fact, I stopped reading the magazine after I became aware of their lack of low carb knowledge. Prevention magazine is a bit anti-low carb and I was surprised that this article was even considered by the editors. I would like to hear what Gary’s experience was with this periodical.

    Low-carb IFing and loving it,
    Mary

    Hi Mary–

    I’ll ask him next time I talk to him.

    Best–

    MRE

  45. Any comments on this study? Sorry, it has nothing to do with the current topic.

    http://www.ajcn.org/cgi/reprint/66/5/1264

    I’m quite familiar with this study. I find it interesting, but without knowing what’s happening to glucagon (insulin’s opposing hormone) at the same time, it’s pretty much worthless.

  46. “I listened in and learned, among other things, that his work with glucogenogenesis has shown that the newly minted glucose (made from protein) goes first into glycogen and from there into the circulation. I always thought it went directly into the blood stream from the liver, but work with carbon 13 tracing shows that it goes into glycogen first.”

    I’m intrigued by this. What is the significance of it?

    Thanks,

    Pat

    No real significance other than the conversion has an extra step that most people didn’t think was there.

  47. Dr. Eades,

    I’ve been reading your blog with great interest (in addition to following the writing of Mr. Taubes) and based on my personal experience, the low-carb lifestyle or diet works great for me. I am planning on reading through your books and Mr. taubes ‘Good Calories, Bad Calories’ book as well to gain more scientific insight into why low-carb works and the general effect of carbs on the body. I have a few questions that I was hoping you shed some light on:

    1) Is it possible that the low-carb diet (or any diet that is being peddled these days) works for some people are not for others due to genetics? I see the arguments that go on about high-carb vs. low-carb, high-fat vs. low-fat, etc., and wonder if there needs to be any arguments at all because maybe one diet works for one person while another wouldn’t, so why argue? All it takes is a bit of self-experimentation to find out what works for your body type.

    2) I workout hard with weights 5 days a week doing circuit training and my concern is that carbs are considered fuel for the body and if I go low-carb where will my body draw fuel from? I assume my fat reserves? What about when I need to replenish my glyocen stores? Is that when I should increase my carb intake?

    Thanks for all of the hard work you pour into the research and science behind what you write about. It’s very refreshing to constantly learn new things.

    Thanks,
    Jeff

    I would think that any diet would work slightly differently within a population of people based on genetic differences. But I don’t think these differences would be great enough to, say, mean that a low-carb diet wouldn’t work for some people. I think it works for all, maybe a little better for some than for others, but still probably the best diet for all.

    Studies have shown that after a period of low-carb adaptation the enzyme responsible for making glycogen in markedly more active, squeezing glycogen out of whatever sources are available, including the glycerol left over from fat breakdown. People are more insulin sensitive after an intense workout, so, if you are going to consume carbs, that’s the time to do it. It will pretty much convert to glycogen as long as you don’t over do it and consume so much that your glycogen stores are filled and there is still sugar left over.

    Cheers–

    MRE