Grist for your insula’s mill

I’ve been working on a nice post showing the difference between a diet using the glycemic index and a regular low-carb diet that should be up tomorrow.  I took a quick break to catch up on a bunch of NY Times and Wall Street Journals that have been lying around giving MD (neat freak that she is) fits.  In reading yesterday’s New York Times, I came upon the following:

How to Stay on the Diet Wagon

From a posting on Diner’s Journal in which Bob Harper, shown at right training a contestant on “The Biggest Loser,” answered readers’ questions:

[Question:] What do you think of low-carb diets in the long-term? Do you think these eventually lead to a “fall off the no-carb wagon” and quick regain of weight (since much of the weight lost is actually water weight)? I would love to hear your thoughts on the best way to incorporate (or eliminate) carbs from one’s diet. TARA

Mr. Harper replies: For many reasons, you can’t cut an entire food group out of your diet. For one thing, if you’re totally deprived of something, you’re going to rebel and fall off the wagon in a big way. For another, people who are exercising — which everyone who wants to lose weight has to do — need to eat carbohydrates. Low-carb diets might work temporarily for sedentary people but it is not sustainable for weight loss.

If you are on a low-carb diet, and you’re  nutritionally sophisticated as most people on this blog (mine, not his) are, then you blow this off as the ramblings of a nutritional nitwit.  But if you are on a low-carb diet, and you are getting heat from friends and family, something like this is enough to send you back to the carbs.

Let’s parse this brief little Q & A to see if it makes any sense whatsoever.

First, is Bob Harper a nutritional authority?  No, he’s a trainer.  A telegenic trainer, but a trainer, nonetheless.  I might pay attention to something he had to tell me about training, but why would I possibly listen to him about matters of nutrition? (I don’t intend to tar all trainers with the same brush.  My friend Fred Hahn knows a lot about nutrition, but it has been my general experience that most trainers don’t.)

What are the many reasons that “you can’t cut an entire food group out of your diet?”  First, carbohydrates aren’t a food group; they’re a macronutrient.  And why can’t you cut them out of your diet?  Are there carbohydrate deficiency diseases, Mr. Harper, that you know about that the rest of the nutritional world doesn’t?  I’ll clue you in: there aren’t.  But there are both fat and protein deficiency diseases written about in every internal medicine textbook.

What about fat?  You recommend cutting that.  Why aren’t those people who are totally deprived of fat not going to “rebel and fall off the wagon in a big way?”  Or is that different than cutting carbs?

You say, Mr. Harper, that “people who are exercising – which everyone who wants to lose weight has to do…”  Can you show me the data that proves that exercise improves weight loss?  I’ll grant you that it sounds reasonable, but can you muster the data that proves it?  I can tell you that you can’t because there is no such data.   Diet brings about weight loss; exercise doesn’t.

And how about your idiotic statement that people who do choose to exercise need carbohydrates?  Another whopper.  Most studies show that after a period of adaptation, people who exercise while following a low-carb diet have better endurance than those following high-carb diets.  Have you seen all those studies, Mr. Harper?  I guess not or you wouldn’t have made such an idiotic statement.

And, finally, where is your data that low-carb diets aren’t sustainable for weight loss?  Virtually every study that has been done comparing low-carb diets to low-fat, high-carb diets has shown better results in those following the low-carb diet over whatever the length of time the study has lasted.  You may say that these studies aren’t long enough to fit your definition of ‘sustainable,’ but can you show me any studies showing the low-fat, high-carb diet is ‘sustainable’ then?  I thought not.

So, what we have here is a short answer to a question about low-carb diets that is a total misrepresentation.  The answer contains four sentences and all of them are wrong.  In fact, one of them, the third one, contains two statements and is wrong  in both cases.

I particularly liked the title of the Q & A: How to Stay on the Diet Wagon.  I mean, if there were ever a statement designed to motivate one to get OFF the diet wagon, it would be this one.

This would all be a joke were it not for the fact that the show on which Mr. Harper appears is a popular show with weight loss as its theme.  I’m sure many overweight people watch this show, and, for whatever reason, give Mr. Harper some credibility.  And I’m sure that many of the overweight people who watch are on a low-carb diet, and many may be struggling.  All it takes is an ignorant answer to a question like this from a person of authority to drive them from their diet.

Remember from the previous post how in the brain it is the insula’s role to be skeptical and say No.  Just a little Q & A like this one can be disastrous to some people, giving ther insulas, which are already riding the fence thanks to negative input from friends and family, the rationale to encourage them to bolt from their diets.  I’m just doing my small part to compensate.  If you have any friends who send you this little tidbit, you can reply to them with this post.

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

Leave a Reply

Your email address will not be published. Required fields are marked *

84 thoughts on “Grist for your insula’s mill

  1. Hmmm, let’s see … on Tuesday morning, I had sausage and eggs for breakfast, then my wife and I went to the YMCA and lifted weights using Fred Hahn’s Slow Burn method. When I started that method last year, I put on 16 pounds in two months, none of it around my waist. My wife also added muscle curves to her legs.

    We seem to be exercising without carbs.

    On a cruise-ship gig last year, I met two dancers (married to each other) who had given up carbs completely so they’d be leaner — some of the dance numbers require the guys to go shirtless and the women to wear very tight outfits. Rehearsing and dancing in a show three nights per week is damned hard work, which didn’t make them lean all by itself.

    They seem to be exercising without carbs.

    After going no-carb for a couple of months, the dancers had a routine checkup with the ship’s doctor. When he saw their lipids had improved since their previous checkups, he said, “These numbers are great! You must’ve really cut the fat from your diets!”

    Did I mention I met them in the ship’s steakhouse restaurant, where we were all tearing into medium-rare porterhouse steaks? The basket of bread remained untouched.

    You definitely need a “Jesus Wept” category.

    Good idea. Maybe I’ll start one.

  2. Dr. Eades,

    Aside from the weight loss benefits that carbohydrate restriction provides, is there any link between serotonin and low-carb? Can high-carbing adversely affect this brain chemical?

    There is a link, but it is too detailed to go into in a comment response. I’ll post on this subject in the future.

  3. I get so irritated when people think low carb means no carb!

    I just recently discovered your blog and am so grateful for all your pertinent info, thank you!

    May I ask one question? How do you feel about low carb for children? My son is nearly 4, and I only let him have fruits and whole grains, but if he had the chance, I think he’d eat bread, pumpkin pancakes and bananas 24-7. I feel like he does need the carbs for energy, as he doesn’t have sufficient fat stores, but I worry about the amount of grains he eats.

    As a rule, kids will eat almost all the carbs you let them eat. Our own kids went on a sort of low-carb diet, and they did fine. If you limit carbs somewhat, you are way ahead of the game. If you can fill them up on the good stuff, meat, green and colorful vegetables, and low-carb fruits, they won’t have as much room for refined carbs. The biggest challenge is breakfast because it’s much easier to simply set out the cereal box instead of cooking eggs or something with more protein. But, we often gave the kids protein shakes for breakfast, so they got the protein and fat, yet the breakfast was easy to make and clean up after.

  4. Hi Doc,

    First off, I’d like to say that any good trainer should know at least the kinds of things you talk about in this post! I’m a trainer. And I read a lot in order to keep on top of my field. I just don’t understand how you can possibly dismiss the benefits of low-carb nutrition given all the available information.

    Thanks for doing so much to “bust” the myths.


    I agree. A good trainer should know.

  5. To be fair to Mr Harper, I do believe he and Jimmy Moore had this out on one of Jimmy’s podcasts a year or so back. Harper (back then) didn’t deny that low-carb works (duh), but found it too hard to get people to stick with it for the long term – which was after all the whole point of your last blog post. Heck, if I were a trainer I’d probably also tear my hair out from listening to people’s excuses regarding non-conformance…
    That said, he has talked a lot about the dangers of sugars and starches (I believe he’s more of a fiber & low-GI guy, FWIW) and how to minimise diabeties symptoms, so he’s not totally ignorant.
    Err… on the the hand, he is a vegetarian, sooo- *chuckle*

    As for the exercise, agreed that physiologically it’s probably unnecessary – but psychologically it surely helps refocus the mind on the weight loss goal? I do concede that given the increased risk of injury the benefit probably ends up a wash. But such is life…

  6. Good post Dr Mike. Thanks.

    I do have a question, however, about the TV program “The Biggest Loser.” I have never watched it. I hear each group has a “trainer” but no one has mentioned the types of diets these folk are on. Have any of the competing groups been on a low carb diet compared to other groups on a low fat/low calorie diet.

    The uninformed want to know.

    If we could somehow influence the show’s producers or challenge them to test the low carb hypothesis, we could get a lot of publicity when they win.

    Just a thought.

    I, too, have never watched an episode of “The Biggest Loser.” I know Bob Harper only by what I found on Google after I read his inane response to the question.

  7. Yes, BH is a personal trainer (and so am I). However, he does some pretty idiotic things with morbidly obese people. By week two on BL most of the contestants are having issues with their knees. Dr. E, don’t listen to anything he has to say about exercise either!

    As we see over and over again, many of the contestants on the Biggest Loser fall off the diet & exercise wagon and gain most if not all of their weight back. So how well does his prescribed program work?

  8. Hi — I saw your post and wanted to clarify that I am not the “Tara” who asked the question. That was apparently just a reader with the same first name.

    Tara Parker-Pope
    Well columnist
    New York Times

    Sorry that I tarred you with that brush. I’ll change the post. Thanks for the heads up.

  9. Dr. Eades: Thanks for this post. A couple of things I have wondered about the biggest losers show. If as Gary Taubes explains in his book it is not about calories in-calories out, but about breaking the cycle of hyperinsulemia by minimizing carbohydrates and promoting fat loss, how come they lose so much weight? Are they consuming substantially lower amounts of carbohydrates enough to break the cycle of fat storage? (so they are in a low carb diet but they are not aware of it). Bring in ridiculous amounts of exercise and they are basically sweating fat…Or, are they on a low fat diet which is not sustainable on the long-term, but coupled with a strong incentive to lose weight ($$), enhanced group therapy and ridiculous amounts of exercise brings their weight down.

    I have always wondered what the weight history of these contestants is after the show is over. If they tend to gain back weight after the show then they were probably on low fat-high carb diets..Wouldn’t you think so? I know the winner from the first season gain back ALL the weight plus a bit more.

    Any thoughts? Best, Jorge

    Many people have lost weight on low-fat, high-carb diets. It’s just that it’s not a particularly pleasant or healthful way to do it. You can read my post about the Ancel Keys starvation studies to see a comparison between low-fat, high-carb, low-calorie diets and low-carb, low-cal diets. And to see the end results of the low-fat diets. As both men (Bob Harper and Jillian Michaels) will tell you, restricting calories and and working out like crazy will result in weight loss. But, most people have to have the motivation of a zillion viewers watching them to make it work. If you Google the show or any of the names associated with it, you can find the tales of the people who didn’t make the cut. It makes for sad reading.

  10. It really is criminal! So much suffering is being caused by such willful ignorance. (with the Mr Harper, it may or may not be just be plain ignorance, but he thinks he knows what he is talking about because of many scientists and physicians out there out there who refuse to see the facts that are in front of them.)

    I have become so angry about this that I think we all ought to mount a class action law suit. Of course “they” would all close ranks and make that pretty well impossible. In fact I believe that is what is going on now. which is why it is so rare for any of them to recant.

    The best thing is to keep responding and commenting on blogs, like the stupid Mayo Clinic one you mentioned (it was great to see that virtually all the commenters had the “true” truth) and in letters to the editor when we see such rubbish. Just inundate them .

  11. (since much of the weight lost is actually water weight)?

    I lost 68 pounds doing low carb. I guess by their belief that was one helluva bunch of water.

    Thanks for bringing this up. I forgot to mention the errors presented as fact in the question.

  12. NOW HOLD ON Dr!

    Those of us who were ON the show don’t even consider him an authority! LOL!!! In all seriousness let me mention a couple of things and address a point from your post, which was excellent as usual.

    First off the press is stupid. And they have an agenda. So of course it was a planted/leading question and an excellent observation of such.

    Second. In tv land it is hard to be honest. Seriously. I was told while I was on the ranch by my trainer that anything she told me about her research into nutrition and exercise becomes the property of NBC if it is ‘said on set’. So some things you simply could not learn while on the ranch or you would get the ‘short’ version. It is sad but anything told to us contestants could be turned into an on-line program or book de jour etc. Imagine Dr. if YOU were brought on the show to educate contestants and at the same time were working on a book. Then you explain the principles and research from the upcoming book and bam – it is online on the NBC web site or a ghost writer had been hired to expound on the information all within a couple months. See the point? You simply don’t reveal everything you know. So even if you hear or read someone from the show in an interview you have to figure out if that is ‘Show Trainer’ or ‘Real Trainer’ because sometimes different answers will be given depending on the context, who is promoting what, etc. I know that may sound like gooblygook but I know how some of these contracts work. Think politics and how politicians roll over for positions they don’t believe in and you will see the parallel.

    Also, as with all ‘professionals’ there are vast difference in trainers and nutritional philosophy etc. Jillian had some sharp words for Gary Taubbes on Larry King if I remember and I had to text her and ask her why the harshness when she taught us much the same thing in summary? (Btw – nutritionally they pretty much agree but on exercise they differ – more on that later) But there is a serious difference in the knowledge and methods of each trainer so one can’t be held up as a standard even though he is out front. Bob is a vegetarian so he is biased a certain way to begin with. Fine. It works for him.

    Now – Regarding exercise – let me preface that by saying I learned in part how to read research studies from you and a few others (you are a part of my daily morning reading).

    On the subject of ‘exercise improving weight loss’ I would have to turn your line of logic back around on you. – Are nutritional and research experts also experts in exercise?
    By that I mean are the studies produced comparatively matched with other studies where the nutritional approaches are kept the same and the exercises are varied. And not just varied but adjusted using the simple F.I.T.T principle of Frequency Intensity Time and Type? I have not found them to be so but I am willing to be corrected. Could Fred Hahn design a program, with nutrition, where people’s weight loss IS improved with the correct type of exercise? I would think so.

    So I question, not just anecdotally from my own experience but also from my reading if researchers are even close to being qualified enough in exercise science to properly include their findings on the ‘benefits’ of exercise in their research?! It you don’t account for the huge variables that are inherent in FITT how can the conclusion be properly drawn?

    I could design that type of study by the way! Get the best nutritional researchers and combine them with the best athletic-style exercise researchers and account for all different types of variables and THEN test. Again this may have already been done but I have never come across it.

    So I am suspect of the conclusion that exercise does not help weight loss.

    In conclusion ever since I stepped foot OFF the Biggest Loser ranch I have taken it upon MYSELF to read up on what works and what doesn’t. I spent tons of hours reading and gained understanding regarding all manner of things including the hormonal response within my body to certain foods and then I experimented through trial and error on myself personally to determine what works for me and what doesn’t. I was my own research subject :-) I can honestly say that Weight Maintenance is a separate subject from Weight Loss.

    Lastly, regarding the show. Undoubtedly you will have a flood of ‘I hate that show’ and ‘they all gain the weight back’ comments. In response to those forthcoming comments, as I said earlier, Weight maintenance is a separate subject from Weight Loss. The show is about Weight LOSS. Only! It is up to each individual contestant to gather for himself the tools need to be successful in weight maintenance. There’s more to be said but this was a post itself instead of a comment. Sorry.

    Pete Thomas

    Current Pics

    Hey Pete–

    Thanks for taking the time to comment; I really appreciate it, and I’m sure my readers do as well.

    The idea that exercise does not increase weight loss is controversial, to say the least. I, myself, haven’t gone through all the literature, so I can’t point to this paper and that. But, I do know that Gary Taubes is an excellent investigative journalist with no dog in the fight on the exercise versus weight loss debate, and when he dug into the literature, that was the conclusion he came to. I know him well, and I know the lengths he goes to to make himself comfortable with reporting his conclusions. And if he says that the literature doesn’t show a correlation between exercise and weight loss, then I’m much more willing to believe him than I am someone who has a vested interest in promoting an exercise regimen.

    It all boils down to the real meaning of the energy balance equation, which is:

    change in weight = energy in (food) – energy out (exercise and metabolic rate)

    A simplistic reading of this equation would say that if you want to decrease your weight, you would either decrease the amount of food you eat or increase the amount of exercise or (as BH and JM would have it) both. This makes sense only if the factors to the right of the equals mark (energy in & energy out) are independent variables. But they’re not. If they were, increasing exercise would definitely increase weight loss. But, as I say, these are not independent variables. They are dependent variables.

    If you decrease the amount of food you eat, your metabolic rate falls and your level of spontaneous activity decreases.. (For example, the subjects in the Keys’ starvation experiments slept all the time.) If you increase the amount you exercise, the body compensates by more efficiently utilizing the food you eat and by making you more hungry in an effort to get more food. If you are on a strict diet – with no variation – and you start a rigorous exercise program, you will lose some extra weight as a consequence, but not a whole lot. And if you are not on a strict diet (and by strict, I mean counting every single calorie), you will compensate by eating a little more and negating any energy-out gain you achieved with your exercise. Why? because exercise, even intense exercise, just doesn’t burn all that many calories.

    Having written all this, I hasten to add that I am a proponent of exercise for a multitude of health reasons, just not for weigh loss.

  13. I was watching an episode of the U.S. TV show Monk last week and at the end of the show, the cast did a short tribute to Stanley Kamel who played Monk’s therapist and who died last April of a heart attack.

    While the cast encouraged us to follow a heart-healthy diet, a large white banner was displayed prominently behind them and read:


    You can’t escape this stuff, even when relaxing, watching a detective show.

  14. The biggest problem I have with the statement is that the word is LOW CARB not NO CARB just like it’s LOW FAT not NO FAT. As you point out, a no fat diet will kill you slowly and painfully. While a no carb diet might not be enjoyable (for everyone), it will sustain you indefinitely in good health. The article is PROPOGANDA and is, at best, one man’s opinion. It is also a perfect example of the straw man argument with no carb standing in for low carb.

    Hi Mark–

    Good to hear from you. And what you write is indeed true.

  15. It’s amazing how much stuff people *think* they know. I’m sure if you asked Mr. Harper if he’s seen evidence of the claims he made there, he’d insist that he has. In his mind, he probably has a vague image of graphs and scientific proofs that back it all up, but he couldn’t actually point you to any of them. After all, if he’d *never* seen such evidence, he wouldn’t be so convinced, right? So it must exist.

    It couldn’t just be that he’s heard it repeated a thousand times by other people like himself who were simply repeating the meme, all assuming someone else must have seen the proof.

    Brings to mind the great Mark Twain quote:

    It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.

    In fact, Mr. Harpers extraordinary success with his show personifies another Mark Twain quote:

    To succeed in life, you need two things: ignorance and confidence.


  16. The way the biggest losers eat and exercise is a guarantee that they will gain it back.

    SF jello? Yuck! The diet is all about calories and low fat.

    And they are terribly overworked as well.

    Bob and Jillian are both terrible trainers because they work these people too hard and know nothing about nutrition and yet act as if they do.

  17. Great article! Thanks. Gonna send this one to my diabetes educators who insist my kidneys are gonna fail ’cause I eat so few carbs (or the other ridiculous statement that I eat too much protein)…give me a break and read the studies…or review my progressively improved BGs in my emailed logs or my great bloodwork results, continuing wt loss, vastly improved mood & energy, & increased exercise. Sheesh. This might stop them from making these asinine statements to me but they’re such a hard-headed group, I’m sure they’ll continue making those same de-motivating, inaccurate statements to others.

    I know it seems like it’s always 20 yrs from study to popular knowledge, but the benefits of low carb have been around since Banting, a heck of a bunch longer. Why the resistance to what’s been shown over and over and over to be true? Are we really that ignorant or are we just too frightened to speak out against the mainstream/media brainwashed by self-serving corporate interests…*sigh*.

  18. That is very true, that a person with authority makes a baseless statement.

    Mine is a fine example…
    I am following your book, Protein Power and at same time I was doing lot of cardio workout (running, swimming, etc). I was down with injury (knee injury due to running) and could not work out for like 2 weeks and I was still losing weight. The only thing I was doing was following your book to every detail.

    have lost 20lbs in little over 2 months…

    So thank you…

    Glad you’ve achieved success. Keep after it.

  19. Excellent posting, as always Dr. E. You are on quite a roll. However, your second paragraph needs an edit. The one beginning “If you are on a low-carb diet…” Thank you so much for your time. I will buy three of your books when they finally arrive on the shelves.

    Thanks. I fixed it. Must have changed thoughts in the middle of the sentence. I appreciate the heads up.

    As to our new book, why stop at three? :-)

  20. Dr. Eades,
    I’d be very interested to know your take on the proposition that chronic carb restriction can temporarily impair T4 to T3 conversion. Have you seen this phenomenon in your practice? Would you ever recommend some mild carb cycling for someone with low T3, and normal TSH and T4?
    Many thanks!

    I’ve seen this phenomenon written about and heard it talked about for years, but I’ve never really experienced it with patients in practice, so I’m not sure it exists. At least as a common occurance. If I did have a patient whom I thought was having difficulty, I would add a little Armour thyroid daily before I would recommend carb cycling.

  21. I’m reading this during my usual breakfast of eggs and bacon cooked in butter and thinking: I’m not on a wagon, I’m on a luxurious chariot smoothly travelling down a road littered with carcases of athletes half my age. Not likely that I’m going to “fall” off, Bob!

    Biggest Loser is enjoyable, it’s great to see the progress people make. Some of the full-body training they do is right on, but it would be fun to be the low-carb trainer and see what is the minimum you could do to get the same results. These guys are working out 6-8 hours per day which is just brutal.

    It is truly amazing the amount of effort uberchavs will put out to get on reality TV.

  22. Now that I have lost 85 pounds on low carb – if that was all water weight, I must have been sloshing as I walked – my blood sugar is doing crazy loopdeloops and I want an explanation. Not necessarily a solution; that would be to continue until I reach a healthy weight and then allow my poor confused body to catch up with the drastic changes. I just want to understand what is going on now.

    So I have been reading new, state-of-the-art books on diabetes, and can summarize their stance as follows:
    “Although low carb diets do work for weight loss, and will improve your lipids, we do not recommend them because we don’t know their long-term effects. However, if you follow our advice to consume 200+ carbs a day and let your pp bg’s go as high as 180, we can pretty well guarantee that even if you now control your diabetes with diet and exercise, in time you will need to add medication and if you live long enough, insulin. But this will not be your fault, because you are only doing what we told you.”

    Thank you for maintaining at least one small island of nutritional sanity.

    My pleasure.

  23. Dr. Mike,
    I watch The Biggest Loser and can tell you that the contestants are encouraged to eat low-fat and count calories. Much of the airtime actually focuses on the hours and hours of exercise the contestants do each day and not so much on what they eat.

    As for low-carb eating, in the most recent episode, there was some negative attention paid to it: one contestant, a 50-ish year old father with knee problems among other health issues, is shown eating a salad with cold cuts on it while other contestants are eating sub sandwiches. Bob Harper’s voiceover describes how this contestant still has fear of eating carbs, and then repeats the bunk you quoted about how you need to eat carbs to fuel your body for the exercise and for sustained weight loss. He uses this contestant’s attempt at keeping LC as an example for all the other contestants to learn from about what not to do. It’s very annoying.

  24. I agree, another excellent posting. I’m waiting for you to comment on the JUPITER study, along with the recommendation that 80% of people over 50 would benefit from being on a statin.
    All best,

    I did comment on the Jupiter study late last year when the results were announced.

  25. Couple what you’ve discussed here with the whole SlimFast, Jenny Craig, Bob Greene/Oprah debacle (and the new debacle poised on the horizon), and no wonder people are completely confused. Not that your average person is willing to put much time and effort in towards the pursuit of any real knowledge.

    At least not any real nutritional knowledge.

  26. As the “BL” television show does so much to advance “memes”, I would be interested if anyone here knows of data regarding the post-BL TV show fat-loss maintenance of former contestants?

    I don’t, other than what I read on Google. Readers?

  27. Doc Mike,
    It appears that a lot of the misinformation that Bob gives out is motivated by toeing the company line. Aside from his own beliefs about nutrition, the sponsors of the The Biggest Loser are the end signers of his paycheck. It takes little searching to discover that the ads on the show touting healthy eating are nothing but attempts prop up the usual junk foods sold by General Mills & Kellogg’s. Keep up the good work.

  28. At the end of the day I see Bob Harper as a salesman telling people what they already believe just as the majority of ‘so called’ health food magazines do when they parrot the official government food guide recommendations for a low fat, high carb diet. Whether the information has any basis in science is to a salesperson, irrelevant. High carb, low fat has the ‘official’ authoritarian stamp. As such, the majority accept it without question. Our government always acts in our best interests, don’t they?

  29. Don’t know how I would get through my week without the Dr. Mike’s voice of reason and knowledge.

    OT: I was told today by a friend that I’m going to get very ill taking 5,000 IU daily of Vitamin D. She mentioned that her doctor told her specifically that it was very dangerous because the body cannot get rid of Vitamin D and it builds up in the system. Should this cause concern? — I need “a voice of reason”.

    Your friend’s doctor is correct in that it is a fat-soluble vitamin and is stored, but the new papers on vitamin D3 show that people can take much larger doses than previously thought (even 10,000 IU per day) without consequence. I, myself, take 5,000 IU vitamin D3 per day all during the winter and pop an occasional 50,000 IU if I feel like I’m coming down with something. In the summer I’m out in the sun a lot so I take a vitamin D3 every now and then just to sort of top things off. If you are concerned, have your doctor check an OH(25)D on you.

  30. In defense of Bob Harper… the people he is training on his show are burning 7,000-10,000 calories per day. That’s a lot. And he has found at that level of training intensity, people lose more weight when they include carbs in their diet.

    I agree that shouldn’t be extrapolated to the rest of the world. We’re not training 6-8 hours a day, it’s a whole different story. But give the guy some credit- he’s found a diet and exercise program that can take a sedentary person weighing 300-400 pounds and enable them to lose 10+ pounds per week of fat while gaining muscle and with a very low injury rate.

    A diet/exercise program that ‘works’ is not the same as an optimal diet and exercise program. People in concentration camps during WWII were forced onto diet and exercise (read: hard forced labor) regimens that ‘worked’ in that everyone lost large amounts of weight, but it’s not a program I would want to go on. How about you? Given the success, however, one could say, ‘Give the Nazis some credit; they found a diet and exercise program that works.’ As a point of reference, I’ve had people in the 300-500 pound range who easily lost 10-15 pounds per week without the 6-8 hours per day of exercise.

  31. Wow, so much to comment on! I watch this show with my teenage grandson so we can ridicule the process;-) I usually say things like, “Don’t ever do that or let anyone else talk you into it.” He now sees the phony product placement exchanges and says, “There they go again!” At least it gets him thinking critically.

    The diet: Just last week, BH found out that one contestant who was not having big weight loss numbers wasn’t eating his carbs. GASP! Bob sat him down and told him that he HAD to have his carbs to fuel his workouts or his weight losses would stall. Turns out the kid ate more carbs and lost 13 lbs. See? says BH, I’m right. BUT, the diet, which was written about in Prevention, is actually more of a Zone plan; the carbs are in small amounts, such as 1/4 cup of brown rice. The fat for each meal and snack is around 1T. each, which I found amazing as the original Weight Watcheres program allowed no extra fat at all, and then moved up to 1T/DAY. Of course the fat is supposed to be good fat, not sat fat. Fruit portions are also small. So overall, there is not a huge carb load. So, while the trainers and contestants appear to tow the lowfat/low calorie line, with the s/f Jello ads, and the Extra gum ads, and the Cheerios promotions, etc., the contestants are really not eating large amounts of carbs and are consuming more fat and protein than the show wishes to disclose to the general public. They are watching their calories though (1200-1400 for women, 1500 for men), and are expected to burn over 6000 calories in exercise every day.

    Maintenance: The record is not good, it seems. The 3rd season winner regained about 100 of his 214 lb. loss, as revealed on Oprah. Other contestants from other seasons have put on some, maybe 30-40 lbs. One of the women from Season 5 became a trainer and is running a Fit Camp based on TBL model, although she too has put on weight and says that TBL “did a number” on her.

    Exercise for weight loss: It only works for the contestants because they’re killing themselves for most of the day. They endure 3-4 exercise sessions/day and sometimes choose to workout in the wee hours of the morning because they are so indoctrinated with the exercise=weight loss dogma, and then there are the challenges and the “Last Chance Workouts” where the trainers “beat the crap” out them, according to trainer Jillian Michaels (one of her team members has been The Biggest Loser for a number of seasons. I don’t think any of BH’s contestants has). Injuries are downplayed, although they are many, esp. shin splints and knee problems.

    This season’s contestants are the heaviest that have ever been on the show. Watching a 400+ person running just horrifies me, though.

    I am one of those sedentary persons (lazy according to BH/JM), as I have a form of muscular dystrophy, which has really weakened my shoulders/hips/quads, but I’ve lost 70+ lbs. anyway on PP. It wasn’t quick, but so what? I try to get in some resistance training when I can, and get some cardio by rolling around on my under-the-car creeper or using my Gazelle. But if I listened to these dolts who insist that I have to exercise to lose weight (Bob Harper/Bob Greene), I’d never even have tried.

    Well put. I’m glad you didn’t listen to the named dolts.

  32. Dr. Eades:
    (kind of on topic)

    I have a plan. Dr. MDE needs to become a famous world-renowned singer and you need to become a sexy soap opera or ER star and then people will listen to the both of you when you start talking low-carb. Better get started now.

    It’s a crazy world when hardly anyone pays attention to your views unless you’re in show business.

    A notion that Suzanne Somers has exploited to the max.

  33. Hi Dr. Mike,

    Just as a journalistic sidebar, BH has 2 credentials (from the BL Bio) “certified with the American Fitness Training of Athletics and with Aerobics and Fitness Association of America.”

    What nutritional training the home study 3-day weekend certification organizations offer, looks like it’s based on the food pyramid, at least judging from the giant full color USDA pyramid graphic on the aerobics site.

    BUT I this would interest you and your readership most -the last line in the course description, which was underlined for emphasis –

    “Completing the AFTA Sports Nutrition Advisor course does not make you eligible to function as a licensed dietitian.”

    CJ Hunt
    “In Search of the Perfect Human Diet”

    Nice. Thanks for the enlightenment.

  34. There is an entire community that may be one of the fittest in the world who tend to eat no more than 40% of calories from carbs, most of which are fruits and veggies. Most of us eat less than 40%. CrossFit has been a proponent of Zone or sub Zone levels of carbs for years and have excelled at fitness.

    I’ll disagree slightly with your analysis of exercise. The studies Taubes refers to are as flawed as the diet studies. Taking a 45% carb diet and calling it low carb and then saying it doesn’t work is like making someone jog 20 minutes a day, them not losing weight and saying exercise doesn’t work. Intense exercise in short bursts can produce similar hormonal responses to low carb dieting. Insulin drops, growth hormone and testosterone go up. This assists weight loss and muscle growth. I am sure people have mentioned CrossFit here before as many of us love your work, but I just wanted to throw that in. We never say CF works because it burns calories. We know better.

  35. Did you know Mark Twain once said, “Beware of health books… you may die of a misprint”?

    I can tell you are a scientist at heart when you claim it just isn’t so if Taubes couldn’t find the literature to substantiate. I am having some trouble with this one, especially since I was exercising intensely at one point in my life, eating anything and everything I wanted while maintaining a perfect weight. This was the only time I experienced this and know it to be true for others I know as well. I have been told by health professionals that there are studies showing weight loss is more successfully maintained among people who exercised daily although I was never shown these studies. It may be overrated up to a certain level and then benefits seem to kick in with duration and intensity.

    Perhaps. And I do think that if exercise has any benefit re weight loss it is in maintenance.

  36. As both men (Bob Harper and Jillian Michaels) will tell you…. Dr Mike, I am not sure if you made a typo or not, but Jillian is a woman, lol, even though she acts like a drill sergeant most of the time. I watched one episode where a contestant was out of breath and she kept yelling at him obscenely to get back on. Poor guy weighed around 350 pounds and was having a panic attack. He did manage to finish his 5 minutes of run, but I was really concerned for all those overweight people watching at home. I know that people are ultimately responsible for making their won decisions, but there are some innocent souls out there that will emulate the same techniques used on the show and will get hurt. The show continuously beats up the same drum that weight loss= calories in- calories out ( exercise + metabolic output + will power! ). Anyone can induce severe exercise regimen for 3 months under bright lights of TV cameras to the tune of millions of people watching. But is it sustainable? I guess Mr Harper thinks it is, and low carb is not. As always, keep your voice of reason loud and clear!

    Nope, it wasn’t a typo. It was intentional. Wanted to see if anyone noticed.

  37. Dr Mike,

    I’m hoping you’ll be able to answer a quick question about sun exposure.

    In your book you say 15-20 mins of sun exposure is a good amount. What I don’t understand about this is whether it’s fine to spend much longer, say an hour, in the sun if you have gradually worked up to it. If the body has a natural mechanism for controlling sun exposure in the form of tanning, does this make longer periods OK if you have built up to them?

    Longer exposure is fine if you have built up a tan. A tan is nature’s sunscreen, but it should be built by gradual exposure and not a burn that ultimately converts to a tan.

  38. Omg, I noticed the Jillian reference and was laughing my arse off about it. I love the show because it’s such a joy to see these folks have some weight loss success, but I yell at the screen every week…my husband threatens to leave the room while I watch it. I’m a trainer, but he’s a commercial pilot and I have to sit through airplane disaster movies with him, so I’m saying we’re even.

    Thanks for a great post and blog, as always.

  39. Hey Dr. Mike,

    I did have Bob Harper on my podcast show in November 2008 where he mentioned the challenge of sticking with a low-carb diet long-term. Since I only had a total of 20 minutes to interview him, I couldn’t press the issue much further than I did:

    But his ideas about low-carb are certainly not new. In my October 2005 interview with him, he gave pretty much the same kind of answer as he did in the New York Times column:

    MY QUESTION: What is your philosophy regarding the low-carb lifestyle and do you believe it is a viable lifetime option for people who are looking for a way to control their weight?

    BOB HARPER’S ANSWER: “If you cut out all carbs, you will DEFINITELY lose weight. Unfortunately, you will gain it all back because I don’t believe that it is a way of life. I am all about changing your way of life and having you incorporate the right amounts of protein, carbs and fats.”

    He may know a lot about training, but these answers show he doesn’t know diddly-squat about healthy nutrition.

    Oh so true.

  40. You mentioned you gave your boys protein shakes and they got all the protein and fat they need, but where did the fat come from?

    We made the shakes with coconut milk or added some heavy cream.

  41. While traditional steady state cardio has not been shown to improve fat loss in any study that I know of, high intensity exercise has been shown to improve fat loss, insulin sensitivity, cardiovascular health, lipid profile and a host of other positive effects. Besides, one of the aims of strength training during a diet phase is to preserve as much lean muscle mass and strength as possible while losing the fat. If you’re obese, you’re not gonna get a body fit for the covers of Men’s Health or Shape magazine by just dieting alone. So I wouldn’t say exercise is useless in a fat loss phase. You just have to do the right type of exercise, and it isn’t half an hour on the brisk walking 3-4x a week in the fat burning zone.

    Do you have a reference showing that high-intensity exercise improves fat loss independent of diet? I agree about the other positive effects, but not so sure about the fat loss. I’m willing to be persuaded if you have the reference.

  42. I love the argument that you can’t go low carb “CUZ U’LL REBEL AND EAT CARBS”.

    To that argument I propose the following.

    Diets high in carbs and low in calories are diets that promote a lot of hunger, especially for glucose intolerant overweight people. Diets low in carbs are also lower in hunger. Hunger is the biggest problem on any weight reducing diet. Hunger is the biggest reason people fall off the wagon.
    Would you rather eliminate carbohydrate or hunger? Which is more sustainable, a diet that is lower in carbs, or a diet that is higher in hunger? If we are assuming that a lack of carbs will propel one to react to the lack of carbs by eating them, shouldn’t we assume that the presence of hunger has the same effect?

    What about high carb (low cal) diets that increase hunger? Why is it assumed people have a driving need to eat carbs, but no driving need to eat for hunger?
    It’s really easy to avoid gluttonous eating of sugar/starch if one is so inclined/motivated but try to avoid eating for hunger is almost impossible for any length of time.

    This is the problem when people who do not have obesity make rules about how to fix it. If this person had obesity, he would understand carbs make one very hungry and make a weight reducing diet impossible. This is the kind of person who feels full after a breakfast of oatmeal or some crap.

  43. A question about exercise and blood sugar, if I may. Although it is particular to me, I think it might be of interest to some others here.

    My fasting Bg has been averaging around 105 hundred. Am trying to bring it down. One thing I realized was that I was a little too casual in counting my carbs, especially nuts. so I am being more careful in that department and although it has only been a few days, and a few handfuls, that does seem to be making a difference.

    I have also started a Slow Burn type exercise routine at home. Yesterday my BG before exercise was 99. I was thrilled to see it go below 100! Afterwards, to my great surprise, it had shot up to 120. I did not feel very good either. An hour later it was 109.

    Although I didn’t take my BG, I felt the same way after the last time I did this routine so I now assume it went up then too.

    Both times I was really trying to get to muscle failure.. Whereas the first three or four times I did it, I was just learning the routine and used lighter weights or stopped in some cases after only 2 or three reps, when I felt some muscle fatigue, but could have pushed further. I felt great afterwards, really energized.

    I plan to experiment and test my BG when using lighter weights or not pushing for so much fatigue.

    But meanwhile I would very much appreciate your thoughts.

    I am guessing this was a cortisol response. Am I likely to adapt? Would that be more likely to happen by sticking with the heavier weights or by backing off?

    Would the brief spikes be considered a problem, or something to be endured for the sake of a longer term gain? ( in lowered BG)

    Intense anaerobic exercise, which Slow Burn is, uses glucose as a fuel. As intensity increases as failure approaches, the use of glucose is at a max. The muscles are really sucking it out of the blood. And sending the signal to the liver to make more. Plus the lactate the muscles throw off is recirculated through the Cori cycle to help produce more glucose. Once the exercise session is over, the glucose-generating mechanisms have to shut down, and there is a little lag to this, causing a temporary overshoot in blood glucose. Nothing to worry about, however. In the long term, these workouts should decrease your average blood sugars, so you don’t have to be concerned about the temporary elevation. And it’s usual to not feel very good after a true Slow Burn workout. You’re trading quantity for quality, and the large output over a small time period can pretty much exhaust you.

  44. Hi Dr. Eades,

    As a continuation of Pete Thomas’ post on exercise and fat loss and your defense of Taubes, it does seem after my reading of his book that he really did not dig very deep within the literature on the effects of exercise on weight loss and things like lipid mobilization and so forth…and he did sort of cherry pick many of the studies which he did use. While I’m agreeing that generally 80-90% of one’s fat loss success can be garnered from nutrition, the other 10-20% based on exercise and lifestyle choices definitely does play a role. It’s just that I wouldn’t be so apt to defend Taubes; the facts and more often the clinical experience itself should be able to speak for itself, if indeed everything is factored in without bias.

    Anyhow, keep up the good work, and try to make sure you don’t razz too many people…I’d hate for you to turn into Lyle McDonald. =)

    As I recall, Gary didn’t dwell a whole lot on the exercise issue in his book. His main writing on it was this piece in New York Magazine.

    And, I’ve got to ask, who’s Lyle McDonald? I know he wrote a book years ago on the ketogenic diet (is this the same guy?), but does he razz people? I don’t know anything about him.

  45. Good afternoon,

    I have been wondering about exercise and weight loss because I do several tough workouts a week in shotokan karate, (short burst, high intensity) and sometimes stagger out of the place on rubber knees I’m so tired. But if for some reason I do not train much I actually seem to drop a few pounds pretty easily, within a few days. I wonder if I am somehow having muscle shrinkage during that time from the (relative) inactivity. I know you’re not an exercise physiologist, but it seems odd and I wonder if you have any thoughts on this. My weight is entirely stable at all low carb calorie levels no matter what I eat or how hard I train. But if I stop I drop about 4lbs.

    You’re right, I’m not an exercise physiologist. I can’t figure why you would drop so fast. It’s most likely a fluid balance change since the change takes place so quickly.

  46. First off, great post and interaction with Pete Thomas who was on the show. The show fascinates me since I am trying to see how these people lose weight. After several seasons of watching the show, it is losing it’s appeal, I tend to agree with many of the comments here.

    In addition, I’ll emphasize that:
    a) This method of weight loss NOT REALISTIC. How many people have a trainer at their disposal to drive them 4, 6, or (like last week) over 12 hours at the gym? Very few. People can not afford that strain on their finances or their schedule.
    b) The starvation diet, caloric balance method is NOT SUSTAINABLE. Just look at many of the contestants in the long term. It is in agreement with Taubes’ references in his book. I’m surprised we don’t have more psychotic episodes on that show. Although it would help ratings, right NBC!?

    I did a google search on “Biggest Loser where are they now” and one from MSNBC popped up:

    I have to think that MSNBC would post the best long term success stories from ex-contestants. They only highlight maybe 25% of past contestants. Of those ONLY ONE weighs less now than when the show ended. Several are within 10lb of their final weight, but it appears that many have gained 30+lb back. Note that the winner of season 1 lost about 120lb and has gained back about 100.

  47. This thing where a woman gets called a man intentionally, presumably because you don’t like her manner and methods (you’ve mentioned the Jillian person before) is not cool.

    I watched as much of an episode of this show as I could tolerate, once. Never mind the trainers, I want to know why some Aussie chef no one’s ever heard of and the soap opera actress hostess are presumed to be in a position to lecture the contestants about nutrition. (I suppose you could argue a well-trained chef is more qualified than an average trainer, but I can’t find anything to suggest this guy has that sort of education). The editing did a good job of pushing the “overweight people are childlike fools” story as well. Great, let’s convince the hordes at home that they’re helpless and dumb unless and until experts descend upon them.

    As far as carbs and exercise go, you know endurance is not the end all and be all of athletic performance and it seems like cherry picking to me to hit on that metric alone. I know the literature backs up my personal experience that sprint performance is poor in a carb-restricted state. It is incorrect to say that any and all exercise requires a mainstream carb intake, but it’s also incorrect to say that all exercise performance is just great in a carb-restricted state. Granted, aside from people who specifically play sports with a sprinting component, really only Crossfitters and hardcore body recomposition nerds will ever do sprints as an adult.

  48. “For many reasons, you can’t cut an entire food group out of your diet.”

    How come nobody says that to vegetarians?


  49. Happy Love Day to you and your lovely wife! I am still a bit confused who gets Cupid wishes on VAlentine’s Day, is it for lovers only or can you extend good wishes to all people? Never bothered to find an answer. I dont beleive love has to be celebrated on any particular day. Love resides in the heart and when you find that special one not only you let her live in your heart you dont even charge her rent!

    Given your long-lasting Love with your wife of many years, do you care to share a recipe for successful marriage?

    Luck. In the early stages people are attracted to one another for all the wrong reasons. In my opinion, it is simply luck when those early attractions end up as a deliriously happy long-term relationship.

  50. BTW, have you and MD always been on the same page as far as low carb? I know nutrition can just be as challenging for couple to agree on as other marital topics. Especially when it comes to feeding kids. Or since MD is the main cook in the family, you had very little say about that part anyway. Lets so for argument’s sake MD wasnt a proponent of low carb regimen, would you care to cook food yourself?

    I got interested in low-carb before she did because I developed a weight problem myself. She – to her credit – rapidly saw the scientific validity of it. When MD isn’t around I cook low-carb for myself or pick up low-carb food at the local deli or eat out in low-carb fashion. I’m not totally depended upon her for my nutritional sustenance.

  51. BOB HARPER’S ANSWER: “If you cut out all carbs, you will DEFINITELY lose weight. Unfortunately, you will gain it all back because I don’t believe that it is a way of life. I am all about changing your way of life and having you incorporate the right amounts of protein, carbs and fats.”

    Why is it that whenever people criticize carbohydrate restriction they always leap to the extreme of no-carb? Cut out all carbs? Who said anything about eliminating all carbs? Do vegetarians/vegans eliminate all protein? No, they change the source and the amounts. I think most low-carb adherents HAVE changed their way of life, too. And who’s to dictate what the “right amounts” are?

  52. I’d be interested to hear your take on the gluten free craze…seems to make sense but all of the products may be deceiving. I try to eat mainly Paleo at best, but have the cravings for sweets of course. I mainly try to only buy the “all natural” gluten free/soy free products but am I just kidding myself?

    Some people have problems with gluten – probably more people than anyone imagines. If you stick to a meat-based diet with no grains, you don’t get any gluten, so it doesn’t matter. Problem is everyone is trying to have their cake (literally) and eat it to by making the cake with ingredients that are allegedly gluten free. No good can come of it.

  53. Yeah you know, that 50 pounds I lost was just a water bag that I carried on my back! LOL!

    Seriously though, great read, and I will do more than share, I’m going to print this out and show my co-workers, who are VERY close minded dieters. It’s funny how they admire my loss and then wonder why they’re not losing as much weight as me (eating their 100 calorie snack packs…lol).

  54. My wife and I watched a two-hour PBS special tonight, “Heart Disease in America.” Here’s what we learned:

    1. The Framingham study proves high cholesterol causes heart disease.

    2. Heart disease was rampant in the 1950s because newly-properous Americans started eating more luxury foods, like porterhouse steaks. (Complete with film footage of said steaks.) Oh, and, uh, yeah, they also took up smoking in record numbers.

    3. We need to cut our intake of saturated fats and replace them with vegetable oils.

    4. Larry King doesn’t take viagra. (That nugget came up in panel discussion.)

    5. Statins are WONDERFUL, STUPENDOUS, LIFE-SAVING DRUGS, AND THEY’RE ABOUT TO GET EVEN BETTER!!!! (Yes, ladies and gentlemen, soon we’ll have drugs to raise your HDL up to where it would be if we hadn’t scared you away from eating fat!)

    6. Teenagers with high cholesterol should start taking statins right now. If you have familial hyperlipidemia and you don’t start taking your statins as soon as possible, you will get heart disease, period.

    I am currently suffering from insula-ache.

  55. “there are both fat and protein deficiency diseases written about in every internal medicine textbook.”

    The amount of fat needed is insignificant, if it exists at all. Pregnant women might need 1% PUFAs. Growing children only need 0.1-0.5% PUFAs. The amount needed by healthy adults is “infinitesimal if it exists at all,” according to researcher Chris Masterjohn. Likewise, protein requirements are highly variable and other macronutrients spare protein. Most deficiencies for fat and protein probably come from grains, vegetable oils, refined food, etc.

    “Diet brings about weight loss; exercise doesn’t.”

    That depends on the intensity. Many studies have noted dramatic weight loss by doing short high intensity interval training (HIIT) with no change in diet. See Clarence Bass’s website, Art DeVany’s website, Cross-Fit, and many other similar programs.

    “Most studies show that after a period of adaptation, people who exercise while following a low-carb diet have better endurance than those following high-carb diets.”

    Again, we would have to define exercise based on the intensity and duration. Many athletes find their performance is severely limited on low-carb diets. Read athletic forums, and you’ll see most people eating high-carb, cyclic ketogenic (CKD) or targeted ketogenic (TKD). Some eat high-carb and are ripped. Most of the world’s top athletes eat high-carb. Where are the top athletes eating strict low-carb with NO carb loading or cycling? They are extremely rare if not non-existent. Now, you can argue that the best diet for athletic performance may not be the best diet for health. Fair enough. But you can’t have it both ways.

    I wouldn’t be so quick to claim that there is no need for fat. Try going on a no-fat diet for a while and see how well you do.

    I agree that resistance exercise along with a low-carb diet increase weight loss over diet alone (I’ve seen that study), but I’m not so sure with other diets. If you have references, send them along.

    It is true that glucose is required for sprints and other short term, high intensity exercises, but fat works better for what are considered endurance exercises. Most of the world’s top athletes are young, and so they can get away with eating a ton of carbs (witness Michael Phelps), but that doesn’t mean it’s the best diet for all.

  56. “You can read my post about the Ancel Keys starvation studies to see a comparison between low-fat, high-carb, low-calorie diets and low-carb, low-cal diets.”

    That diet was based on grains, beans, and potatoes. What would have happened if it had used fruits and vegetables for the carbs with no starches? Or maybe just getting rid of the grains & beans would have helped, since the Kitavans are lean on a diet of about 70% carbs mostly from potatoes, fruit, and root vegetables. You need to acknowledge that there are many diets that can promote health and weight loss, not just the low-carb diet. Keys’s study is not proof that high-carb diets fail. It’s proof that grain-and-legume based diets fail. Maybe other foods would work. You have to look at diets as a whole, not just individual foods.

    I suspect the Keys study would have turned out the same had it been filled with fruits and vegetables as long as the calories and macronutrient composition were the same as his actual starvation diet.

    There are other diets that can promote health and weight loss. I’ve never said otherwise. What I have said that just because a diet improves health and promotes weight loss doesn’t mean that that diet is the optimal diet for health and weight loss. It is my opinion, based on many years of taking care of thousands of patients, that the low-carb diet is the best diet for the greatest numbers of people.

  57. I have been on and off the low-carb wagon alot in last 5 years. I am a scientist myself and although I know how good a low-carb diet is for me, the lure of sweet tasty things is always present.

    Chocolate is always what makes me fall off. I just like it too much. I could easily go rest of my life without potatoes, french fries, rice, bread, pizza, grains, cereal, beans, etc

    But no way in hell can I manage without chocolate and milk. Perhaps I am doomed forever!

    However I’m not so convinced that in the future things will change and we will instead see lots of advertising of juicy fat cuts of meat. Atkins is such a dirty word these days amoung media, and of all the low-carb diets that come out, when the author is interviewed they always say ‘no its not the atkins diet’ even though it blatently is.

    The media’s opinion will have to change before mainstream changes.

  58. Off topic perhaps but not off blog topic ?!

    ref losing fat after having done it afore on a low carb diet.
    Low carb is usually low cal right….
    so very likely it’d have evolved to best ‘keep’ fat on the body.
    So it evolved to keep fat as it were as fat meant survival.
    So the very fact of it being low cal kind of scuppers one or at best and seems after the first time to slow fat loss down to a trickle ?

    Is this right or wrong or a mixture please ?

    See the answer to your comment in the ‘Rapid Health Improvements on Paleo diet’ post.

  59. OT, but should be interestingFrontline update from Sweden:
    – The Swedish heart and lung fund has suspended their multi-million cooperation with Unilever with regards to their “cholesterol-lowering” margarine Becel. Their stated reason is the increasing uncertainty with regards to the role of fat for health, which was apparent at a recent hearing of experts conducted by the fund.

    See: (In swedish, but Google can help you out if you aren’t a speaker)

    – Unilever had previously launched a major counter-offensive against the increasing trend away from margarines and unnatural fats. This included buying a 16-page special in Sweden’s largest weekly magazine and arranging an “educational seminar” for journalists about the health effects of fat, with Sweden’s foremost “expert” on fats, Claude Marcus.

    – The counter-offensive from the low-carb community, however, which involved mobilizing a major investigative TV show as well as preparing to picket the seminar, caused Unilever to cancel the seminar.


    In short, in these parts things are going the right way.

    Sounds great. Maybe I should consider moving to Sweden. Had a great time last time I was there.

  60. I have some anecdotal evidence about the role of exercise in weight loss to share. About 2 years ago, my office ran a weight loss contest. We got 100 people to put in $10 each and the person who lost the highest percentage of weight in a 10 week period would win the entire $1000. I had fallen off of my low carb diet at the time and needed to lose 20 pounds. I was concerned about entering a contest where I had to compete against several 250+ pounders as I was only at 190lbs looking for 170. But I entered none-the-less as I knew the $1000 was excellent motivation.

    As expected, most folks were doing a strict low-fat diet along with plenty of exercise. As the contest wore on, I noticed two things. First, most everyone struggled with the low-fat diet and most fell off of it part way through. Secondly, most everyone ratcheted their exercise up to at least 1 hour of aerobics per day … some more. We have a beautiful wellness center at the office, with every conceivable machine. We also have a staff who promotes exercise as the cure-all for everything.

    The bottom line is that almost everyone stuck with their increased exercise program, but almost everyone stopped dieting … they just couldn’t stick to the low-fat diet. I heard countless people say something like: “I know I’m not eating any less, but that’s OK, all of this exercise will pull the weight off and make me much healthier.”

    And now for the results … drum roll please … I won the contest easily. I lost my 20 pounds. The next closest guy lost 7 pounds. If you took the two of us out of the contest, the average weight “loss” was +1.5 pounds! It was proof positive for me that exercise does not contribute to weight loss in the real world. I did not change my exercise regimen one bit during the diet. I followed my low carb diet to a tee, and the weight dropped off without any pain. BTW, I do slow-lift weights once per week, have done for years. I don’t do any other exercise. At 49 years, I’m 5’11 around 165 lbs and about 12% body fat. I can run up the 15 flights of stairs at our office without a problem. Many of my aerobics loving co-workers stall at around 7 flights.

    P.S. I bought a new suit with $1000. My wife still refers to it as the suit that the office bought me.

    P.P.S After reading GCBC a year ago I will never fall off of my low carb diet again. I’ve taken Taubes advice and I treat sugars and starches like cigarettes. I’ve quit cold turkey and will never go back.

    I think the experience of your co-workers is pretty common. Thanks for taking the time to write it up and post.

  61. Tom Naughton: I just finished listening to your podcast interview with Jimmy moore. I CAN”T WAIT to get my copy from amazon, and i plan to show it to my parents and friends. Great interview with Jimmy, and i wish you lots of success !!!

    Dr. mike: I just wanted to tell you how much my wife and I enjoy your recipes that you’ve included in The protein Power books. This morning for breakfast we had paleolithic punch (from frozen strawberries, bluberries and raspberries), crustless quiche with spinach, onions, mushrooms and green pepper, and a patty of your homemade pork sausage. MMMMM!!!!!!

    And one question. Are you still planning to revamp your website and repeat your christmas offer? I tried to order PP from Canada but the site wouldn’t let me.

    All the best,

    Yes, were in the throes of a revamp right now. Unfortunately, our tech person has been down with the flu for a week, so we’re a little behind. When we get things up and running and have the bugs worked out of the new shopping cart, I’ll repeat the Christmas offer.

  62. “To succeed in life, you need two things: ignorance and confidence.”

    Reminds me of Michael Phelps and his wonderful diet of sugar, sugar, and more sugar!

  63. To Ellen Ussery

    May be worth trying your exercise regime at different times of day.

    Although my insulin resistance is greatly reduced it is still cyclic on a daily basis, overexertion in the morning may bring on a liver dump and drive my BG high whereas doing the same in the afternoon may drop me down to near hypo levels.

    In both cases I use small boluses of carbs and fat to adjust the BG manually, following from a relatively high protein low carb breakfast which evens the whole day out.

    I don’t get such wide variation from lower impact longer term stuff like walking. Over the long term the variability and need for snacking seems to have reduced, so keep at it! A bit of fine tuning may make it easier.

  64. Re: My previous comment on high intensity exercise and your request for references. Where should I send them to?

    Post them to a comment so everyone can read them.

  65. Hmmm, Allen’s story has me hatching an evil plan… go face-down in the carbs for a few weeks, then engineer a simlar weight loss challenge in our office… sounds like an easy payday, hahaha…

    It does sound like an easy payday. Wish I could get in on it. :-)

  66. For those seeking extra motivation, may I suggest a second full reading of Gary Taubes’ book (GCBC). On first read, I largely skipped through to the weight loss section, which interested me most. But the middle part is where he talks about heart disease, dementia and cancer. The premise is pretty easily stated: any disease that presents more frequently in connection with diabetes and metabolic syndrome than in individuals without those conditions is plausibly linked to insulin/carbs. The cancer mechanism is also easily stated: insulin provides a more nourishing environment for tumors to grow. (Of course this isn’t stated as definitive, but a promising line for further research.)

    I think of my own mother’s death about two years ago. At 79, she had short-term memory failure and moved to an assisted living facility. The family urged her to relax her lifelong diet discipline and enjoy the food offered at her new home. She did–particularly the desserts–and gained 20 pounds in four years. We all told her she looked fine and not to worry. Soon after she developed breast cancer from which a year later she died.

    I am absolutely floored at the thought that extra ice cream and pie could have been encouraging terminal cancer. Not to mention the fact that her lifelong diet of the usual gospel (fruits & vegetables, whole grains, lean meat and no fat) might have had a role in her memory loss. The truly ironic part is that my Mom was a scientist, paid attention to what she ate and truly thought she was doing everything right. Neither of us had any idea! Thanks so much for your work Dr Eades–how I’d love to put your book in her hands.

  67. @Kindke: You said, “But no way in hell can I manage without chocolate and milk. Perhaps I am doomed forever!”

    I say: no way! A low-carb diet doesn’t exclude chocolate, by any means. You just have to make careful selections. I eat chocolate a LOT on my low-carb diet; I just mostly eat dark chocolate, and small portions which I savor instead of bolting. And by “a lot,” I mean that of the 47 days for which I’ve put up data on my food blog (, I’ve had chocolate on 22 of them, so basically every other day. And that’s on a diet of under 50g (and usually under 35g) carbs per day, which is really quite low; non-diabetics can obtain a lot of the benefits of low-carb on a greater allowance than that.

    Milk, similarly, can be worked in. Yeah, it’s relatively high carb, especially if you choose the reduced-fat variety (whole milk has fewer carbs per ounce, because more of the volume is occupied by fat). There are some reduced-carb milks, though — I like Hood’s low-carb milk, and one of my local groceries has a store-brand reduced-carb milk that’s also good. Even regular milk, though, can be fitted in — just give yourself a carb allowance, and choose where to spend your allowance to allow yourself the things that keep you from feeling deprived while still keeping yourself on track. It’s a lot easier to resist the call of the cookies if you’re not feeling like you NEVER get to eat anything you really want.

  68. Allen,

    Great story, Hilarious!

    I just started an office job, first thing I noticed when walking in is that everyone is fat. A few days into the job when I started to get to know people I overheard one fatty talking about how her brother is a nutritionist that recommends low fat, moderate carb, high exercise regimen to lose weight. I wanted to laugh, but kept it at a grin. She said she had been going to the gym 3-4 times a week sweating her butt of for at least an hour each time. She hasn’t lost any weight yet. Today I saw on her desk some new diet pills. Personally, I lost over 20lbs going from 182lbs(14-15%bf) to 159lbs(under 10%bf) in 2 months and absolutely no working out. The most workout I had was walking from my home to car to a desk job; literally sitting for over 12 hours a day.

    There are even company sponsored nutritional guides around the office encouraging alot of whole grains and pasta with low fat content meat and cheese.

    I’m thinking about giving a course on nutrition/diet for the office but this is pending company lending of the space for the course. Maybe not the most effective, but I would love to do a quick poll of who thinks saturated fats are unhealthy, then immediately bring out a jar of coconut oil, ask if everyone knows what it is and its fat content. Then eat a table spoon in front of everyone just to watch the faces contort in disgust.


    Dr Eades,

    Ever since I went paleo, my #2s have gone down from once every 2-4 days to once every 4-7 days. I’m not constipated, they are just regular #2s but less frequent. Can infrequent #2s lead to any kind of health problems? Should I make an effort to increase the frequency and if so, how?


    I wouldn’t worry about the constipation, if that is truly what it is. Meat is the perfect food, and, thus, is almost completely digested and absorbed. If you eat foods that you completely absorb, there is not a lot of waste moving on down the tube that has to be eliminated. As I say to my patients, such a diet is a lot for the jowls, but not much for the bowels.

  69. I had seen that nitwit Harper’s comment about low carb in the NY Times and seethed. I loved your blog, but I wish it would be PRINTED in the NY Times for other readers to see. Perhaps you can contact your friend Tara?

  70. Well, I lost all my pregnancy weight, plus some – 100 pounds total, without one workout. I am actually pretty sedentary, unless you count vacumming….haha..And, I did this by the time my daughter was 13 months!

  71. I’m curious about what studies have shown increased performance in exercise with low-carb diets. The only studies I have seen show that a higher carbohydrate diet increases endurance in physical activity. The American Dietetics Association recommend a diet with 60-70% of calories coming from carbohydrate for athletes (50% for non-athletes). I just had a test on this in my Medical Nutrition Therapy class today. Just wondering what your sources are.

    From my understanding of studies I have seen, main sources of energy for extended exercise are muscle glycogen and plasma glucose. Muscle triglycerides and plasma free fatty acids are also important energy sources, but glucose is required in the reaction to utilize these sources. (Krebs Cycle). In a marathon or endurance event, when you run out of glucose, you “hit the wall.” In your low-carb studies, what kind of exercise where they participating in and where were their main sources of energy coming from?

    There are numerous studies throughout the medical literature showing that people often (not always, but often) increase their endurance on low-carb diets, but only AFTER adapting to said diet. It’s beyond the scope of the comments section to write an entire post on all the whys and all the studies. Maybe I’ll do a post on this subject at some point. Until then, go to PubMed, enter ‘low-carbodydrate diet’ and ‘endurance’ in the search function and take a look.

    As far as ‘hitting the wall’ goes during marathons, long endurance events such as marathons are usually fueled by fat, not glucose. When people have a chance to adapt to low-carb diets, they do well in these events. The type of races that requires glucose are sprints and other anaerobic exercises.

  72. I agree entirely that the statement change in weight = energy in (food) – energy out (exercise and metabolic rate) requires a coupling term connecting the variables, but to say that exercise does not promote weight loss is to deny the obvious. The main question here is the most effective form of exercise, and this comes back to intensity as several readers have already pointed out. Serious weight training is effective, and high intensity intervals are likely even more effective. The key here is to realize that high intensity implies short time duration. If the exercise is truly intense, you cannot do it very long or without long rest intervals.

    The work by Tabata is particularly illustrative and Tabata intervals (20 seconds hard, 10 seconds easy for 4 minutes) were shown by him to be very effective for fat loss, anaerobic improvement, and, surprisingly, improvement in aerobic capacity. The websites of Clarence Bass and Art Devany are excellent sources for further information about intervals and how to remain functional with age (both Clarence and Art are about 70). Clarence has a good discussion about Tabatas specifically plus some other studies of different high intensity intervals. Unfortunately, Art now requires a fee to view his site.

    On a personal level, I can attest to the effectiveness of Tabata intervals. I used to conclude my weight training sessions with 15-20 minutes of a conventional aerobic activity, usually a rowing machine or uphill walking on a treadmill . When I learned about Tabata intervals at about age 50 I substituted my aerobic component with 4 minutes of Tabatas on the rowing machine. During the next 6 weeks my weight dropped from 217 to 202 lbs, and I was NOT trying to lose weight. Nothing else changed in my diet or exercise routine (which also includes competitive tennis). The weight just came off by itself.

    High intensity intervals appear to work by causing a change in metabolism. They are certainly not long enough to consume many calories. On days that I do Tabatas (and twice a week is enough) I notice a different feeling in my body the rest of day. Something is happening which I can only describe as a feeling of warmth. I have since taken my weight lower to match what it was at age 25-30 and have done this without loss of muscle mass or strength, which is the other major advantage of intervals over long steady pace aerobics. Tabatas and uphill sprinting are the tools I’ve used to achieve this. The good dietary advice contained in this web site and Art Devany’s (which is quite similar to this one) will take you a good distance, but the right exercise tools are needed to take you further.

    I agree that if any exercise will help one lose weight, it is high intensity exercise or resistance exercise. I’m just not sure how much, and I know it’s not as effective as diet alone. I probably need to look into this a little further and post on it.

  73. Greetings all, I have been on the Protein Plan now for almost 5 weeks…I lost 10lbs the first week but have only lost 3lbs since then…I was expecting this to be much faster since I do about 3 total body workouts a week(lifting weights). I do know that I need to drink more water. Is there any other reason why this time it’s taking so long…I know I’m impatient but any thoughts would be great…I was 323lbs…I’m now 310lbs…but I’ve been 310lbs now for about 3 weeks.

  74. I don’t know if people are still reading this far back but someone asked about the gluten-free thing. Gluten is a very, very common food sensitivity, if not outright allergy. Think about how many people are allergic to grass. Wheat’s a grass; so is every true grain. Not everyone with a gluten sensitivity has celiac disease but if you have issues with grain it may be worthwhile to get an allergy test done.

    By the way, while immersing myself in Weston A. Price Foundation-related reading, I came across a claim that baking bread using traditional sourdough methods does something to the gluten that makes it far less allergy-triggering, and possibly even safe for celiacs. Seems there’s one little link in the protein chain that’s been identified as the trigger for celiac symptoms and other gluten-related health issues. The human gut can’t break it down, but bacteria can. And bacteria are one of the components of a wild-caught sourdough starter.

    I’ve also heard that sprouting grains changes the protein structure as well, not to mention giving the baked end product a nutritional profile closer to that of vegetation. I know that I can have one or two slices of Ezekiel bread in a day when I’m in ketosis and am not knocked out of it. I would be curious to try again from fasting glucose now that I have a meter, and then test myself after eating a slice, to see how far I spike if at all.

  75. Oh, and I should mention that small amounts of brown rice don’t affect me much either. I think I can probably get away with about a quarter-cup cooked with one meal over the course of my day and I just shrug it off. But rice is one of the gluten-free grains.

  76. 30. I’ve been surfing online greater than three hours today, but I by no means discovered any interesting article like yours. It¡¦s lovely price sufficient for me. In my opinion, if all website owners and bloggers made just right content as you probably did, the internet shall be a lot more useful than ever before.