Changing dietary trends and the obesity epidemic

Dinner tonight at Casa Eades

Dinner tonight at Casa Eades

Last Sunday the New York Times published a color spread on the US Department of Agriculture (USDA) data on the changes in food consumption in this country between 1970 and 2006, which got me to musing.

To the uninformed, which, sadly, probably means most people working in the nutrition industry and even those employed in a nutritional capacity at the USDA, these changes (all save two) seem to be in a positive direction. The intake of dairy products has decreased; the intake of vegetables has increased; the intake of red meat has fallen; the intake of fish, chicken and skyrocketed; the intake of fruit is up; the intake of grains has increased markedly; and the intake of vegetable fats has almost doubled. The only two negatives are that sugar and sweeteners have increased and overall food consumption has gone up by about 11 percent, or an addition 1.8 pounds per person per week.

At the same time all these positive changes have been taking place, changes that all the (misinformed) people in the mainstream nutritional biz have been advocating, there has been an enormous increase in the rate of obesity. According to the Centers for Disease Control (quoted in the Times article) the rate of obesity has more than doubled since 1970, which is interesting because up until 1970 the rates of obesity hummed along at about the rate of 15 percent for decades.

What has happened since 1970 to cause this enormous societal change?

If asked, people give many answers: too much saturated fat, too much refined carbohydrate, too much food, etc.

I have my own opinions, which I will elaborate. I believe that the obesity epidemic has probably been driven by several dietary changes that have occurred since 1970. These changes are an increase in fructose and vegetable oil consumption and a decrease in saturated fat consumption. I believe that another contributing factor is the increased overall consumption of carbohydrates, which leads to an increased food consumption in general.

I want to emphasize that these are my opinions based on a pretty good knowledge of nutrition, metabolism, biochemistry, and physiology.

First, a sort of no-brainer. Since the USDA came out with the idiotic Food Pyramid we all loathe, there has been a major strategy in the food industry to move away from fats and toward carbohydrates. We have all seen this in various food consumption statistics. And we can tease it out from this Times piece if we look at which foods have increased and which have decreased in the diet. There has been a large increase in carbohydrate consumption as evidenced by the large increase in grains, vegetables, fruits and sweeteners.

Forgetting about all the metabolic events that carb intake precipitates that we all know cause obesity (i.e., increased blood sugar, increased insulin, etc.), let’s focus on simply one of the brain processes that carbs affect. The satiety center, located in the hypothalamus, is the part of the brain that tells us when we’re full. Unfortunately, it runs about 20-30 minutes behind our actual eating pattern, so we can stuff food in for a good while before our brains tell us we’ve had enough. Fortunately, it works a little more quickly (thanks to the help of cholecystokinin and some other gut hormones) when we eat primarily fat. If you eat a big steak, you feel full more quickly than if you eat a lot of carbs. Carbs tend to override the satiety center, allowing you to eat more. Let me describe a situation we’ve all experienced, and you’ll see what I mean.

You’re at a restaurant. You’re just at the end of a big meal and you’re stuffed. One of your dinner partners asks you to try a bite of his wonderful swordfish. It’s the best he’s ever tasted, he tells you. You say, I just can’t eat another bite. If I do, I’ll be sick. Then appears the waiter with the dessert tray, loaded with wonderful gooey treats. You look them over and say: I’ll take the carrot cake (or the chocolate mousse or whatever). How can you eat this calorically-laden dessert when you’ve just refused a bite of meat because you were so full? Because your brain’s satiety center is overridden by the carbs. And you haven’t even eaten the carbs yet. But experience has taught you that no matter how full you seem to be, there is always room for carbs. And fat, since most desserts are pretty high in fat as well. But it’s the carbs that do the satiety-center-blunting trick. It’s the reason dessert is always at the end of the meal. If you ate the dessert first, you would never be able to eat all the steak. And this carb overriding of the satiety center is why people don’t binge on steak, eggs and bacon. They binge on cake, chips, cookies and other high carb treats because they can stuff them without their satiety center telling them they’re full.

Since we’ve (as a nation) significantly increased our carb intake, it only makes sense that we’ve also increased the overall amount of food we eat. Carbs let us do that without even trying.

We have definitely increased our intake of fructose since 1970. I used the figures in the Times article to make my own calculations. Considering that table sugar is one half fructose and high-fructose corn syrup is 55 percent fructose (the most commonly used variety; some go as high as 90 percent fructose), I calculated that we ate about 50 grams of fructose per capita per day in 1970. By 2006 that figure had increased to 75 grams, a 50 percent increase. And we’ve got to bear in mind that these are average figures. I eat maybe 3 grams of fructose per day, and MD eats the same. That means that two other people out there are eating their 75 grams plus our extra 72 to make the averages come out as they do. I would suspect that most of the people reading this blog eat very little fructose, leaving a lot of other people to consume their share to keep the averages up.

But even 75 grams of fructose is a helluva lot. A little fructose – the amount you might find in a piece of fruit, for example – actually helps with glucose metabolism. It more or less primes the pump so that less insulin is required to reduce blood glucose. Large amounts of fructose are a different story, however. Fructose bypasses the enzyme phosphofructokinase, which is the rate-limiting enzyme in the glucose metabolism pathway. Consequently, large amounts of fructose are shunted past the sugar-regulating pathways and into the fat-formation pathway instead. The liver converts this fructose to fat, much of which, unfortunately, remains in the liver. ( Here is a nice paper on fructose metabolism. Ignore the idiotic conclusion, which is just another ad hoc attempt to make the data fit a preconceived notion acceptable to all academics.)

With continued consumption of large amounts of fructose, fat tends to accumulate in the liver leading to a condition called non-alcoholic fatty liver disorder (NAFLD). At this point, not only are we in an obesity and a diabetes epidemic, we are in an epidemic of NAFLD. Studies on ‘normal’ adults have shown that a little more than a third have significant fat accumulations in their livers. Even worse, 15-20 percent of children show the same thing.

NAFLD is the same disease people get who chronically over consume alcohol. Under the microscope NAFLD looks exactly the same; pathologically it acts the same. The only way to differentiate is by history of alcohol consumption: if there is fat in the liver and no history of chronic alcohol abuse, then NAFLD it is.

NAFLD has the same progression as the alcoholic variety. First, an accumulation of fat that becomes inflamed leading to a condition called non-alcoholic steatohepatitis (NASH), which means a non-alcoholic inflammation of fat in the liver. This condition can then progress to liver fibrosis, then to cirrhosis, then, ultimately, to liver cancer. Not all NAFLD follows this complete progression just as not all alcoholics get cirrhosis, but enough follow it to not make you want to get NAFLD if you can help it.

And one of the big ways not to get it is to avoid fructose.

By increasing fat in the liver, fructose also increases circulating insulin levels, which can lead to hyperinsulinemia and insulin resistance. How? Because a liver full of fat doesn’t work as well as a non-fatty liver. One of the jobs of the liver is to metabolize hormones and clear them from the circulation when their work is done. When you consume carbs or protein you stimulate the release of insulin to deal with them. Once insulin has done its job, the liver breaks it down to its amino acid components and puts them back in the circulating amino-acid pool. If the liver is filled with fat, it can’t do this as well. Insulin stays elevated (and in a diabolical twist even stimulates more fat synthesis in the liver) and tends to downregulate the insulin receptors, making them less responsive. The entire process can lead to insulin resistance, hyperinsulinemia and ultimately to obesity.

Below is a nice chart showing how the increase in obesity has paralleled the rapid increase in sugar consumption. Remember that table sugar is half fructose. Also remember that correlation is not causation. But in this case we do have the biochemistry of why worked out.

From Johnson RJ et al, AJCN 2007; 86:899-906

What about saturated fat? How does a decrease in saturated fat cause obesity. First, the decrease in saturated fat has tracked with the increase in vegetable oils, which are typically rich in omega-6 fats. Omega-6 fats have been shown in numerous studies to be proinflammatory. They have also been shown to worsen alcoholic fatty liver disease, and, one would assume, NAFLD as well. I haven’t seen any studies showing a worsening of NAFLD with increased consumption of vegetable oil – it hasn’t been studied as far as I know. (Maybe one of you readers can dig up a paper.) But it has been shown repeatedly with alcoholic liver disease, and since NAFLD is basically the same disorder, it makes sense that vegetable oil would worsen NAFLD as well. And if vegetable oil indeed does worsen NAFLD, then it promotes obesity by the mechanism described above.

Saturated fat is a healthful food. Read this article by Mary Enig that describes in detail the health benefits that come from eating saturated fat. I’ll address a couple of different issues.

Saturated fat is, well, saturated. That means that every carbon in the fatty acid chain has a full complement of hydrogens attached to it. There are no double bonds. In the picture below you can see a saturated fatty acid on top and a monounsaturated (one double carbon-carbon bond) fatty acid on the bottom.

Double bonds make fats unstable. These double bonds are the places that free radicals strike to convert unsaturated fats into peroxides, or oxidized fats. The more carbon-carbon double bonds a fatty acid has, the more susceptible it is to oxidation. Oxidized fats don’t function as well as non-oxidized fats. They make faulty cell membranes and less than optimal membranes for all the organelles within the cell. Oxidized fats can themselves become free radicals attacking adjacent fats and damaging them, or worse, starting an entire free-radical-fat-damaging cascade. All these forces work even more effectively at higher temperatures, so unsaturated fats shouldn’t be used for cooking. Unless, of course, your goal is to eat oxidized fats.

Saturated fats have no double bonds. They are immune to free radical attack. They are immune to heat damage. You can cook with them, you can hit them with a hammer, you can throw them on the floor and jump up and down on them. And they stay the same. Saturated fats are stable fats.

Most people don’t realize this, but the body has the ability to convert saturated fats to unsaturated fats. But the body doesn’t have the ability to convert unsaturated fats to saturated ones. The body can make saturated fats (palmitic acid, a 16-carbon-chain fatty acid) from excess carb consumption, but it can’t make a saturated fat out of an unsaturated one. If nature hadn’t wanted us to have saturated fat, why did she make us so that we make our own if we eat too many carbs. Could it be that during our evolutionary past the only time we might over consume carbs would have been when there was no meat available…and we needed the saturated fat? Sounds reasonable to me.

We have enzymes called desaturases that desaturate, i.e., add carbon-carbon double bonds, fats. We can take unsaturated fats and make them more unsaturated. And we can take saturated fats and make them unsaturated. But we can’t go the other way. In order to have saturated fats that provide the necessary structural stability that only saturated fats can provide is to get them in the diet, which we can do by eating saturated fats or by eating a whole lot of carbs. Since over consuming carbs comes with its own set of problems that we would rather avoid, that leaves eating saturated fats.

So how does avoiding saturated fats lead to obesity. In my opinion in a couple of ways. First, indirectly, by having them replaced by vegetable oil, particularly hydrogentated vegetable oil, i.e., trans fat. Due to their stability, saturated fats have cooking properties that no other natural fats have. Food chemists have created trans fats to have the same cooking properties – and in some situations even better cooking properties – as saturated fats. But the addition of trans fats to the diet creates a host of other problems. The medical literature is crawling with studies showing that trans fats drive the development of obesity.

The other reason is that saturated fats compose the lion’s share of normal membranous fats and of the brain. When membranes don’t work as well, especially mitochondrial membranes, our energy storage and regulation system doesn’t work as well. Anything that impairs membrane functioning impairs signaling function. If signaling function falls off, then various hormones, neurotransmitters, etc. lose function. As insulin loses function, more insulin is required, more insulin leads to more downregulation of receptors, all of which ultimately leads to obesity.

Even overeating carbs doesn’t help even though saturated fats are produced as a result. Carbs stimulate the production of palmitic acid, a 16-carbon chain fat. For proper membrane function and signaling we need shorter-chain saturated fats as well. These we can’t make – we get them from diet only. We can make shorter fats longer with elongase enzymes, but we can’t make longer fats shorter. We’ve got to get them via mouth.

Since this is speculation on my part – educated speculation, but speculation nevertheless – we may ultimately find that there are other reasons for the obesity epidemic instead of these or in addition to these. In fact, I can think of a few other minor causes, which I’ll save for a later post.) But I’ll bet that when all the work is done – which may not be for a hundred years given the academic climate of today – I’ll bet these ideas will be close to the mark.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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55 thoughts on “Changing dietary trends and the obesity epidemic

  1. I find it interesting that the NYT published this article 3 weeks after I submitted a similar op-ed to them. I cited the very same diet shifts and changes in obesity prevalence, and used the same CDC and USDA data to support it. Except I didn’t put the emphasis on fat as the culprit of course. I’m pretty peeved about it as you might imagine.

    Another trend it’s important to remember is the increase in grain consumption. The way the data are presented in the article obscures the fact that wheat is our primary carbohydrate (in absolute amount), and it increased by 21%. Corn and rice consumption increased by a larger percent, but the total amount of wheat we consume is still far higher than corn or rice.

    Increased wheat consumption is associated with all sorts of problems on a cultural level, even if it’s replacing another source of carbohydrate like root vegetables.

    I would be more than “pretty peeved.”

  2. To avoid oxided fats, would it be wise to avoid the high heat of frying and BBQ’ing entirely since even a good fat such as lard is only 40% sat (per USDA nutrition lab)? The caution against BBQ seems to pop up every summer but who can resist BBQ?

    The caution against BBQ is because of the supposed danger from heterocyclic amines, products formed when the amino acids in the meat is exposed to high temperatures. These compounds have been shown to be carcinogenic, but I’m not really a believer. We, as humans, have cooked our meat over open fires for hundreds of thousands of years. I’m sure that either a) heterocyclic amines aren’t all that carcinogenic, or b) we’ve evolved a way to deal with them in the amounts that are produced in grilled meat. I’m not worried.

  3. Can you point me to a reference that discusses where medium-chain triglycerides (MCTs) fall into this fat mix? Or, have you already written about them? I can’t see how they might be beneficial to our diet, but I’d like to be more educated on it. Thanks!

    MCTs are saturated fats and are handled by the body like any other saturated fat, with one exception: they are absorbed directly into the liver instead of through the lymphatic system. Because of this direct absorption, they provide immediate energy in the same way that carbs do. And they tend to more rapidly produce ketones since they are so rapidly absorbed.

  4. Dr. Eades,
    I’m salivating over that picture of the ribeye steak you’ve included in this post, and it’s reminded me of a question I’ve been longing to ask you for a while now, despite the fact that it may be slightly off-topic here.
    Between your well-written and thoroughly researched articles regarding saturated fat, I’m convinced they’re not the monsters the media have made them out to be; I’ve read many of Mary Enig’s articles as well, and her words have also put me at ease that I’m not slowly killing myself whilst ingesting these delicious, fatty steaks (which allow me to control my weight beautifully–I’ve been low-carbing since you and the wife published ‘Protein Power’)

    Finally, my question (speaking of the ribeye picture above)–do you subscribe to the notion that grass-fed beef is much healthier to consume? Every internet store selling it claims their steaks are much higher in the omega 3’s (some claim their beef has just as much if not more than fish!) thus are less inflammatory and less ‘contaminated’ with hormones, antibiotics, etc.

    I know organic or ‘natural’ may tend to be better, but does the food the animal eats actually make the beef on my plate much less dangerous than say, a store-bought steak, which, according to many of these purveyors of grass-fed, contains too many omega 6’s?

    I’m not a lover of fish, and I easily get ‘chickened-out’, so I’d love to hear your opinion about the so-called ‘health benefits’ of grass-fed beef. Yes, it’s alot more expensive, but if you think it’s healthier to consume on a more regular basis, I’m willing to spend the money.

    Thanks for your help, Dr. Eades!

    The ratios of omega-3 to omega-6 are different in grass-fed and grain-fed beef, with there being higher levels of the omega-3s in the grass-fed. But the amounts of both are pretty small, so I wouldn’t get all that worked up over it. I like the idea of grass fed because of the lesser amounts of pesticides, hormones, antibiotics, etc., but I like the tastes of grain-fed better. I eat about equal amounts of each.

    If you’re looking strictly at the best steak to get for health reasons, I would go for grass-fed. If you’re looking for both taste and health, go for organic, natural beef, which, as I understand it, are grass-fed up until the final few months, then grain-fed until slaughter.

  5. Dr. Eades

    This is somewhat off topic, but I thought you would appreciate it. Recently I read the book The Histories by Herodotus (Greek Father of History). In book three I came across a conversation between Herodotus and the Egyptian King:

    “Last of all he came to the wine, and having learnt their way of making it, he drank a draught, which greatly delighted him; whereupon he asked what the Persian king was wont to eat, and to what age the longest-lived of the Persians had been known to attain. They told him that the king ate bread, and described the nature of wheat- adding that eighty years was the longest term of man’s life among the Persians. Hereat he remarked, “It did not surprise him, if they fed on dirt, that they died so soon; indeed he was sure they never would have lived so long as eighty years, except for the refreshment they got from that drink (meaning the wine), wherein he confessed the Persians surpassed the Ethiopians.

    The Icthyophagi then in their turn questioned the king concerning the term of life, and diet of his people, and were told that most of them lived to be a hundred and twenty years old, while some even went beyond that age- they ate boiled flesh, and had for their drink nothing but milk.”
    —The Histories, Herodotus, Book Three

    In some other translations the word dirt is substituted for manure (a better description in my opinion). It is also worth noting that the Egyptians who fed on meat and fat had much thicker skulls than the Persians, and always defeated them in battle.

    Here is one other quote from the Egyptian preists to Herodotus:

    “All human sicknesses follow from the food that is eaten.”

    Thanks

    Thank you for the interesting quotes.

    Cheers–

    MRE

  6. Hi Dr. Eades.

    It seems strange to me that nature made us so that we make saturated fats our own by eating too many carbs and then provided us with enzymes that desaturate them.

    Why all this needing for saturated fats if they have to be desaturated later?

    Sorry for ignorance…

    They don’t necessarily have to be desaturated. They need to be desaturated only to meet the body’s needs for less saturated fats. The body still needs the saturated fats as well. If you provide saturated fats to the body via diet, the body then has saturated fats for its use as well as those it desaturates. If only unsaturated fats are provided, then no less unsaturated fats can be made and the body goes begging.

  7. If obesity rates “hummed along at 15%”, what indeed has happened since 1970 to cause this enormous societal change?

    People stopped cooking at home and they turned food preparation over to various arms of the food “industry”– the restaurant, the grocery store food bar, the creators and purveyors of non-food convenience portions of all sorts.

    carb is cheap, trans fat is stable. carb costs may be going up, but the stuff is still cheaper than any type of protein or high quality fat.

    people don’t even have their important events at home anymore. how many times when travelling from a job to home have my husband and I been the unwilling viewers of birthday parties, anniversaries and ball club get-to-gethers at low cost chain restaurants (they have all you can eat meat, so we are forced into them when we are far from home).

    This mass created food is loaded with sweetening, because it is cheap and easy. People are accustomed to this sweetening overage, so what little is cooked at home is loaded with it too. download a cake, cookie or bar recipe from somebody on the net, and the sugar content is unforgivable. sometimes there is more sugar than flour. this stuff would have to be sickeningly sweet. your would think so, anyway.

    I am making our daughter a home-sewn gift (from a really ancient pattern, home sewing is another dead art) and when I happened to mention to the clerk that I make three meals a day, 360 or so days a year, I thought she was going to collapse on the floor in stupefaction.

    I saw a box of pretzel treats in the frozen food case, bready ones stuffed with “apple” filling. four of these monstrosities cost $4.99. at my health food store, a pound of natural ground sirloin is $4.99. go figure. somebody is making a killing, and it’s not the health food store, at least on on the meat anyway. the whole grain this and that is another story, and sales of that stuff is how they stay open.

    this is all depressing. most of the changes since the 1970’s have not been positive.

  8. For how many thousands of years did we just eat food?

    Animal protein, fruits, vegetables.

    Grains, dairy, seeds & nuts were eaten in smaller quantities due to the processing requirements.

    The more processed our food becomes, the fatter we become.

    That fructose study used 85 gram test samples of fructose and glucose. How many heads of lettuce, or peppers or apples is it going to take to equal 85 grams of usable carbs.

    A lot.

    How many cans of Coke?

  9. I would like your opinion on this study:

    “One of the earliest and most convincing studies of the better efficacy of unsaturated than of saturated fat in reducing cholesterol and heart disease is the Finnish Mental Hospital Study conducted in the 12 y between 1959 and 1971. In this study, the usual high-saturated-fat institutional diet was compared with an equally high-fat diet in which the saturated fat in dairy products was replaced with soybean oil and soft margarine and polyunsaturated fats were used in cooking. Each diet was provided for 6 y and then the alternate diet was provided for the next 6 y (3). After a comparison of the effects of the 2 diets in both men and women, the incidence of coronary artery disease was lower by 50% and 65% after the consumption of polyunsaturated fat in the 2 hospitals.”
    References found here:
    http://www.ajcn.org/cgi/content/full/80/5/1102

    Thanks.

    Read pages 36-38 in Gary Taubes Good Calories, Bad Calories to find out all about the Finnish Mental Hospital Study. It’s just one study. And at about the same time it was published, there was another study published on the results of the Anti-Coronary Club in New York showing that those who ate the most unsaturated fats had the highest rates of death from heart disease. If you’re going to believe one, then you’ve got to believe the other.

    I think the first line of the article you linked says it all:

    It is an article of faith that saturated fat raises LDL cholesterol and accelerates coronary artery disease, whereas unsaturated fatty acids have the opposite effect.

    An article of faith, not of scientific certainty. That’s why the whole idea is called the lipid-HYPOTHESIS and not the lipid fact.

  10. I think lifestyle changes since the 1970’s also contributed to obesity rates. I suggest a decrease in manual labor and factory jobs and more people driving cars due to suburban expansion. More jobs are sedentary. I don’t even walk to meetings anymore! They are on conference calls. In the 1970’s, much of the entertainment was active or at least communal. You had to travel to see a movie. Now we have home computers, video games, cable TV and DVDs. There is more time spent at home rather than in the community. We use our back decks instead of our front porches.
    On the positive side, Chicago has created bike lanes on many city streets and encouraged the public transit system to make room for bicycles.

    Maybe. But what about all studies showing that exercise doesn’t promote weight loss?

  11. Mike, that pictures looks like what we’re having tonight for dinner… only the meat will be top sirloin.

    I do have a question about the overriding effect of carbs on satiety. Maybe other readers may have the same question as well. I understand why feeling ‘full’ after eating a good steak would make me refuse another bite of it. I also understand that we ‘always’ seem to have room for dessert. Our experience on how good that piece of cake tastes may influence a behavior we can’t control (the physiological effect of the actual image of a succulent carrot cake, for example, or the smell of German chocolate cake), so I could see how that effect overrides our sensation of being full and we would go after that cake. However, when you wrote about eating the dessert first, you said that we would never be able to eat all the steak. If the carbs in the dessert are overriding our satiety centers, then why would we stop eating? Wouldn’t we actually feel the need to eat the steak because eating carbs are not making us feel satiated? Or is it because the immediate effect of those carbs in blood sugar that makes us feel satiated until insulin takes care of it, which in turn makes us feel hungry a couple of hours later?

    Thanks in advance!

    Hey Gabe–

    I’m not sure of the exact mechanism, but I know it works.

    Take someone who binges. That person can eat a steak then binge on ice cream, cookies, or any number of high-carb foods. But ask that person to binge, then to eat a steak. It’s impossible. Whatever the override is, it works for foods with a high-carb content, and doesn’t spill over onto foods that are high-protein, high-fat, i.e., meat.

    This phenomenon seems to occur in the presence of foods that are both high-carb and high-fat. For example, no one much binges by eating sugar out of the sugar bowl. And I’ve never heard of anyone binging on butter. But mix the two together and you get frosting (as in on a cake), which people can’t seem to get enough of.

    Cheers–

    Mike

  12. Here’s an anecdote about the carbs vs. fat/protein consumption patterns of Americans. I was invited to a luncheon at work today. I skipped it and ate my own low-carb legal lunch alone in my office, assuming that most of what they would offer to eat would be food I do not normally consume. Sure enough, it wasn’t, as I know from a very thoughtful staff member who brought a meal from the lunch to me. A salad (okay, but I bet the ranch dressing is low-fat), breaded fish, roast potatoes, macaroni and cheese, and some kind of a brownie-looking square covered in powdered sugar. She gave me a choice of regular or diet cola. I accepted the diet, despite the aspartame. Fortunately I was already quite full from my lunch with plenty of protein and saturated fat, so I have no desire for any of this stuff. But you just can’t escape it if you have any kind of a social life. Here I risked being anti-social so I could eat a proper lunch, and, God bless my (overweight) co-worker, she brings it to me without a clue there’s anything wrong with it. I often feel like a Hebrew wandering in the wilderness with a horde of Egyptians after me. But it’s awesome to be free of the cravings that had enslaved me to carbs. There was once a time when I would have eaten this lunch right away even after I had already eaten. Maybe tonight I’ll give the breaded fish to a family of stray cats I feed.

  13. Your posts are thought provoking – my kind of reading. I came upon your Net presence when trying to research the Framingham Heart Study. I wanted to know how many participants, if any, had a total cholesterol level < 150 mg/dl: “No one in the study with a cholesterol level < 150 ever had a heart attack” – so people keep citing. After some determination and persistence, I concluded my ‘security clearance’ must not be sufficient to access any meaningful data from that study. I like to review studies meticulously, not just read analyses by (often anonymous) others.

    I am “employed in a (lowly, front-line) nutritional capacity [by] the USDA”; but maybe I’m not among the “uninformed.” :^ )

    I plan to read “Protein Power.” I’m curious to see how it compares and differentiates from other books and studies on nutrition. As a public health nutritionist, I not only love to preach what I practice, I love to analyze what others preach. If you are as successful as I in this practice, then you must be in exceptionally good health. Congratulations on that fortune!

    I sincerely expect to learn a lot while reviewing (possibly debating) your book.

    Thank you for the well-written posts, and particularly for the respect for others with which you write (minor exception withstanding :^ )

    Zach

    PS: The study published in the NEJM on diets July 17 2008 was questionable, e.g., 322 obese Israeli “nuclear-research employees” (oddly high incidence rate of obesity there) who lost two-pounds more (males only) on [Atkins diet] than on [AHA] diet (for a total of 12 pounds in two years), funded in part by the [Atkins Foundation], with vague comment about physical activity and apparently self-monitred calorie-restricted diets, etc. I bet you could write a post “questioning the validity” of that study. Will you?

    Hey Zachary–

    No offense intended. Perhaps you’ll raise the average IQ in the place by several points. :-)

    I did write both in the post (I think) and in numerous answers to comments that I thought the work on the NEJM paper could have been a lot better. It wasn’t a perfect study, that’s for sure.

    Cheers–

    MRE

  14. Hmmm, I have to disagree on the taste of grass-fed beef, though it does depend a lot on where you get it from (what the cows ate), and even what time of year they were slaughtered. I’m lucky enough to live close to a producer who delivers to my doorstep. The flavor is unbelievable, just my opinion of course. I would tend to agree that the omega-3 thing is probably less relevant. Grass-fed is higher than grain-fed in many respects, including minerals like calcium and magnesium. It’s also insanely lean, which means you need to smother it in butter :-) For the same reason, many cuts need to be cooked VERY slowly. I do my London Broils at 170F.

    Making stock from soup bones, and then using that stock as a base for sauces is a good way to up the mineral content of your steak dinner when having grain-fed beef.

  15. I think you are dead on with the vegetable oil, fructose indictment. Wheat is probably also another contributing factor to the current epidemic of obesity.

    An inverse relationship of sorts exists between fat and carbs such that as the portion of calories from carbs decreases the calories for fat must increase. This relationship holds true for low fat diets but only if one sticks to the diet. Assuming they do, carbs must increase as those such as Ornish well know. Although it is not typically mentioned, low fat diets are really Trojan Horse high carb diets. Put another way, those such as Keys and Ornish are Carbinators (has a nice ring to it doesn’t it?).

    The problem with the low carb diet is that we are programmed to crave fat. Even when we get hooked on carbs we still crave fats. Here is the rub. Proponents of the low fat diet are really driving people to a high carb, moderate or even high fat diet comprised of the worst kind pf fats because they are typically toxic vegetable oils (oxidized or superoxidized). If we are low in the essential fatty acid LA Omega-6 our cells will suck up toxic Omega-6 configured toxc fatty acids like a dry sponge.

    On the other hand, anyone who is truly eating low carb finds it hard to eat too much saturated fat even when it is on a juicy steak.

  16. Here’s a couple of interesting studies on the possible effects of fatty acid chemical composition on metabolism:

    Fatty acid chain length determines cholecystokinin secretion and effect on human gastric motility: http://www.ncbi.nlm.nih.gov/pubmed/9869601?dopt=Abstract

    The Insulinotropic Potency of Fatty Acids Is Influenced Profoundly by Their Chain
    Length and Degree of Saturation: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=508203&blobtype=pdf

    I doubt these represent the last word(s) on this topic. The latter one is pretty interesting, claiming that glucose-stimulated insulin secretion is up-modulated by longer chains and greater saturation. That strikes me as sensible in the context of energy regulation, since both greater chain-length and greater saturation result in larger outputs of metabolic products like ATP.

    Peter over at the Hyperlipid blog has some interesting discussion relating to the effects of glycation and oxidation on lipoproteins, see e.g. http://high-fat-nutrition.blogspot.com/2008/08/age-rage-and-ale-segregation.html. That post also postulates an elegant hypothesis as to why fatty acids take a rather indirect route from the GI tract, rather than heading directly into general circulation, namely that it is in an effort to protect lipoproteins from glycation due to post-prandial rises in blood glucose.

    Hey Dave–

    Thanks for the links. I new someone would come through with them.

    Great post, BTW, on conservation of energy.

    Cheers–

    MRE

  17. Hi Mike–do you know if they counted potatoes and corn as “vegetables?” I ask because I saw that beans seem to be included in the vegetable category. I never thought of beans as being vegetables–the same for corn and potatoes since they are all starchy and don’t come close to the nutritional value of broccoli, leafy greens, etc. Some “nutritionists” think potatoes are vegetables, so just have lots of french fries and you’ll be OK. Then again I live in the south, where rice and mac-n-cheese are “vegetables” :–)

    Hey Paul–

    I don’t know. I was going only by what the Times article said. I didn’t see the original USDA data.

    Best–

    MRE

  18. Hi Dr. Mike! Another excellent post once again.
    I have an observation. You said:
    “Studies on ‘normal’ adults have shown that a little more than a third have significant fat accumulations in their livers. Even worse, 15-20 percent of children show the same thing.”
    If I recall correctly, those with alcoholic fatty liver disease tend to have a distended abdomen but are thin, almost emaciated looking. Could it be this NAFLD affecting many of these young children with these big bellies but skinny arms and legs? I always thought this was such an odd body shape but it seems to be appearing more and more these days.

    Fatty liver doesn’t mean enlarged liver, at least not until a much later point in the progression. I imagine what you’re seeing is simply the results of too many kids spending too much time playing video games instead of playing outside like the kids of previous generations.

  19. “Could it be that during our evolutionary past the only time we might over consume carbs would have been when there was no meat available…and we needed the saturated fat? Sounds reasonable to me.”

    Me too. Low carb diets require fat. If you were like me I had to learn to go for fat, not carbs, whenever I got hungry when I first went low carb. So, if you are unable to find fat you can and will eat carbs if for no other reason than to charge your saturated fat battery.

    So far so good. Now let’s suppose you were to be convinced by a good story (It doesn’t have to be true, it just has to be a good story) that fat is bad for you, that fat will kill you, especially saturated fat. So you decide to cut back on fat, at least in intent anyway. There are only two possible macro nutrients that are suited for fuel. One is fat. It is an essential macro nutrient. The other is not essential. But if fat is poison what to do? Marie Antoinette had the answer – almost when she said “Let them eat carbs.” OK, it was cake. But she was still right.

    Now what if the big gun Low Fatters were really Carbinators of the first order and they really weren’t that concerned about how much fat we ate so long as we ate carbs? Think about it.

    The big-time Carbinators produce the very saturated fat they were trying to avoid by eating carbs.

  20. Slightly off topic but one thing I don’t understand about the Lipid Hypothesis. Given how many of us have so-called high cholesterol, is the medical community saying we all essentially have defective livers? How could this be?

    I think the medical community is saying we all eat too much saturated fat. I don’t think that most in the medical community even know that the liver makes cholesterol. Sad but true.

  21. Dr. Mike,
    You stated, “Double bonds make fats unstable. These double bonds are the places that free radicals strike to convert unsaturated fats into peroxides, or oxidized fats. The more carbon-carbon double bonds a fatty acid has, the more susceptible it is to oxidation.”

    I basically agree with your article on the dangers of fructose and PUFAs. However there is one small caveat which I take from Chris Masterjohn’s blog. See
    http://www.cholesterol-and-health.com/Anthony-Colpo-Great-Cholesterol-Con.html
    Chris states, “The point on a fatty acid that is vulnerable to oxidation is the point located between two double bonds, so the vulnerability of monounsaturated fats, which have only one double bond, seems to be minimal.” This would mean that monounsaturates would be more or less as stable as saturates, so that oleic acid for example, the predominate fatty acid in olive oil would not be dangerous even though it has a unsaturated bond. Certain animal fats like lard also have a large proportion of monounsaturate fatty acids. It is pretty much the PUFAs that are dangerous, not fatty acids with a single double bond.

    Porter

    I absolutely agree. The greater the number of double bonds, the greater the opportunity for the fat to go bad. Since monounsaturated fats have only one double bond, they are only a step removed from saturated fats in terms of stability. That’s why lard is so good to cook with: it’s basically saturated and monounsaturated fat.

  22. We’ve recently read fructose is poorly absorbed by most of us. Does this include the fructose in fruits & vegs or does the glucose counter the fructose malabsorption in these two food groups ?

    I don’t believe it’s all that poorly absorbed. In fact, I think it’s absorbed pretty well.

  23. how much fructose is found in fruits such as apples and berries? Wouldn’t you also lose the desire for dessert if you have eliminated carbs such as sugars and starches and only ate salad, veggies and protein sources such as fish, eggs and poultry and lean meat instead of fatty meat?

    There isn’t a lot of fructose in the fruits you mentioned – a few grams more or less. You do lessen the desire for carbs when you remove carbs, but many people don’t lose all desire.

  24. Thanks Mike. I can relate to the last part of your reply… about cakes!

    I seem to remember a study (and maybe you also blogged about it as well), in which mice or rats were exposed to foods that were mainly carbs, fat or the combination. The animals didn’t go for carbs or fat alone but for both. I know, I know… mice are not tiny furry humans, but their brains seem to be and respond like ours (okay… maybe I’m wrong on this one too!). Maybe something similar happens to us as well and we don’t go for the isolated carbs or fat but for the mix. In another study (2-3 yr ago), I read that the taste buds are rich in certain receptors, mainly CD36, which can act as receptors for fats, which could help explain why we’re drawn to foods that contain some fat as it gives us a survival edge in times of scarcity, but to make it a bit more palatable, we also choose those foods that come with a little ‘sweet’!

    Thanks again-

  25. “For example, no one much binges by eating sugar out of the sugar bowl. And I’ve never heard of anyone binging on butter. ”

    My sister, when she was little, used to grab handfuls of butter and eat them. We also had butter and sugar on white bread as snacks.

    Of course I grew up with homemade bread. Oh my, how delicious. Fresh out of the oven, not even ready to cut with butter on each delectable slice.

    Okay, mostly I don’t eat bread, just a little now and again.

    By the way the steak looks scrumptious. Is that herb butter on top?

    It is indeed herb butter on the steak.

  26. Sir thanks that stella post.

    So can you give us a taster of how yr new books differs from yr last proper book..would that be PPL (i was out of le loop for a few years) ?

    Also to get enough fat what are yr top choices please ?

    Thankum

    We just got the new book back for the first editorial go round, so don’t really have the time right now what with everything that’s going on to differentiate the books.

    My top choices are fat from steaks, coconut oil, butter, and bacon drippings.

  27. I have two comments about food changes over the years.
    1) Last week we went to a pig roast that a local restaurant had for loyal customers. I really liked the pork; it reminded me of the pork roasts of my childhood. I have always liked pork but recently it seems too dry. The roast pig had lots of tasty fat. Today the pork producers and butchers remove all the fat from the pork that we get via breeding and trimming. This fat reduction does not show in the NYT chart and is another reason why we get less saturated fat today and dry tasteless pork.
    2) I was trying to make an apple pie for a friend. I compared the recipe in the Joy of Cooking that we had received at my first wedding in 1963 with a current copy that someone had given me. Guess which one had significantly more sugar.
    When I ate pork roasts and apple pie as a child, I was never overweight. I started to gain in the 1970’s and lost all the extra weight on the Atkins diet. In the 1980’s I started to read all the negative publicity about low carbs and started to gain again. Now I am a happy low carb eater and losing a pound a month.

  28. Thanks for the information on dietary trends. I sure didn’t know that we are that much healthier!

    We recently wrote an article on obesity trends at Brain Blogger. Did you know that two-thirds of America is overweight? We can always blame ourselves for this sort of thing, but could it be more? Could the destruction of neighborhoods for retail stores play a part?

    We would like to read your comments on our article. Thank you.

    Sincerely,
    Kelly

    I’m not so sure that the blame for the obesity epidemic can be laid at the doorstep of lack of exercise. When people first move to New York City and begin walking everywhere, they lose a few pounds at first, but then regain them as they adapt to the extra walking. Gary Taubes has presented the data showing that people don’t really lose weight with exercise – it simply makes them eat more to compensate.

  29. hi dr. eades,

    i’m not the brightest bulb in the socket so i don’t profess to always understand the science but my life changed on a dime when i began reading this blog and low carbing. when i was struggling to be “healthy” and “humane” by following vegetarian, vegan, low fat and produce only diets, i was completely ruled by sugary treats, even fruits. i ate sweets in enormous quantities, no matter how much i had just eaten and was truly incapable of resisting them. i ate them in public, i ate them in secret and thoughts of obtaining and eating them consumed me. and mind you, i was able to give up smoking 1.5 packs of marlboro a day and numerous recreational drugs with relative ease! it was embarrassing, frightening and damn expensive! within 72 hours of going low carb, i simply had no interest in sugar…no physical interest and no emotional interest. i could sit next to a freshly baked triple chocolate cake and admire it’s looks and aroma but felt no compulsion to stuff it down. my understanding of why this seemingly miraculous change happened has grown thanks to the information i always get in this blog, but even if i never fully understand it, low carb (especially combined with ifing) is the only way of eating that has ever put food back in it’s proper place for me. i get hungry, i eat real food, i get full, i stop eating..and life goes on.

    doctors are supposed to save lives and with this blog, you are doing just that!

    best to you,
    ida

    Hi Ida–

    Thanks for the kind words. I’m happy to hear you are doing so well. Keep it up.

    Cheers–

    MRE

  30. ” A little fructose – the amount you might find in a piece of fruit, for example – actually helps with glucose metabolism. It more or less primes the pump so that less insulin is required to reduce blood glucose.”

    Dr Eades, how would the above work if one is diabetic?

    And, as an aside, what do you think of a zero carb diet?

    Great work, as always!

    It depends on which type of diabetes. It should work with type II, but not so much in type I, since in type I there is no insulin to be sensitized.

    I think zero carb diets are fine. A little tough to stick with for a lot of people, but, healthwise, they are dandy.

  31. Rings true to me based on my incredibly anecdotal, by which I mean personal, experiences.

    For example, tonight we went out to a steak place and I got a 12oz prime rib (with cheese and mushrooms, yum), green beans, and a side salad (hold the croutons and dressing, please.) To drink: iced tea, unsweetened as it was meant to be. It was extremely good. It was also impossible to eat all of. I know _for a fact_ I could once have eaten all that plus a baked potato and a coke with a few refills. Instead, I got a box and will get to enjoy the steak and green beans some more later.

    Another example: I recently asked myself, then others around me (okay, I was baiting people a bit) why I shouldn’t just eat eggs — say, 18 eggs per day, nothing else. I mooted some observations about the pretty impressive micronutrient numbers, at least compared to the various RDAs, and not to mention the macronutrient figures by my reckoning, and was surprised at my inability to get anyone to freak out. Emboldened, I grabbed some rough numbers off of Fitday, then fiddle with some alternate scenarios involving bacon. And cheese. Surely this would get people to spaz out, yes? Anyway, here’s those:

    http://rfrancis.livejournal.com/467633.html

    Now, I had no intention of doing any such thing, but by the end of this thought experiment my interest was stoked. So for the last, what, week now, I’ve tried it. Well, mostly; I’ve eaten out a few times, keeping it low carb but not necessarily trying to mimic the numbers of the meals in question. (I’m working on that, though.) But generally, my default meal has been similar to this: specifically, it’s been four eggs, half a cup of cheese, half a cup of spinach, a dozen blueberries. In the evening I treat myself to a couple of squares of Lindt 85% dark chocolate and a small glass (a few oz) of wine.

    Of course, you already knew what would happen, right? The weight loss appears to have already started again. And I feel great. Last night I decided it was time to get back into my workout routine, and knocked out a couple dozen hindu squats, some hindu pushups, a few dozen low weight dead lifts and a couple dozen toe touches. Today I’m a little sore but nothing I can’t handle (and pretty pleased with myself for an overweight 40ish guy) and more convinced than ever that this is how we’re built to live.

    Sorry this ran so long, and won’t blame you if you don’t post the whole thing, but I just wanted to say: yeah. You still look right on the money to me.

    R

    Thanks for all the data. It was interesting to see.

    Don’t feel bad. I often have to learn this same lesson over again myself.

    Cheers–

    MRE

  32. Dr. Mike,

    While i do think many people find protein and fat foods, such as steak and eggs, to be satiating. Others do not, regardless of the amount of fat they consume. I’ve seen this in others who have tried to adopt a low carb diet. Yet, give them something like wheat cereal and milk and they’re full for hours, not too mention in a good frame of mind. I think it has to do with the effect of carbs on brain chemicals. Some people seem to need carbs, like an addict needs drugs for instance, to feel good. Thus, in relation to your reply to Gabe’s post, where you wrote, “Take someone who binges. That person can eat a steak then binge on ice cream, cookies, or any number of high-carb foods. But ask that person to binge, then to eat a steak. It’s impossible.” I think this phenomenon results from the relationship between carbs and brain chemicals. The carbs satisfy the person, and then they no longer desire any more food, even if it is a delicious fatty steak. Of course, i do agree that people tend to binge on sugar and fat-rich foods, but i think it is the carbs which plays the pivotal role on the feed good brain chemicals for a lot of people.

  33. Hey, Dr. Mike.

    I think it’s also important to mention that eating carbs drives hunger, according to Gary Taubes, which leads to more eating.

  34. I like your evolutionary theory about carb consumption in lieu of saturated fat consumption, but, at least in most climates, game is at its leanest in the spring while fruit is at its peak in the late-summer/fall. Any thoughts?

    Also, an off-topic question — since you and other low-carb experts are fairly comfortable that saturated fat consumption does not lead to arteriosclerosis/heart disease, do you have a working hypothesis as to other causes? Carbs? Trans-fats? (I think I remember something about carb consumption promoting the production of “bad” LDL molecules.) (You probably posted on this in the past and I missed it.)

    Thanks.

    I think that fruit peaking in the fall lead via natural selection to our handling fructose differently than glucose. If there was ever a time we (our Paleolithic selves) needed a little extra fat it was when we were headed into winter. We found fruit, we ate it, we gained fat, and had a better chance of surviving the cold.

    I believe the most probable cause of heart disease is inflammation. The inflammatory hypothesis of heart disease makes much more sense to me than the lipid hypothesis. See this post for more details.

  35. As an athlete (for 40 years, now age 66), I’ve gradually refined my diet in accordance with the feedback that I receive during exercise – running distances up to 100K (62.2 mi). I can tell you that I only feel at my best when I eat saturated fats, specifically, milk and eggs. If I have an omelet followed an hour later with a glass of milk the night before a long run (currently, 2 to 2.5 hours) or hard speedwork, I invariably am able to run farther, comfortably, and faster.

    I do know of athletes who’ve been extremely successful on a strict vegan diet (e.g., seven-times Western States 100-Mile winner Scott Jurek, and Canadian 50K road champion Brian Brazier). I’m forced to conclude that their bodies are able to get from plant foods the nutrients that I can only assimilate from dairy and eggs. Individual differences are enormous, and are strikingly apparent, in sports this apparently applies not only to native talent but to diet as well. When I tried a vegan diet (for up to 2.5 years), I simply did not thrive.

    Forty years of exercise tell me that sat-fats are essential. By limiting them to the days when I exercise hard, I’ve been able to keep the weight off – though I’m skeptical that I could do so if I imbibed eggs and/or milk daily. By the way, you mention Mary Enig – I found her book, “Eat Fat: Lose Fat” fascinating (co-authored with Sally Fallon).

  36. “The big-time Carbinators produce the very saturated fat they were trying to avoid by eating carbs.”

    I agree. But I think the big-time Carbinators know this. If they do then what is the motivation for their fat, especially saturated fat, is bad campaign? To me it strongly suggests an undeclared agenda to promote carbs. Could it be that Carbinators are motivated by the same things as Statinators – industry ties?

    Some posters have noted changes in diet since the 1970’s. That may have been the point where the high carb diet became obvious. But the real shift to the current dominance of carbs in our diet started long before 1970. The first clue of a shift to what I call carb based edible products came in 1937 when the Sam Kraft introduced Kraft Dinner in the US and Canada. World War II was in progress. There was rationing of meat, milk and dairy products. Because of there there was an growing reliance on meatless entrees (read: carbs). A captive market created a huge opportunity for high profit, carbohydrate based products like Kraft Dinner which came to be considered a hearty meal for families.

    Another significant event happened a few years later. In 1941 Dr. Ancel Keys (a University of Minnesota physiologist) was assigned by the U.S. War Department to design a non-perishable, ready-to-eat meal that could fit in a soldier’s pocket. Out of Keys work came the K-Ration, the prototype of the American fast food phenomena.

    The shift to a high carb diet was underway. But it needed one more thing to give this non-essential macronutrient credibility – quasi scientific status that would make the lowly carbohydrate appear on the surface at least to be something that it wasn’t – an important, essential part of the human diet. The carbohydrate food industry needed an opportunity to put a spin on carbs and WW II provided it – a shortage, and in some cases rationing, of the very foods needed for controlled carb eating.

    While keys was working on his K-Ration in 1941 the Food and Nutrition Board was deliberating on a set of recommendations for a standard daily allowance for each type of nutrient. Note that this was recommendations for ‘allowances’ for nutrients and not a program to establish intake for essential nutrients. The resulting standards would be used for nutrition recommendations for the armed forces, for civilians, and for overseas population who might need food relief. Roberts, Stiebeling, and Mitchell surveyed all available data, created a tentative set of allowances for “energy and eight nutrients”, and submitted them to experts for review. The final set of guidelines, called RDAs for Recommended Dietary Allowances, were accepted in 1941. The allowances were meant to provide superior nutrition for civilians and military personnel, so they included a “margin of safety.” Because of food rationing during the war, the food guides created by government agencies to direct citizens’ nutritional intake also took food availability into account. The latter provision rationalized the inclusion of carbohydrates which were in plentiful supply during the war.

    Now the door was swung wide open for carbs in the American diet. The problem was how to keep the door open and keep carbs in the RDA once the shortages of WW II were alleviated. The story gets better. But I will save the rest for my next post. Keys is about to make a cameo appearance.

  37. Mike,

    This post was interesting and informative to read. You have the knack of explaining it to non-medical professionals as well. Thanks.

    I want to share some information similar to what you have mentioned on the effect of Fat and Carb on Satiety.

    I grew up in India. During weddings where cooks used to prepare food for the large gatherings –I once heard a cook saying – “when the available food becomes less and you see more people in the queue to eat – increase the quantum of dessert per serving per individual and serve that first”. In fact when they did that for the gathering – we found that people ended up eating other foods comparably lesser. Please remember that these cooks may not even have formal education. This happened approx 20 years back but I still remember the instance and able to connect with what you have explained.

    Thanks

    Venkat

  38. Dr Mike, after decades of SAD, will NAFLD reverse at all on a low carb diet, or are you stuck with your fatty liver and impaired function?

    Also, what do you consider an optimal blood sugar range? Mine is extremely stable, but in the low 70s, since going low carb (under 20gm) a month ago. It beats the reactive hypoglycemia I had, but I am lethargic and feel better when my blood sugar is 80+. I am hoping as my body adjusts to low carb it will come up a bit. -Thanks, Susan

    We have been able to reverse NAFLD in our patients who have had it. It seems to get better fairly quickly, so, I would say, no, you are not stuck with it.

    I suspect your sugar will come up ultimately. You might try adding a little more protein to your diet to give more ready substrate for gluconeogenesis so your body can more easily make blood sugar.

  39. Dr Mike,

    Here is another great article by Mary Enig which raises suspicion about the new trans-fat alternatives (Interesterified blends) and further supports the use of natural saturated fat products.

    http://www.westonaprice.org/knowyourfats/interesterification.html

    As the article states, the Interesterified blends may have heath problems of their own but in addition, based on Dr Enig’s description of the manufacturing process, it seems that the new blends are mostly omega 6 oils. At least the trans-fats were mostly saturated.

    Regrettably, the “solution” to trans-fat may prove to be much worst than trans-fat itself!

    Mary Enig wept.

    As always, thanks for your blog!

    Philip Thackray

  40. Brenda, I think the big bellies in kids is due to the fact their stomachs have to be disproportionally larger to handle all the food fuel their growth (especially as babies). My theory is, the taller the kid will be, the longer their baby belly stomachs stay with them (maybe until age 6 or so?). Our 5 1/2 year old is this way (belly with thin arms and legs, very lean) and he is a giant at almost 4 feet tall. His belly isn’t fat, it’s just his stomach. He can eat as much grass-fed steak as me and as many berries as we will let him eat. When I kept him at home I felt like I ran a restaurant since he was always hungry, despite having just eaten.

    And on the topic of cooking fat, I have great success with coconut oil. It fries nicely and you can add it to smoothies for extra umph. I buy mine in gallon buckets from Tropical Traditions, which imports it from the Philippines. Expeller pressed has no flavor at all and the virgin crushed oil has a slight coconut flavor. What’s funny is, I hate coconut taste but I don’t mind the oil.

    Zachary, I highly recommend “Protein Power LifePlan” (an improved and updated Protein Power) and “Good Calories, Bad Calories”, and of course William Banting’s pamphlet on corpulence.

  41. Also off-topic, but something I’d love to get your and others’ opinion on. Whilst people are battling to eat the right foods and being told one thing by the establishment but learning other truths on this site and elsewhere, scientists are working hard to fool our bodies into thinking one food is another (e.g. artificial sweeteners.) In this short article I ask whether scientists will one day succeed in doing this to such an extent that the doctrine of self-discipline to which many of us subscribe will no longer apply. In particular I am interested in whether the mechanisms I suggest they might use seem plausible and how our lives might change.

    The Professor Diet Part Two: Healthy Junk Food

    Thanks!

    Methuselah
    Pay Now Live Later

    Interesting and thought-provoking article. Thanks for sending.

  42. Related to this somewhat, Jimmy Moore had a recent post about a doctor that wrote a book blaming fructose alone for the obesity epidemic. It was interesting and Gary Taubes countered somewhat…

    Here my post to Jimmy’s article:

    Very interesting! I think it is true that sugar is worse than starchy carbs. Why do I say this? My grown-up sons are pretty much sugar-free 99% of the time, however, they did not adopt my low-carb lifestyle. They will eat white buns and large flour tortillas, potatoes, rice and the like. They are both very slender and don’t exercise a huge amount as they are computer guys/techies. When I have made desserts, it has been with Splenda the whole time they were growing up. My eldest son does not indulge in desserts very often. He only likes apple desserts. LOL I can’t believe he is my son! As well, he does not care for chocolate. How is this possible? :-)

    Sure, they are young, however, there are many young people that eat the same way as they do, but also add large amounts of sugar to their diet – and the result is sometimes (not always – good genes, perhaps?) too much weight gain, and sometimes even diabetes develops at a young age.

    The other thing is our sons don’t eat too frequently. They eat two meals a day, typically, and, therefore, less insulin is produced, right?

    I think sugar and high fructose corn syrup are probably more dangerous than the starches, however, they are probably worst in combination with starches. The starches that are the least offensive, I think, are starchy veggies. These days the boys say I have a carb conscience. I don’t like having white flour or sugar, but I will have starchy veggies from time to time. When I indulge in the former, my carb conscience gives me trouble.

    Certainly, when our metabolisms have a problem (mine, unfortunately from sugar soda abuse in my youth and also a low thyroid disease, Hashi’s) with carbohydrates, the cure is to go easy on those.

    Just my opinions – and I’m sure because everybody is so very different, this hypothesis may not hold true for everybody. In fact, it might have a lot more to do with genes; one’s body’s ability to handle carbs, etc. I don’t know for sure, but it is interesting to think about these things.

    To add to this comment more pertinent to this blog post here: The boys don’t have vegetable oils (other than olive oil – is that okay?), but will obviously ingest them at restaurants. They get plenty of saturated fats from the high meat diet we eat. They don’t consume much sugar at all and have always relied on Splenda for treats, which were sometimes plentiful and other times not. They are not big bread eaters, but do get their fair amount of wheat flour carbs, about 3 or 4 times a week. The boys eat fruit, but only in normal amounts and sometimes not even. They eat vegetables and sometimes not enough. They have taken vitamin supplements for years.

  43. The ending of WW II brought with it some serious challenges for the carbohydrate based edible products industry. First, as shortages of meat and dairy products eased there was the tendency of people to return to their established habits, especially their former ways of eating. Having been deprived of a good steak or prime rib roast for a most of the war, many craved such foods. Food shortages and rationing were unpleasant, something most wished to relegate to a distant memory. The likelihood was that without good reason to do otherwise, people would start to revert to their old habits and, in so doing, reduce their consumption of carbohydrates to pre-war levels, something the carb based edible products industry would want to avoid for obvious reasons.

    There was also the issue of a potential problem with the inclusion of a non-essential macronutrient in the RDA. This could be justified in times of shortages and the rationing of meat and dairy products. But justifying carbohydrate’s inclusion in the RDA in the absence of such shortages was another matter. Critics could draw attention to this discrepancy unless some compelling reason could be cited to validate the continued inclusion of carbohydrate in the RDA. Trying to rationalize the inclusion of carbohydrate without such a reason would only serve to draw attention to the obvious.

    Then there was a problem with the “carbs are good for you” story. The very low carbohydrate diet that was part of the standard (and often very successful) treatment protocol for type II diabetics told a different story. If carbohydrates were “good for you”, why were they severely restricted for diabetics?

    All these issues would have to be successfully addressed if the consumption of carbohydrates and carbohydrate based edible products were to increase, and they were.

  44. Just had a couple of questions after reading this fascinating post.

    1. Which fats do you recommend for cooking with? Which should be avoided? (Feel free to plug your book if the subject is covered).

    2. What role has addiction played in the massive shift towards unhealthier diet over the past four decades? I know people who have had a ton of success with Atkins for a time, go off the wagon, and are never able to get back on track despite numerous short-lived attempts. I know people who talk about carbs in much the same way smokers talk about cigarrettes or alcoholics talk about drinking.

    We use coconut oil and bacon grease to cook most of our stuff that requires cooking oil. If the temp isn’t too hot, we’ll occasionally use olive oil.

    I do think there is an addictive component to carbs. Most people don’t miss them once they start on a good low-carb diet, but after falling away, they do seem to have difficulty getting back on a strict low-carb diet.

  45. Hi. Does Intermittent Fasting reduce fatty liver? What’s the best way to burn off that fat for fuel?

    Also, I’ll mention that I’ve never had grass fed beef but I have had wild venison. There is very little fat on it and what there is of it is tough and it tastes bad. So when I see people saying that they like the taste of grass fed beef, I wonder how much sleight of hand is involved on the part of the producers.

    I would say that intermittent fasting would get rid of a fatty liver as long as one didn’t go hog wild on the carbs during the eating days.

    Some people – my wife, for instance – love venison. I hate it. I love lamb; she hates it, especially if it smells at all lamby. I think it’s a matter of different taste preferences that different folks have more than malign intent on the part of the producers of grass-fed beef.

  46. On the subject of fructose…I was surprised to read that you limit yourself to only around 3 gms/day! That would mean that you are restricting your consumption of fruits. I must admit that I’m somewhat surprised and amazed at how much negative publicity fructose has been receiving lately while being blamed for everything from the obesity epidemic to the reason why Bush invaded Iraq. ;0)

    I’m aware that it is a type of sugar found mainly in fruits and that it requires metabolic processing in the liver, which is a big problem I take it. Studies out there have also suggested that consuming too much fructose messes up all kinds of things in the body — they show a correlation with obesity and tends to promote an increase in triglycerides in the blood, which of course are markers for heart disease. And as you’ve already implied…fructose can make the liver look like that of an alcoholic.

    So seeing that fructose may be detrimental to one’s health, it would follow that our goal should be to reduce the fructose content as much as possible. But if you look at the % of fructose in some common fruits, compared to equal portions of sucrose, honey, and HFCS-55. (I’ve listed the total sugars in parentheses) you’ll notice something interesting:

    Grapes: 42% (18)
    Mangos: 54% (15)
    Apples: 70% (13)
    Strawberries: 52% (6)
    Papaya: 60 (6)
    Sucrose: 50% (100)
    Honey: 53% (82)
    HFCS-55: 55% (77)

    Looking at those apples and papayas…one can see that they have a high % of fructose, higher even than honey, sugar, and HFCS-55. But does that mean they’re bad? I don’t believe so, especially if you were to look at the total amount of sugars per 100g, then couple that with some fiber, vitamins, minerals, and other goodies that you don’t get in other carbohydrate sources, and also contributing to bulk that limits how much you can eat.

    So, I personally don’t feel that we should all get our panties in a twist over fructose thinking that it such an evil thing that we should limit it as much as possible, even if it means avoiding those fruits containing a lot of it. Hasn’t fruit been around for hundreds of thousands of years to nourish our Paleo ancestors? I will say with all due respect Dr. Mike, that I think fruit should not be avoided because of its fructose content, but should be eaten mainly as a dessert. We may need to watch the quantity because of the sugar content, but I sincerely don’t believe anyone is going to get fatty liver disease from eating apples, strawberries, etc.

    On the subject of grass-fed beef…I just wanted to add another benefit to eating free-range beef and that is that the CLA content is found in much greater quantities as opposed to the amounts found in grain-fed beef. CLA has been reported in some studies to aid in weight-loss for some reason.

    Sky King

    The fruits that you find in the supermarkets today bear no resemblance to the fruits our Paleolithic ancestors had to eat. Large, juicy, sweet Washington Delicious apples didn’t exist 20,000 years ago. The apples that were around were little and gnarly. And your ancestors and mine had to fight the birds and the bugs for them during the brief time in the fall that they were ripe. The rest of the time there were no fruits, so although fruits have been around in some form for thousands of years, it ain’t in the form that you find it at Whole Foods today.

    Although fruits contain a few vitamins and antioxidants, they are really not much better than candy due to their high sugar content. Sugar content not put there by nature, but by Luther Burbank and other folks who have developed hybrid fruits to fool the unwary into thinking they are eating health food.

    Cheers–

    MRE

  47. You asked me to keep you updated on the weight loss, so even though comments are closed I’ll let you know anyway.

    I started at 162 and am down 7.5 pounds to 154.5 in three weeks. I have even had some lapses such as a bowl of ice cream and some fruit that put me near 50 g. daily on a few days. Also, flavored coffee most days last week and I don’t have carbs for that but probably a no no. Still, good success and without weight lifting as my schedule is very busy right now. I could probably lose even faster if I really buckled down.

  48. Over the past several years, I’ve gone from using canola oil to olive oil to now … bacon grease. I tried coconut oil, but hated the flavor, even though I bought the expensive expeller produced kind. The bacon grease lends a nice flavor to meats and even chicken.

    Anyway, I make bacon maybe once every 8 to 12 weeks. I cook it in a frying pan over very low heat so that it doesn’t burn and stays nice and limp, but cooked, the way we like it. Does the fat still oxidize over low heat?

    What do you think of my using the leftover bacon grease for cooking — like browning meat, etc.? I pour it into a ceramic dish and keep it covered in the fridge. It lasts for quite a long time (at least I use it for quite a long time, not sure if it actually “keeps” for that long).

    Thoughts? Good, bad?

    I’m intrigued by rendering lard (ala MD’s current blog). I tried it once, to very mediocre results. Maybe it’s time to try it again, if only I can find some good source for organic lard.

    My thoughts on bacon grease are that it is good. We use it a lot.

    MD has found a source for orgainic lard, which she listed in her blog post.

    Cheers–

    MRE

  49. The ‘Age of Carbesity’

    With the implementation of the RDA the world entered the ‘Age of Carbesity’ as defined by the new religion of the Church of Carbinology and the growing girth of its followers, the carbinists. Carbinologists toiled endlessly to find a process by which cholesterol could be rendered into gold through the art, which came to be known as Statinology. And lo and behold their efforts bore fruit in abundance and the Statinators went forth with their wares. And big pharma was pleased.

    Meanwhile, the High Priests of Carbinology ordained thousands of upon thousands of certified nutritionists and dieticians as ‘Carbinators’ and bade them to go forth to spread the gospel according to the scriptures of the RDA, of the good that would come to those who consumed of the carb and the evil that would befall those who indulged in the fat of the land and the excesses of cholesterol as well as the evils of those who preached of the teachings of Atkinsinism.

    The Carbamarketers looked over all this. They saw that it was good. And they gloated at their skills of their deception for having fooled so many who thought themselves to be wise. For the Carbamarketers knew full well that it was through their sleight of hand brilliance that the lowly carb had been vaulted from obscurity to a place of prominence in contemporary nutrition and, in so doing, they had overcome the limits of non-essentiality. The Carbamarketers had removed science from nutrition and installed religion in its place. And they saw that it was good. And they rejoiced.

  50. I picked up a copy of “Protein Power,” copyright 1996, by Michael R. Eades, M.D. Thank you, Cheerwino, for the recommendation to read “The Protein Power Lifeplan” that was published years later.

    From the reading of “Protein Power,” I was wondering if the author’s thoughts on various topics evolved over the years. For example, the author recommends “Beta-carotene (for vitamin A) 25,000 IU.” This is under the category of “In Search of an Excellent Vitamin and Mineral Supplement.”

    My education is in clinical dietetics (B.S.) and in human performance and nutrition (M.Ed.). My job (funded by the USDA) is to counsel women during and after pregnancy, including how to feed their infants and children (WIC). My “expertise” in nutrition does not include the nutritional approach to fat loss as advocated by our host, Michael Eades, M.D. – a more-and-more useful field of expertise.

    So, when Dr. Eades ventures from weight-loss (“fat loss”) to an area of nutrition science where I have more insight, I wonder how his knowledge has evolved.

    None of us knew in 1996 that Beta-carotene in supplements, and added to foods, would ‘perform’ adversely in studies on cancer and heart disease. The recommendation now is to consume carotenoids (not just Beta-carotene) naturally from foods (as opposed to artificially from chemical companies, e.g., DSM and BASF, in the form of vitamin supplements), as carotenoids seem to work together as a team to prevent cancer and heart disease, whereas too much Beta-carotene interferes with the “teamwork” – increasing the incidence of oxidative and inflammatory diseases.

    I am used to categorizing people nutritionally: athletes, pregnant women, infants, elderly, and so forth. Obviously, a patient in the “burn ward” has different nutritional needs than a patient with end-stage renal disease. I respect the fact Dr. Eades knows as much or more about these different sub-populations, in terms of their nutritional needs, as I. “Protein Power” is directed at a very specific sub-population – those who need to lose and to prevent excess body fat.

    My interests recognize that particular need, but I am also interested in studying how concepts in “Protein Power” are (or are not) useful to health apart from fat loss.

    The USDA’s stance on this sub-population (people in need of fat loss) is to advocate eating a diet based on the food pyramid and increasing physical activity (known as “Eat Smart / Move More”).

    We (public nutritionists) are against low-carb diets for at least two “scientifically-based” reasons: 1. The Glycemic index is commonly misunderstood and misused for diet books, e.g., The South Beach Diet (most people do not eat two-cups of a single food after fasting, so why eliminate nutrient-dense foods from our diets based on this index?); and, 2. The low-carb diet is relatively high in saturated fat and cholesterol – “killers.” So, upon this “scientific knowledge” we recite “Eat Smart / Move More” to everyone who insists on talking about “losing weight” (not a public-health nutritionist’s favorite topic, I can tell you).

    I agree the Glycemic index is misapplied.

    I agree with Dr. Eades – the goal is not to lose weight, but to lose fat. I also agree the cholesterol concern is misgiven, and probably for the worst possible reason – the ties between “researchers” at the NIH and the drug companies that manufacture statins.

    Knowing nutrition as it pertains to human performance, I am amazed at how most nutritionists remain on the anti-cholesterol bandwagon by failing and refusing to analyze this issue independently. I do not laugh at the number of people who stopped eating eggs and dairy products, since this tragedy outweighed the humor (e.g., trans-fat margarines).

    My physician tells me I have a 1% chance of heart disease, based on my activity level, family history, lab results, EKG, BMI, blood pressure and on other data (but not based on a review of my diet).

    Most of my calories are from complex carbohydrates, followed by fats and then proteins (I don’t drink – alcohol is readily converted to uric acid).

    I don’t eat beef or pork. I am against the conditions under which too many of these animals are subjected. I only eat out once or twice a year and I’m too lazy to cook chicken.

    Fish, dairy products (1% milk, cheeses and non-fat yogurt), eggs and beans are my protein sources.

    I find my knowledge evolving. Stephen J. Barrett, M.D., posted a statement on low-carb diets on his Quackwatch website. Based on various studies, he acknowledged low-carb diets are an acceptable option for weight loss for a sub-population of people. His reputation and his position on low-carb diets inspire me to keep an open mind and to learn more.

    The anti-inflammatory and anti-oxidative properties of foods are more likely to help prevent heart diseases and cancers than the concept of “fats versus carbohydrates.”

    So, is Omega-3 superior to saturated fat as an anti-inflammatory agent? Are saturated fats less oxidative than PUFA in vitro (PUFA’s, e.g., Omega-3 fatty acids, are escorted by tocopherols)?

    In “Protein Power,” the idea is to limit carbohydrates (30 grams / 120-calories per day in “Phase I”) and limit protein (~ 72 grams / 288-calories for me per day), but “don’t worry” about such limitations for fat, except to choose “healthy fats”: “olive oil, nut oils, avocado, and butter.”

    This daily diet is equivalent to about one slice of bread and 12 large eggs. (Vasily Alekseyev, who set 80 world records in weight lifting in the 1970’s, ate a 36-egg omelet each breakfast when weight-lift training. Yet, he still lives…)

    Well, if my energy demand for a given day is 2,400 calories, then I would need an addition 221 grams of fat to maintain my weight. That’s ~ 16 tablespoons of those “healthy fats” listed above. So, one slice of bread, 12 large eggs and 16 tablespoons of “healthy fats” (“good eicosanoids”) per day in “Phase I.”

    I’m already glad I don’t need to lose fat. But, I recognize many people do have this need.

    The first question I need to answer before I present “Protein Power” as an option for certain patients to discuss with their physicians is on how fat is metabolized in the absence of insulin.

    I cannot agree complex carbohydrates are “bad.” Can we agree any energy is “good,” so long as: 1. Energy intake does not exceed total energy demand; and, 2. The specific energy source, e.g., strawberries, does not promote oxidative damage and promote inflammation?

    Fats enter fat cells with insulin, but fats enter non-fat cells without insulin (how could fats be useful to us on the “Protein Power” diet if not?). Even if fats could not enter non-fat cells without insulin, then would we want excess fat remaining in our blood (increasing blood viscosity, etc.)?

    This is the heart of my concern – If excess calories are not stored as triglycerides in fat cells via insulin, then … where are excess calories going? (This is not an issue if there are no excess calories. But, “Protein Power” tells us “don’t worry” [about the amount of fat intake].)

    Dr. Eades promotes exercise (“weight-lifting is best”). If a person loses fat with this diet and exercise (not just loses “weight,” e.g., dehydration), then the fat is being used aerobically for energy. (Only carbohydrates are used for anaerobic exercise.) In this case, fats would not pose a risk to organ function, as the fat is entering muscle cells to do work without insulin.

    But if a person does not lose weight on the “Protein Power” diet, then I would “worry” there is too little exercise and too much fat intake, and the fats may be entering non-fat cells without insulin which could pose a risk to organ function. My plan is to study this concern. Perhaps I will find where Dr. Eades already addressed this issue.

    In the meantime, posts here about – “fats good, carbohydrates bad” – while neglecting to mention exercise – concern me. Speaking for all nutritionists, we do not like the hopeless quest to be fit by dieting without exercise. Dieting without exercise is not what Dr. Eades is prescribing, so why not post comments discussing our exercise habits, too?

    I exercise daily, but thanks to my car, my desk job, my local grocery store and so forth I doubt I get half the physical activity as my “Paleolithic ancestors.” So, why eat like them if we’re not going to move (and migrate) like them?

    Without the exercise Dr. Eades recommends, I cannot imagine any diet building muscle tissue or bone density, with or without carbohydrates and insulin.

    Thank you for providing this opportunity to learn more about healthful fat loss by decreasing carbohydrates, calculating protein intake, unmeasured fat intake (“good eicosanoids”) and with exercise.

    “But the exercise must be strenuous and done until muscle exhaustion almost to the point of failure for maximum results” – “Protein Power,” page 192.

    I’ll keep reading…

    Zach

  51. Carbohydrate became part of the recommended daily allowance (RDA) in 1941 but in an indirect manner. The RDA contained a requirement for energy and protein. It specified the amount of protein required but noted that the recommended amount represented a small percentage of a person’s energy allowance. The remainder of the energy allowance was to be acquired from carbohydrates and fats. The general guideline for carbohydrate and fat is that more than half (i.e. more than 50%) of daily energy should come from carbohydrates, with no more than one-third (i.e. 33%) from fat. This was a back door way of making carbohydrate appear to be an important nutrient without running headlong into the non-essential nutrient issue.

    It was also a back door way of invalidating a restricted or low carbohydrate diet with in many cases is less than 5% of the total energy requirements. Since carbohydrate restriction goes hand in hand with a high fat intake the RDA energy recommendation limiting fat intake caught the carb restricted diet in a pincer vise.

    The inclusion and prominence of carbohydrates in the Food Guide is an important issue because carbohydrate is a non-essential nutrient. As far as I have been able to ascertain the fact that no requirement in human nutrition has been identified for carbohydrate has never been indicated with recommendations for the allowance for this macro nutrient.

    The above issues raise the question of whether the campaign against fat and cholesterol has its roots in a program to promote carbohydrate consumption.

  52. Superior Nutrition
    The RDA was touted providing superior nutrition as based on the input of experts. Superior nutrition according to the RDA was a diet high in carbohydrates and low in fat. “More than half” (of the energy allowance), as applied to carbohydrate, implied that a diet would be the most superior if all the energy allowance remaining after deducting protein’s contribution came from carbohydrate. “No more than one-third”, as applied to fat, implied that a diet with less fat was better and that a diet with zero fat was most superior.
    There was one more neat little trick in the RDA. Grouping fat and carbohydrate under the term ‘energy’ put them on the same level. That fat was an essential nutrient and carbohydrate was not was not necessary to mention once they were both reduced to ‘energy’. Giving carbohydrate almost twice the energy allowance of fat implied that carbohydrate was a superior nutrient.
    The message in the RDA was clear; maximize carbohydrate and minimize fat intake. The RDA also implied that this relationship was based on science which it clearly was not.
    In the early 1950s the RDA was revised to include the serving concept. This further drove home the message to eat one’s carbs and minimize or avoid fat.
    It was also about this time that Keys started his campaign against cholesterol and fat which coincidently just happened to support the recommendations of the RDA.

  53. Hi Dr. Eades: Great Picture – especially the real butter on top of the steak. Meals like that have hleped me keep my weight off and heart healthy, AND have helped my wife maintain sanity as a type 1 diabetic. Scary thing is that if the American Diabetes Association had their way, this would be our dinner tonight!
    http://www.diabetes.org/recipeoftheday.jsp?WTLPromo=HOME_rotd&vms=272459344953

    Thanks again,

    David and Susan Futoma

    PS: I have the same weakness for fresh summertime tomatoes as well, despite some carbs!

    Very few carbs in the summertime tomatoes.

  54. Did the RDA (which was formulated based on considerations of rationing and the shortage of certain foods) and the K-Ration of the early forties change the way we eat? According to this article they did exactly that and in a big way. The K-Ration and RDA changed the ‘business of farming’ too. In what way did the business of farming change? Read on.

    Changes in Eating Habits
    During the war rationing at home and K-rations abroad changed the eating habits of Americans and changed the business of farming.
    http://www.livinghistoryfarm.org/farminginthe40s/life_24.html

    According to the article here are a few of the new foods that were first produced and sold in the 1940s.

    * Mrs. Paul’s frozen fish sticks
    * Cheerios (first sold as Cheeri Oats, the first read-to-eat oat
    cereal) and Kellogg’s Raisin Bran
    * Minute Rice
    * Reddi-Whip whipped cream
    * Nestles Quick powdered drink mix
    * Packaged cake mixes
    * M&Ms Chocolate Candies, Peppermint Patty, Junior Mints, Almond
    Joy, Whoppers malted milk balls, Jolly Rancher Candies
    * Deep Dish Pizza (Pizzeria Uno, Chicago)

    Looks like the beginnings of carbohydrate revolution to me. Does this give anyone an idea of how the nature of farming changed? Back in the days before the RDA and K-Ration, most people bought everything they needed for their meals from a corner grocery store, a vegetable stand, a butcher shop and perhaps a fish monger. That was in the pre-carbinean era. Today, thanks to carb based manufactured edible products, we have huge super markets with thousands of new pseudo foods – all made possible because of the events of WW II.

  55. On the question of fructose and fruit, the mountain of money that found its way into cardiovascular disease research in the 70s and 80s has recently had some side benefits for cancer research.

    A clear association has been established between insulin resistance and cardiovascular disease as a result of the Insulin Resistance Atherosclerosis Study (funded by the successor to the National Heart Institute, the National Heart, Lung and Blood Institute) conducted in the US in the early 90s.

    In-depth analysis in 2003 of the response to questionnaires from that study by researchers from the Department of Epidemiology (medical statistics) at the Universities of South Carolina, Minnesota and Wake Forest confirmed the subsidiary conclusion from the original study, that fibre increases insulin sensitivity. This means that the fibre in fruit appears to have a protective effect against the lipid production caused by the fructose in the fruit. So perhaps fruit is only bad for us when we eat the fructose and throw away the fibre (also known as fruit juice).

    I’m not so sure that fiber is the magic substance many people think it is. It does reduce the rate at which sugars absorb, but I can’t see how it could affect insulin sensitivity. It can, however, cause damage to the GI tract.