Low-carb battles in your brain

I’m going to toss off a question about the paradoxical nature of low-carb diets.  Here is the set up.  Most people reading this post will have – at some point, at least – enjoyed the benefits of a low-carb diet.  They will have had more energy, slept better, rid themselves of heartburn and GERD, stabilized blood sugar, reduced blood pressure, normalized lipids and lost weight.  Many will have been able to rid themselves of one or even a handful of drugs.  All will have felt much, much better than before starting the diet.  And, if most are like me, will marvel on what a wonderfully filling and satisfying diet it is and will tell them selves that the low-carb diet is really the only diet worth following.

Okay, that’s the set up.  Here is the question:

Why are low-carb diets so difficult to stick to for so many who have had the above experience?

When I am in full low-carb mode, genesis-ing that neo glucose like crazy, I feel like a million bucks.  I’m not hungry, I don’t really obsess on food, and I have energy out the yang.  So, why would I ever go off the diet?  I can assure you that I do.  And sometimes I go off in a bad way for longer than I should.  I pick up a few pounds, finally get a grip on myself and plunge back into low-carbery.  When I’m back  sailing along, I wonder why I ever went off in the first place.  So, why did I do it?  Why do we all do it?

Here is what Don DeLillo writes in White Noise that is apropos to our question:

Who knows what I want to do?  Who knows what anyone wants to do?  How can you be sure about something like that?  Isn’t it all a question of brain chemistry, signals going back and forth, electrical energy in the cortex?  How do you know whether something is really what you want to do or just some kind of nerve impulse in the brain?  Some minor little activity takes place somewhere in this unimportant place on one of the brain hemispheres and suddenly I want to go to Montana or I don’t want to go to Montana.

The above quote leads off  Jonah Lehrer’s new book How We Decide, which I’ve started, but haven’t finished.  I got the book because of an article of Lehrer’s I read in the Dallas paper when I was there a couple of weeks ago. So far, the book has met and exceeded all my expectations.  And tomorrow night, I’m going to meet the author, so I’d like to get most of the book finished by then.

The article in the Dallas paper got me thinking about diets, low-carb diets in particular.  And about how much easier it would be for all of us if a lot of things changed.  Before I go into detail, read this excerpt from the article:

A recent experiment…sheds light on what happens inside the brain when people make shopping decisions. While economists have long assumed that consumers are rational agents and purchase goods based on calculations of utility, that assumption turns out to be false. In reality, every shopping decision is an emotional tug-of-war, as the pleasure of getting something new competes with the pain of spending money.

The experiment went like this: A few dozen lucky undergraduates were given a generous amount of cash and offered the chance to buy dozens of different objects, from a digital voice recorder to gourmet chocolates to the latest Harry Potter book. While the students were making their shopping decisions, the scientists were imaging the activity inside their head with a powerful brain scanner.

They discovered that when subjects were first exposed to the item, a part of the brain called the nucleus accumbens (NAcc) was turned on. The NAcc is a crucial part of our dopamine reward pathway – it’s typically associated with things like sex, drugs and rock ‘n’ roll – and the intensity of its activation was a reflection of desire for the item. If the person already owned the complete Harry Potter collection, then the NAcc didn’t get too excited about the prospect of buying another copy. However, if he’d been craving a George Foreman grill, then the NAcc flooded the brain with dopamine whenever that item appeared.

But then came the price tag. When the subjects were exposed to the cost of the product, the insula was activated. The insula is associated with aversive feelings, and is triggered by things like nicotine withdrawal and pictures of people in pain. In general, we try to avoid anything that makes our insula excited. Apparently, this includes spending money.

By measuring the relative amount of activity in each brain region, the scientists could accurately predict the subjects’ shopping decisions. They knew which products people would buy before the people themselves did. If the insula’s negativity exceeded the positive feelings generated by the NAcc, then the subject almost always chose not to buy the item. However, if the NAcc was more active than the insula, the object proved irresistible. The sting of giving up cash couldn’t compete with the thrill of getting a George Foreman grill.

So far, nothing much new other than putting names to the parts of the brain – NAcc and insula – that constantly debate with one another over what we’re going to buy or do.  We think we make decisions rationally, but we really don’t.  We make them because our brain chemicals tell us what to do.  As I mentioned in a previous post, we can control this to a little better extent than Mr. Lehrer indicates that we can.

But this constant debate goes on in our brains, with our spendthrift hedonistic NAcc wanting to buy, buy, buy while our tightfisted, frugal, money-hoarding insula trying to hold the line.  That this debate occurs is not lost on retailers.  They want to do whatever they can to encourage the NAcc and discourage the insula.

…retail stores already manipulate this cortical setup. Just look at the interior of a Costco. It’s no accident that the most covetous items are put in the most prominent places. A row of high-definition televisions surrounds the entrance. The fancy jewelry, Rolex watches and other luxury items are conspicuously placed along the corridors with the heaviest foot traffic. And then there are the free samples of food, liberally distributed throughout the store.

The goal of these discount warehouses is to constantly prime the pleasure centers of the brain, to keep us lusting after things we don’t need. Even though we probably won’t buy the Rolex, just looking at the fancy watch makes us more likely to buy something else, since the coveted item activates the NAcc.

But it’s not enough to just excite our reward centers: Retailers must also inhibit the insula. This brain area is responsible for making sure we don’t spend excessively, and when it’s repeatedly assured by retail stores that low prices are “guaranteed,” it stops worrying so much about the price tag. In fact, researchers have found that even when a store puts a promotional sticker next to the price tag – something like “Bargain Buy!” or “Hot Deal!” – but doesn’t actually reduce the price, sales of the item will still dramatically increase.

These retail tactics lull our brain into buying more things, since the insula is pacified. (Paying with a credit card seems to have a similar effect. Because the actual payment is postponed until the end of the month, the insula doesn’t fully process the pain of spending money. Of course, this leads, over time, to rampant credit card debt.)

This inner-brain debate we all have going on and the retailers response to it is a kind of model of what happens to us when we’re cruising along on our low-carb diets.  Before we get into the specifics however, let’s look at how this model works with another form of pleasurable and addictive behavior.

Smoking involves these same parts of the brain, the NAcc and the insula.  Back in the 1930s, 40s and 50s a whole lot of people smoked.  In fact, it was all the rage.  As my mother never tires of telling me whenever I point out the negative health consequences of her own past smoking, back then you were regarded as an outcast if you didn’t smoke.  Although people may have wondered deep in their heart of hearts if it were really a good thing, their NAccs got plenty of encouragement everywhere.  All the movies made during the time were filled with actors smoking, characters on television series smoked (Mary Tyler Moore and Dick Van Dyke, for instance), talk-show hosts smoked (Johnny Carson always had a cigarette going), cigarette ads were everywhere.  And if you thought that maybe tobacco might not be good for you, there were even ads showing doctors who smoked and who recommended smoking.  Even cartoon characters smoked.  People smoked on planes, in restaurants, at work, at meetings – everywhere. You couldn’t get away from it.  It was the norm.  Your NAcc got a boost everywhere you looked and your insula was inhibited.

Compare then with now.  In most places you can’t smoke in restaurants, in California you can’t even smoke in bars, you can’t smoke in planes, you can’t smoke much of anywhere.  You don’t see a lot in movies, and when people do smoke, it really stands out, and looks pretty revolting.  If you do try to smoke publicly, you will be glowered at by someone.  You are bombarded with ads showing the negative effects of smoking.  Whenever you hear someone died of lung cancer, you always ask if he/she was a smoker.  And if so, you may have less sympathy.   Whereas in the 30s, 40s and 50s the entire system was set up to encourage and enable smokers, it is the opposite now.  As a consequence, way, way fewer people smoke.  Why?  Because even though the NAcc might still want to smoke, the insula has so much encouragement from the world around, that it easily overcomes whatever desire the NAcc might have.

The insula can be pretty strong, too.  Alcoholism is a severe type of addiction and dependency, but can be held at bay by Alcoholics Anonymous.  How?  By attending meetings and getting the insula all fired up to cease and desist when alcohol is around.  I have a friend who is an addictive personality type and who is a bad alcoholic with a bad, bad history of alcoholic self destruction.  He’s been sober now for over ten years, but right before attending ANY event where alcohol will be available (including dinner at our house), he finds an AA meeting to get his insula topped off.

When we think about low-carb dieting in these terms, it is clear that we low-carbers are operating in a high-carb world.  We are the low-carb equivalent of the non-smoker in the 1950s.  We are considered unusual.

Everywhere we look we are bombarded with carbohydrate temptations.  No place is safe.  Just like the cigarette ads that were ubiquitous in days gone by, so now are the carbohydrate ads.  You can’t pick up a magazine, turn on the TV or even look in a newspaper without your eye falling on an advertisement for carbohydrates.  Nutritionists recommend them; dietitians recommend them; doctors recommend them; even the government recommends them.

If you tell three people you’re on a low-carb diet, I can almost guarantee that at least one of them will tell you that you are going to croak your kidneys or dissolve your bones.  Probably another is going to tell you that although you may lose some weight, you will do so at the risk of clogging your arteries.  Your insula is gathering info.  Everything you hear like this beats down your insula just a little more, making it more prone to look the other way when your NAcc wants to take control.

Looking at this situation, it’s remarkable that anyone is able to stay on a low-carb diet for any length of time at all.  In the ongoing debate in our heads between the NAcc and the insula, the insula doesn’t stand a chance.  Society is aligned today to prod the NAcc with carbs just like it did with cigarettes a couple of generations ago, even though it was/is disastrous for health.  And as it was then, society today is aligned to discourage the insula.  Just like the retailers with merchandising, societal forces are pimping our NAccs and distracting our insulas.

When you’re doing well on the low-carb diet, your NAcc is happy, and if you hang in there and keep immersing yourself in low-carb info (this blog, other low-carb blogs, low-carb forums, low-carb books, etc.), your insula stays happy.  But let yourself get away from this insular world, and what happens?

You go out for a nice dinner and hear comes the bread basket, often filled with warm, aromatic bread.  All your dinner companions are scarfing it down.  Hey, what’s a little piece of bread going to do to you, for God’s sake?  (If you happen to find yourself in the unfortunate position of having not had a booming weight-loss week, you’re really in trouble.)  Then the dessert tray comes after dinner, and if you’ve had a little bit to drink, you may be a goner.  Alcohol is the gateway drug for carbs – as a general rule, the more you drink, the more carbs you eat.  Hey, you only live once.  Go for it.  You head home after consuming about three day’s worth of carbohydrates. You resolve to do better the next day, but you’ve derailed the smooth running of all the metabolic processes that your low-carb diet had set in motion, and the next day it will be a little harder to get back on track.

Your NAcc has been beguiled by the carbs while your insula has been overcome (overtly) by your dinner companions and (covertly) by the high-carb society in which we all live, where you’ll hear things such as:  Hey, it’s okay.  Everyone knows that carbs are good for you.  We’re supposed to consume at least 150 g per day for good health.  I saw a doctor on Oprah who said we don’t get ENOUGH carbs.

And you wonder why it’s tough to stay on a low-carb diet?  And you wonder why you have cravings?  It’s pretty obvious when you think about it in these terms.

What can we do?  Aside from the Glasser techniques that I wrote about before that serve mainly to get us away from the temptation, the best thing to do is pump up our own insulas.  Just like my friend who goes to AA before any exposure to alcohol to get his inhibitory insula ready to dominate his NAcc, you’ve got to prep yourself.  Go through all the reasons you’re on a low-carb diet.  Think about how good you’re feeling.  Think about all the good things you have going with your low-carb diet.  Get yourself psyched up just as if your were going out to play in the Super Bowl.  It sounds corny, but that’s what AA does, and it’s very effective.  I call this getting into diet mode or putting on your diet face.  We’ve all got to do this until the world changes.

Think how nice it will be when the world comes to its senses about diet and realizes the superiority of the low-carb diet for health and weight.  We will be bombarded with ads for different cuts of meat.  Instead of the smell of fresh baked bread in stores, we’ll get the aroma of sizzling bacon.  We’ll be presented with dozens of options for foods prepared with coconut oil and butter.  We will look at an overweight person eating a big carb meal with the same disgust we now feel toward someone who is coughing his/her lungs out while smoking.  At restaurants we will have to ask for starch, and it may cost extra.  Dessert trays will be filled with different varieties of berries and other low-carb fruits.  If there is a tart or something similar, we’ll be assured that it comes with a crushed-almond crust and no added sugar.  Should such a world ever exist, our NAccs will constantly be stimulated with the foods that are actually good for us and that are, unlike carbohydrates, satiating, and our insulas won’t really have to be inhibited, so we will be in constant NAcc drive to eat properly.  Won’t it be grand?

When that time comes (and it probably will – who would have thought in the 40s that a time would come when no one smoked), I’ll pity the poor folks trying to sell low-fat diet books.

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

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120 thoughts on “Low-carb battles in your brain

  1. This is exactly why I love my TiVo/DVR. I zap out all those nasty carb commercials that want to make me lust after grease soaked starch foam and chips. I like the grease, but the starch, not so much.

  2. Brilliant post. It explains so much more than just carbs and cigarette smoke! It reminds me of the old Bible verse – “whatsoever things are good and pure (etc.) think on these things.” Our behavior is shaped by the ideas and images we are flooded with; I think most people won’t admit it even if they accept it could happen.

  3. Regarding your third to last paragraph, I quit smoking not by thinking about how bad smoking was for me but rather how little I was actually getting out of smoking. I had this belief system that told me I was getting something out of smoking like a deep sense of fulfillment puffing after a good meal or the joy of the first one in the morning. Once I was able to right my mind and unwind the untruths surrounding what I thought I was getting out of smoking, I just quite. No pain, no fuss, I just quit. Just thinking on the positives of being a non-smoker wasn’t enough to make me quit anymore than thinking on the negatives of smoking. I had to wholistically come to know that the positives of smoking were in fact lies.

    I need to apply that to bread. That warm bread you described being passed around the table, it really isn’t as satisfying as what I am believing in my head. What we think we are getting out of carbs just really doesn’t exists and the true means of moving beyond carbs is fully realizing that fact.

  4. I am in a Community Chorus and tonight I stayed on the other side of the room during the break where the cookies were served. I was surrounded by a bunch of people telling me how great I look and asking me to send them my low carb recipes. Last week, one of the members decided to bring in a healthy treat – oranges and juices – and I just stayed on the other side of the room again – away from all that sugar. And yesterday when I went to my family doctor she said she would love to recommend the Atkins diet but she was worried about all that fat! I gave her a writeup by a doctor telling about a pilot who normalized his lipids, sugar and blood pressure just by lowering his carbs to 30g a day and losing 30 lbs doing it.

    Fabulous post, doc!

    I’m glad that writeup by that doctor came in handy.

  5. I had to go outside and have a smoke after reading that. Why was it so easy to quit carbs, yet I can’t quit smoking to save my own life? I’ve heard it said many times that sugar is more addictive than heroin, but I have no desire for heroin or sugar. Show me a smoke and my brain lights up, so I suppose that for me, cigarettes are more addictive than either heroin or sugar.

    • Karen, I quit smoking and drinking after reading a book by Allen Carr called The Only Way to Stop Smoking Permanently. It absolutely worked. You brain wash yourself. Please do try it. You can quit smoking if I did!

  6. The constant pro-carb propaganda is by far the hardest part of the diet for me. No, I am not going to let the naysayers derail me. But it’s extremely annoying to have to deal with the rolling eyes, the speeches about the evils of meat, the dire health warnings, the painfully ignorant misconceptions about what we eat, etc. I hope you’re right, and things do change. Jane Brody had an article in the NYT yesterday about the link between sugar and obesity — not a peep about fat. And there was a pro-low carb article in Oprah’s magazine last month. Hmmmm…. maybe all is not lost.

  7. This is exactly the shot in the arm I needed today… Thanks so much for posting this, and giving us another tool to use in the fight against overloading on the carbs.

    I am currently trying to talk my mom into this WOE, but so far, she is still stuck on the calorie bandwagon… But I will persevere. I will admit it makes it harder for me, hearing her mild arguments about low-carb.

    For years I have observed that whenever I am sucessfull at low-carbing, I must bury myself in literature, or have friends that are also lc-ing for support. Never knew there would be research to back it up.

  8. Jane Brody had an article in the NYT yesterday about the link between sugar and obesity — not a peep about fat.

    You know what’s got Brody running scared? The internet, and more specifically, comments. She (and ‘gurus’ like Ornish) can’t post their idiotic garbage without getting called out by hundreds of people posting links to Taubes and PubMed studies proving them wrong.

    For a while I was scared that Taubes had done all that work for nothing, but his book is like the Colorado river…it took a while, but it carved the Grand Canyon.

  9. I’ve also heard some low-carb advocates can be tempted into carb-temptation if they are forced to flee their homes in the face of an approaching wildfire, then have to hurry down the coast to attend a film premiere party and burst through the door just moments before the film begins, only to find that the party is being held at an Italian restaurant because it was the only available facility in the filmmaker’s town with a party room big enough to accommodate the guests and a movie screen. And least that’s what I’ve heard.

    Tony Robbins explains in one of his books that humans are hard-wired to seek pleasure and avoid pain. Conflict occurs when we associate both pleasure and pain with an activity. The difficulty in trying to avoid a bad habit is that the pleasure is immediate and the pain is usually in the future. Hot, buttered sourdough bread washed down with a pint of Bass Ale tastes good NOW. The weight gain, the bad lipid profile, the possible type II diabetes, well, heck, that’s LATER.

    His suggestion is similar to yours: make the pain real, right now. Picture the flabby belly. Think about what it would be like to become a diabetic. (Or in my case, imagine the sluggishness and wheezing that follows if I load up on wheat.) Then create pleasurable images for doing what you know you should do. Imagine feeling energetic and healthy, wearing the clothes you want to fit into, stepping onto the beach and being proud of your body, etc. In other words, link pain to indulging in the bad habit and link pleasure to avoiding it.

    When I was in grade school, there were posters all around the school that showed photographs of smokers’ lungs. Boy, did that make it real. There were also pictures of street bums smoking cigarette butts to offset the glamorous image of smoking. (Oops, that wasn’t very P.C. I meant to refer to them as homeless people. They probably couldn’t put up those pictures today … not properly sympathetic.)

    I heard about those people who fled the fire and ended up at a film premiere party – for a low-carb film, no less – at an Italian restaurant. But, in the face of those carbs, the low-carb advocates did okay. Sort of. :-)

  10. Funny, when I have a drink or two at a restaurant I start advocating the good book: PPLP.

    My wife rolls her eyes and gets this look on her face that says “oh crap, here he goes again with one of his ‘carbohydrates are the root of all evil’ sermons. :-)

  11. As a poster above stated I find reminding myself that I don’t enjoy the carbs as much as my false memories lead me to believe I will and remembering that I really didn’t enjoy it last helps. Another way to pump up your own insula is to know the true cost. Art De Vany recently blog about how a hit of sugar effected gene expression for two weeks – two weeks!!! I’d be interested in reading anything you care to type on this subject.

    I’m the same way. Whenever I break and indulge, it’s never as good as I imagine it’s going to be. Then I have to deal with the aftereffects. It’s really not worth it. You’d think I would have figured this out, but from time to time I still go face down in it.

    • I have been unable to concentrate for a week and having a hard time with my diet. All I have been thinking about is having a break and eating some goodies on my b-day. I had carbs today. I was tired of fighting it and decided to get it out of my system. The after affects always seem to re-enforce that it is not worth it.
      My biggest motivator to stay on the diet is the 3 days it takes me to get into keytosis. I feel like I’m starving the whole time. Why does it take so long? Is it just me? Is there anything I can do?

  12. Dr. Eades, your prescription is well intentioned but it won’t help people much. The brain doesn’t work how you suspect (you’ve got enough knowledge to be dangerous though).

    The two key concepts here are (1) that your brain is not monolithic; it’s a collection of independent systems, some of which have evolved over hundreds of millions of years, and some of which are pretty much the same parts as alligators and chickens have; and (2) that the part of your brain making the cost/benefit decision about eating the carb is different from, older than, and less conceptual than the part of the brain that understands what it means to be on a low-carb diet. Basic eating decisions are as old as life; they evolved hundreds of millions of years ago, long before the abstract reasoning of the prefrontal cortex.

    What this means is that if you’re going to effectively change your behavior you need to speak directly to that part of the brain making the decision; you have to talk in language it understands about a subject it can grasp (in this case, the carb right in front of you at that moment – not a conceptual “diet”). Only concrete, present tense concepts will reach the brain regions we have in common with dogs and chickens.

    You’re going to have to change the cost/benefit value of the bread itself. That’s what Scott Pierce did when he convinced himself that the actual benefit of the cigarette was near zero. For something that’s actually worth zero you won’t even be tempted to cross the room. You can try that for carbs; it might work.

    The alternative is to increase the “at this very moment” cost of carbs. Telling yourself that this cookie will give you diabetes -in-the-future- doesn’t work, because your insula doesn’t understand what this future is your speak of (future and past are too high falutin’ concepts for that part of your brain). But try visualizing a diabetic ulcer right on the cookie. See it in your mind’s eye. Visualize the inflammation and arterial lesions hiding inside the cookie. The “benefit” evaporates and the costs go way, way up. You won’t be tempted.

    Seriously, a little visualization practice can make sweets as appealing as putrid meat. You may occasionally get nauseous if someone pulls you into a Dunkin’ Donuts, but staying on the low-carb diet is -easy.-

  13. Now I know why I’ve been reading all the research, immersing myself in all of data on the health benefits of low carb, and writing my website.. it’s all to keep my NAcc activated and oriented toward a healthy and low carb way of eating! Neat! Thanks, Dr. Eades, it’s helpful to know WHY I do the things I do. I kinda knew it already, but now I can explain it to someone else. :)

    BTW, thanks to your post, I’m half way through Glasser’s book and I agree with you, it is very helpful. Thanks for the tip..

  14. Back in the ’50s and ’60s, my grandparents were on the fringe as they followed Adele Davis and popped supplements (nothing too exotic–Theragran vitamins, iodine ration, and vitamin C). My sister and I lived with them when we were young, and I can assure you, we were the only children in the school who took vitamins and ate sardine sandwiches and sunflower seeds for lunch. Yet, my grandparents succumbed to the anti-saturated fat propaganda to their detriment; my grandmother became a devotee of that “heart healthy” Mazola corn oil, along with Chiffon margarine. They were terrified of saturated fat. My grandfather’s best friend died of a heart attack, and of course the saturated fat he ate was to blame. Never mind that lots of sugar went along with it, or that he was a heavy smoker of cigars. He also had a stressful job and a perfectionist wife. In retrospect, I now see that for my grandfather, suffering with eczema, allergies, a lung condition, and finally Parkinson’s, the refined industrial oils were certainly not healthful in the least, and probably caused much of his misery.

  15. A brilliant analysis, as always. But my situation is different. I kicked grains and sugar and dairy a decade ago and don’t crave them. I’ve never had anything alcoholic (because I knew even as a very young person that I had an addictive personality). But, I don’t like meat. No matter how beautifully I prepare wonderful cuts, as soon as I take a bite, I realize that I’d enjoy beans so much more than a sirloin steak. I fry and roast and crockpot and grill and broil and nothing appeals to me. For several years, since I read Protein Power, I’ve really made an effort to like meat, but nothing works.

    I believe in low-carb eating, but I’m driving myself crazy trying to follow a low-carb regimen. In order to save what’s left of my sanity, I’m going to eat the foods that I love and keep the carbs under 100 grams a day. I know that isn’t low carb but I simply cannot look at another piece of beef or pork again. This may have been caused by my eating zero-carb for months periodically over the years.

    I’ll continue to visit your blog daily because I so admire your ability to explain data but if there’s a confessional booth for low-carbers who fall off the wagon, please direct me to it.


    What can I say? If you can’t stand meat, you can’t stand meat. You may want to try tofu and other bean products that provide pretty good protein while keeping the carbs low. You ought to ranger up and eat a little meat here and there, though, just to get the nutrients contained therein. You can confess to this blog anytime.

  16. Yeah, I like modular theories of mind as well, they account well for many of our little quirks. (And some big ones!)

    “While economists have long assumed that consumers are rational agents and purchase goods based on calculations of utility.”

    This irks me though – economists *model* consumers as rational actors purchasing according to a utility function. That doesn´t mean they actually believe that every transaction has extensive reasoning behind it. The author should be able to grasp that important distinction.

  17. Just a quick note, apropos the history of the elephant hook. Again the Buddhist theory on the way the mind works was remarkably prescient. Without going into detail they (or rather Acharya Dignaga originally) said that the mind was a series of systems, 51 in all (in one system — there are several variations), some of which were independant and some of which worked in groupings. Some were called (in English) primary and some secondary (or “factors”). Some could work simultaneously, while others would be on while the opposite system mind would be off. There’s a guy in Califormia called Alan Wallace who studied both the Buddhist description (in Tibetan) and the Western description, where he is a major player and has given one of those Google lectures.
    Again, so much is not new and the ancients, by which I mean the Indians and the Greeks, really had their act together.

    Meanwhile, the 2nd CD in Eliot Gardiner’s Brahms series has arrived today.
    Contains the Alto Rapsody:
    And Schubert’s Gesang der Geister über den Wassern:
    and the good ole 2nd Symphony:

    Isn’t the internet amazing?
    Michael Richards

    Thanks for my morning wake up music. The internet is phenomenal.

  18. I rarely go “face down” in carbs. With me, it’s more insidious in a way. Take yesterday (Tuesday). I started the day with several cups of black coffee. Breakfast was 2 eggs fried with butter and 4 small sausage patties around 10:30.

    Lunch was leftover beef stew. I know that sounds very carby, but it wasn’t. It made 5 servings, and I used one medium potato and a few carrots, so the amount in my serving was two or three small chunks of potato and a couple chunks of carrot. The stew was thickened with a couple tablespoons of Wondra (so one serving had maybe a teaspoon). Granted, it wasn’t the lowest-carb meal I’ve ever made, but all in all, not bad.

    I wasn’t hungry for dinner, so I had a little less than 2 ounces of Havarti cheese. I wanted some crunch, though, so I had 10 saltine crackers (total of 22 carbs, according to the package). So, for the full day, it’s still probably less than 50 carbs.

    The day before (Monday), I had the same thing for breakfast, lunch was 3 slices of deli ham wrapped around a total of less than 2 ounces of Havarti, and dinner was a ribeye with butter.

    So, probably 6 out of 7 days a week I eat the “Monday” menu, and 1 or at the most 2 days of the week I eat the “Tuesday” menu.

    To me, this sounds reasonable and pretty darn low carb. However, I think I’m probably sabotaging myself on those “Tuesday” days with the higher carbs, despite the fact that 50 carbs a day is not that much.

    I’m still doing well with staying away from the Jameson’s. If I do have some, it’s one small glass that holds only 1.5 ounces (I measured).

    See? This is what I mean. It sure sounds like I’m doing pretty well with LC eating, but maybe it’s still too much. (Obviously, huh, since I’m not dropping the pounds like I should be.)

    PS: Your recent posts have been very inspiring. I always love your posts that deal with studies and facts, but these recent posts have really gotten me thinking. THIS is exactly what a lot of people need. We all “get” why LC eating is best, but it’s so hard to internalize it so that it becomes a no-brainer for us living in a HC world.

  19. Thank you, thank you. I believe 100% in the low-carb way of life, but I’m still stuck with 30 lbs. to lose because of this very reason. I tell people all the time that it’s hard to stick to because we’re surrounded by carbs and everyone telling us they’re okay. Since I’m perfectly healthy with no risk factors or numbers out of whack, my insula is pretty weak. It’s nice to know that there really is something going on in my brain that makes it so difficult. Maybe I need to fire up my low-carb blog that I neglect when I’m not being “good”.

    That, and I’m going to start paying cash for everything!!!

  20. Dr. Eades,
    FANTASTIC post!

    A long time ago I read the following and firmly implanted it in my head;
    “Your ability to work miracles (stop smoking, drinking, sticking to your resolutions, sticking to low carb, be happy etc etc) is predicated entirely on how easily and quickly you can give the collective unconscious the slip. It is your attachment to the unconscious, or world belief patterns that holds you back.” SW

    I really feel grateful for your blog!


    I agree. giving the collective unconscious the slip is the first step toward any kind of success. The CU is both a crutch and a barrier.

  21. Hi, couldn’t find where to send this link to you (not relevant to this post) but thought it might interest you, i have read in the past that you are not concerned with sodium nitrate http://www.reuters.com/article/healthNews/idUSTRE50R78120090128

    I’m still not concerned. The study quoted is an observational study, and, as such, is worthless in determining causality. Take a look at just the first paragraph of the article:

    Children who regularly eat cured meats like bacon and hot dogs may have a heightened risk of leukemia, while vegetables and soy products may help protect against cancer, a new study suggests.

    Look at all the weasel words. Children who eat cured meats MAY…while veg and soy MAY protect…a new study SUGGESTS.

    The new study is meaningless.

  22. i have been on the low carb band wagon for some time now in an effort to improve my lipid profile which on the surface did not appear to be to bad: cholesterol 141, HDL,43, LDL,90, and TRG 41. My doc did an NMR and LDL was much higher and almost all small particles. So, after reading this blog i changed the diet: out with sugar(except through some fruit, 85% dark chocolate on occassion, and red wine),all grains, and in with meat,fish, eggs,cheese,non sugar Whey protein powderand plain greek yogurt. Fish oil was added to the mix with some Vitamin D. Snacks: pupkin and sunflower seeds, but on infrequent basis. Results not in from NMR, but indirect measurements show: Total Chol of 172,HDL of 63, Trig of 51, and LDL of 103. Quite a jump in HDL which is good! Am hoping that NMR results will show improvement as well. As one who does not like to count carbs i am guessing that the elimination of grains and sugar and just eating the above is enought to do the trick.
    I believe that part of the problem is people feel they have to monitor what they eat in terms of low carb to get the benefits which is not what most want to do. If it could be as simple as eliminate grains,starch and sugar of all kinds, except some fruit or wine many more might stay with it.
    Excellent post, i would like to add.

  23. An oversimplification of why we get off the bus.

    We believe that carbohydrate is food yet we reduce the intake of carbohydrate to return to good health. The two concepts are contradictory. Food cannot be both bad for us and good for us. Rather, our definition of food includes “if we eat too much of it, we get sick, fat, weak, etc”. We suffer from cognitive dissonance.

    Invariably, those who eat carbohydrate, even low carb, argue that there are good carbs and bad carbs and that they only eat the good carbs. As if, the good carbs will not make blood glucose rise, will not make insulin rise, will not cause fat to accumulate, will not cause all the other symptoms we get when we eat the bad carbs.

    Obviously, if we believe carbohydrate is food, we have to contend with calories and moderation. Two more contradictory concepts. They are contradictory because it causes us to eat less (The Positive Caloric Balance hypothesis) yet it’s obvious that this doesn’t work. Our belief must be strong indeed to allow us to continue in the face of constant failure.

    No, if carbohydrate was food, it would act like it. It would not cause us to eat more of it. On the contrary, it would cause us to stop eating once we’ve had our fill. That’s right. Good carbs, like bad carbs, cause us to eat more of it. Yet another contradiction.

    Take out the belief that carbohydrate is food, and the whole system falls apart. “Low carb” stops making sense. “Zero carb” starts making the most sense. Cognitive dissonance stops. We’re on the bus for good.

    Or, we can just go on a lengthy explanation about the brain and how it works. Well, I got an answer to that too.

    A priori, the brain can’t function properly when it’s malnourished.

    So I guess it’s just a matter of nourishing that brain properly. I bet there’s no carbohydrate involved here.

  24. always enjoy your commentary dr. eades.

    regarding smoking:

    i learned after years of smoking that too many people make the same mistake: they go from smoking a generally stable daily number of cigarettes to frantic attempts to quit all at once and begin a binge and purge cycle that gets them back to their baseline smoking habits.

    for some people going cold turkey may be the only way, but for most that try i have observed nothing but emotional exhaustion, and the eventual feelings of guilt and inadequacy or “lack of will power” that follow when they return to their habits.

    i found that gradually cutting back, evey so slowly before eventually learning to go a full day w/o a smoke smoothed the transition. eventually over time, say months or even a full year a 10 cigarette a day smoker can go down to 2 or 3 per day. they might still be a smoker, but if someone told you they reduced their deadly habit by %80, who wouldnt be optimistic about future prospects to kick it entirely?

    for some reason w/ smoking people take an all or nothing approach without allowing for the shades of grey in between.

    i learned early on when i quit that i didnt need a whole cigarette, that most fo the cessation came from the initial feeling of lighting up and the first half dozen puffs. i started to but out the second i felt most fo the cesssation gone, about 1/2 through the stick. it wasnt easy but it was managable to fight the desire to smoke the rest of that butt as opposed to going cold turkey.

    after months and months my body adjusted to about half the usual nicotene, and eventually i could smoke less frequently.

    if i ever got stressed or had a moment of weakness, and wanted a cigarette, id smoke one. but only half or even less. i didnt need to shame myself for it or view it as a lack of will power.
    over a few years smoking slowly phased out of my life, and became the domain of a few puffs after a few drinks at the bar once a week. i can live with that as it became more of a guilty little pleasure like smoking a cigar than a dirty habit.

    if people could do the same w/ carbs i think they’d have more success. too much dietary nonsense is predicated on a shame-based approach all too common in our society. its the idea that we are fat because of our own faults and weaknesses, that our diets dont work because we lack will power, that we are lazy or that we just really dont want to loose weight or kick that dirty habit. if youre 300 pounds and consume 400 grams of carbs a day, why not just go slow motion and cut it to 200 grams a day. a few less bites of cake, slices of bread or bites of hash browns. thats more manageable than getting up one morning and saying “ill never eat carbs again, and if i do, ill feel like crap about it and begin a shame-cycle, which inevitably leads to binge eating”….

    im down to about 25 g of carbs a day, and its very manageable, i keep it low to allow for the odd cheating. when that dessert tray comes around if i really really want a dessert, i ask my dinner companion if they want to split a piece of cake. i get the cessation from a few bites but not the guilt. i satisfy the craving in a reasonable way. surgar/sweets are the enemy as much as they are a luxury like caviar. not something you eat all the time and always in small quantities. if i eat more i know it opens the flood gates where i cant stop, so i keep it manageable. if i deny them too much, they will haunt me and ill binge. i suspect many people are in a similar boat.

    thx again for the ongoing work on this site, its a low-carbers best support!!

    Thanks for your input on this. Over the years I’ve had experience with many thousands of patients on low-carb diets, and I’ve tried all kinds of different strategies. I’ve tried – with patients – the idea of gradually removing carbs, and it doesn’t seem to work as well for most as simply going full-speed onto a low-carb diet. You are the exception, but there are probably other exceptions out there as well. The important point is to develop a strategy and stick with it (as you have done for yourself) to get where you want to be.

  25. I reached a point about 4 years ago where it became clear that the only way I could handle making decisions about whether or not to eat sugar is to decide once and for all that I was done. No more sugar, real or fake, ever: no birthday cake, Christmas cookies, Valentine candies, not even tiny tastes. The only exception I make is an occasional piece of sugar-free gum. Making that one decision means that now I don’t have to make several decisions every day, and that makes my life so much easier. It was hard sometimes at first, but now the sight and smell of sugary things doesn’t even appeal in the slightest–in fact, they’re a little repulsive. I can sit at a table and watch other people eating things I used to love, and just smile and be glad I no longer consume that poison.

    It doesn’t seem realistic to me to apply the same zero-tolerance policy to grains and potatoes, so although I try to eat very little, sometimes I make the wrong decision and eat too many fries, or that piece of warm bread dipped in olive oil. Luckily (I guess), I’m finding recently that consequences for these indiscretions are appearing quickly enough that my brain seems to get the connection. I’ve wondered sometimes, though–how many times do I have to prove to myself that I’ll have heartburn an hour after eating even just a few chips? Does repetition have any effect in the brain chemical dance?

    I suspect repetition does have an effect, and it probably varies with the individual. Some of us have to have more reps than others to learn the same lesson.

  26. i have lost 70 plus lbs. eating low carb. i talk myself into believing i can count calories. i try it and i end up gaining weight and obsessing over the amount of food im eating and craving more and more. i dont know why i keep putting myself through this!! its low carb for me from now on! i gave 140 lbs. more to go. thank you for these web sites!!

  27. BTW, for those of you interesed in the Glasser book ( and who just like books generally), you might want to search for the hard cover version “Take Effective Control of Your Life”. I was able to find an on-line seller that had NEW (1st Edition it turned out) ones for the same price the paperback is selling for. And if you read the Glasser book, and synthesize it’s ideas with those of the Haidt book, you get a pretty good combo that will greatly help you. IMO.

  28. Great write-up, Doc! For me, it’s a struggle because I never feel as well on a low carb diet as you apparently do. I don’t seem to ever get over the “induction flu”. I function best with carbs in the 100 – 125 range. the problem is that it is a slippery slope from that point to 200-300 carbs a day.

    I have some really quick off topic questions for you about the Protein Power Life Plan book. Do you still recommend the gut recovery program as written in the book? I was wondering if augmenting the protein shakes with just meat would work as well? Would the fat from the meat be a problem? Doing nothing but shakes seems to be really hard on my stomach.


    I do still recommend the gut-recovery program. Meat as a substitute for the shakes is perfect.

  29. This article is so helpful to me. Thanks very much. I, like everyone, have been off and on, and am on again and finally seeing some success. This gives me encouragement.

  30. I’ve been a die-hard low-carber ever since reading Protein Power a decade ago. The rationale, the science, and the proof is branded on my brain. I never doubt that it’s right for me. When I slack off a little, the bad results are obvious. I know the science inside out, backwards and forwards.

    Yet still, after 10 years, I still need a daily dose or two of your blog and other low-carb confirmations — simply because the environment is SO full of ‘whole grains’ ‘red meat kills’ ‘sat fat is bad’, ‘low-fat this’, and ‘vegans live longer’. ‘Let’s make this meal healthy, leave out the fat.’ The bullcrap ‘science’ on the Today Show.

    The din is relentless. I know it is dead-ass wrong, but I still need a puff or two of low-carb sense every day or so — just for grounding.

  31. Very interesting, but I think another factor is our tendency to forget the past. I feel good now, and I don’t remember how bad I felt before I started low-carbing, so it doesn’t enter into my weighing the pros and cons of going off-plan for some carby thing. Luckily I don’t feel inclined to go off very often!

  32. At the risk of starting a controversy greater than that provoked by a discussion of human-generated global change, I wanted to offer some thoughts on two topics.

    Regarding potatoes in Ireland and the diet of the Irish: This issue is enmeshed with MANY other issues that I probably shouldn’t attempt to relate … At Wikipedia (http://en.wikipedia.org/wiki/Great_Irish_Famine) I found the following information:

    “The potato was introduced to Ireland as a garden crop of the gentry. By the late seventeenth century it had become widespread as a supplementary rather than a principal food, the main diet still revolved around butter, milk and grain products. In the first two decades of the eighteenth century, it became a base food of the poor, especially in winter.[22] The expansion of the economy between 1760 and 1815 saw the potato make inroads in the diet of the people and becoming a staple food all the year round for the cottier and small farm class.[23]

    “The potato’s spread was essential to the development of the cottier system, delivering an extremely cheap workforce, but at the cost of lower living standards. For the labourer it was essentially a potato wage that shaped the expanding agrarian economy.[23] The expansion of tillage led to an inevitable expansion of the potato acreage, and an expansion of the cottier class. By 1841, there were over half a million cottiers, with one and three-quarter of a million dependents. The principal beneficiary of this system was the English consumer.[23]

    “The Celtic grazing lands of… Ireland had been used to pasture cows for centuries. The British colonized… the Irish, transforming much of their countryside into an extended grazing land to raise cattle for a hungry consumer market at home… The British taste for beef had a devastating impact on the impoverished and disenfranchised people of… Ireland… Pushed off the best pasture land and forced to farm smaller plots of marginal land, the Irish turned to the potato, a crop that could be grown abundantly in less favorable soil. Eventually, cows took over much of Ireland, leaving the native population virtually dependent on the potato for survival.[24]”

    22^ Cathal Póirtéir, The Great Irish Famine, Mercier Press (1995), ISBN 1 85635 111 4, pp. 19–20
    23^ a b c Cathal Póirtéir, The Great Irish Famine, Mercier Press (1995), ISBN 1 85635 111 4, p. 20
    24^ Jeremy Rifkin, Beyond Beef (pp. 56–57)

    I recall reading that prior to the appearence of the potato blight, it was common for the previous years potato crop to run out before the subsequent harvest. These people were on the edge of famine BEFORE the blight arrived. If the blight didn’t actually kill the plants outright, it infected the tubers. So if there were potatoes to havest, they would have shorter “shelf-lives”. One other item: While there were so many Irish starving death, food (beef, oats, etc.) was being exported to England.

    Regarding the carbon sink of grazing lands:
    I remember the ‘factoid” (Without being able to provide the reference) that the biomass of roots is directly proportional to the biomass above ground. As I recall, in a perennial ryegrass / white clover pasture, (a temperate, perennial plants) this ratio is 1:1. Given the yields of dry matter from such pastures, this amounts to a very large “sink”, comparable to forest lands on an annual basis.

    Remember that when the great plains were “settled” by Europeans, the existing prairie sod was so thick that a new form of plow had to be invented. Observers recalled that these new plows cutting through the sound sounded like cloth ripping. In fact, blocks of this sod were cut and used to build homes.


  33. Hi Doc — I rarely have problems sticking to my diet of real foods. Much more satisfying than any desserts.

    A little off topic, and I know you can’t give medical advice, but I’m wondering. My grandfather has had diabetes for about 20 years, and his health is starting to fail (kidneys). I sent him Protein Power for Christmas hoping it would encourage him to go low carb. And my pre-diabetic uncle recently lost lots of weight doing low carb so I’m hoping that’s inspiration. I guess what I want to know is whether you think at this late stage he could be aided by a low carb diet. I think he’ll probably have to have dialysis within a year. Is low carb effective in turning around diabetes at such a late stage? (He has also had two cancers and is quite overweight now. I think it’s partly the carbs. His diet is way too heavy in carbs. Not sugar, but way too much starch.)

    Yes, I do think his health could be aided. Much of the damage to the kidneys thought to be caused by protein is actually caused by glucose. Getting that under control will help. But he needs to be a little careful with the protein since he already has damaged kidneys. He still needs to get an adequate amount, but not overdo it. And his renal function needs to be watched closely.

  34. From 1960 to 1962, one of my part time college jobs, was passing out 4 cigarette, packs to students at dances, football, and basketball games, etc. I gave out boxes full at most functions. We could smoke in the class room during class. Most of my Professors smoked during class. My, how times have changed. Maybe the LC diet will have its day.

  35. I duuno, I think low carb stimulates my NAcc pretty powerfully. I can eat as much as I want (almost). For a guy with a big appetite, that is a huge plus. I love meat, the fattier the better. I think it helps to really hate being fat, and to have tried various forms of low fat diets of the years, and eventually of course failing. I think it also helps to be a bit of a contrarian, who doesn’t mind disagreeing with almost everyone I know on what’s healthy to eat. I kinda get off on that, ha.

    There’s not really much pressure the other direction, since I simply dont believe anyone who tries to tell me my diet is unhealthy. My friends all know not to even bring the subject up, lest they have to endure another endless lecture, heh heh. I even recenty switched doctors and once again had to go throught the you-need-statins-your-LDL-is-sky-high-no-I-don’t-look-at-my-triglycerides-and-HDL-you-fool-and-why-haven’t-you-read-GCBC-yet? routine. I simply told the doc to drop it, I wasnt ever going to consider statins or a low fat diet. Cased closed.

    Probably the most efficient way of handling it.

  36. Tom, your first paragraph (so funny) is the point I was going to make. I absolutely agree that we are hard-wired to seek pleasure and avoid pain and also, I think stress can turn that hedonic craving on to the max, which makes me wonder… Dr. Mike, is there any mention in Lehrer’s book of the influence of stress concerning these differences in brain function? Does cortisol influence cravings or affect the ability of the brain to react rationally? I know a couple of people with addictions and their inability to handle stress is a major factor. It seems that if you live with some level of stress on a constant basis you probably have more difficulty resisting that pleasure switch. BTW, can you keep a secret… I have noticed that when my husband is out of town for a few days (he is an intense guy) I eat a lot less and have no trouble sticking to the plan… always wondered why.

    You suggest a lot of our desire and downfall is due to marketing and I agree, however we weren’t brought into this world with a cigarette in our mouth; we were born with the sweet taste of mother’s milk. We are probably programmed for sweetness which indicates a physiological connection between cravings, carbohydrates, and therefore increases in seratonin and endorphins causing more craving, hence the cycle allowing a baby to thrive. Granted this was natures way to feed a baby’s brain and body but to have this inherent hardwiring for sweet become our peril as we age, well… it sucks (sorry for the pun).

    I do find it most effective not to give in to it carbohydrate cravings just as with the alcoholic and his drink. You describe the low carb experience to a “t” with every one of its benefits. The occasional craving just never fails to rear its ugly head. What kills me is that when I give in it is more a case of I’m feeling great, I can handle this, not a reaction to an intense craving. It’s almost like it is a little subconscious one. I think realizing the wiring is deep within helps us understand why the craving never totally goes away. I think it is interesting learning “How We Decide” but I think you do a great job teaching us “how to control what we decide.” That’s what benefits us most.

    I haven’t gotten to it in the book yet, but I know cortisol and other stress hormones make a large difference.

  37. Wanted to just say how much your books and blog have helped me to get started and also convince me that I am doing the correct thing as far as my diet.

    Had blood work in Nov. 08 and had very high blood sugar (348) and vey high tri’s (1868). Immediately started to search for a healthier way to live with my new found health issues. It wasn’t long that I would not accept that all I could do was med up and wait to die.

    I bought a few of your books and started reading past and present blogs and it all made sense in a hurry. Your work is important to alot of us. I can only feel that my temporary dip in health was a wake up call and made me pay attention to my health instead of taking it for granted. I have always been a person who has struggled with weight, up to 300 pounds at one point, but most recently about 240(nov. blood test). I have followed your advice since two days after I got the news from my doctor, I am considered a diabetic because of that blood test. I am now at about 195 and am not taking any meds and feel great. My morning blood sugar range is now between 65 and 80 every morning for about a month now.

    It has been easier with constant reinforcement and can’t help but think this may have saved my life.

    Will be heading to your neck of the woods in a couple of weeks to visit friends in SB. Any thing I shouldn’t miss? Maybe I will see you on a trip to the post office or something and I could actually shake your hand and thank you for the influence your words have given me. Keep up the fight!

    Not really any single thing in SB that is a do not miss – it’s the entire area (weather, views, ocean, etc.) that is the draw. In a couple of weeks I may be in Seattle, but don’t know yet.

  38. Pete, I don’t find anything you said controversial, actually. I’m sure that the diet of the Irish had at least some dairy or meat — you correctly note that most of it was exported, though — either to Britain or Europe. Even during the famine. I know several Irish people (actual Irish, not American Irish) and even today their diet is very high in starchy tubers and roots, including carrots. I also know a vegan that eats a diet mostly of potatoes and is on an altered form of the McDougall diet and seems to do OK. (I don’t know if he supplements but his diet is extremely restricted to starchy fruits and vegetables and has been for decades.) Don’t get me wrong, I am no advocate of the McDougall diet. I think without supplementation with essential fats and vitamins, and absent certain health issues, it’s probably pretty dangerous long term because it calls for grains.

    This may be a controversial statement to make on a low carb blog, but I suspect that potatoes in a large proportion of the diet may actually be all right for someone who does not have prior obesity or other insulin issues — due chiefly to the lack of toxins like lectins that would promote leptin problems, and the fact that potatoes are pretty high in protein and that the protein is complete. My mind is open on this to either view… but we don’t know enough about it, I don’t think. If I am doing the calculations correctly and you eat 2500 calories of potatoes, which is 5.9 pounds of potatoes (2.2 lbs. per kilo), you will get 63 grams of protein (nutritiondata.com). That’s not adequate protein for an active male but still pretty decent. I could actually see if they were active, as Doc Eades suggests in the previous thread, that the intake could go even higher than 6 lbs. for adults. Of course, due to their high starch content I think potatoes are probably still a disaster for many people in the context of a modern western diet where most of the carbs are coming from breads and sugars. In the case of a diabetic, I would guess that even eating a lot of nuts high in carbohydrate would not be good so at that point any carb would be bad. On their own, though, without grains and sugars I’m skeptical that potatoes are very harmful for a healthy person. Several healthy cultures (Kuna, Kitavans, Tokelauans, the original Maori eating lots of kumara) have a diet high in starchy tubers (but also moderately high in animal protein and fat, though, which might be confounding.) But what no healthy culture eats are lots of improperly prepared grains or legumes — the exact things the Gladiators were eating in high amounts. It would be very interesting to know how those grains and legumes were prepared in Roman times. it would also be good to have better data on the fat content in the diet of the Irish prior to 1840s.

    I think it’s the rare person in the west that gets most of their carbohydrate from potatoes. Or white rice. And therefore, some more data on the Irish might be a good basis for controlled studies that limit the carbohydrate source to either 1) potatoes, 2) rice, 3) wheat and 4) a control group. The results could be very interesting, I think…

  39. I started low carbs several years ago – short male – went from top/shorts XL to M tops, and L to S shorts, and have stayed there. Probably still 15-20 lbs overweight. I do heavy weight lifting and sprints. During that time I developed T-2 diabetes, blood pressure and lipids have not changed (dropped statins and they went up), GERD is somewhat better. Because of the diabetes I have gone to very low carbs for the most part. LC/higher protein and fat diet is not a cure all.

    I am uncertain as to what changes I could make that would improve things – obviously the only change I would make is to vary fat-protein ratio. Would dropping fat improve lipids? Would increasing protein (and hence insulin) increase weight? Or the opposite. Meds control BPs, GERD does not always need meds, BP is OK with moderate meds. My health normally is excellent at almost 70.

    I would guess that dropping fat would decrease LDL, but since LDL has never really been shown to cause heart disease, what’s the point? In fact, at ages greater than 65, higher levels correlate with longevity.

  40. the hard wired evolutionary past meets the contemp.abundant in all manner of sweet, shitty and dopamine illiciting things present and wallop !
    Operating far from equilibrium any little thing will, if we’re fragile enough ( and i reckon we’re fragile even when we think we’re not) ‘set us off’ a chomping

    Do you know Koobs work about dopamine and it being illicited by places sounds smells and people one associates with narcotic addiction ?
    No difference as far as i can see with carbs.

  41. Marly,

    You might check your zinc status. People who are deficient in zinc often find meat repulsive. One cause of zinc deficiency is too many grains or a vegetarian diet.

    Good idea. I hadn’t thought of that.

  42. As far as feeling “better” on low carb, I would have to confess that at 30-40g/day, I have about 20% less energy than I do on 60g. (I am currently at my ideal weight.) I am hoping that this will improve over time, because I have only been at it three months, and maybe my metabolism has yet to adapt completely to ketosis. My breath also stinks so badly my mother hands me the mouthwash at regular intervals.

    The real benefit, as far as I can tell, is mental health. Yesterday my fiance sent me a box of chocolates, and after sampling one of them, I had the same kind of anxiety session that plagued me almost constantly when I was vegan and/or drinking a half a bottle of wine a day. I have to watch my intake carefully at individual meals: any more than 10g of carbs/meal and I get an emotional roller-coaster.

    So the “bite” isn’t decades away for me, but minutes, which keeps me on the straight and narrow. I suspect it is the Amerindian heritage–the legendary talk about the “drunken Indian” probably refers to the hunter-gatherers’ response to the carbs as much as to the alcohol. For me, the groundless rage is the same in both cases.

    Fortunately, my fiance is on board with the low carb eating program, and is reporting steadier mental health as well. (He is also part Amerindian.)

  43. This website and your blog have helped me stay on the low carb wagon. My HDL is over 80, but my LDL has been dificult to lower. My doctor sent me a certified letter telling me that my refusal to follow his low carb, low fat diet (which caused me to gain 25 pounds) and refusal to take statin drugs resulted in his decision to drop me as a patient for non-compliance, and that he would not be held legally responsibile if I had a heart attack. I started seeing an alternative practitioner and had nutrogenomic testing done. Turns out I have a high genetic risk for developing diabetes and need to be on a low carb diet and the more extensive lipid particle profile testing showed that the only component of my LDL that is elevated is genetic and will not respond to diet, exercise or statin drugs! The original doctor refused to reconsider, even with the additional tests.
    Everywhere I go I am bombarded by misguided advice. What is good for one person is not good for all. I need to eat low carb to stay healthy while others may have a different biochemistry.

    The depth of the dumbth (not to mention arrogance) of the physician who dropped you is unfathomable. And you can tell him/her I said so. What a dolt. Having said that, however, I’m not real taken with nutrogenomic testing at this point. I’ve seen a few people who have taken this testing and been informed that, genetically, they are at low risk for heart disease, then subsequently have had heart attacks. I just don’t think the accuracy is there yet. In your case, the test came out recommending a low-carb diet, which I think is great, but, remember, a broken clock is still right twice per day.

  44. Monica –

    Isn’t there a substance in potatoes that makes it unsafe to eat them raw? Seems like I’ve read that somewhere … If so, then the question is how much of this substance is “neutralized” by cooking? And is that, in fact, safe?

    The sugar and HFCS consumption of the Irish (not Irish-Americans) might well be different from ours in the US, but there’s undoubtedly several other important differences, too (must factor in the pints of Guinness, right?). It will be an interesting exercise, requiring a lot of time in Ireland … Where to get the funding?


  45. I believe that what you have described is not analogous to addiction, but rather that you have not determined your correct chromium requirement. When you are chromium deficient, you cannot viscerally feel high fasting insulin or moderately elevated blood sugar. When the chromium level is correct, even if it is a higher dose of chromium than seems rational, high fasting insulin causes a headache, and elevated blood sugar can manifest as persistent itching. If you are not conscious of the true discomfort of high fasting insulin, the body knows it can “solve” the problem with more carbs. If you are conscious of the problem, then you know your “low carb” diet is either too high in carbs, or else has some other problem that is raising fasting insulin (slowing hepatic insulin clearance) and priming the pump for carb desire.

    Do you have references for this? If so, I would like to see them. If not, I’m not sure I’ll buy into it whole hog.

  46. I have done a lot of reading on the potato famine in Ireland, and believe I once read that the average person (prior to the famine) ate approximately 5 pounds of potatoes in a day, along with butter and milk/cream. Very, very little meat.

    Even today, Ireland is still the land of the potato. We’ve been over there three times already. I love Maine, but Ireland is really tempting. It’s the only place other than Maine that I’ve ever wanted to live.

    Anyway, one time when we were there, up in the Northeast around Donegal and Bundoran, we went to a restaurant for dinner. I ordered fish and my husband ordered beef. The dinner started with a huge bowl of breads, and then our dinners came with rice on my plate and roasted potatoes on his plate. They also brought large family-style bowls of french fries, mashed potatoes, and more roasted potatoes “for the table.” I’ve never seem so many potato dishes in my life!

  47. The culprits for me isn’t money, it’s availability and perhaps some lazyness.

    There’s hardly anything eatable in the grocery stores nowadays. I get really frustrated when I check the ingredients lists of all foods to see what there is I can eat. There’s hardly any attractive food. I’m not too fond even eating the meat because of all the stuff they put in/on it. The result is often that I give up and just grab some arbitrary food.

    Second thing is cooking. If I don’t give up in the grocery store I come home with vegetables, eggs and meat. What can I cook with this? I’m no cook, I can’t make something good from these three ingredients every day.

    If someone would come home to me with low carb food and cook it for me every day, I’d gladly pay the double of what it costs in the stores.

    I’ve been tinkering with the idea of opening a store with eatable foods. But I already have a nice job. Or maybe start a non-profit association that sells locally produced foods. That would be the only way to get some real food I think.

  48. @Joann: I wonder if perhaps your issue isn’t that you haven’t adapted to ketosis, but that you’re getting too much protein and not enough fat. Bad breath, which you mention, can be a hallmark of taking in more protein than your body knows what to do with; the odor, in those cases, is a result of nitrogen-containing breakdown products of the extra protein. Also, you mention a lack of energy; this can be a symptom of “rabbit starvation,” which occurs when one eats only very lean protein sources, which would again point to an imbalance between fat and protein — I’d be curious to know what you’re replacing the carbs with when you cut from 60g to 20-30g, and if it’s mostly an increase in lean protein. It’d be interesting to calculate a protein intake target (I’d use weight in kg times 1.6g per kg, as given in the study Dr. Mike reviewed a few posts back), and compare that to your current intake; if your intake is considerably higher, then shifting to less protein and more fat might be a worthwhile experiment. We’ve all been SO indoctrinated with the low-fat mantra that it almost takes a conscious effort to eat fatty foods, so choosing too-lean protein would be a really easy trap to fall into.

    Dr. Mike, what do you think about this?

    I’m not so sure that bad breath is a sign of taking in too much protein. As long as one gets either adequate fat or adequate carbohydrate, the rabbit starvation isn’t likely. An increase in lean protein – assuming it’s from meat – usually provides enough fat. But, the recommendation to increase fat intake a little to see what happens is a good one. Give it a try.

  49. Dr Mike~
    Thankyou for the great post.
    I find the less sleep I get the more I struggle with the desire for carbs. I get the urge for carbs at 4-6 AM whenever I work night shifts. ( This is the point in time I feel most tired.)
    I could set a clock by those darn cravings. It’s like “oh here we go again ….what else is new? ”
    I have learned the hard way that I feel worse if I give in to it.


  50. Loved the article Doc…thanx muchly! Hmmm, handling carbs a la my quitting smoking…novel concept. I eliminated all mindless smoking…that cut it in half. Then, after a week, I cut out those I wouldn’t miss too horribly. Finally, got down to them getting stale and I started mooched or buying 1 or 2…this was embarassing and that led to being able to quite without much struggle (several months). Not sure that translates to eating carbs. I gave up desserts as I never had much of a “sweet tooth”, breads and pasta were tough to give up but do-able as wheat makes my nose congest, fruits tough but I still had berries. The carb slayer for me was a diagnosis last Aug of diabetes with BGs >300 & an AIC of 11…yikes. NO MORE CARBS until I got fasting BGs under 150, then I started adding a few berries and a few tablespoons of beans now and then to see what effect they had. In 4 mos, A1C dropped to 6.9, HDLs up, TriGs down, & lost some wt.

    What have I learned? My emotional ‘state’ has a huge effect on my BG; I have a volatile personality & that ‘up down sideways’ roller-coaster makes my BGs fly high. Prednisone makes ’em go up like a rocket. I try to live and respond moderately…this is really, really, really tough. Reining myself in all the time is likely to stimulate inner rebellion at some pt but so far so good (I look as my food diary-BG log from beginning to now and smile) as long as I don’t catch someone’s illness (another BG booster). Focusing on what I have accomplished is inspiring & contemplating how much further I need to go a la reducing BGs and losing weight is depressing and de-motivating. I now think in small units, eating to keep BGs <140, staying in that moderate zone, eating to improve my fasting 7-day average BGs, planning meals ahead for the next day (carting stuff to wk) & the next week (shopping & cooking-marinating ahead)..anything else is just more than I can handle. I’m in high tech and that’s its own sort of volatile world…we’re all stressed or nuts *G*.

    Restricting carbs is an acceptble WOL as long as I can have my homemade sugar-free Ghirardelli hot cocoa…when I realized powdered Splenda made my BG rise 11 pts (yikes) and I didn’t have the hot cocoa…wow! Major battle to not eat sweetened chocolate (I started dreaming of chocolate, ya know a la those Dove ads?). In a day or so (until I found the Splenda+Fiber) that craving stimulated nearly irresistible, horrible cravings for popcorn (my traditional snack food) and potatoes (my favorite carb) — this was an eye opener! After a few hot cocoas, the cravings stopped as if by magic…amazing. The unsweetened cocoa’s having some effect; however, I can’t deny that it might be psychological: one treat (cocoa) compensates for all the foods I’ve given up…maybe…naw…gotta be cocoa’s effect on the brain.

    Reading your blog & my obsession with that # on my meter make it easier to stick to <8 carbs meal as my family & friends are tired of hearing about my latest ‘adventure’ only my 2 diabetic buddies understand the hr-to-hr ‘stuff’ needed to stay healthy. Anyway, great article and great posts…keep ’em coming *G*!

    PS the 2.5 gms resveratrol supps for diabetics are human studies by Sirtis before Galxo bought ’em. Still considerating adding more pills to my regimen.

  51. The only thing I have found that keeps me from eating too much carbohydrate, is to eat none at all. Just like with smoking, continuing to have a little bit just leads to having a lot.

  52. Tim, if you live in a city, you can most likely find a food delivery service that will bring you meals every day. Check around. They will usually cater to whatever food plan you are on.

  53. I confess to lurking here for a very, very long time, but today I had to say, “Good post!” I have been a follower of Protein Power since 1996. I am a 55 year old retired lawyer, now turned professional artist (the other path). I smoked and quit smoking, cold turkey. I have been on a low carb diet (more or less) since 1996, although I do slip off from time to time.

    In regard to smoking, I quit after years of smoking simply by deciding to do it. My mantra was along the lines of, “I have become a complete non-smoker. My lungs, teeth and breath are completely clean and their condition is clear and healthy. I love the smell of my hair and everything around me smells clean and fresh. I have quit because this is exactly what I want to do, not because I have been pressured by anyone or anything around me…” ,etc. I would go through it every night before falling asleep and in the morning as I awoke. Then, I set a date — for me, Independence Day.

    This was based on something a friend who had been a Navy Seal during Viet Nam had told me about his training, that you had to set your mind absolutely on some thing or action and be 100% in on the deal. Then, you [your mind] becomes unstoppable.

    For the most part, I don’t have a large problem with the low carb life. Most of my grocery shopping happens on the outer perimeter of the store, bypassing the bakery, of course. I have found several terrific products to ease the burden of having to be unduly restrictive, such as 1 carb Heinz ketchup, Capt. John Derst’s Lite bread (7 grams per slice), Bluebell No Sugar added vanilla ice cream, etc. (These are southeast US products, but if you look hard enough there are substitutions). I can easily stay below 30 grams a day without doing handstands.

    So, why do I fall off the diet? You named a few, such as dining out with friends, etc. But over the past year, my post menopausal system has been a major discouragement… I gained 15 pounds and it just doesn’t want to disappear. Amazon informed me that your book on middle age was delayed in release, which was a big disappointment. On the plus side: I just received a whole set of lab values that had my doctor “Wow-ing!” When he asked about my diet and I told him, he just stared. The next day, I dropped “Good Calories, Bad Calories” off for him to read.

    Maybe, just maybe, it will cause him to question all of the diet extracts that he never really bothered to read in toto.

    Let’s hope your doc gives it a read. Based on my experiences with doctors, though, it’s doubtful. It’s interesting to read all these comments and realize all the different successful strategies people have used to solve their problems.

    Sorry about the new book. It was beyond our control. Believe me, I got pretty riled about it, and even got in a little hot water with our editor. But, nothing I could do. The publishing house believes we are in a recession right now and that it might be better in September, so they want to bring the book out then.

  54. Here’s a great visual for the soda-loving folks:


    Great post and I agree, some days it’s tough battling all the pro-carb messages that surround us.

    Regarding smoking: I was a child of the 70’s when the anti-smoking campaign was in full force. I remember going to the county fair year after year and going through the exhibit that one group always had set up with jars of lungs from smokers and non-smokers. Of course, the smoker lungs were always a nasty grey or black color. Sometimes those same lungs popped up at school when we got a lecture on the dangers of smoking. I remember very few of my peers smoking in high school and college. Nearly all of us were non-smokers. Today, I can’t help but wonder if the tide has turned in the opposite direction as I see a lot of high school and college age kids that are smokers, far more than I recall seeing when I was their age.

    Nice graphic on the Pepsi ad.

  55. Dr. Eades, is it possible to eat a modified low fat/low carb diet with gallstones? I have been eating a low-fat high carb diet, but cant lose any weight. Thanks.

    Are you saying that you have gallstones identified by ultrasound or MRI? If you do have them, what’s the plan to get rid of them?

  56. “We think we make decisions rationally, but we really don’t. We make them because our brain chemicals tell us what to do. ”

    This doesn’t make any sense AT ALL. The implied meaning is that if we actually *did* have free will, there would be NO chemical release or observable activity of any sort in the brain but we would just magically react to the “will” as if by a supernatural cause. That’s as if saying when I move my arm an electrical signal can be traced back to my brain which caused the movement, and therefore since the electrical signal was the cause, and not my own free will, I had no control over the movement of my arm! If you don’t believe in free will, that’s one thing, but you can’t have your cake and eat it by insinuating free will and determinism both.

  57. One person at a time.

    One household at a time.

    One community at a time.

    My goal is to transform my community of Clinton, NY into a low-carb haven.

    What’s your goal?

    My goal is to cheer you on and to encourage you to encourage the entire community to purchase our new book. :-)

  58. “Marly,

    You might check your zinc status. People who are deficient in zinc often find meat repulsive. One cause of zinc deficiency is too many grains or a vegetarian diet.”

    Good idea. I hadn’t thought of that.


    Your comment is interesting. I was a vegetarian for 60 years. I completely disavow that way of eating now but it unquestionably has had a huge impact on me even though I’ve been low-carbing and eating animal protein for several years now. I bought wild salmon today and perhaps that will help me segue to meat. Thank you for your comment.


  59. What a fantastic and unique perspective you have of the efficacy of the low-carb diet, doc.

    By the way, I am currently enrolled at UW-Milwaukee, and am in a few nutrition/exercise classes. One is a dietitian, the other a nutritionist, and both promote carbs as the most essential aspect of ones diet. And after reading Protein Power, and a good portion of your site, it makes me just want to lambaste the hell out of them and their ill advised claims. We, the students, pay good money in order to acquire a knowledge of a healthy and effective diet, but no, we get info that is the complete opposite of what you adamantly advocate, and what I, and countless others, have benefited immensely from.

    It is indeed annoying. Especially when the present this claptrap is if it has come down from on high and is almost sacred.

  60. Joann,

    Is it the carbs in the chocolate or is it the salicylates – perhaps both? Have you looked into the Failsafe diet? Many Failsafers are also LC.

  61. I suspect that the anti-low-carb propaganda machine is a major hidden factor in those studies that supposedly show people losing weight like crazy on a low-carb diet, then regaining most of it by the end of the study period. The standard response is: “See? People can’t stay on low carb diets. They are just too extreme.” From that they springboard to a conclusion that low carb is ineffective. I haven’t seen any analysis of why the dieters in the studies regained some of the weight. It could be just standard run of the mill cheating. But then again, dontcha know they are all being told how dangerous the diet is, how they are going to die of a heart attack if they don’t eat more carbs, etc. If no one tells them the truth, and they do not manage to discover it on their own, no wonder they would regain. It would be interesting to do a lowfat/lowcarb comparison study with a group of people who have been well informed and convinced that lowcarb is healthy.

  62. You’re fighting biology. We evolved to consume concentrated carbs (sugar and starch, cheap energy) whenever available, but they just weren’t widely available during most of our evolutionary past. In the modern world we’ve worked to produce/invent the cheap carbs that feed the craving.

    The sugar part of the equation is now easy to fix, given all the sugar substitutes, but the starch craving is tougher (pizza, bread, cake, etc.) since we don’t have good, cheap substitutes. Like other cravings, however, the key is to avoid the stimulus and replace it with other satisfying stuff. Having a mate/family on board is probably the biggest help.

    How could we have evolved to consume concentrated carbs if they weren’t widely available in most of our evolutionary past? We evolve to do well on the foods that are at hand. Sugars and starches weren’t at hand – in fact, they were scarce. We evolved to eat meat in the form of fish, game, insects, worms, etc. with a little plant food thrown in. Which is why we get sick when we eat a lot of sugar and starch. Because we’re not really designed to eat it.

  63. like Katy, my grandmother was into health food in the 60’s and 70’s, so I took vitamins, and ate whole grain “wholesome” food. We too were sucked into the whirlpool of polyunsaturated oil, and all that bran did absolutely no good for my IBS. I think I have an “orthorexic” eating disorder because of the eccentric food ideals that were promoted to me as a child.

    It was a huge wake up for me when I did Atkins in 99. I felt so much better than I had in years. My IBS resolved. I now see it related clearly to wheat and gluten — that huge part of my former diet that I no longer eat.

    Eating this way is sometimes hard because it goes so far against everything i was indoctrinated to think about food as a child. We were “progressive” in food — basically — what is taught as gospel nutrition today is what we ate at our house back then. I consider myself living proof that those ways do not work. And the other part of why it is hard to eat this way is that I worry that I have gone extreme the other way, and have now cut out a new “orthorexia” in place of the old.

    But if I have, I really have no choice. The blood sugar meter tells me I can’t have sugar or starch. My stomach tells me I can’t eat gluten. It’s really pretty clear.

    But I agree, it is a lot easier when I “top-up” with information from my low-carb books and websites. I reread “Good Calories Bad Calories” and “Life Without Bread” all the time, and stop in here a lot. That helps.

  64. Lyn, the non caking agent is what makes your blood glucose spike up when you take powdered splenda. You might try a davinci sugarfree syrup, or a splenda tablet instead – and see if that is still true, because neither of those forms have the caking agent that causes the rise in blood sugar. I find I can have splenda tablets. I don’t care for davinci syrup, too sweet IMHO. I have also tried erythrytol and stevia, together and separately. There’s a new one out called “Truvia” — it’s erythrytol and “rebana” which is actually stevia. I didn’t used to be able to taste stevia, but either the stevia is getting better, or my taste has changed. I have founds packs of powdered stevia as well, but beware, the evil caking agent may lurk in them, too.

  65. We are creatures of habit/reflex. It is useful, we do not have to think about everything we do.

    It also frees the mind from wondering about where our next meal is coming from. The local store/supermarket seems to have taken over from our ancestral widerness.

    From day we one we have brainwashed into the virtues of high carbohydrate consumption. Just think of the “Lords Prayer” in christian based cultures. (Our daily bread?).

    Commercially restaurants, cafeterias, cterers are not into (it is expensive).

    Hey does it matter if over 365 days of a year I pig out on enlish trifle, lemon meringue pie,
    strawberryberry cheesecake once every 3 months? I do not think so.

    Lighten up and get realistic.

  66. Thanks for the suggestions, guys. It helps to have some experienced hands on board. I am getting the high end of protein recommendation per Dr. Eades’s recent post, but not that high. I will try adding more healthy saturated fat to my diet and see if it helps. The trick is the fact that with my carbs so low and protein intake so high, I am simply NOT HUNGRY. Eating is a chore, so I just need to treat it like a duty and get some local farm butter in my system.

    About the salicylates and chocolate, I suspect you are right. I get a “buzz” every time I eat a section of orange that seems to be way in excess of what I get from a few bites of baked potato (at low levels, nothing), so it might be salicylates. Darn. I love a few berries on my morning yogurt.

  67. You mean to say that, when I visit this site several times a day, I’m actually trying to do myself a favor, and am not just helplessly addicted to clicking my bookmarks? Whew.

  68. How could we have evolved to consume concentrated carbs if they weren’t widely available in most of our evolutionary past? We evolve to do well on the foods that are at hand.

    I think if your ancestors lived in a colder climate wouldn’t eating whatever fruits or roots they could find to put on weight before a very bad winter have given them an evolutionary advantage over people who couldn’t put on weight? The fat would have kept them warm and given them calories to live off of while waiting for spring, either of which could make a difference in survival. The carbs weren’t as concentrated as they are now, the fruits not as sweet, but they were enough to give us a taste for them.

    Yep, it would have given them an evolutionary advantage. But, much of the sugar in fruits is fructose, which doesn’t influence insulin a lot. It gets made into fat in the liver instead of being treated like glucose.

  69. I havent evolved to produce concentrated carbs, have I missed that part of evolution? Dr Mike, I have relapesed big time. I have done so well on low carb to only get myself on high carb junk again for the last month. I havent been able to catch a low carb express since. Its so hard to get back on once you leave it. I even saw a psychiatrist about my carb binges. His answer off course was 25 mg of Paxil. How come I havent invested in Paxil? It seems that everyone is taking them nowadays, and now with reccession even more Paxil. He said I am low on Serotonin and therefore need it badly. He also claimed that with my hyper personaliyt I might have always been ADD and needed to be on Paxil since childhood!!!! Ha? Ok, needless to say I came out of his office more depressed than I truly was. No disrespect to medical profession, my mom and few of my cousins are Docotrs, but some MDs stand for meaningless degrees. How does he know I am serotonin deficient? Because I crave and binge carbs? I have done so since I was 3 months old! My mom told me that I was the happiest kid ever, and the only time I would fight with anyone was for candy. So I think its a lollypop of crap that everyone who craves sugar needs Paxil! What I need is to get on the next low carb express again. I dont know when its coming or if I can get on it soon enouph. My body has been forgiving for so many years, I need to strat respecting it more .

    So, thats that! Dr Mike, has your opinion changed about fiber and weight loss? There have been more and more studies coming up recently claiming the connection between fiber consumption and increased satiety levels. I used to love Shirataki noodles until I was scared into believing it was bad. I may need to start cooking it again. I used to cook it with sautedd chicken in wine and garlic and mushroom. The whole plate was about 200 calories. Sure beats a heck out of one lick of cake which has about same calories!

    The Shirataki noodles with chicken would be infinitely preferable to the cake.

    Why don’t you take some 5-HTP (the precursor to serotonin that converts to serotonin)? Take 100 mg at about 5 PM every day. You can go up from there. If it truly is your serotonin that’s low, the 5-HTP should fix it without your having to take Paxil, which is not a drug without side effects. You can get 5-HTP at most health food and natural grocery stores.

  70. When I got misdiagnosed with Celiacs I used to read the celiac boards for Info. The thing that amazed me the most was their whole association with wheat/gluten and how that had to reassociate wheat/gluten as being bad was really fascinating. Even more so was unlike say us (low carbers) who know that eating the carbs will probably cause us diabetes or heart problems later on down the road. They (celiacs) would have an immediate reaction of hives, diarrhea, cramping, edema, etc. along with being painfully aware that down the round was the inevitability of cancer, removal of part of your intestine, etc. (I vividly remember my gastroenterologist telling me that if I kept eating wheat I would have cancer, it was just “when” not “if”)

    But even though they knew the problems, many would still eat it now and again. Succumbing to temptation of marketing, or thinking maybe it was all a fluke or in their head, or wanting to fit in at a social event, and all soon felt the ramifications of their choice.

    I point all this out because you would think the risk/reward of this choice in their brain would be an easy thing for them. It’s literally life or death. Still they wrestle with their brain about it all the time.

    Anyhoo, on a more related note. I’ve learned a very interesting mental technique that keeps me on the straight and narrow. I buy cookies/desserts for other people, usually at work. I really do find that I dervie the “pleasure/satisfaction” of buying the cookies. It feels good walking to the register with a big box of fresh baked cookies. The smells, everyone in line admiring it, you don’t feel deprived because “hey, you’re buying cookies”. I then walk back to the office. Walk around, pass out some cookies, everyone is all smiles. I then take the rest back to my desk, and watch them line up to grab cookies, they’re gone within a half hour easily and I never had one. They’re usually gone so fast I couldn’t have even caved into temptation if I tried. And best of all everyone thinks I’m such a sweetheart for doing. “How nice of you, I though you did atkins?” “Oh, I do. I just saw these on sale and I thought everyone would like a cookie.” or I notch it up as a random act of kindness, which it is.

    Here’s the rub, I psychologically get to watch everyone do everything you write about in the blog. It’s fascinating, people waking by, “Oh I guess I can have just one”, “Who can resist a cookie”, “Oh I know I shouldn’t eat this. I’m on a low-fat diet”; people actually debating whether “to take a few extra, just in case they’re gone after lunch.”

    I usually find that watching everyone go through that process and watching every cave in like a house of cards just fortifies my own will not to eat the crap.

    It’s a very interesting thing to try if you’ve never done it :)
    Of course I guess it makes me just as bad an enabler as alcohol 😉

    I don’t know that running a bunch of people’s insulin up, causing many to have reactive hypoglycemia, and tempting others to abandon their diets in an effort to fortify your own will power can be called a “random act of kindness,” but I do get your point.

  71. Halle, yup, the malto-dextrin/dextrose is the culprit (the tabs have the same buling agents). Splenda+Fiber seems OK (tho that soluble corn fiber does have an aftertaste) as does erythitol (slight taste too). Stevia’s taste is too noticeable (the foodies say assertive *G*) & unpleasant for me. Gonna try the liquid sucralose, xylitol (in gum my gut has no prob, we’ll see about larger amts), and just ordered a sample of “Just Like Sugar.” You’d think I had a real sweet tooth but there’s gotta be something that’s GRAS, doesn’t increase blood sugar or insulin, & is essentially tasteless for use in my unsweetened cocoa and the egg custards I’d like to try for my once in a rare while desserts, like birthdays, holidays, etc. The search continues.

    Hey Doc, familar with Richard Moore(MD, Phd)’s book “The High Blood Pressure Solution” & his K-factor eating plan? That’s the one that posits an imbalance between potassium & sodium intake initiates (I think, just got his updated in ’01 bk) the biochemical mess that leads to the metabolic syndrome factors. I know they theorize that the loss of potassium from thiazide diuretics causes many older women with impaired glucose control into overt diabetes (my experience) and this sounds like it validates Moore’s theory of probs at the potassium-sodium pump in the cell membrane . Comments? It seems reasonable. I plan to talk to primary (who might laugh at me as he thinks HPT is for life) & work with cardiologist (apnea has me visiting specialists *sigh* & he’s open to altenative approaches) to increase potassium (already drink low-sod V8 daily, add parsley?) & get off this diuretic (low carb has seen me be able to cut Cozaar dose in half). Some women who get off the thiazide see a 35-45 pt drop in BG…that’d be gluconormal for me if that happens.

    I’m familiar with the theory. And it does make some sense. But on a low-carb diet people actually need a little extra sodium along with the potassium. Sadly, many foods that are high in potassium – orange juice, bananas, parsnips, etc. – are also high in carbs.

  72. it’s funny, after eating low carb for so long, it’s so easy to control myself around carbs. Sometimes i have 1 tsp of raw honey with cream and it’s heavenly but i don’t feel like eating more sweet stuff – it completely satisfies me, but not overly so. In fact sweet things start to taste yucky after a while.
    Today i had about 20g worth of carbs in the form of white rice with lots of butter (trying to gain weight you see) and even though I could have had more it was easy to restrain myself. Ithink when you know the immense health benefits of low carb it’s much easier to stick to it

    by the way, off, topic, but i was wondering something. I want to become a doctor, but have no idea how to deal with the fact that everything i know about a healthy diet is against conventional “wisdom” which is taught to doctors. There’s no way i want to advise patients with diabetes, heart disease, etc to eat high carb, low fat diets, but couldn;t this cause problems? how the heck am i supposed to convince team members that everything they think about nutrition is bull? it’s so confusing, what if i get sued?! :(

    If you want to become a doctor, you’ve got a long way to go before you get to the patient-treatment stage. Once you get there, however, you can pretty much do what you want nutritionally. I’ve put patients on low-carb diets for years, against the recommendation of many of my patients own primary care doctors, and I haven’t been sued yet.

  73. Justin Hola…………………..Of course one can Squire !

    Why not..just cos its not palpable idea ?!?!?!?!

    We obviously do have some free will by some loose defintion (we do decide however that process is defined and we think we have free will..which is at once contradictory, highly amusing and very tragic the more we find out about how we ‘work’) and also are nowt but biochemically detemined.

    We didn’t evolve to understand ourselves. It’s not a requisite for survival..of course

    As someone who is not offended by the word god (for me god is a synonym for evolution) i adore the aphorism ‘ As God said in the beginning one has to draw the line somewhere’.

    I.E. the free will/determined thingy is just..well not predisposed to being clearly defined.
    And clearly defined as an animal out of evol. context is exactly what we “IS” !!!!!!

  74. i seldom stick my neck out and give definitives but i’d wager heavily yr publishing house has got its head firmly stuck up its ‘arris’.
    I’d wager things will be worse as the ‘rattled but still standing tree’s’ from the initial ‘blast’ start a-tumbling.
    And of course one hopes one is very wrong.

    Precisely the case I made to them, but if fell on deaf ears. Plus, they are worried about the book out now titled The Flat Belly Diet, which is a total POS and no competition at all. They figure it’s star will wane by September, leaving the field open to us. I countered with the suggestion that, due to the unwarranted success of The Flat Belly Diet, there may be a dozen books out in September that will have belly, waiste, middle, etc., in their titles, but that argument also fell on deaf ears.

  75. This raises a bunch of questions for me, the two biggest of which are:

    1) So what does this mean for “free will”? I used to think this was a metaphysical-type question, but maybe it’s not.

    2) Might this discovery lead to a disability (as in ADA recognized) of, say, eating carby stuff and being unable to lose weight? Or maybe a line of criminal defense: “My client pleads a defense of “insula non facio” [sorry, latin and I don’t mix]. She had no control over her actions, yer Honor, her Nucleus accumbens was controlled by all the ads that told her she just had to have that [diamond ring], and it overrode her insula…”?

    You might try suing under The American’s with Disabilities Act. It seems like everyone does for everything else.

  76. From Moore @ http://www.drpasswater.com/nutrition_library/Potassium%20_to%20_Sodium_Ratio.html (June 2001): We now have very strong evidence-not totally conclusive, but very strong evidence-that this potassium/ sodium imbalance also is a cause of insulin resistance. Furthermore, this potassium/sodium imbalance, which contributes to insulin resistance also is associated with an abnormal metabolism of carbohydrates and fatty acids, and may contribute to causing Type 2 diabetes.

    Interesting. He says the Hypertension Society nor the Diabetes Society were interested at that time.

    I’d like to see this “very strong evidence.” I suspect it’s a bunch of observational studies that are worthless for determining causality.

  77. Thanks for another great post. Today I finally finished Gary Taubes book! I’m usually pretty quick to get through a book but that was so full of bewildering and yet obvious truths that I kept having to take day long breathers to soak it all in! I’ve now got over my fear of just eating meat (with no salad or vegie to make it ‘balanced’!) and leaving the fat on instead of ‘saving’ the calories… a world of difference. Thank god for you and thanks for pointing me in the direction of Gary’s book. My next book starting tonight (thanks also to you) is the 4-hour work week. Hopefully once I’ve finished that, your new one will be available in the UK.

    The 4-Hour Workweek is a fun book and the author is a friend of mine, but I don’t think it was an official recommendation through this blog. I enjoyed the book, but it really has little, if any, bearing on nutrition. I just don’t want you to think you are getting another book on low-carb dieting that happens to have a strange title.

  78. I’m not sure that what you’ve written about your alcoholic friend topping off his insula (resistance) is why AA is believed to work. My understanding, based on the writings of Gregory Bateson, is that dealing with an addiction to alcohol as a symmetric interaction is doomed to failure is because “[s]ymmetrical effort requires continual opposition from the opponent.” Thus, for example, if an alcoholic battles the bottle, then “a brief period of successful struggle weakens his motivation, and he falls off the wagon.”

    BTW, this argument explains why just when things are going well we are most likely to slip. When our modus operandi depends on the opposition from the alcohol or the nicotine or the sugar rush, then when it stops opposing us, we will stop opposing it.

    (Symmetric interactions are ones where the two parties behave similarly and the behaviors are linked “so that more of the given behavior by A stimulates more of it in B, and vice versa….” . Boxing matches and “keeping up with the Jones” are both examples of symmetric interactions that can be stable.)

    AA works because the alcoholic takes a complementary stance towards the bottle and accepts his or her powerlessness. “Once an alcohlic, always an alcoholic.” (Bateson defines complementary interactions as ones, such as nuturance-dependency and dominance-submission, where “the two parties behave dissimilarly but the behaviors fit mutually such as to be reiniforcing.”)

    Yes it would be easier in some ways for us low-carbers if we lived in a low-carb world. But to the extent that we are addicted to carbs, we need give up our pride and accept that once a carb-addict, always a carb-addict.

  79. “How could we have evolved to consume concentrated carbs if they weren’t widely available in most of our evolutionary past? We evolve to do well on the foods that are at hand. Sugars and starches weren’t at hand – in fact, they were scarce.”

    You’re missing the point. It’s the stuff that was NOT widely available that poses the greatest risk, since our past adaptation to it could not account for a later abundance of the stuff, whether it be sugar or cocaine. We are full of “preferences” that can easily be overwhelmed by modern technology. When it comes to sugar and starches, our past harmless (useful for fruit and root eating) preference for them when available became a liability when we devised ways to produce them in abundance. The solution is to avoid the stimuli, change your genetics/biology, and/or focus mental awareness on the known negative consequences – same as with a cocaine or nicotine addiction/habit.

  80. Tim,

    I have two suggestions if you don’t want to spend a lot of time cooking and reading labels in the supermarket (these are good for you, too, Dr. Eades, if MD isn’t around to be your personal chef or if you are like my husband and dine on saucisson and cheese for every meal, maybe an egg when the cook is gone).

    These easy ways to prepare meat/chicken (I hate to even call these recipes) do take a few hours to simmer, but the hands-on prep time/cleanup is really very minimal and you’ll also have basic leftovers that can be dressed up any way you want for fast meals and snacks lasting several days.

    These are perfect for making on a “day off” around the house or you can use a slow cooker and they will cook while you are away during the day or while you sleep (but you’ll have to be prepared in advance with the ingredients).

    First, make yourself a big pot roast with a nice bone-in chuck roast. Seriously, it’s really easy, tastes even better the next day, and the bone adds minerals to the broth (no calcium supplements needed when you consume bone broth). Salt and pepper the meat and brown it I even skip this step if I’m really in a hurry) on med-high in a big enough pan you can cover and put in the oven (Dutch oven), slice up some onions and add them to the pot, add some broth or red wine (or both),bring to a boil, cover and bake in a 300°F oven for 3-4 hours, until the meat is so tender it comes apart with a fork. Serve with the onion au jus and buttered steamed cauliflower/broccoli or roasted cauliflower and a nice salad of sliced tomatoes drizzled with olive oil and balsamic vinegar – even easier than a tossed salad (there’s a more refined version of this pot roast in Bruce Aidell’s Meat cookbook, but this will do in a pinch).

    Nearly all the big budget cuts of meat are some variation of this – a few minutes to brown the meat and get the other ingredient ready to add to the pot, then cooking covered a low oven for a long time. I have bison short ribs baking in my oven right now (mid-afternoon) for tonight’s dinner.

    You can also cook a whole chicken – get a big one (just check for and remove the bag of giblets from the cavity) in a Dutch oven on the stove. Just add chopped onions, carrots, and celery (if you have time and energy, or omit if you don’t), a bay leaf, juice of a lemon or a couple tablespoons of cider vinegar (slightly acidic water moves the minerals from the bones to the broth) and cover or nearly cover the chicken with water. Bring to a boil, cover and reduce heat to Low or Medium-Low until the water is slightly simmering (NOT a rolling boil). In 2-4 hours (depending on temp and size of the chicken), the chicken will be cooked through. Carefully remove the chicken from the from the water (now it’s weak broth) – watch out for hot splashes!!! especially if the chicken legs fall off) and let the chicken cool a bit on a platter, then remove all the meat from the bones. Store the deboned chicken meat in a container in your fridge for easy, fast chicken meals and snacks throughout the week.

    Finish up by making broth. Put the bones and skin discards back in the broth and simmer again, as long as all day (or up to 24 hours if you use an electric slow cooker appliance – remove the fat when it’s cold if you cooked it that long). Strain the broth to remove the bones and scraps, and you’ll have nice rich broth for quick soups, etc., better than any broth you’ll find in the supermarket. I make a very quick chicken soup for my son by boiling some broth with carrot slices and cauliflower until tender, then I add diced chicken meat, diced tomatoes, hot sauce and salt to taste, chopped cilantro, and big avocado chunks, remove from heat when everything is hot, with a big spoonful of sour cream in the bowl to garnish. I also use the broth to make cream of “whatever” soup, blended in the pot with a handheld blender, then add cream. Homemade bone broth is very handy to have in the fridge and freezer. Beef broth is made similarly with roasted meaty bones (meaty neck bones, cross cut marrow femur bones, oxtail, etc.). If you make more than you can freeze or use, the neighbors are usually happy to take it ;-).

    Both these “lazy cook stand-bys” use a big Dutch oven pot with cover on the stove/in the oven while you are at home (and can take a peek now and then); you can do household chores, chill out, or whatever for 3-4 hours. OR you can make them in a slow cooker appliance, which can be left cooking while you are away during the day. But the heat is lower the cooking takes longer – up to 8 hours if you use the Low temp setting).

    If that’s too much meat/chicken for you at one time, just freeze some as soon as it cools down (better to freeze while it is “fresh” leftovers”) in a freezer bag, flat with all the air pressed out (air is what causes “freezer burn”. Thaw the bag quickly in a bowl of water or under hot running water.

    Hope that helps.

    Mmmm. Sounds great. All of it. Thanks for sharing.

  81. DR.E Have you seen the studies showing how protective low carb keto diets are to the brain? Pretty amazing stuff!

    I have, but it’s not all that amazing when you think about the fact that cancers mainly survive on glucose.

  82. Wow. This line of thinking explains why only this month have I been able to consistently eat low-carb again (after many months of failures). I am a medical student doing a rotation in forensic pathology. My insula has been reinforced by seeing all that subcutaneous fat on obese decedents once they are cut open at autopsy. In addition, I am reminded of my own mortality and that carb-eating puts me closer to a slab with a tag around my toe.

    Sub Q fat is pretty nasty; so is visceral fat. Would prefer to have little of either. Enjoy your rotation.

  83. I can’t believe that anyone, let alone a publisher, would think that one of your books would be in the same league with The Flat Belly Diet! It IS a POS, completely and totally inane. I know because I was given the book. The first four days you’re on the anti-bloat diet; your supposed to drink “Sassy” water (a special recipe named after Cynthia Sass, the nutritionist) that’ll start the shrinking of your belly. Your supposed to avoid salt, fiber, excess carbs, gassy foods, and chewing gum (the extra air you swallow will swell your belly). And monounsaturated fats should be included at every meal because of their belly-shrinking abilities and other “health” benefits:

    “it’s the additional health benefits that make this type of dietary fat so unique. Not only can it prevent and control type 2 diabetes and reduce the risk of heart disease (by lowering “bad” LDL cholesterol levels and boosting the “good” HDL), but a 3-year Italian study found that a diet high in MUFAs from nuts and olive oil also helped reduce markers of inflammation, a known trigger for aging and disease.”

    And this “competition” is why we can’t buy your book? What an unbelievably bad business decision!

    You’re preaching to the choir here. I tried valiantly to get them to understand, but I was totally unsuccessful. Once publishers get something into their heads, it’s hard to get it out. To them, books are pieces of commerce. They don’t really distinguish between good and bad books in terms of content. As far as they are concerned, one book on reducing waist size is the same as another. They don’t really feel this way themselves, but that is the way they think readers view the situation. They truly don’t think readers are smart enough to realize the difference in content – they believe that to readers (read:great unwashed masses), one book with a similar title is as good as another. Which is the reason there are so many surprise bestsellers and so many books that publishers pay a fortune for that don’t earn out.

  84. An interesting and insightful blog.
    The brain dialogue makes sense. We all experience it.
    I think there is a degree of habituation in our brain pathways ( for very good reasons).
    We do things on a habitual/reflexive basis to avoid wasting time and energy on decision making.

    The last time I smoked a cigarette was on 31 December 2000.
    By January 31 2001 I was over smoking.
    This was no happenstance. I had attempted a few times before.
    I planned that (successful attempt) some 6 months in advance and worked out exit strategies
    for the trigger points (and a reward system if I succeeded).

    In February 2001 I was one of a group of “guinea pigs” in a television documentary that required me to adopt a (very) low carb diet and a light exercise programme.

    After 6 weeks on this regime I was so much better healthwise it was easy to resolve that :I was never going back to where I had been.

    I took on the TV thing as a challenge, it was only to be over 6-8 weeks. I’d been smoking for thirty years and quit. What terrors could 6-8 weeks of dietary discipline hold for me? Zilch!

    I am still on a low carb diet. I still do not smoke cigarettes.

    As far as smoking is concerned there have been a couple of neurogical incidents, five months after I had quit I was heading out of the house to meet some friends at a nearby bar and found myself checking my pockets to ensure that I had my cigarettes and lighter. I had not smoked for 5 months or even felt the desire to do so. That has to be a habituated neurological pathway. It was a Saturday evening and most Saturday evenings I headed for the bar to watch some sport with friends about 5.00pm.
    After 5 months the reflex was still there, but no desire.

    Last year some 8 years after quitting smoking I was cruising down the highway and the insane idea of having a cigarette overwlmed me, mercifully only for a moment.

    I think the habituation keeps prompting us to the high carb bit.

    We have been brainwashed (and still are) that starchy foods are “good for us”.

    I assess what I have eaten on a weekly basis rather tn a per meal basis.

    This takes a load off dietary concerns. In fact it works well on longer time spans.

    Ask not what have you eaten per meal but what have you eaten per week.

  85. Here’s why things won’t change any time soon. THEY’RE TEACHING THE LOW-FAT/HIGH-CARB DOGMA IN THE SCHOOLS!

    A friend at work told me yesterday that her 14-year-old son came home from school the other day to announce that he would not be eating any red meat (beef or pork) again because it’s bad for you and will ruin your health. His teacher told the class that they need to cut as much saturated fat out of their meals as possible.

    I’ve already emailed her several links articles on on saturated fat from this blog, and a copy of “What If It’s All a Big, Fat Lie?” by Gary Taubes (GCBC is too much to expect a 14-year-old to read). Although my friend is skeptically open-minded about LC and saturated fats, she does believe it’s important for him to read both sides of the debate.

    Jesus wept.

  86. Regarding what coba said, I wonder if exceptions might not be more common than that? Not just gradualism, but other variations on the standard low-carb diet plan, may work better for some people. Of course, telling which people is the trick; most people do not know the insides of their heads very well at all.

    It took me a while to move to low-carb because I knew that I would hate the induction phase the diets started with, and almost certainly quit because of it. After reading enough to learn the science (though several low-carbing friends were appalled!), I decided I could handle 50 ECC/day. Which I have, for probably 30 weeks straight. Sometimes I decide that party=carbs or date=carbs, and sometimes I misjudge how many carbs were in that piece of watermelon, but I don’t go off-plan very often, it’s no hardship to get back on, and it hasn’t interrupted my absolutely straight-line weight loss. Not even the holidays caused a plateau or a more-than-water-weight gain, though there were more parties then.

    A lot of people think self-discipline is willpower, but I’ve found that powering myself through stuff gets old pretty quickly and isn’t sustainable. There’s a lot more of gaming my brain involved. In my case, I knew that I could be really self-disciplined waiting for weight loss to start (it took almost a month) and moving slowly (.7 lb/week is a lot slower than most low-carb dieters report), but would have no interest in self-discipline if I tried to give up my vegetables or dark chocolate.

  87. The 4-Hour Workweek is a fun book and the author is a friend of mine, but I don’t think it was an official recommendation through this blog. I enjoyed the book, but it really has little, if any, bearing on nutrition. I just don’t want you to think you are getting another book on low-carb dieting that happens to have a strange title.

    Nope – I always have at least 3-5 books going at any given time and they’re usually a good mix of fun/fact/nutrition/fantasy/sci fi & rubbish! I don’t expect 4 hours to give me anything on nutrition but hoping it might kick off a ‘how’ on some of my ‘life I want to lead’ ideas! And although I don’t think you even recommended it, I think I saw it on MD’s pics of your stack of books in your office (I’m with her, you should tidy!) or reference was made in a readers comments, a couple of google clicks later and looked like something I wanted to read. And to me that’s a recommendation!
    After my last post I read about your book publisher’s September date and got a little cranky! Why oh why… can we start a petition? How many votes does it take for a publisher to publish? Or preorders?

    I guess you could start a letter-writing campaign, but it would probably just get me in to more trouble. And it wouldn’t work. They haven’t even sent us the galleys yet, and the galleys come out months before the book is actually published, so even a lot of pressure couldn’t speed them up.

    I think you’ll enjoy the 4-Hour Workweek – I just wanted to make sure you knew it wasn’t a diet book.

  88. Do all cancers virtually survive on glucose? Also its interesting to note the theory that lack of oxygen can also contribute to cancer. EFA’s enhance and promote oxygen transfer. Eskimos-High EFA’s- no carb = NO Cancer

    Also doc whats your opinion on mad cow and non organic animals> Do you buy into the whole infectious theory of the diseases or the pesticide side? Also do you think there is any risk from not organic animals? This is all confusing.
    thanks Doc

    I think you’ve used up your quota of questions for a while. Comments are fine, but let’s take a break from the questions for a bit.


  89. As a food addict, I literally must approach the foods I eat with the same program that I used to overcome alcohol addicition, which are the 12 steps. I find the parallels mentioned in the post quite compelling. The dopamine pathways for food, alcohol, drugs, sex, overwork, etc. are stimulated quite easily and frequently in our culture – and they seemingly overlap with urges in one area cross-cutting into urges in other areas. Cravings to spend money often end up in cravings to overeat, for example – they are seemingly the same in many respects. I must take a disease approach to food or I find myself “face down in the sugar” very easily.

    Many multiply addictied alcoholics who have been in recovery for some time will tell you that food addiction is the final frontier and the core addiction for them. Once they peel back the layers of addiction (alcohol…gone, overwork…gone, pills..gone…) food is left as the remaining challenge. Gee, I wonder what that is all about. :)

    Those of us who have recovered using a spiritual program (12 steps) and who maintain a fit spiritual condition are typically unaffected being around our drugs of choice – we have recovered. I am routinely exposed to alcohol and high carb foods in my profession. AA meetings don’t protect me from alcohol – my curent spiritual fitness is what does that. For me, this has also been the key to staying away from the first compulsive bite of food – prayer and program. And I have found that turning off the TV and shutting off the blackberry does wonders for that spiritual connection and gives me some carb-culture separation when its most needed.

    Maybe a study on prayer, Higher Powers, and the NAcc and Insula is forthcoming.

  90. I think my mother must have a particularly large insula, she complains about the furniture she bought seventy years ago but is highly resistant to the concept of replacing it. (My ex had a particularly small insula and that’s all I’m going to say about that )

    I think the inheritance shows in me. I had little difficulty following the Healthy High Carb Low Fat diet, and now I have equally little difficulty following a proper diet.

    What changed? A FEEDBACK LOOP.

    I discovered this


    The longer term feedback loops which keep me on plan: lipid panels, and the fact that so lonmg as I keep my BG in normal range I lose a lot of symptoms, from anergia to tingling fingers and toes.

    My previous doctor worked hard to keep this feedback away from me by refusing me access to my notes and test results, so obviously the various parts of my brain failed to make the connections which are now obvious between carb consumption, symptoms, worsening lipids and BP, etc.

    Sometimes it does no harm to test the feedback loop. The other day I weakened and ate lassagne. The effect was partly ameliorated by a brisk walk around the village in subzero temperatures, my BG barely broke through the 110 barrier, BUT i became somewhat bloated and lethargic for a while afterwards, long enough to remind me that hitting the carbs is not a good plan. The other interesting thing is that I no longer find them nearly as enjoyable as I think I’m going to before I eat them.

    More fascinating stuff in this thread, as always.

    Your blog, along with a few others and some newgroups and forums, is yet another feedback loop helping the different brain systems to pull in the same direction.

  91. Not much new I can add here as most of it’s been said and well-said already. It’s a carby world out there. Things like this blog and others I follow, are what help keep me sane and focused this time around. I’m luck that my doctor is not *totally* anti-low carb. She suggested the South Beach diet to me among her other suggestions after I told her I didn’t want to consider bariatric surgery. So even those sorts of concessions are a step in the right direction. But think how many human social functions revolve around carbs? Whenever there is a baby shower or retirement party or promotion party or award party at work it’s always celebrated with things like cake, cookies, chips, pizza. Whenever we have weekend system upgrades at work, and the whole team comes in on a Sunday, the boss comes in with bagels and Dunkin Donuts for everyone. I sing in a church choir and choral society, and at our weekly rehearsals people are assigned to bring in snacks – and heaven help you if you don’t bring in cake or cookies or brownies! That’s what most people are looking for. Hmmm, it’s my turn for snack this coming week. I feel obligated to bring cookies lest I suffer ostracism, but plan to bring a LC snack too. More and more people are appreciating it. Last time I did snack I did bring in cookies, but also little dice-sized cubes of cheese skewered on toothpicks with a grape tomato. They were a hit and went faster than the cookies did.

    But yeah, I do buy into the visualization theory propounded by Brock above. Since reading GCBC it’s so much easier to visualize the internal damage done by a Boston cream Dunkin Donut that it *does* make it so much easier to resist. I have to make it automatic to the subconscious part of my brain that influences these decisions.

    Of course I’m a bit biased here as I have every reason to believe that ‘Brock’ is actually my son Brock, as I have heard him expound this theory in person. :-) Since he just caught me out being quoted on http://freetheanimal.com/ I guess turnabout is fair and now I’ve spotted him too. It’s a small internet world. I like to say that Brock is a lot like me, only smarter. LOL

    But I still have to choose my audience before I spout off about low carbing. I leave for work early in the morning, too early to have breakfast and enjoy it, so I tend to get something to eat about 9 AM, long after I’m at work. Lately I’ve been getting swiss cheese omelets in the deli. But a few times lately I’ve brown bagged breakfast and had something else (a protein shake, a carton of Total Greek yogurt with some berries and chopped walnuts, for example). But the last time I was in the deli the owner *congratulated* me on trying to “limit” the number of eggs I was having! Heck, I’m not limiting my eggs! But sometimes you just have to smile and nod your head and say “thank you”.

    But if anyone asks we what I’m doing I’m more that happy to spout off about LC. I just wish I had the more retentive brain of my son to be able to remember all the wonderful facts presented here and in GCBC and on the other blogs I follow, but it slips out as through a sieve. Could it be because my son is *younger* than I am? :-) Or could it be from all those extra carbs I consumed over the years? I do feel mentally sharper and more focused on LC, so maybe by memory will rev up a notch too.

  92. I’m interested in your remark recommending 5-HTP for the above poster. Why 5 p.m.? Also, having now read that the pill form comes from a plant seed pod only growing in Africa, and knowing about all the political disturbances in Africa right now (and thus how trustworty might any pharmaceutical type product be), might there be any foods (carb friendly) with natural 5-HTP. Quick internet searches produced garbled information about food sources, inter-tangled with info on L-tryptophan. Would attempting to insure regular daily inclusion of high tryptophan foods possibly have the same positive results as taking 5-HTP in pill form. I was pondering the other day the cycling together (in myself) of lapses into high carb binging and mild, but sustained marginally depressed mood (job loss/401k erosion type stuff). Thanks.

    There are a number of companies that produce high-quality, pharmaceutical grade 5-HTP, so I wouldn’t worry about contamination if you get your supply from a reputable source. I have people take it at 5 pm because on of the side effects of 5-HTP is somnolence. If people take it around 5 PM, then the effects are at their maximal sleep inducing at around bedtime. Since people have varying times at which they go to bed, the 5 PM dosage hour can be adjusted accordingly. Including high tryptophan foods would have some 5-HTP effect, but not as much as the supplement.

  93. Re: “Alcohol is the gateway drug for carbs – as a general rule, the more you drink, the more carbs you eat.”

    This is exactly what happens to me: I go to a party, with a resolve to stay on plan, but figure, well, a nice glass of wine with friends won’t hurt. By the end of the 2nd glass, I’m scarfing down whatever tray of carbs is nearby. And the scarfing continues until I’m almost sick. But, if I go to a party with the same resolve, and stick to mineral water, diet soda, etc., no scarfing occurs.

    Perhaps a topic for another post would be to detail exactly WHY this happens with alcohol.

    As always, thank you for your insights!

  94. Unlike others, I find my modified carb nutrition plan isn’t difficult to stick to. (I say modified because at 100mg of slow-converting carbs/day, most would say it isn’t a true low carb plan.)

    Why/how does my plan work?: Because I don’t mind cycling through 5 or 6 seasonally-appropriate pre-planned meals every day.

    My small set of fixed meals makes shopping for ingredients in bulk a less expensive, less stressful, more attractive experience. I know what I need, then get in and out of stores in a flash.

    As long as I stick to these meals 95% of the time, my appetite is sated and I’m guessing I’m not “beguiled by NAcc”. I don’t feel a need to succumb to the siren song of delicious looking/smelling carbs, so perhaps my insula is in the driver’s seat.

    The main driver for this eating plan was glucose control. Given a 2-hr OGTT result of 180mg/dl during 2004, I discovered I had impaired glucose tolerance and seemed to be headed toward type 2. My casual post-prandial self-testing at 1 and 2 hours after the first bite of meals confirmed the problem. So, a modified carb plan was my solution.

    Outcome: I lost weight even though I wasn’t trying to, and my lab results are pretty astounding. The recent development of high microalbuminurea (Stage 1 CKD) has me concerned, but a nephrologist appt in 2 weeks will hopefully provide some insight.


  95. What an amazing article, Dr. Mike. You should write a book or something.

    I really think you wasted your time in Medical School, when obviously you were born to be a writer. :)

    Thanks for the kind words. I appreciate them.

  96. Dr. Mike,

    Superb article. Could you briefly explain why “alcohol is the gateway drug for carbs”? Obviously alcohol has a tendency to break down certain inhibitions, but why the cravings for particular starchy/carby foods?

    Alcohol simply overrides your inhibitions. Typically people drink when there is food around. If you are able to ranger up and avoid the carbs in a buffet line, then have a few drinks, your resolve weakens thanks to the alcohol. Then it’s, Oh well, maybe just a little ice cream will be okay. When that happens, you’re a goner.

  97. Thank you, Dr. Eades! You’ve put your finger on just what’s been nagging at me lately. A year ago I adopted a low-carb lifestyle. One of the things I enjoyed most about it was knowing how to control my weight in the face of impending menopausal changes.

    But it still amazed me what a slippery slope sugary treats were. I actually was pretty scrawny last summer – I work out a lot, too – and thought I was safe to “indulge” – needed to put on a couple of pounds! Once my body gets a taste of it, though, yowsa. I find myself putting sugar or carb nibbles in my mouth all day. So a funny paradox – needed a couple of extra pounds, but the “easy way” was still detrimental even with all I knew.

    It is tough to have sugar and carbs all around as well as people bashing low-carb (and I want to say – but I don’t – what are the people who don’t have weight issues eating?). Plus, the endless media stupidity about it. Endless! Oh, I could go on….

    Really just wanted to say thanks to you for being that ‘voice in the wilderness’….

  98. Why not publish your own book through Lightening Source making it available through Amazon and promoting it through your site? Because it is print on demand there are no stocks to be held, etc. Theres a book on how to do it by Aaron Sheppard “Aiming at Amazon”.

    On another topic – what do you recommend to do about the severe constipation that comes with a high meat diet?

    Can’t do the self publishing route with the current book because the publisher owns the rights to it.

    To solve the constipation problem, increase the intake of fat, i.e., fattier cuts of meat. That usually does the trick.

  99. “Hmmm, it’s my turn for snack this coming week. I feel obligated to bring cookies lest I suffer ostracism, but plan to bring a LC snack too. More and more people are appreciating it. Last time I did snack I did bring in cookies, but also little dice-sized cubes of cheese skewered on toothpicks with a grape tomato. They were a hit and went faster than the cookies did.”

    That’s more common than you might expect, many people have told the same tale about making and bringing low carb stuff principally for themselves and finding it scarfed down rapidly by everyone else.

    We can’t change the world but maybe we can change our street . . .

  100. I’ve been on a basic Paleo diet for about 4 months now, since coming across it on the internet, and I am just amazed how much better I feel. Some days I also enjoy the simplicity of being able to ignore 80% of the supermarket aisles. I also really enjoy meat anyway, as I grew up in a part of the world where they appreciated steaks. I’d been mostly veggie for the last 20 years, following the usual “advice”, and I grew more sluggish and depressed, but simply put it down to age and psychological problems.

    So I’m now Paleo, and my mood is good and I feel like I have a body that I like again, but the other day I looked at the potato chips and had one of those little devil thoughts… “I’m feeling so much better, so now I can eat some of that…” Fortunately at that moment I happened to also be on the phone to a friend who was describing to me the utterly horrific health problems of his late father, and how his various vital organs had slowly been failing. Diabetes was also an early problem. I felt horrible just listening to the story. I left the supermarket carb free.

    I don’t know if it is the availability of carbs, or perhaps just that I’ve been Paleo dieting now for a while and simply forget how bad I used to feel. On the plus side, I’ve found that eating Paleo has made me more aware of the effects of carb food. In particular, heavy carb food (on the couple of occasions where there’s been a set meal at a party) now immediately leaves me feeling empty, unsatisfied, heavy, and a bit sickly if it has a lot of sugar. More recently I simply opted not to eat what was on offer. I’d sooner go hungry and lean, than make the body feel worse.

    On the whole, I find that nothing compares to a steak for satisfaction. But the culture of carbs can be a bit of a pressure, so the helpful reminder from my friend about the horrors of complicated illness after diabetes, was a welcome and fresh wake-up call. Perhaps occasional and varied reminders are what it takes?

  101. Would appreciate your comments on recent study indicating that the Atkins diet causes cognitive changes: http://www.science-direct.com/science/journal/01956663 (Paper 16)
    I’m doing well after a year just cutting out the bulk of the potatoes, rice, bread and candy, and I love the meat, dairy, eggs, greens and fruit. Lipid profile is much improved, as you would expect.

    I haven’t had the chance to pull and read this paper, which I need to do before commenting.

  102. Hi Doc!

    I downloaded a sample of the book to my Kindle. When I get thru my current “stack” of books, I’ll give it try.



  103. This post was the answer to a question that had been plauging me: why am I always “swayed” off low-carb by my low-fat, weight watchers pals? Why do I find it hard to ignore all the articles and advertisement pushing a low-fat diet?

    Indeed, why is a program like Weight Watchers sucessful? It’s not the food – it’s the rah-rah, we-are-doing-this-together factor that inspires people and their, well, insula, I guess.

    When I have a difficult day food-wise – not enough healthy food around, don’t feel like cooking – it’s so easy to give in to the notion that low-carb is not a reasonable plan. From now on, I plan to spend a lot more time on this site!

    Thank you for a great post.

    Glad you enjoyed it.

  104. Doctor Mike:

    This is an interesting question and one I have wrestled with in the past.

    My answer as clearly and simply as I can state it:

    A body, once obese, wants to remain obese. Convincing the body that it no longer needs to be obese is goal 1.

    I have had UNBELIEVABLE success in combining PP with ideas from The Gabriel Method. (See http://www.thegabrielmethod.com).

    I didn’t know what the Gabriel Method until I went to the website. Now I still don’t know what it is. But I am glad you’ve had success with it.

  105. This was great information. I’m finding sticking to a low-carb diet easy since I read “Good Calories Bad Calories” by Gary Taubes and all of the background information in a popular low-carb diet book. Two weeks in a row, someone brought cake to our Toastmasters meeting. I actually disliked the smell. Thinking about the stress the cake would induce on my body, it was easy to overcome the celebratory aspects of the cake and say, “No!” If I did not have that background information, it would have been more difficult.

    I also related to the comments from the person who quit smoking by thinking about what he was not getting. The truth is, I really don’t like cake all that much in the first place. In fact, I’ve often been disappointed by the actual taste of desserts I thought I might enjoy. Recalling those moments has helped, too.

    Even with other carbs like cereals and breads, I have found that I really did not feel that good after eating them. They make me feel sleepy and sluggish. I bring this to mind as well when I think about eating them, and it helps.

  106. I think humans are – in some sense- just animals with a consience. We are less rational that we would like to think. And that is really oké. Yesterday I had a friend over for dinner and I had too much carbs. And I loved it. I know that today I will be back on the right track. And I refuse to beat up myself for yesterday. Instead I think : it was a wonderfull evening.

    Guilt is not a usefull emotion and I only feel regret for the things I didn’t do.

    Besides, the biggest health improvements come from staying in ketosis most of the time. And my mother is 86 and still going strong. And she ate carbs all her life! I must have strong genes!

  107. Just another thought. I learned some things about energy-homeostatis. And that really means that you are addicted to the amount of fat on your body. When you lose fat, your brain will try to make you eat more untill all the fat is back again. Fully on the auto-pilot!

    Now if you think you are done when the fat is lost, think again. That’s when it really starts. Keeping off the weight is much harder than losing it. You are really done when you have reset the sensitivity of neuro-receptors in your brain. And that could take 6 months or longer.

    I think this is a very powerfull system and it could explain why so many people bounce back in weight. Still, I never heard about it until I read an article on pubmed.

    The good news is that the longer you keep off the weight, the more your brain will help you to stay there.

  108. Thank you for sharing your own carb weakness. Makes me feel better for falling off the wagon.

    Re constipation: I find psyllium husks to be a wonder drug for both constipation and diarrhea – a tablespoon dissolved in a glass of warm water.

    Re smoking: almost everyone smoked in the 50s and cigarettes were called cancer sticks. I quit in 1984 with the help of nicotine gum (and knowing the guilt I would feel if my nonsmoking husband developed lung cancer). What really pissed me off was that it was relatively easy! The hardest part was changing your preception of yourself to being a nonsmoker.

  109. Fantastic! I suspected that something like this might be at work, but the research you cite serves as a reminder that we are not quite as rational as we might like.

    I wonder if we can train ourselves to increase our sensitivity to the Insula’s signal? That might help us keep ‘on track’ when faced with temptation.

  110. I can’t believe you quoted Don DiLillo’s White Noise! I don’t know anyone else who has read that book, love it.

    I read Protein Power in the late 1990s and it really got me interested in paleo eating. But I didn’t do it. Was scared off by the naysayers. I was vegetarian at the time, had been for 13 years. I did start eating meat again a few years later, and felt better, but was still primarily vegetarian by habit.

    I’ve just spent three years studying/doing research in biological anthropology and it all started to click. I started paleo eating in December after being diagnosed anemic, and I feel great.

    But I only found your blog recently, and am loving it. You’ve blogged about some of my favorite anthropological journal articles and are really confirming what I’ve learned in anthropology about human health and diet and what we are REALLY meant to eat. I use the Leslie Aiello Expensive Tissue Hypothesis every time someone criticizes paleo eating. It’s so clear to me that meat made our brains big, and that the shift to agriculturalism has had a negative impact on human health.

    I’m in graduate school for Public Health now and hope I can convince some of my future colleagues there that we need to incorporate paleo eating into thinking about obesity and overall health.

    I could gush more but just wanted to say that I feel like you’re on the right track and I love your blog.