A toxic environment


In the last post I wrote that I would explain why George Bray and his brethren in the academic obesity research world are in great measure responsible for the toxic world they all blame for the obesity epidemic.  We live in a world, they say, filled with impossible to resist foods that throw us into hedonic overdrive.  As long as we live in such a world, there is no hope – other than drugs, of course – for the obesity epidemic to be reversed.  They may be correct.  But, as I said, they are in part responsible.  Let’s see why.

You can’t just go around gibbering as they do about a toxic environment without defining what it is that is toxic about it.  If pressed, these folks almost always default to the position that it is the elevated levels of fat in the diet that are toxic.  They will often say – as Bray did in his rebuttal to Taubes – that the ready availability of high-fat, high-sugar foods is what makes the environment toxic, but that is just a kind of code for high fat, which is what they really believe causes obesity.


The statistics show a different story however.  Most food consumption data indicates that fat consumption has actually been falling or, at worst, has remained about the same.  Caloric intake has been on the rise, however.


The latest NHANES data show that the average American consumes about 250 calories more per day.  If fat is falling or remaining the same, and calories are increasing, those calories can come from only two sources: protein or carbohydrate.  Since protein intake pretty much mirrors fat intake, it’s most likely that the increase in calories has come from an increase in carbohydrate intake.  Which is what the data actually show. NHANES data confirm that this 250 calorie increase comes from carbohydrates.

So, if anything has changed in the diet over the past 40 years, it is that carbohydrate intake has increased, which is a pretty good argument to say that if the food environment has become toxic, it is the increased carbohydrate intake that has made it so.

If you look at the scientific literature and try to find a study that shows that consuming more fat causes health problems, you’re going to come away empty handed.  Sure, there are a lot of studies out there showing that bad things happen when fat intake goes up, but subjects in those studies are eating a ton of carbs along with the fat.  I religiously read the medical literature, and I haven’t found any studies showing a decline in health with an increase in fat without an increase in carbs or calories going along with it.

It ain’t the same with carbohydrates.  The scientific literature is crawling with papers showing detrimental effects from overconsumption of carbohydrates.

It’s pretty obvious to anyone who cares to look that if there is indeed a toxic environment out there luring us all to overeat and become obese, that toxic environment is made of carbohydrate.

If this is true – and I think it is – then why are Dr. Bray and his henchmen responsible?

Easy.  They encourage carb consumption by focusing the public’s attention on fat and away from carbohydrates.  Bray and friends are the go-to experts driving the recommendations of various governmental agencies that ultimately drive large food manufacturers to produce products adding to the toxicity of the environment.

General Mills, Nestle, General Foods, Kellogg, and other giant food companies aren’t managed by intrinsically evil people who set out to make us all fat.  These companies – just like Microsoft, IBM, Exxon and others – are in business to make an honest buck for their shareholders.  Shareholders want to see growth in value and a steady income for their investments, and management wants to deliver.  But these companies are constrained by what they sell.

Basically they sell calories.  If you take the number of people in the United States (we’re just talking domestic production here) and multiply that number by the average caloric intake per person, you can arrive at the total number of calories consumed by the population.  That’s the market for these companies.

If you are running a food company selling calories, you can grow your company in just a few ways.  You can do nothing and just grow as the population grows, but all food companies can do that so you don’t achieve any advantage over the competition.  You can improve your branding and merchandising and/or develop new products to try to gain a bigger market share of the calories consumed.  You can buy one of your competitors.

And you can work to simply increase the average number of calories consumed by each person and therefore make the overall caloric intake of the country rise.  How do you make people eat more?  Simple.  You make products that are convenient, tasty, inexpensive and widely available.  And you make them addictive.  What makes them addictive?  Carbohydrates, of course.  What gets the blame?  Fat, of course.

These processed foods are typically a mixture of fat and sugar, which provides a taste sensation that most people seem not to be able to resist.  They want more and more of it.  And food companies are happy to provide it.  The USDA’s School Nutrition Dietary Assessment from 2007 showed that the three products groups consumed the most in schools were candy; cookies, cakes and brownies; and soft drinks.  All fat and sugar and, in the case of soft drinks, sugar alone.

All of these foods are thought of as sweets.  People who crave them are often said to have a sweet tooth.  Yet most academic obesity experts criticize these products because they are high in fat.  In their minds, it’s the fat that’s the problem, not the sugar.

Since these academicians fill the seats of all the government panels that convene to come up with solutions to the obesity problem, the usual message is to cut the fat.  So the food companies cut the fat or change the type of fat…and leave the sugar.  The addictive part of the equation doesn’t change.

Lest you think this is a problem only for children in schools, I would encourage you to go to just about any office in America and take a look in the break room.  You’ll find cakes and cookies and brownies and chips and all the rest of the stuff you find in schools.  The problem is endemic.

And it is going to be extremely difficult to change.
I just finished one of the better books I’ve read in a long time.  It’s a book that opened my eyes as to why it will be difficult to change and why Bray et al are going to make it even more difficult.

The book, titled Stuffed: An Insider’s Look at Who’s (Really) Making America Fat, was written by Hank Cardello, a former executive in the food industry who spent his career at General Mills, Coca Cola and other food giants.  Stuffed_Cardello_1Mr. Cardello got sick and, after experiencing an epiphany about his own diet and health, realized the companies he had worked for (along with many others) were in great measure responsible for his illness.

If you are interested in finding out how the food industry drives us to overeat, you need to read this book.  I can’t recommend it highly enough.

I had no idea how the various arms of the food industry – food manufacturers, grocery stores and restaurants – all work hand in hand to make us fat.  The government is in there, too, always making the wrong moves and usually making the situation worse.  I was always naïve enough to think that if only McDonalds or one of the other fast food giants would make some minor changes, the world would be a better place.  But after reading this book, I can see why those changes are almost impossible to effect because of the structure of the industry.  Who would have thought that purchasing agents are responsible for much of the problem?  Yet they are trapped in the system and can’t change without creating huge problems for themselves (read: their own unemployment).

The first four fifths of the book are a brilliant expose of the food industry.  It’s actually not so much of an expose as it is an accurate description of why the industry is locked into the way it is and why change is damn near impossible.  The book shows why food manufacturers makes foods that make us fat, why the grocery stores are set up to beguile us into buying things we shouldn’t, and why restaurants trick us into ordering not what’s best for us, but what’s best for the restaurant’s bottom line.

The first four fifths more than justify the price of the book, which is a good thing because the last couple of chapters are pretty weak.  Pretty weak, but not without their highlight moments, one of which we will soon see.

The last chapters are weak because, sadly, Mr. Cardello has bought into the idea that what really makes us fat is that we eat too many calories.  In his mind, it doesn’t matter what those calories are made of, they’re all the same.  Except for saturated fat, or course.  He’s convinced that saturated fat will do us in.  He has pretty much bought into the notion that fat and calories make us fat, and the last couple of chapters of the book are a compilation of his ideas as to how to change the food industry.  He thinks that people love nasty processed food and they’re going to eat it no matter what, so why not make it lower in calories and lower in fat.  Most of his ideas revolve around making smaller portion sizes and products with lower fat and calorie counts.

Why does he buy into all this?  Because of Dr. Bray, among others.

Writes Mr. Cardello about a conference in which nutritional scientists sit down with food industry people to discuss how to solve the obesity problem:

It also was refreshing for me to listen to and learn from Dr. George Bray, the esteemed biomedical researcher and professor of medicine at Louisiana State Medical Center in Baton Rouge.  To many insiders, he’s known as the founding father of the obesity issue.  Bray is a doctor and scientist who has been practicing his craft for fifty-one years, and he still has the energy and curiosity of colleagues who are half his age.  When he first began studying obesity, he was a doctor gently sounding a warning bell, but nobody was listening.  The American population was about 14 percent overweight at the time.  Now 30 percent of us are fat, so he said the problem has doubled since he began his work.

Now there is a backhanded compliment if I’ve ever seen one.   I don’t think the author was being ironic, but it sure came out that way.  And it corroborates my suspicions.

Bray truly has been a founding father of the obesity issue in ways that he probably doesn’t like.  When he started working on the problem, the rate of obesity was 14 percent.  After 51 years of effort on his part, the rate of obesity has more than doubled.  That should tell anyone with sense enough to listen that Bray is a part of the problem, not a part of the solution.

Let’s imagine a world in which nutritional scientists actually pay attention to the growing mountain of studies showing that high-carbohydrate diets are bad and that low-carbohydrate diets do all the good things the readers of this blog know they do.  Let’s imagine that these nutritional scientists make recommendations to the government to limit the advertising of carbohydrates in an effort to improve the health of the nation.  Let’s imagine that people stores and restaurants started stocking and serving low-carb foods and that overweight people who were face down in the carbs were looked at with disdain.  And let’s imagine that when someone suffers a heart attack or is obese, everyone says, well, he/she deserves it because he/she was a carbaholic.

If all this came to pass, public opinion would turn against high-carb consumption and my guess is that the obesity epidemic would end.

But is this all a pipe dream?  Could it really happen?  Not while Bray and friends are around ignoring the scientific evidence and continuing to push carbs on us all.  But if these guys ever shuffle on off, there is a chance.  It’s happened before.

Fifty years ago everyone and his brother smoked.  It was the thing to do.  When I was a kid my parents smoked and all my friends’ parents smoked.  Every time I ate dinner, my mother had a cigarette going at one end of the table while my father had one going at the other.  A haze of smoke always hung in our house. But I didn’t think anything of it because a haze of smoke hung in the houses of all my friends.  Whenever I went someplace in the car with my parents or with the parents of my friends, the car was full of smoke.  It was a way of life.  As my mother – who is now a nonsmoker – never tires of telling me, back then if you didn’t smoke, you were considered some kind of freak.

If you watched TV at that time, it seemed that every show was sponsored by a cigarette company.  It’s difficult to believe now how pervasive smoking and cigarette commercials were at that time.  I’ve posted videos of a few of these commercials here and here.  Everyone got into the act.  Even the Beverly Hillbillies.



And actors.


And professional athletes.


There were no nonsmoking sections in restaurants.  People smoked on planes and even in theaters.  If you want to get some notion of what is was like, look at a few episodes of Prime Suspect, the terrific Brit detective series starring Helen Mirren.  You can almost get nicotine toxic just watching.  Granted, this series was filmed in the UK, but it presents smoking the way it was so widely done in the US a generation or two ago.

Now substantially fewer people smoke, and those who do are, for the most part, apologetic about it.  Now there aren’t just nonsmoking sections in restaurants, the entire restaurant is nonsmoking.  People can’t smoke in office buildings, public buildings, or much of anywhere else.  There are no ads for cigarettes on TV or in magazines or newspapers and there are no billboards encouraging smoking.  As far as smoking is concerned, it’s a different world.

What happened?

The scientific community figured out that smoking was a huge health problem.  Scientists worked through the government to launch an enormous public health campaign to get people to quit smoking.  It started with warnings on cigarette packages and went from there to a prohibition against advertising, first on television, then ultimately to just about everywhere else.  And it has worked.  Rates of smoking have plummeted, which is amazing considering how addictive nicotine is.

If this kind of scientific driven public health campaign can work to get people to give up a tremendously addictive and enjoyable habit, why wouldn’t it work to change the way people eat?  I’m sure it would if it were ever initiated.  But the problem is that as long as you have Bray and others telling the powers that be that the only thing causing the problem is calories and that carbs are wonderful, it never will happen.

When the public health campaign against smoking started, the only scientists who spoke out against it were those hired by the tobacco companies.  And, of course, people realized that these spokesmen had a dog in the fight and pretty much ignored them.

Now we would have scientists who are not in the employ of the food industry who are telling us that carbs are good, fat is bad, and the reason we are all obese is simply that we eat too many calories and don’t exercise enough.  As long as these people are spouting off, there will be no change.

Just like there were nonsmokers back then who bucked the trend (and were thought of as freaks by my mother and other smokers), there are those of us who buck the high-carb trend now (and are probably thought of as freaks by the rest of the population).  We all have to rely on our own internal public health campaigns to keep us going.

I don’t know that there will ever be a public health campaign against the high-carb diet, but I know that if there is, it will work.  If people can be broken from the chains of tobacco, they can certainly be weaned from carbs.

There has been a nutritional public health campaign of sorts, but unfortunately it has been misguided.  Bray and others have gotten the government on board for a jihad against fat, particularly saturated fat.  And, as anyone can see, the campaign has been successful.  Sadly, they picked the wrong macronutrient to campaign against, as is evidenced by both the generalized fear of fat along with a doubling of the rate of obesity.

Public health campaigns do work.  We’ve just got to work to get the right one.

Hat tip to Whole Health Source blog for the nutrient intake graphs

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81 thoughts on “A toxic environment

  1. Whenver I, against my better judgement, try to convince anyone that the problem is in the sugar, not the fat, eyeballs roll. I dont blame them really, here I am, asking them to believe that somehow little ole me knows better that 1) Most doctors 2)Harvard Medical School 3)various government agencies (AMA, ADA, etc.), 4) All of those scientists 5) all those vegetarians and vegans, and 6) practically all purveyors of official health advice. You know, cuz I read it all on the internet.

    It’s a weird and frustating position to be in. I’m convinced I am right, they are convinced I am a nutcase, and that’s where it ends. Oh well.

    Btw, if you want to see loads of early 60s era smoking and drinking and out of control mysogony, check out the show Mad Men. I was just a kid then, but it all rings true to my memories.

  2. Between your blog and Stephan at Whole Health Source there is a ton of great information. I recommend them to anyone who wants to share in my “secret” knowledge of how to stay in great shape and have tons of energy while eating tons of fat! PS, just watched Fathead. You and MD were both articulate and informative in a way that will help even those with no scientific background. Great job, enjoyed the extended interviews as well.

  3. Well, someone posted a comment on the Fat Head YouTube channel to inform me that the brain needs lots of glucose and can’t function well without it. I was going to answer him, but all I had for breakfast was a goat-cheese omelet, so my brain was shutting down.

    @Paleo — I could’ve clipped in two hours of extended interviews, but there’s a limit to what they want on a DVD. I’ve heard from a few folks that the bonus interviews were at least as interesting as the film. (Not sure how I feel about that … all I did for those was point the camera and shoot.)

  4. Hi Dr. Eades,

    I really appreciate the graphs at the top describing the change in macronutrient, and obesity over the last few decades. It’s so graphically obvious! To me, it really indicts carbohydrates for the obesity epidemic, but how do the typical researchers respond to this? Have you ever read or heard a genuine response to these changes in our diet?

  5. mrfreddy – The AMA and ADA are not government organizations, they are trade associations for professionals and corporations who make money from products or services that cause and/or treat diabetes and other chronic lifestyle disease.

  6. Hi Mike,

    “Mad Men” is a interesting show and a good indicator of how much things have changed over the last 50 years – not just smoking … but it does make me feel old!

    I also thought it was instructive that you went from governments “always making the wrong move” and “generally making things worse” to a great example of how governments can (and have) been a big part of the solution … all in one blog! 😉



    I’ll have to admit that the smoking issue is one in which the government here performed as it should. But I think it was probably just the law of averages catching up. 🙂

  7. I give up, I give up. I sat through a horrible meeting today at the institution where I work, where we discussed, among other things, the sad case of a young resident who is on a low calorie. low fat weight loss diet, because his psychotropic meds are making him gain weight and messing up his lipids. But his “behaviors”, (read agitation and food seeking) was causing the staff to question the doctor about new meds. But, God forbid, not the diet, that is causing his behavior.
    I don’t know what to say anymore, so I just go to my happy place. (I gave Taubes book to the doctor in question, to no avail.)

  8. I find it interesting that in the first graph, the level of “overweight but not obese” stays the same, even while the levels of overweight children/adolescents and of obesity are increasing. I guess all those overweight kids/teens are then becoming obese adults.

  9. Great post. It does seem like an endless uphill battle to get the word out.
    Rarely I come across a hint of an attempt to get closer to the real issues, as in today’s Wall Street Journal article by Melinda Beck:

    She describes Arnone’s position that carbs cause uncontrollable hunger, thereby causing obesity. The article is pretty good, but unfortunately still in denial on the benefits of fat.

  10. I had to learn the hard way that a low-fat diet didn’t work for me. Many years ago my doctor told me I should go on a low-fat diet to lower my cholesterol, which was around 210. I started buying all the processed foods that were labeled “low fat”, but my cholesterol went up, along with my weight. The doc put me on a statin that brought the cholesterol down but told me to stay on the low-fat diet to lose weight. Instead, I gained about 40 pounds over several years before I finally came to my senses. I saw a friend lose 30 pounds by going low-carb. I started buying all the processed foods that were labeled “low carb”. But I didn’t really start losing much weight until I got serious and broke my sugar addiction. All those low fat processed foods had lots of sugar added to make up for the lack of that fatty flavor we all like. I minimized all foods that have added sugar and cut back on starchy carbs as well. I also began walking every day and lately doing some intermittent running as well as intermittent fasting. I now have lost all 40 pounds that I gained, despite gaining about 10 pounds of muscle (50 pounds of fat loss) and I’m 56.

    Moral of the story: don’t trust doctors, er, most doctors 🙂

    I now view sugar as a toxin and it appears to be the fructose in it that’s the real culprit. I find it very interesting that milk is high in fat calories and has no fructose. Maybe nature has been trying to tell us something all along. I also suspect that flavor enhancers like MSG and trans fats are also part of the toxic equation for weight gain.

    Thanks for the great thought stimulating post 🙂

  11. Many thanks once again.
    But it’s funny as to which anti-anything ads work. Here in Aus, anti smoking ads used to show anotmical parts, the more disgusting the better. And then they didn’t work any more. Raising the taxes to make smokes prohibtively expensive did the trick.
    Anti-speeding ads used to show horrific crashes and heart-wrenching scenes of carnage in slo-mo. They would only work marginally, if at all. And only for a while. Then NSW Road Traffic Authority came up with THIS ad and the road toll plunged by half and still stays that way:
    Now, a campaign with a lycra-clad low-fat (male) fool getting the little finger? Whatya think?
    Michael Richards

  12. There is an excellent book on the cigarette saga and the fight with Big Tobacco called “The Cigarette Century.” I’ve been reading it lately and, as you point out, can’t fail to be reminded of the parallels with carb consumption.

    I believe the battle to effect a change in carb consumption will be a lot harder. Cheap carbs have become such a staple food, particularly for the poor. I’d be interested to see an extrapolation of the national and global shifts in demand for food resources if everyone were to follow an optimum diet. Cheap carbs have helped fuel overpopulation. Is there any going back?

    ps: mrfreddy, you are not the only nutcase, we can form a club…

  13. If you’re right that the carb-pushers eventually will go the way of the tobacco-pushers …

    I can hardly wait to see what hideous health hazard they foist on us next.

  14. Plenty of people eat plenty of carbs and never get fat. I think the blame falls more on Fructose and Vegetable Oils and not on starch.

  15. As a meat farmer I’m preparing for the day when public opinion changes to fat being a health food. The time will come when fat regains its prestige. Farmers will be paid for producing good fat in the future. The challenge for me is to increase the quantity and quality of fat in the meat.

  16. Does anyone else see the law of “unintended consequences” at work here? All those people whose habit for years was putting hand to mouth with a cigarette in the main substituted a new habit of hand to mouth with what? Candies, cookies, sodas and other sugary/carby snacks, all happily and gainfully supplied by the agri/food conglomerates. And all those poor people, who probably think they’ve saved themselves from having a heart attack caused by smoking, only increased their cardiac risks and doubled their risk of diabetes with their new “healthy” habit of eating low fat snacks and taking a statin.

  17. I think the only reason the government responded as it should regarding the smoking issue is that smoking isn’t required to sustain life as food is. If smoking was required and it was proven something in cigarettes was making people sick, they probably would have narrowed it down to the color of the filter.

  18. Jeanne,

    Give the director a copy of Fat Head: You’ve been fed a lot of bologna! You might make more headway with a DVD than the the excellent, but dense Taubes book.

  19. I think it would be much harder to have a complete change in public perception to the perils of carbohydrate consumption like there has been with smoking because carbohydrates are a component of almost all food, and we must all have food to live. It is much easier to avoid the desires and triggers for vices such as smoking and alcohol than it is to eliminate a certain class of food.

    I find the only true influence I have is with my children. They are the ones who benefit from watching how my daily choices for eating relate to my battle with migraines, and I make sure that I share how badly I feel when I have eaten badly. I have many adult friends who intellectually understand the idea that carbohydrates are the true culprit, and many have even quickly lost weight on a foray into low-carbing, but only those facing some sort of severe health problem have any motivation to stick with it. The feedback from eating carbs is just too immediate and gratifying to overcome unless one is facing debilitating symptoms from their consumption. Even I am in this category: I read Protein Power when it first came out, but didn’t follow for very long because I was a very fit athelete with no health problems. It wasn’t until my migraines that I was forced to adopt low-carbing as a lifestyle, and even now I have to consciously choose not to eat that cookie. I have definitively linked eating carbs to getting severe (read ER visit) migraines and I STILL will slide down the slope of thinking it’s not really the carbs and have to suffer the pain all over again to convince me that the cookie is just not worth it. But I still want it.

  20. It is probably not a coincidence that part of the increase in obesity is caused by a reduction in the smoking rate. The decrease in rate of smoking mirrors the rise in carbohydrate consumption. Taubes makes the point in ‘Good Calories, Bad Calories’ that nicotine is probably the most sucessful weight reducing drug.

    I’m sure there is some truth to this, but the extra 60+ grams of carbohydrate per day (250 kcal) has helped the situation along.

  21. I call this issue Food Supply Politics.. the high carb, low fat message is promoted by the US Government to support industrial agriculture and continue the welfare checks it provides via farm bill subsidies, which ultimately benefit companies like Kraft, Monsanto and Cargill.
    It’s my little theory, and as such may be completely wrong, but it seems to me it’s all tied to industrial agriculture..

    The government pushes the message a healthy diet is a low fat, high carb diet. This message is pushed by the USDA through the food pyramid and repeated by all of its sub-agencies.

    This same message is then restated as “cholesterol and fat cause heart disease, so you must lower your cholesterol and fat intake” and it is pushed by the Department of Health and Human Services (DHHS) and repeated by its sub-agencies (the NIH, the NHLBI, the NCEP, etc), and supported by the drug companies and the health care industry.
    The message then gets repeated by clueless people like Bray and every other medical professional who believes the lie that fat is bad..

    Most Americans hear the message repeated from just about every source around them – friends, media, doctors, dietitians, etc.. so they buy into the lie too, and increase their purchases of low fat, processed, grain based food.

    This influx of cash benefits the food processing companies, and they buy more grain products from the Cargills and Archer Daniels Midlands of the world, who buy from farmers. The farmers grow more corn and soybeans to sell to Cargill, and in turn, have to purchase more genetically engineered seed and pesticides from Monsanto. All the senators and other govt officials who own vast tracts of farmland benefit as well from the subsidies, and the cycle continues.

    Note that Tom Vilsack, the new head of the USDA, was honored by the biotech industry as governor of the year, before he moved on. They LOVE that guy.

    This may be a major oversimplification, and I realize these companies are just trying to stay in business, but it seems to me, the high carb message drives a huge circle of benefit for the agricultural industry in this country.

    The average farmer working to support his family sees very little of the farm subsidy millions that are paid out each year. And the low fat, high carb certainly doesn’t benefit the population as a whole.

    I agree right down the line. But if an entire phalanx of scientists were constantly forcing the government to come to grips with the idea that too many carbs are bad, I think things would slowly change. Remember, when science went after smoking, the tobacco lobby was enormously powerful, and tobacco was a huge cash crop.

  22. If the government ever does something “right” (by which I mean aligned with the interests of the public) it’s only because that action somehow provided benefit to their personal or organizational goals. Congress pushes public health campaigns only when they perceive an election issue; correspondingly they use their budgetary power as incentive for other government organizations (e.g. USDA) to align with Congress’ goals.

    In our current situation, there is no incentive for any of these organizations to do anything but maintain the status quo. Congress-people no doubt get significant support from the food industry, and the population at large isn’t really screaming for a solution to the growing metabolic epidemic. Rather they are pushing for the government to subsidize health care, i.e., take money out of my pocket so the illiterate masses can continue to stuff down the carbs while getting their insulin paid for by me. Until the electorate demands change, there will be no change. And if the electorate were informed enough to demand that change, we wouldn’t need the government to do anything.

  23. Anna,

    I’ve been written off here as a “low-carb nut.” I come here to get strokes from all the rest of you who know better.
    I will say, thought, that another doctor asked me if she could borrow the Taubes book, herself. Maybe it’s not hopeless.

  24. Dr. Mike: The tide can turn. I’m in my 50s. My folks didn’t smoke, so I was very aware of others smoking and the gross aspect of smoking. It just takes one good man or woman in the right place at the right time . . .

    BTW, thank you a million times for making your blog in a small column. I must increase the size of anything I read, and the small columns make it possible.

  25. The fascinating observation that obesity but not overweight changed so dramatically seems to raise a suspician that some specific genetic/biological factor may affect those who became obese. Nicotine may be part of it, as may diabetes but it certainly could be a useful area for research.

  26. Jeanne: Hang in there! I know of a case where parents had almost immediate success in stopping much of the disruptive episodic food-seeking of their 6-foot tall, large, 18-year old, retarded, non-talking, autistic son who has to be on psychotropic meds in order to live in the community. All they did was to feed him several tablespoons of (light-tasting) olive oil twice a day (in the middle of two-hour flavor-free window) per Seth Roberts’ Shangri-La Diet (SLD). I know olive oil is fat but possibly your low-fat believing colleagues might think it to be healthy fat. Of course a low-carb diet (or low-carb plus SLD) would be better but if this simple intervention were to work as well for your resident as it did in the case I described, it might gain you some respect.

  27. Part of the problem is in calling it a low carb diet or low carb movement.

    Carbs include fruits and vegetables. So when the mainstream hears us say ‘low carb’ they see in their minds eye ‘no fruits and no vegetables’ and then think “these low carb people are bonkers.”

    The root concept gets lost in translation. It’s like saying ‘Muslim’s are crazy.’ Not all are of course. But some are and those that are differ from the peaceful Muslim’s like night and day.

    We should instead advocate a low refined sugar diet. This then points the finger directly at the evil culprits like breads, pastas, cakes, waffles, soda and other such murderers and away from peace loving carbs like whole sprouted grains, vegetables and fruits. While I do not advocate eating groats, oats and other such horrific plant matter, these foods are not the fiber of the problem.

    By calling it low carb, we Gattling gun the target idea, ripping it to shreds rather than snipering it. In doing so, it causes the cause more harm than good.

  28. Make a list of all the reasons we eat carbohydrates. Eliminate what’s not true, what’s left must invariably be the truth. We don’t return to good health eating carbohydrate. We don’t lose weigh eating carbohydrate. What’s left? We make gobs of money producing, selling, eating, then treating people who eat, carbohydrate. There is too much money at stake for anybody to change this. In order to change things around, we must make it costly rather than profitable to continue with the carbohydrate economy.

  29. the processing of foods allows producers to make crap and sell it to a public becoming increasingly addicted to HFCS and MSG-like additives.

    as an ex-smoker i remember specifically rolling my own using drum tobbacco which was just pure dried tobacco at the time. it was about the same price as regular cigarettes but tasted better and it was only minor effort to spin up my own cigarette.

    no matter how many of those hand-rolled buts id smoke there was something missing. the full cessation would not occur until i lit up a regular cigarette, regardless of the brand. whatever was in factory made cigarettes was not present in natural tobacco and it was part-in-parcel of the addictive profile.

    so i applied this logic to other foods:

    i always wondered why frozen pizza was still so popular when you can order a fresh made one in Toronto for $10 and it takes 30 minutes to get to your house as opposed to a high-end frozen one that costs $10 and takes 30 minutes in the oven, and tastes like crap compared to a fresh one. people who i know say they just like the frozen ones despite any objective reason why these products continue to thrive in the presence of better tasting option that costs the same and takes about the same time…. pizza pizza is the big chain in parts of canada, look at their ingredient list for a regular pizza compared to that on the box of McCain Deep and Delicious…. the amount of HCFC, hyrogenated oils and other enhancers are off the chart.

    secretly i suspect part of the reason low-carb is so difficult to manage is simply because our bodies have been acclimated to high-flying artificially gassed up flavours….

  30. @Tom Naughton, you shouldn’t take it personally. You must understand here, that for most people, this is the first time we get to see some of the people we consider experts in nutrition “on the TV.” People like Mary Enig, Al Sears, and of course Drs. Eades! And for me Eric Oliver and Jacob Sullum were great additons as well. None of us can turn on the TV without getting a dose of Oz, Gupta, et al. It is more a complement you on your selection of experts, than to suggest that the quality of the additional interviews where somehow better than the main movie.

    And the main feature is really good!

    But alas, I am a member of the choir. Hopefully others will like it as well.

    I wish I too had access to the filmed interviews, and since the disk came in at about 6GB of space, it was already going to be put a dual layer DVD, that left at least 2GB or so of empty space so I don’t understand why you couldn’t put more on there. yeah, I am a nerdy programmer too…

    I do have one question. Having cited Gary Taubes a few times in the movie, I was wondering if you tried to get an interview with him?

  31. First: Doctor Mike: “Public health campaigns work…” Are you saying the government can actually get something done? Amazing.

    Second: Since the calories have gone up, isn’t a reasonable explanation that it is the calories? I’m not saying it isn’t the carbs, that the carbs aren’t worse, etc, but the occam razor explanation of cals up, weight up is that the cals up cause the weight up (or vice versa, as Taubes asserts).

    Third: Here’s the thing that’s tweaking me from your chart… Overweight is holding steady. Obesity is taking off. Oh, wait, never mind. I have to think of it properly. Folks who used to be overweight are now obese and people who used to be normal weight are now overweight… The Fat Acceptance movement would have you believe that it’s really just like 8 pounds on average, and that it’s just ticking across the boundaries from normal to overweight and overweight to obese. It is usually a very obese person making this claim, so hard to believe.

    Fourth: Recently returned from France. Paris. Did not see many obese people with good French skills. What I mean to say is that the natives were mostly thin (and sexy if female) with a few overweight people here and there, and the Americans were mostly easy to pick out in any crowd (The fat loud ones). Was curious what was going on, since these Parisians eat pastry and coffee for breakfast (and what pastries and breads), eat potatoes with everything, really like dessert, and had a line out of an ice cream store in a residential, non-tourist district in March when it was 45 degrees out. I suspect it has to do with the food environment (didn’t see as much in the way of processed foods), the food environment (saw a lot more eating of animal fats, like foie gras and confit de canard), the walking and the wine. I myself, a person who gains weight with carbs, maintained my weigh on this trip, despite eating WAY off the Life Plan (Clafoutis… your name is temptation… Berthillion, you too).

    Last thing: On the upside, Duck Confit is about as low carb as you can get. Thoughts on confit as a PPLP approved cooking method (low temperature, long cook in animal fat or olive oil)… It’s like frying, only you don’t fully boil the oil… is this a transfat nightmare or LP Kosher for a

    The gov’t got it right with the smoking, but as I said, that was probably just the law of averages catching up.

    Duck Confit is definitely on the diet.

  32. You talk about carbaholics, but maybe it has to come that that, a 12 step program, designed around the the sound nutrional science that Protein Power has proven to be effective and healthful.

    I’m also concerned that the standard overweight person today is being perceived as “normal” or worse “thin” compared to the majority of obese people. I witnessed this first hand when I saw an (obese) instructor I had at a local community college address an (overweight) former student as being “so skinny.” Perception is reality. And our reality is almost always overweight or obese.

  33. I’d like to think the tide can turn, but not if we stay silent all the time (though there’s a time and place, and a way to spread the word, not that I’m a perfect judge of that ;-)). And people need a reason to want to believe. Someone else mentioned it, usually health issues are the force that opens people up to new views. That’s how it was for me, then it was a cascade effect – the more “naked” the emperor looked to me, the more my views and habits changed.

    One of my parents and both my siblings definitely think I’m a low carb gluten-avoiding health nut. They’re mostly terrified of CVD because our grandfather died at age 50 of a MI in the late 1950s. So you can imagine what they do in an attempt to reduce their risk, with all the wrong results, probably actually increasing their risk of CVD and other nasties. I take another approach.

    They must be absorbing some of my info, though, because I’ve seen a few positive changes in their pantries and tabletops in the past few years, but of course, they’d never admit anything I say has something to do with the changes. I can live with that.

    One way I know they are paying attention even if they pretend not to is this winter we visited and took extra Vit D to avoid catching the raging cold that was spreading around. Then my sister had her Vit D levels tested for the first time (wasn’t her doc’s idea, she had to ask for the test). She was quite deficient well <20 ng/mL, so then her teenage daughters were tested around the same level – one even has spinal issues in the past few years (NE location, high SPF users, sun avoiders – classic Vit D deficency). Then my mom tested, also quite deficient (25 years of night shift nursing will do that), though she hasn’t said a word to me, but the grapevine carried the message. The only one who wasn’t deficient was my 74 yo dad, who listens patiently to me, asks questions and seeks more information. And he faithfully takes the high dose Vit D3 I sent him for his birthday last year. His test result was over 50 ng/mL, a much healthier level, and it shows. Other taking than a medication for mild hypertension, he’s very healthy and fit (and his wheat bread and jam belly is greatly reduced from its size several years ago). He visits me in CA in the winter specifically to trade digging in my garden for shoveling snow back home.

  34. I have a question. Can a person gain weight while in ketosis? Thank you!

    It’s probably tough to do while in continuous ketosis.

  35. I agree right down the line. But if an entire phalanx of scientists were constantly forcing the government to come to grips with the idea that too many carbs are bad, I think things would slowly change. Remember, when science went after smoking, the tobacco lobby was enormously powerful, and tobacco was a huge cash crop.

    Very, very slowly. I’m guessing that added together, grain crops and the processing of same is a much larger percentage of the GDP than tobacco and cigarettes ever were. A much larger percentage of the population owes their jobs to processed foods and eat them than ever worked in the tobacco industry or smoked.

  36. Here’s what I don’t understand about people like Dr. Bray & other obesity research scientists who are anti-low carb diet.

    Have none of these obesity scientists or any of their colleagues ever been overweight and used a low-carb diet to lose weight?

    Most people don’t pore over scientific studies before trying a diet. They just try and see if it works. I lost 17 pounds the low carb way without reading one actual scientific study beforehand. Imagine that.

  37. Bray is hardly a scapegoat. He’s one of perhaps 10 people who controlled the funding, the research, and the peer-review journals for the past 30+ years. He as much as anyone took the country down the low-fat, high-carb road.

  38. @Davo —

    I don’t take it personally, of course. I was glad when the distributor asked if I could come up with perhaps 20 minutes of bonus stuff for the DVD. (Ended up being close to 30, actually.) Some of what went into the extended interview section was orignally in the film before I had to trim it down, so I welcomed the chance to put it on the DVD.

    Gary Taubes was willing to be interviewed, but his publisher wasn’t crazy about him appearing in a film billed as a comedy documentary, which is perfectly understandable. His mission right now is to sway the white-coat crowd, and his publisher didn’t want him to risk his credibility.

    Nonetheless, Gary liked what I was doing and served as a technical advisor, as did Dr. Mike. Mike saw the earlier versions and knows (even if he doesn’t say) that it wouldn’t have been the same film without their guidance.

  39. The decrease in smoking, increase in obesity observation is interesting. If government had foreseen this, they might have condoned smoking as a viable defense against obesity and then come up with drugs to counteract cancer rates, much like the statins to counteract heart disease attributed to high fat diets.

    Hmmm. Good thing you don’t work for the government. 🙂

  40. Fred,

    Good point about the stigma against names like “low carb.”

    I tend to think of it as “The Real Food, Controlled-Sugar” plan.

    1. Eat real, whole foods
    2. Severely limit real, whole foods that your body converts to sugar

    Maybe this is to simplistic and you and Dr. Mike can elaborate.

  41. Dr. Mike, I’ve been searching all through your site, and am having a hard time coming up with an answer to a question I have. I hate posting a comment that’s off topic, but I suppose it IS consistent with the overall theme of your blog and life’s work. 🙂

    What is the place of the low-carb diet in the life of someone who is already thin and is possibly hypoglycemic? I preach low-carb all the time, but my sister wonders if it’s right for her, because she’s really thin (just normal thin, not “anorexic” thin or anything), has trouble gaining weight, and gets dizzy an hour after eating unless she eats something like a potato. I understand that a low-carb diet can stabilize blood sugar and eliminate hunger, but I don’t know if it’s healthy for a thin person to eat so few carbs. Will she lose too much weight? My understanding is that if she can get her insulin low enough, and turn over her blood sugar needs to her liver (which will make glucose and ketones “as needed”), then she won’t be having these hunger attacks. Am I wrong? She tried eating low carb for a day or two and felt spacey all day. She wonders if maybe she NEEDS more carbs than other people, but if that’s the case, how will we ever “fix” this and get the blood sugar stabilized? Seems like the problem would just keep perpetuating itself in the presence of continued carbs.

    Thin people do fine on low-carb diets, and these diets help their reactive hypoglycemia as well. Thin people don’t lose weight on low-carb diets unless they really restrict their calories. If she does go on a low-carb diet, it should stabilize blood sugars and prevent her hunger attacks. The way you described them sound like reactive hypoglycemia to me. Have her give it a try – she’ll know if it works in just a few days. What’s the downside?

  42. @David,

    I have a friend just like that. The problem was she had trained her system to run on sugar and starch all the time, and she has a really high metabolism. It would be like feeding a fire only with notebook paper – you have to feed all the time and it can’t keep going unless you do.

    when she increased protein to PP levels, added fat, and reduced carbs to the PP maintenance level, AND moved to 3 meals instead of snacking all day, it all resolved. Now she rarely has crashes like that and the quality is much less awful. She just had to restore her ability to run on fat too, by eating enough non-carby things and reducing the fast carbs.

  43. I have a question regarding Caffeine, which may be a topic you covered but I can’t find it in the archives. I stopped drinking caffeine when I was still pyramiding it, and after almost a month I started blacking out and I couldn’t breathe properly. After having one attack at home depot with my 2 year old son finding someone to help mommy cause she was on the floor, I knew something was seriously wrong. Since caffeine was the one major change, I started drinking it again, and I stopped blacking out to that extent. I was still dizzy and disoriented, mind you. It wasn’t that bad, however. I have not had one single incident since going low-carb, and absolutely no dizziness, but I’ve still been drinking a fair amount of caffeine. I have read that caffeine is an insulin inhibitor, even though it does spike your insulin sometimes when it is processed. Could you explain the affect of caffeine on a low-carb hypoglycemic (the time between breakfast and lunch, and lunch and dinner used to be the worst), or even just how a low-carb diet deals with caffeine? I want to know if I should ingest MORE or LESS caffeine, and my doctor isn’t particularly useful with these questions (I already asked). He did suggest caffeine pills, since they helped with the dizziness/blacking out.

    I have no idea what caused your blacking out. I’m surprised your doctor hasn’t looked into it a little more. You could have postural hypotension, a condition that causes light headedness and sometimes unconsciousness when standing up too rapidly. This usually is caused by blood pressure that is low and can’t keep up with the demand for blood to the brain when one goes from sitting to standing. I have a touch of this myself because my blood pressure is in the 100/60 range (which is fairly low for my advanced age 🙂 ). Assuming everything tested out okay, I would say go for the coffee. I drink a ton of it. Most of the studies out there indicate that coffee, if anything, is a health food.

  44. @David —

    My wife is naturally thin (5’7″, 117lbs) and does very well without sugar or starch. In fact, she says her energy and mood are more stable now. She used to crash hard if she went five or six hours without eating. Not anymore.

    Her father has been lean his entire life but still became a type II diabetic, so she fully understands that skinny people aren’t immune from the effects of elevated insulin.

  45. Cindy and Tom–

    Thanks for the feedback on this (and you too, Dr. Mike! Much appreciated!). It’s good to hear of other thin people who have done well with the low carb lifestyle. It makes sense to me, and it’s what I probably would have recommended to “other” people, but when it’s my own sis, well I just wanted to double check, you know? I basically just told her that her pancreas was doing a lousy job, and it was time for her to let the liver have a go at it– i.e., drop the carbs and let gluconeogenesis and ketosis take over to create a steady, “as needed” blood sugar situation. We’ll see in the next few days how she does with it. I told her that even if she’s making the ketones and such, her body might not be acclimated to using them right away and will have to do some adjusting. I’m excited to see how this works for her!

  46. “the ready availability of high-fat, high-sugar foods ARE (??) what makes the environment toxic”


    Can’t blame that one on Bray. Thanks for the heads up. I fixed it.

  47. In the early 90’s chief executives of Big Tobacco were brought before a congressional subcommittee on health.

    This exchange is particularly amusing in retrospect:

    “James Johnston of RJ Reynolds compared cigarettes to milk, sweets, and Twinkies. [The congressman] pounced on him for downplaying the harmfulness of cigarettes. “You and I both know that Twinkies don’t kill a single American,” he charged, “The difference between cigarettes and… the other products you mentioned is death.”


    Hmmmm, indeed!

  48. @David —

    Sounds like good advice. I’d definitely mention not to judge the diet on a day or two of trying it. “Induction flu,” as it’s sometimes called, can last up to four weeks as the body re-learns how to burn fat as the primary fuel and make glucose from protein when needed.

    The first time I went very low-carb, I felt foggy, assumed it meant the diet wasn’t a good one, and gave up. I was a major starch-eater at the time and simply going through withdrawal, but I didn’t know that. The next time I knew better.

  49. I’m a thin person, 182cm and noticed my weight was slowly going up to 72Kg as I approach 40. But what got me started on diet was my skin was breaking out with Rosacea. The doctors prescribed antibiotics which helped, but being techy minded myself, I wondered about the cause, and what little I got from reading said that the cause was unknown. I had noticed for about a year or two before the Rosacea started that my face often felt hot, sometimes like it was burning. I thought this was just dry skin and air conditioning, but it was far too uncomfortable to be normal. Once Rosacea started I mentioned this history to the doctors but none of them seemed to say anything about the burning feeling. To my techy mind it seemed that the burning, a painful symptom, led to the Rosacea. I started experimenting with diet, and for several months went a little nuts trying to eliminate one thing and then another, bearing in mind that any change may take several weeks to have an effect. When I finally came across Paleo and PP, it made a lot of sense to me. I’d grown up eating a lot of meat, but had stopped over the last 20 years due to the “meat is bad” culture. Instead my diet had progressively become about bread, and then pasta, and then potatoes, and croissants, and donuts, and cakes and ice cream. Once I stopped all that, I immediately felt stronger, more energy, and my mood improved. I went from mildly depressed all the time to feeling positive. I lost 10 Kg whilst eating contentedly. And the burning sensation has gone, and my skin has softened and is gaining a normal feeling.

  50. David,
    It might be helpful for your sister to get a gucometer and check exactly what her blood sugar is doing. I and some other people I know have found that when we thought we were having low blood sugar it was actually high.

    Also, if she sees that her blood sugar does not drop into the 60’s, which is when it starts getting dangerous, she ( and you) might be more comfortable during the process of adjustment to low carb.

  51. Dr. Mike,

    My recollection is that you brushed off the West of Scotland Study as being an epidemiological study and therefore worthless. Well, I just happened to come across a link about it, and it was actually a randomized, double-blind, placebo-controlled clinical trial. The abstract claims: “The rate of death from cardiovascular causes was reduced (P=0.01), as was the rate of death from any cause (P=0.03), over the entire follow-up period. There were no excess deaths from noncardiovascular causes or excess fatal or incident cancers.”


    You always say that double-blind placebo controlled studies, the scientific gold standard, show no decreased all-cause mortality from taking statin drugs except for men under the age of 65 who have already had a heart attack. Again, the abstract says, “The West of Scotland Coronary Prevention Study was a randomized clinical trial comparing pravastatin with placebo in men with hypercholesterolemia who did not have a history of myocardial infarction.” So, here’s what appears to be a gold standard scientific study showing that pravastatin actually works, and the study specifically picked men who hadn’t already had a heart attack. I’ve been telling people what you say about statins, and now I’m feeling like I may have given them false information. This doesn’t mean I’ve jumped on the statin bandwagon, but I do now have some doubt about what you say about them. If the West of Scotland study really isn’t the solid gold it appears to be, but is just gold leaf on a feline sphincteral extrusion, can you please explain why? Thanks

    You are confusing two different studies. The West of Scotland Coronary Prevention Study (WOSCOPS) was a double-blind, placebo-controlled study that did indeed show a decrease in deaths from heart disease. Although there was a slight decrease in rates of all-cause mortality, it didn’t reach statistical significance, which means that the slight decrease could as easily be from chance as it could from an actual reduction. So, the WOSCOPS is like the other statin studies – it shows no improvement in the all-important parameter of all-cause mortality.

    After the WOSCOPS was over, some of the patients in the statin arm stayed on statins while some in the control arm started statins. Researchers found that after ten years those subjects taking the statins had a slightly reduced rate of death from cardiovascular and all-cause mortality as compared to those subjects who were originally on placebo and didn’t switch to statins. This part of the study – which the unwary confuse with the original WOSCOPS – is an observational study, and therefore worthless. The slight decrease in mortality could easily be – and probably is – due to the adherence effect.

  52. “Part of the problem is in calling it a low carb diet or low carb movement. ”

    I kind of agree with you there, Fred. It seems the media has successfully turned the term “low carb” into a negative one, to be associated with fad-diets, way out there stuff, appealing only to extremists.

    I’ve taken to calling it no sugar/starch diet. Of course, an amazing number of people are very fuzzy on what “starch” means, and which foods are starchy…

  53. @David —

    You might suggest that your sister get a glucose meter, and go ahead and test to see what her blood glucose is really doing at the times she feels off, instead of just guessing that it might be low. Wal-Mart sells a simple and fairly accurate meter, under the ReliON brand, for $9; it comes with a lancing (finger stick) device, but you do need to buy strips separately, and they’re $9 also. Of course there are plenty of other choices, but if the plethora of choices is intimidating, then I’d suggest this one.

    It’s been my personal experience that low-carb eating really smooths out the peaks and valleys of reactive hypoglycemia, which makes sense — if you don’t poke the pancreas, it doesn’t spit out a big glob of insulin and make you drop. I’ve had hypoglycemia issues for years, and only recently became diabetic — in fact, my diabetes was discovered because the lows were bothering me enough that I did in fact get a meter and test myself, and discovered that the lows were preceded by some rather nasty highs, which was not the case a few years ago when the early part of a glucose curve was normal for me — and the switch to low-carb eating has essentially eliminated lows that drop to the point where my body has to take countermeasures, which are the part that’s uncomfortable for me (I get adrenalin shakes that last HOURS, and a surge of nausea from the glucagon hit). Switching to low-carb was like moving from burning notebook paper (and I love that analogy Cindy used — that’s exactly right!) to a good quality anthracite coal; the fires still take a little tending, but it’s much steadier and more efficient.

    Mention to her that feeling spacey for a few days as she’s switching over is normal. It can take a few days to really crank up the ketogenic furnace, and in the meantime the body does a bit of, “Wait, do WHAT now?” when the carbs are taken away. She should use her meter to assure herself that she’s not actually going dangerously low, snack on nuts (a little carb, but also some protein, and a good amount of fat to slow the carb absorption down so she doesn’t start a rebound cycle) if she feels the need, and stick it out until it settles down.

  54. @David,

    I am a Type II Diabetic Male, 38 years and was 108 lbs last June (June 08). I was sick and tired of seeing myself so thin (not to mention when others comment on my health). This is when I came across Low Carb diet and wanted to give it a try. I was skeptical though. The reason was everywhere Low Carb was touted as weight reducing diet.

    After following LC diet for 10 months, now I am healthy, do not take medicines at all for Diabetes and am weighing 130 lbs and my weight increasing still. This needs a religious adherence though. As Dr Eades mentioned, ensure that the calories are coming from protein and FAT, you should be good. Once the optimum weight is reached, we can cut on calories and maintain weight.



  55. Ellen is spot on!

    Some numbers from the UK, now out of date but I doubt the ratios have changed much

    wheat ex farm £100/tonne
    bread £1000/tonne
    breakfast cereal £4000/tonne

    potatoes ex farm £100/tonne
    potato chips £14 950/tonne

    Some of my farmer friends (or more likely their bank managers) have over a million pounds invested in kit principally to grow carbs

    Tell me one other food source that has such a huge markup for the processors (in a bad year the growers can still make a loss)

    Then go look at the sponsors of the ADA, AHA, Diabetes UK etc. etc. see any similarities?


    that’s where it all started

    To David, yes I had reactive hypoglycemia for years which I tried to treat with carb boluses. Removing the carbs and resulting excess insulin and rebalancing things between protein, fat and non-carby veggies has evened out my BG and normalised my lipids no end.

    The Heart Healthy High Carb Low Fat diet pushed me right up to the boundaries of overt diabetes before I wised up.

  56. Saturday, 18 April
    Henry VIII became the tyrannical monster remembered by history because of a personality change following a serious jousting accident, according to a new historical documentary.

    After the accident – just before he became estranged from the second of his six wives, Anne Boleyn – the king, once sporty and generous, became cruel, vicious and paranoid, his subjects began talking about him in a new way, and the turnover of his wives speeded up.

    The accident occurred at a tournament at Greenwich Palace on 24 January 1536 when 44-year-old Henry, in full armour, was thrown from his horse, itself armoured, which then fell on top of him. He was unconscious for two hours and was thought at first to have been fatally injured.

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    But, although he recovered, the incident, which ended his jousting career, aggravated serious leg problems which plagued him for the rest of his life, and may well have caused an undetected brain injury which profoundly affected his personality, according to the History Channel documentary Inside the Body of Henry VIII. The programme focuses on the king’s medical problems which grew worse in his later years, especially his ulcerated legs and his obesity: measurements of his armour show that, between his 20s and his 50s, the 6ft 1in monarch’s waist grew from 32in to 52in, his chest expanded from 39in to 53in, and, by the time of his death in 1547 at the age of 56, he is likely to have weighed 28 stone.

    Robert Hutchinson, a biographer of Henry; Catherine Hood, a doctor; and the historian Lucy Worsley, who is chief curator of Britain’s Historic Royal Palaces, offer a picture of a sovereign eventually overwhelmed by health problems by the time of his death. His doctors recorded that he had badly ulcerated legs, was unable to walk, his eyesight was fading, and he was plagued by paranoia and melancholy.

    However, Henry had started out with excellent health as a young man, being universally admired for his manly physique. An ambassador at the Tudor court reported: “His Majesty is the most handsomest potentate I have ever set eyes on. Above the usual height with an extremely fine calf to his leg and a round face so very beautiful it would become a pretty woman.”

    He may have had a bout of smallpox at the age of 23, but the experts speculate that his real medical problems began at the age of 30 when he appears to have contracted malaria, which is thought to have returned throughout his life. They were intensified by two factors: open sores on his legs and sporting injuries.

    The sores – varicose ulcers, which began on his left leg when he was 36, and later affected his right – may have been caused by the restrictive garters he wore to show off his calves. They never healed, and increasingly restricted his mobility.

    Henry also suffered various injuries because of his well-known love of sports – he excelled at pursuits such as archery, wrestling and real tennis, and, playing the latter game he seriously injured his foot.

    But it was jousting – two armoured horsemen charging at each other with wooden lances in “the lists” – which proved the most dangerous. His first serious accident occurred in 1524 when he failed to lower the visor on his helmet and was hit by his opponent’s lance just above the right eye, after which he constantly suffered from migraines.

    Jousting nearly killed him 12 years later. The fall at Greenwich left him “speechless” for two hours, and Anne Boleyn, the woman for whom he had divorced his original queen, Katherine of Aragon, was told that he would die – the shock of which news, she said, caused her to miscarry the child she was expecting. The miscarried baby was male, and it was immediately after this that Henry told Anne they would clearly never have male children together, and turned against her. Less than six months later Anne had been executed and Henry had married the third of his six wives, Jane Seymour.

    But the jousting accident may have affected his whole personality, the experts suggest. “We posit that his jousting accident of 1536 provides the explanation for his personality change from sporty, promising, generous young prince, to cruel, paranoid and vicious tyrant,” Lucy Worsley says. “From that date the turnover of the wives really speeds up, and people begin to talk about him in quite a new and negative way. “After the accident he was unconscious for two hours; even five minutes of unconsciousness is considered to be a major trauma today.” Henry may have suffered a brain injury, Dr Worsley says. “Damage to the frontal lobe of the brain can perfectly well result in personality change.”

    What is beyond doubt is that the end of his jousting combined with his leg ulcers to restrict his movement and Henry, who had a large appetite anyway, began to put on weight rapidly. The programme reconstructs his diet, suggesting he may have eaten up to 13 dishes a day, the majority comprising meat such as lamb, chicken, beef, game, rabbit, and a variety of birds like peacock and swan, and he may have drunk 10 pints of ale a day as well as wine, as water was unsafe.

    Henry, the programme says, “became a comfort-eating paranoid recluse – a 28 stone man-mountain.”

  57. I’m a positive person so I’m going to point out what I HAVE been noticing at the grocery store. TONS more ‘no sugar added’ options. Some might be against these because they’re with SPLENDA, but I happen to love the stuff. I see just as many low-fat options still, but for example yesterday I was perusing the chocolate toppings to go on my Carb Smart icecream (I’m pregnant, give me a break) and next to the no fat fudge topping was the no sugar added hot fudge topping. Who would want to eat no fat fudge?! Gag. Such a waste of shelf space! There’s also no sugar added Hershey’s syrup now! I don’t eat these things much, but it’s nice to have a replacement and now I don’t notice the difference b/w Splenda sweet and sugar sweet, except that the real sugar gives me a headache now. Dr. Eades, any thoughts on why real sugar now gives me a headache? I tend to notice this because it’s only on occasion, like after a piece of cake at a birthday party. Just wondering if you have a scientific answer for that?

    Also noticed that Tropicana just came out with an orange juice with no artificial sweeteners in it but the sugar is cut in half. Trop 50 is what it’s called. It has something called Reb A in it, do you know what that is?

    Reb A is the substance in stevia that gives it its sweetness. It’s a natural sweetener.

  58. Wow, everyone, thanks for all the feedback! This is all super helpful. I’ll suggest to her the idea about the glucose meter. Seems like that would be helpful for anyone, just to know how various foods affect us. And for such an inexpensive price, why not?

    Tom– Yes, I’m familiar with the “induction flu,” as you called it. I always adjusted fairly quickly to ketosis– usually only feeling down on energy for a few days at most, and then hitting an energy high. But as I’ve gone over some of the literature, it appears, more in line with what you said, that it can sometimes take anywhere from 2 to 6 weeks to fully adjust.

    Also, in going over some of this stuff to try determining the acclimation time period, I was looking again at this study in Nutrition & Metabolism: http://www.nutritionandmetabolism.com/content/1/1/2. In it, at the conclusion, it states:

    “Therapeutic use of ketogenic diets should not require constraint of most forms of physical labor or recreational activity, with the one caveat that anaerobic (ie, weight lifting or sprint) performance is limited by the low muscle glycogen levels induced by a ketogenic diet, and this would strongly discourage its use under most conditions of competitive athletics.”

    Dr. Eades (or anyone else who knows), I love being in ketosis, but have been thinking of getting back to some weight lifting. How does this conclusion affect that? Does weight lifting require the “strategic” use of some carbohydrates? I remember back in the day when I used to do a lot of weight lifting, I would have a dextrose/maltodextrin/protein drink post-workout (in what’s known as the “window of opportunity”) for a shot of insulin, to get protein synthesis going, refill glycogen stores, etc. I like to do High Intensity Training for no more than 30 minutes, a couple times per week. How does a low carb lifestyle fit in with that? Is it still a good idea to throw in some carbs due to the glycogen demands, or is there a way around this?

  59. Just read some comments, I learn just as much from the comment sections a lot of times! Happy to hear some answers about already thin(ish) people with hypoglycemia. My new stylist started talking about how she was hypoglycemic and I didn’t go much into the low carbing conversation because I didn’t know enough about the connection there. I figured low carbing must help in some way, of course.

  60. As always, a very informative and insightful post!!

    Seeing that advertisement with Ronald Reagan brings to mind how he kicked the smoking habit. Two words: Jelly Belly. Nothing like replacing one bad habit with another…hmmmm!

    Until next time,


  61. David,

    I also agree with the suggestion that your sister try using a glucometer to see what is happening with her BG. She should use the test strips liberally for a while to generate enough data to get an accurate picture (graphing is great). That’s what I did, with a lot of help from Jenny’s excellent website Blood Sugar 101.

    I’m another normal weight person who has glucose regulation problems if I eat high carb foods with sugar and starch. For a long time (until age 29) I was actually underweight and really wanted to gain some weight, but found it difficult, and I thought I could eat anything I wanted (though I mostly craved carbs). Then all of a sudden, in a year I gained about 20 pounds, 2/3 of which I welcomed (finally had a few curves). I think the gestational diabetes diagnosis should have been a clue, but it wasn’t. I LC’d in the final trimester with great success, but went back to my carbs after the birth, a big mistake. More weight crept on when I bought a bread machine and got into baking pizza, bread, and making homemade pasta! When I hit 140 pounds (5’3″), it hit me that the carbs were the issue. I was back to the low 120s in 5 mos by cuttign carbs, and subbing non-starchy veggies, plus being more generous with protein and fat than before. Now I’m even grain-free and consume very little sugar and I don’t really even miss them much.

    One thing I learned what that even though I still have normal Fasting BG (90-100), my BG went really high (140-275) after eating common carb-rich foods (now I stay under 110 almost all the time after eating). The feeling that I needed more carbs (cravings, jitteriness, intense hunger, lack of energy, fatigue) really felt like low BG, but the glucometer told me my BG had already peaked and was on its way down (rapidly), but was actually *still quite high* (perhaps 180-150). So my body was saying, “eat more carbs, BG is low”, when it was very clear from frequent glucose testing that I still had a lot of toxic glucose to clear from my bloodstream. Sugar and starch makes the regulatory system very screwy and the messages it gives us are not always accurate.

    It’s clear to me now that my first phase insulin response (which starts secretion of stored insulin at the first bite or even before smelling and anticipating carb-rich foods) is shot or inadequate (unknown reason). So 45 minutes or so after starting to eat, my pancreas starts the second phase insulin – realtime production of insulin. Like the calvary, it rushes in to mop up the toxic excess glucose, but often overshoots the mark and then the roller coaster BG cycle really gets going. It’s awful, for me and anyone else around me, because I get short on patience, etc. I am so glad to be free of that “carb grip” now.

    Good luck with your discussions with your sister. I know how resistant people can sometimes be with this issue, until they are ready to make changes and see things differently.

  62. Hello, Dr. Eades. Essentially, I stick to a paleo/low carb eating pattern (at least I try, though not always successfully), so I understand that too much carbs is bad but what about fat, especially from plant sources: I’m speaking about olive oil and oils from nuts (walnut, hazelnut)? Should I refrain from consuming them?

    My rule on fats is that if they can be gotten by pressing the subtsance they come from, i.e., olives, nuts, etc., I don’t mind them in fairly small doses. Coconut oil and palm oil and palm kernal oil, I consume in fairly large quantities as we cook with those. But I avoid all fats that have to be chemically extracted, i.e., corn oil mainly.

  63. Off on a tangent: From reading these comments I picked up on the concept of an “Induction Flu.” Is this possibly a Herxheimer reaction? The idea that your new low-carb body isn’t conducive to some of your old bacteria makes sense but from what I’ve read the “Induction Flu” is viewed as direct reaction low blood sugar levels.

    Until people started commenting on this, I had never heard of ‘induction flu.’ I don’t think it’s a reaction to any kind of bacterial kill off, in fact, based on work with thousands of patients on low-carb diets, I’m not sure exists.

  64. Anna, are we related? (grins) we have several people in the family that have the markers for obesity (lipids, BG, blood pressure) while remaining skinny, it appears to be insulin resistance behind this but somehow unrelated to weight gain. Lipids may be a clue, especially trigs/HDL ratio.

    I probably never had a proper Phase 1 response since childhood but 50 years later my Phase 2 can still drop my BG like a stone if I let it go high in the first place, and it’s the rate of change that brings on the hypo symptoms.

    Agree on the testing, this was my paradigm


    except it may help to start 1/2 hour postprandial and go out to three or four hours to see the full peak to peak swing.

    I seem to be well able to run on ketones and generate all the glucose I need from protein without the peaks and dips caused by trying to bolus carbs. High protein moderate fat and low carbs for breakfast, and probably higher fat during the rest of the day seems to keep me most even with more energy – and keeps the lipids normalised no matter that it freaks out my GP

  65. I’m pretty sure that the “induction flu” being discussed is nothing more than another name for the bad feeling at the beginning of a low-carb diet when the body is switching over (but not yet fully acclimated) to a fat metabolism. This is just kind of a weak, worn down (and temporary!) feeling that nearly everyone I know who has gone on a low-carb diet experiences from one degree to another.

  66. Agree with David, also it seems to vary in intensity between individuals probably depending on their carb intolerance at the time (insulin resistance) and is very likely associated with running high BG over a period of time as many Type 2s do before diagnosis: the body panics when BG drops to a normal level, and panics more until it works out how to generate glucose from protein and run on ketones instead.

    After that all settles down, well I’ve noticed a major improvement in endurance and while I still carry sweets and other carbs as hypostop for emergencies I haven’t needed to hit them for ages now, and my snacking has reduced severely. Occasionally I will need to stuff some carbs after relatively high intensity exercise, but in general my pancreas and liver now work cooperatively.

    It’s worth pointing out something you may not realise (I didn’t until it was pointed out to me, so I’m passing it along): the total blood volume only contains around 5g glucose at any one time, so there’s major work going on in the background stashing dietary glucose into store and retrieving it into the blood on demand, one system is the pancreatic beta cells producing insulin, the other is the pancreatic alpha cells generating glucagon. There only needs to be a 5g glucose disparity between these systems for your BG to double.

    Food for thought!

    I posted on this very subject a long while ago.

  67. Dr. Eades, I am a devoted reader of your blogs and books and I can’t tell you how much I appreciate all I’ve learned from you and your wife. Now that I’ve buttered you up, a question. I live in NYC, and as I’m sure you know there is a fair amount of panic here over the swine flu. If you were living in the blast zone, what precautions might you take? Thanks. S.L.

    I think the panic is a little overkill. Events like these always remind me of the great quote from H.L. Mencken:

    The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.

    The same applies to the media. This really gives them something to get their teeth into. But I think a recent headline from the BBC says it all:

    The first Britons confirmed to have caught swine flu have been discharged from hospital after recovering.

    If you’re concerned, keep protein and fat intake up since those are the substrate of your immune system. And make sure to take at least 5,000 IU of vitamin D3 per day. That’s how I’m dealing with it.

    I probably should put up a post about this.

  68. “I posted on this very subject a long while ago.”

    So sue me, I’m a slow reader, haven’t gotten back to 2005 yet (grins)

    That’s an excellent post, now added to my list of cites for newbie diabetics.

    Glad you enjoyed it.

  69. Why does nicotine gum cessation cause weight gain when my diet hasn’t changed.?

    Because nicotine is a stimulant. Whenever you take away a stimulant, your metabolic rate falls. When your metabolic rate falls, you gain weight on the same amount of food. That’s why people gain weight when they stop smoking.

  70. This is a magnificent post and glad it was linked from… I think Hyperlipid, I can’t remember. I’m glad I discovered it. There are more than a few posts that you have dating back to 2008 and earlier that simply cover a very pertinent issue from every angle, and would be submitted as evidence in a trial to find the real culprit/cause of obesity, if one ever does take place. This piece is definitely one of them.

    Other than comb through all of your archives, please allow me to ask you to consider perhaps doing a post of links for blasts from the past posts to catch up some of your newer readers… maybe when you’re busy with your other projects when you know you’ll be out on the road for a few weeks? I’ve been reading your work well over a year, and am still finding new things here that stand alone and tie back into points made in Protein Power Life Plan. Muchos danka, have a great day.

  71. Truly obesity and overweight is environmental in nature. And of course lifestyle. While the community and environment produces more food with more carbohydrates then people simply tend to eat them and more of them and thus making them obese. The right education that would educate society and the market in general will help individuals overcome obesity.