Are all diets the same?

Synchronicity strikes again.  The seeds of this post were sown when Gary Taubes emailed me about a study published in early 2009 in the New England Journal of Medicine (NEJM) that I had seen at the time, briefly skimmed and tossed aside as worthless.  Gary agreed that the study was of little value, but notice that it contained a peculiar statement by the authors, an interesting admission about HDL, the lipophobe’s favorite lipoprotein.  And not only had the authors made this strange admission, but so had another prominent lipophobe who wrote the accompanying editorial.

I pulled the study, read it more thoroughly and still found it mediocre at best.  But I did come across the strange HDL statements that Gary had mentioned. (More about which later.)

As I was shaking my head over the amount of money spent on what was a truly abominable study, the synchronicity occurred.  I got a ding that I had a new email.  It was a notice from the American Heart Association telling me that this august body had deemed the very study I was holding in my hands as one of the ten most important papers published in 2009.  The sheer stupidity of it nearly took my breath away.

Before we get into the study – which we won’t get into very deeply because, believe me, there’s not much depth – I want to use a parable to show just how silly this study is.

Let’s set our story in the wonderful country of Stupidland where a debate has been raging about the feeding of dogs.  A vociferous old woman who kept dogs had been insisting that different breeds of dogs eat different amounts of food  The majority of the populace were of the opinion, however, that all breeds eat the same amount (it is Stupidland, after all) and looked down their noses at those who  believe a chihuahua may eat less than a collie.  To put an end to the bickering, scientists at Stupidland U ( who were believers in the all-dogs-eat-the-same doctrine) decided to do a definitive study.  They went to the Stupidland pound and procured a German Shepherd, a Labrador Retriever, an Irish Setter and an Alaskan Malamute.

They provided the four dogs with pleasant accommodations and all the food they wanted to eat.  The scientists carefully measured every gram of food eaten by each dog and recorded it.  At the end of the two year study, they reviewed the data and confirmed what they already suspected to be the case: the different breeds of dogs ate just about the same amount.  They did notice one little disparity, however: the larger dogs ate a little more than the smaller dogs, but they were able to correct for that by controlling for size.  Their paper proving that different breeds of dogs ate the same amount of food was accepted for publication in one of Stupidland’s most prestigious scientific journals, The Stupidland Journal of Veterinary Medicine.  Buried deep within the paper was a sentence few noticed stating that size was a biomarker for food consumption by dogs.

The Stupidland press picked up on the study and headlines proclaimed that all breeds of dogs eat the same amount.  The mainstream Stupidlanders nodded their heads sagely; they, after all, had been right all along.  But the old woman, who didn’t actually live within the borders of Stupidland, but who lived close enough to cause trouble, kept insisting that different breeds of dogs didn’t eat the same amounts.  She had a beagle and she had a Great Dane, and she had kept careful records of the food consumption of both. She insisted that the Great Dane not only ate more than the beagle, but that it ate a huge amount more. She would bend the ear of anyone who took the time to talk to her, and her data was so persuasive that she was beginning to make converts.  Just as the population of Stupidland was once again starting to wonder about the dog breed verses food enigma, the Stupidland Heart Association came out with its annual bulletin announcing that the paper by the brilliant scientists from Stupidland U showing that all breeds of dogs ate the same was the most important paper of the year.  The old woman’s first impulse was to attack the Stupidland Heart Association for its sheer stupidity, when suddenly a sense of calmness and clarity settled over her.  She experienced a spiritual awakening (just as did the Grinch in another tale) and finally realized the real meaning of Stupidland. She took her dogs and moved far away, leaving the denizens of Stupidland alone to marinate in their stupidity.

The paper that inspired this parable was published in Feb 2009 in the New England Journal of Medicine and titled Comparisons of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates.  (This is another one of those studies the editors feel is so important that they provide the full text free of charge as a public service.)  The authors include Frank Sacks, George Bray, Steven Smith and an entire rogue’s gallery of lipophobes.  All the usual suspects, as they say.

What the NEJM study sets out to demonstrate is that different breeds of dogs different weight-loss diets of varying macronutrient compositions all bring about the same loss of weight.  According to these authors, it doesn’t matter if you go on a low-carb, high-fat diet or a low-fat, high-carb diet, you’ll lose the same amount of weight.  Doesn’t matter how the protein, fat and carbohydrate stack up in your weight loss diet, you’re going to lose the same amount of weight.  So, you can go to the bookstore, stand by the diet-book shelf, close your eyes and pick.  Whatever diet book you end up with won’t matter because you’ll lose the same amount of weight regardless of which one you choose.  And, even more importantly – again, according to the authors of this study – whichever diet book you select will help reduce your heart disease risk factors.

As Dave Barry says: “I AM NOT MAKING THIS UP.”  It’s right there in black and white in a study done at Harvard and published in the New England Journal of Medicine.

What’s more, the American Heart Association (AHA) deemed this study to be one of the top ten most important studies published in 2009.  And they put it #1 on their list.  Now they said that they listed these ten studies in no particular order – and you can call my cynical –  but I’m just betting that they put this one right at the top for a reason.

Said the president of the AHA, Dr. Clyde W. Yancy

We all thought the statement made in that study was pretty profound. It really dismissed the notion that there’s something clever about weight loss, [showing] that it really is about calorie consumption or, to make it even more straightforward, portion control. You can spend a lot of time wringing your hands about which diet and the composition of which diet, but it really is a simple equation of calories in and calories out.

Give me strength.

My disgust aside, you may be thinking:  Why isn’t the study valid?  If they did analyze all those diets and found them to bring about the same results, what’s the problem?

The problem is that the diets they used in the studies were similar.  They didn’t vary all that much in carbohydrate.  The diet with the highest carb intake contained 65 percent of calories as carbohydrate while the lowest carb diet was made up of 35 percent.  To put this into the gram figures we’re all used to, the highest-carb diet contained 325 gram of carb while the lowest-carb version contained 175 gram of carbohydrate.  Now, as those of us who have ever followed a low-carb diet know, 175 gram of carbohydrate does not a low-carb diet make.  Granted, it’s lower in carb than the diet with the 65 percent of calories as carb, but it doesn’t even approximate a low-carb diet.  As I’ve written before, you’ve got to get the carbs substantially below 100 g per day before good things start happening metabolically.

What this study has done is to study roughly similar diets for two years and pronounce that all produce about the same results.  What the authors (and, apparently the AHA) want you to take away from this study is that real, honest-to-God low-carb diets don’t perform any better than low-fat, high-carb diets.  Which, as most of us know from bitter experience, is not the case.

There are major problems in doing studies such as this one that make their outcomes suspect.  And these problems aren’t necessarily the fault of the researchers – they are simply a fact of life.

When you try to do a dietary study by recruiting people who want to lose weight then randomizing them to a particular diet, you are asking for trouble.  If you run the study out over a long period of time – two years, for example, as this study did – you are asking for even more trouble.  People go into diets with a lot of enthusiasm and pretty rigorously stick to them at first.  But as time goes on, people tend to cheat a little, then cheat a little more and pretty soon find themselves pretty much trending back toward and finally squarely back on whatever their regular diet was before they started the study diet.  (Sadly, it’s not just subjects in studies who follow this pattern, but is the fate typical of most dieters.)  For this reason, after time, all the people in all the different arms of the study are eating about the same thing.  This is why you always see the charts showing weight loss and macronutrient composition start out wildly diverging then converge as the end of the study draws near.  In other words, they all end up consuming the same diet, so they all end up with about the same result.

How can researchers overcome this dismal outcome.  Well, you can put out the call for people who really believe in low-carb diets to fill one arm of the study.  And recruit people who love the Ornish diet for another, and the Zone for another.  These subjects are more likely to stay enthused and stick with their respective regimens for the duration of the study.  But then you haven’t randomized your sample and you will be accused of generating worthless data because your sample groups self selected.

The other way, of course, is to randomize subjects into various diet groups, then put them under lock and key for a year or two and feed them like you would lab animals.  Another impractical solution from a cost perspective if in no other reason.

It’s extremely difficult – virtually impossible, I would say – to conduct accurate studies on diet over a long period of time with a large number of subjects.  Consequently, it is nonsensical to rely on the data from such studies to make the case for anything other than how difficult these studies are to carry out.  I certainly don’t think for all the reasons above that the study in question merits being listed as one of the top ten studies of 2009 by anyone, much less the AHA.

In their discussion of this mishmash of questionable data, however, the authors did make a most interesting statement.  Almost an admission, if you will, of the superiority of a lower carb diet.  This statement is what Gary emailed me about.

(Before we go on with this, I have to make this aside.  HDL and LDL and IDL (intermediate density lipoprotein) and VLDL (very low density lipoprotein) aren’t really cholesterols.  Even though we often refer to them as LDL cholesterol and HDL cholesterol, they really aren’t.  These different groups of letters refer to transport proteins that carry cholesterol through the blood, not to cholesterol itself.  Cholesterol is cholesterol.  It is a specific molecule that doesn’t change.  Cholesterol is a waxy lipid (fat) that virtually every cell in the body synthesizes (because is it so important).  Cholesterol, like all fats, is not soluble in water and therefore can’t dissolve in blood (which is a watery substance), which means that the body has to package cholesterol in a form in which it can be transported from place to place in the blood.  The body attaches a specific protein (a lipoprotein) to cholesterol to make it dissolve in the blood.  The names LDL, HDL and the rest refer to the specific type of lipoprotein being discussed.)

Here’s what the authors wrote:

There was a larger increase from baseline in the HDL cholesterol level, a biomarker for dietary carbohydrate [my italics], in the lowest-carbohydrate group than in the highest-carbohydrate group (a difference in the change of 2 mg per deciliter at 2 years)…

Even Martijn Katan, a lipophobe if there ever was one, and the author of a number of anti low-carb diatribes that I’ve taken to calling the Katanic Verses echoes the same fact – carbohydrates drive HDL down – in an editorial he wrote about the above paper.

…compliance was assessed with objective biomarkers.

The authors used the difference in the change in HDL cholesterol levels between the lowest- and highest-carbohydrate groups to calculate the difference in carbohydrate content between those diets.

Now the differences weren’t all that spectacular, but the drop in HDL in those on the higher carb diet was there and noticed by the researchers.

I find this extremely revelatory because if there is one lipid parameter a lipophobe loves, it’s HDL.  And here you have an entire cluster of lipophobes admitting that HDL varies as the inverse of carbohydrate intake.  Take any of these folks individually – or, heck, take ‘em together – and they’ll tell you that low-carb diets are bad because they give you too much fat.  Yet they admit that their beloved HDL goes up when carbs go down.  Doesn’t make a lot of sense, does it?

When these folks compared these fairly similar diets they found that all of them reduced the risk for heart disease.  They used the fact that HDL went up on the lower-carb diets to deem them heart healthful; and they pronounced the higher-carb diets as heart healthful, too, because the LDL declined on those.

As Yogi Berra said: “You can observe a lot by just watching.”  And they watched LDL go down on the higher-carb diets and HDL go up on lower-carb diets.  But the reverse of the Yogi-ism is also true: you can also fail to observe if you don’t watch.

This refusal to watch is what really gets my dander up.

The researchers whose names are listed at the top of this paper are all affiliated with prestigious institutions.  I am quite sure that there is not a single one of them who is unfamiliar with the work over the last 15 years or so of Ronald Krauss, the researcher who made the discovery of the differences between LDL particle sizes. (The same Krauss, by the way, who published the paper about the meta-analysis of saturated fat and heart disease much in the blogosphere currently.) Krauss and his team showed that large, fluffy LDL particles aren’t particularly harmful whereas the small, dense LDL particles are the ones that cause the problems.  He also discovered that increasing carbohydrate in the diet caused LDL to shift to a smaller, denser pattern while decreasing carb and adding fat made LDL change to the larger, fluffier non-problematic kind.  (You can read a nice review of LDL particle size in this article published in the popular press.)

If you reduce carbs and add fat to the diet, not only does your HDL go up, but your LDL makes a particle size change for the better.  However, when you increase carbs and reduce fat, your HDL goes down and your LDL goes down too, but it changes for the worse. So even though the high-carb, low-fat diet decreases LDL, it doesn’t decrease risk – it increases it because even though LDL is lower, it is made up of a dangerous particle size,which negates any possible value of the fall in LDL.  All of these researchers know this.

Why didn’t they check LDL particle size on these subjects?  Had they done that, they would have found that those subjects on the higher carb diets would have lowered their HDLs and althought they lower levels, would have shifted to more of the dangerous, smaller, denser LDL particles.  They couldn’t have then made the case that not only did all diets work the same where weight loss was concerned but they all decreased heart disease risk.  They would have had to say that although all diets brought about the same degree of weight loss, the lower-carb diets clearly reduced the risk factors for heart disease the most.  And that’s an admission I suspect they didn’t want to make. Therefore they refused to observe.

I don’t know what the deal is with these folks.  Why don’t they simply tell it as it is?  Do the long-term lipophobes who have ridiculed low-carb diets for years and built their careers on the rickety edifice of the low-fat diet not want to admit they were wrong? That’s understandable, I suppose, but what about the young ones?  Why are they stampeding over the low-fat cliff like Gadarene swine?  Do the younger lipophobes not want to offend the older ones?  Why do they fail to reconcile their theories with what amounts to basic biochemistry and physiology?  Whatever the reason, they are fighting a losing battle.  Ultimately the truth will out and when it does, all these people who have tenaciously clung to the low-fat, high-carb fantasy will be – like the phrenologists and other failed theorists of the past –  so much detritus in the history of medicine.  And their books and papers will be displayed as curiosities of the boneheaded thinking of an earlier day. A sad but fitting fate.

Photo: Set of phrenological heads, England  circa 1831
via The Pollo Web

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92 thoughts on “Are all diets the same?

    • I know this was posted a long time ago but I just discovered this website. I am not a lipophobe but as a non-M.D. it is extremely hard to buck the system. When patients come in to see me for an eye exam I have a difficult time contradicting everything their diabetes educator says. If someone comes in and flat out asks me about low carb I am always positive about it. If a patient asks me what I follow, I tell them, but I don’t go proselytizing about low carb in patients who have sought my counsel on their contact lens prescriptions.

  1. I enjoyed the Men’s Health article on the nuances of cholesterol that you recommended, but the following paragraph from the article confused me:

    “If you substitute polyunsaturated [good] fat for saturated fat, you see a reduction in heart-disease risk,” Dr. Krauss says, casting more doubt on four decades of diet advice. “The interpretation of that finding has been that saturated fat is bad. My view, based on the data I have seen, is that it means polyunsaturated fat is good; it doesn’t necessarily say anything about saturated fats being bad. . . . Does that mean saturated fat is bad fat? Or just that saturated fat is not a good fat?”

    Is that first sentence accurate? (Based on the rest of the article, Dr. Krauss seems to have a good understanding of heart disease risk.)

  2. @JW

    I noticed that sentence, too, and it struck me the same way it struck you. I can’t really tell what he’s getting at since it’s at odds with the rest of the article.

  3. I’m old enough to have seen quite a few scientific theories go into the dustbin or be raised on the shoulders of victory. Example: when I was in high school, the theory of continental drift was a curiosity and not widely believed. Then (from memory, thus unreliable dating) around 1965 the bombshell dropped in the form of an article, and associated scientific papers elsewhere, that used residual magnetic data to support the hypothesis of mid-ocean ridge spreading of the continental shelf. That did it. By the time I was in university in ’69, continental drift and techtonic plates were now the credible explanations. In just a handfull of years. Is it because geologists and geophysicists were REAL scientists, while Bray and his colleagues are only poor scientists? One is tempted to think so.
    Hence my perpetual amaze at the slowness of uptake of “The Carbohydrate Hypothesis” as Gary Taubes terms it.
    Phrenology (alas) was around for a very long time — practically the whole 19th Century. I cannot recall a “killer blow” that trashed this silliness for good. I guess it was a death of a thousand cuts.
    I guess that’s it. The truth, at least before the Internet, took a while to disseminate. The ancient Greeks knew the earth was round and that it revolved around the sun — at least those astronomers and mathematicians who designed the Antikythera Mechanism (150–100 BC). But we had to go through the stupidities of the Ptolemaic system for over 1 thousand years. And then came the Renaissance (as I recall we discussed previously).
    Do we really have to wait THAT long???

  4. I’m just impressed by any article about lipid metabolism that can get in a reference to “Gadarene swine,” and “Phrenologists.”

  5. It’s nice to see more science like that of the Krauss study, but I worry that the war has already been lost. After my retirement I decided to take some college classes in the biological sciences for my own interest. In these classes at my local community college it’s depressing to see how many young people are simply sure that the vegetarians are right, in everything. It doesn’t even seem to be a matter for controversy for these kids; the only question is whether or not a person is ‘ethical’ enough to eat the diet that they are sure is best for them and the environment. One day I listened to a young woman bemoaning the fact that she had fallen off the wagon and eaten a hamburger. She was feeling very guilty about it. Like I said, depressing.

  6. @ Michael Richards

    Let’s hope we don’t have to wait a century. What we have that they didn’t have in the phrenology days is bloggers. They keep the flow of information going. Just a few years ago, the only way I could express my displeasure with a study like this one would have been to write a letter to the editor, which probably wouldn’t have been printed. Now I can reach several thousand people some of whom may forward the post on to who knows how many people. It’s a lot easier to reach critical mass now than it was for the anti-phrenologists.

    @Charles

    And in the same paragraph to boot. 🙂

    @Lee

    You’re much more pessimistic than I. When these college boneheads are confronted with a little 9 to 5 reality therapy, they’ll change their thinking.

    • Why don’t you and other lo carb proponents get together and design a study of diets–Mediterranean, vegetarian, low fat, low carb (at a level you think would be reasonable), etc., specifying the parameters to be measured, and petition NIH to fund it? Then maybe things would be clearer.

  7. @ mreades and JW

    Krauss is still in the public health business so he’s still trying to hold onto multiple (probably wrong) hypotheses, instead of throwing out the refuted data and conducting good science. He’s still caught in a paradigm.

    I always find the “substitute A for B” sentence confusing. I want to substitute Bird for McHale. Who’s going in the game? Who’s coming out? I do know it’s familiar though, because the authorities always seem to use it when they publish things like “Rationale of the diet-heart statement” and the Willett and the Nurses Health Study use this kind of dialect in their articles.

    But I think he was saying if PUFAs get in the game, and you put SFAs on the sideline, you see a reduction in heart disease risk (according to the authorities and maybe himself – or whomever – by the idea that PUFAs lower total cholesterol and LDL and they interpreted this as reduced risk, end of story), and the author took it the other way; that you put SFAs in the game and PUFAs on the sideline, and that’s why he wrote that Krauss’s statement was “casting more doubt on four decades of diet advice.”

    By this logic, the rest of it makes some sense that if it were the case that PUFAs lower risk more than SFAs (which they probably don’t), it might just mean that SFAs aren’t as effective in reducing risk than PUFAs, but it doesn’t mean their bad per se.

    Krauss really is trying to hang onto the Ptolemaic system of nutrition with his multitude of epicycles (PUFAS, high fiber, low cholesterol, calories-in-calories-out, Mediterranean diets, diet-heart) to explain public health when the right thing to do would be to throw out the hypotheses and give the Copernican (restricted carbohydrate) model the rigorous, and fair, testing it deserves.

    There is a weird disconnect when it comes to Krauss’s research and his public health stance.

    You would think he would have an a-ha moment like Gardner did with the Atkins study. Alas. (And to your point, Dr. Eades, the Gardner study was a great example of a longish-term study on diets where everyone relatively quickly regressed toward the mean diet, and the most profound improvements between the diets was when people were adhering to them – where Atkins was better in just about every respect. When the data began to get more insignificant was when the diets started to resemble each other – Atkins went from 17% CHO at 2 months to 35% at 1-year…Ornish 21% fat at 2 months to 30% at 1-year.)

  8. AHA summary of the paper states:

    “Over a two-year period, 811 overweight adults were assigned to one of four diets that differed from high to low fat, average to high protein and highest to lowest carbohydrates.”

    I agree that it is intended to mislead the readers into believing that the researchers have tried Intervention stage of PP also. God save them if they follow what they preach!

    Thanks for your analysis.

  9. Is this a case of science vs religion, metaphorically speaking… or then again, perhaps not (the metaphor that is). This scenario reminds me of what it must have been like for Darwin when he claimed the earth is round and God does not exist. Most people will rally to group opinion in spite of evidence to the contrary. Unfortunately, these days much more is probably needed than just a good shepherd.

    “Never forget that only dead fish swim with the stream.” – Malcolm Muggeridge

  10. Maybe they’ve all bought into the Ornishian HDL garbage truck paradigm and simply don’t care that carbs drive HDL down, ‘cuz hey, they’re just garbage trucks. Less of ’em means there’s less garbage, therefore the diet is working.

  11. @ LB

    You’re probably right about the sentence in question, but one shouldn’t have to go through all that parsing just to know what the thing really says. Should have had a better editorial once over.

    @kb

    Nice Muggeridge quote. Thanks.

    @Alex

    In case you haven’t read it, here is a post I did a while back on Dean Ornish and his views on HDL.

  12. “Do the younger lipophobes not want to offend the older ones?’

    Dr. Eades, if you had even spent a few years in academe directly observing the game, you would not be displaying such a youthful lack of cynicism : )

    Academic freedom is an oxymoronic joke.

    If your lab and your mentor and the guy who edits the journal you submit the papers to that your tenure depends on (“up or out”) get funded to do cold fusion and you are a post-doc or fellow, you believe in cold fusion.

    Or like Samuel Jackson’s character Jules in Pulp Fiction says, “my girlfriend is a vegetarian, which pretty much makes me a vegetarian”.

    It is no different than the climate change scam.

    But I know you already know that.

    Great Post.

    How true, how true. Thank God my girlfriend isn’t a vegetarian. 🙂

  13. Code for Stupidland doctors:

    If they are drinking the ‘koolaid’ (*haa* thanks Dr. Kurt Harris MD for that!!!!!!)…

    RUN.

    RUN as fast as you can away.

    (KOOLAID = statins = mitochondrial poison)

    Nice equation.

  14. Dr. Mike,

    Do you have any thoughts on good food habits for kids?

    Obviously it’s good to limit refined sugar (to the extent that’s possible) and to make sure they get enough protein and non-starchy vegetables … but what limiting about amounts of fruit? Is whole milk preferred to low-fat milk for a school kid who is not counting carbs?

  15. A bit off topic – a geologist (now retired) told me that when he was in University his professor went to a conference, came back and told his students to rip up all their notes from the course so far. He had just been to the conference that brought all the various bits together and produced the theory of tectonic plate theory. This would have been in the early 1970’s. So things can change quickly. On the other hand, until then the researchers in the various areas thought that they were getting to a replacement for continental drift, but since that theory was so discredited they were afraid to talk about it until the evidence was put together from various sources. As a biologist I was delighted with tectonic plate theory since there are fossil locations that it explains so nicely.
    PS You have a huge sample size in all of use who are doing this WOE. When I started (because of pre-diabetic blood work results) my doctor looked at my triglycerides after 3 months and knew I was low-carbing, we had a good discussion about how diet has changed since the 50’s and 60’s.

  16. Most people who write about nutrition these days think flour and sugar and trans fats are bad, even though they disagree about saturated fat. I would be more interested in a study that compared the long term effects of two diets, both of which eliminated most of the factory produced carbs that most people demonize, but disagree about total carbs/fats.

    I also think that calling everyone who has misgivings about fats “lipophobes” (not to mention “stupid”) you make the same mistake those people do in thinking all diets that limit carbs in some way are the same.

  17. Another great post, Dr Eades. Thank God for the internet, or algore if anyone insists.

    No need to gild the lily by adding to what Dr Harris said.

    @lee
    “The Vegetarian Myth” by Lierre Keith, hailed by Dr E, Tom Naughton, and everyone who’s familiar with it, may arm you with some thought provoking rejoinders for the CC students, where appropriate.

    Sean Croxton has a lengthy interview with Ms Keith on his ‘Underground Wellness’ show on BlogTalkRadio.com
    She’s very engaging, pleasant, knowledgeable. logical, etc. Destroys the ‘ethical’ argument in a matter of fact, non-threatening way. Well worth listening to. Here’s a link
    http://www.blogtalkradio.com/undergroundwellness/2009/10/08/the-vegetarian-myth-with-lierre-keith

  18. @Engineer

    I have a lot of thoughts about food habits for kids. Whole foods, avoid as much refined carb as possible at home (they’ll get plenty outside the home), and low-carb fruits. Too many people give kids way too much fruit and fruit juice, in my opinion. And, yes, I would go for the whole milk.

    @Patricia Duffy

    Would that this could all be resolved as quickly as the tectonic shift was.

    @Peter Silverman

    The definition of phobe is fear. Lipo means fat. Lipophobe means fearer of fat, which is what they are. If someone wants to call me a carbophobe, I wouldn’t be offended. And I didn’t call them stupid. The only people I referred to as being stupid were those citizens of Stupidland.

    @mrfreddy

    That’s too close to home. Don’t you have something you could be cooking sous vide?

  19. If one is comparing low fat diets and low carbohydrate diets, maybe another factor should be taken into account.
    Ie how much sanity does the subject retain after each type of diet?
    Someone who spends years on a low fat diet may well lose weight, but how many of them are bulimic or have a raging eating disorder?
    I spent several decades eating low fat and it’s only a decade of low carb eating that has (sort of) helped me regain some sanity.
    Low fat dieting screws you up,mentally and physically. Low carb dieting repairs you.
    Thanks for another excellent post, Mike!

  20. Lets first and foremost realize that a the opinion leaders in medicine have invested their prestige; reputations and financial futures on the lipid hypothesis coupled with the belief that saturated fat is bad. Statins do whatever they do by lowering chlestorol. High amounts of fat cause heart disease. These are the beliefs behind the treatment of heart disease. The fact is most disease including CVD are the result of inflamation with LDL riding along as a passanger.The Krauss study will be ignored even though it goes a long way toward explaining the failure of ezetimibe : which can be be thought of as a medically enforced low fat diet ; has thus far shown in clinical trails. Statins on the other hand may in fact work not by effecting LDL levels but by raising vitamin d levels :but heck the tale of the good and bad cholesterols is much more compelling and marketable

  21. I’d like to point out that the Bray study diets were all calorie restricted: “Each participant’s caloric prescription represented a deficit of 750 kcal per day from baseline…”

    So he’s really testing calorie restriction, which we know must produce weight loss. What we need to show is that an ad libitum low-carb diet works better than a calorie restricted diet of arbitrary composition.

  22. @Dr_A

    Good point. I suppose there are people who could be screwed up psychologically on a low-carb diet as well. If so, such a diet may not be the best for them if you regard the person as a whole. I’ve never really seen anyone who fits this description, but I assume it’s a possibility. Many people would rather be fat, insulin resistant and inflamed than lose a close friend, and many people have formed a strong bond – almost a friendship – with food, so who’s to say those people aren’t better off keeping their best friend until or unless they can get their heads straight.

    @Nigel

    Yes, I’ve seen the study, and I plan to post on it soon.

    @Gary Katch

    That would be a nice study, but I’m pretty sure such a study would find (as most low-carb studies have shown already) that those subjects on the low-carb diet arm would spontaneously restrict their calories to a level coming close to or even under the caloric-restricted low-fat diets. If weight loss were the same in both arms, the naysayers would simply claim that it was all a matter of caloric deficit.

  23. Dr. Eades…
    I just ran a search on your blog, but came up empty-handed. Did you know that Enova has been completely removed from the market? I was able to buy it through their website back when I began the 6 week cure. I needed to re-supply, so I returned to the website and there was an announcement that they were removing Enova from the shelves of stores and from the website because they had to address issues raised by the EU; they said it would be back on the market in March 2010. Then, about a week ago, I went back to check on any further notes: There is no longer an “EnovaOil.com” The webpage has been removed.

    Do you know anything about the controversy?

  24. I have a suspicion that one could spend a lifetime looking for a doctor whot has not been steeped in Stupidland doctrine. It may even be a requirement for graduating.

  25. So glad to have you back on the blog. Sous-vide madness must have eased off. Your last entry was inspiring for someone coming out of residency into family practice (my sister), and trying to figure out how to put this wisdom into practice. It’s still scary now, as it was for you when you started, because it’s still against the prevailing current. But thanks to you it is somewhat easier now. I have a question about the best way to measure endogenous insulin production in a type 2 diabetic. Someone near and dear very closely fits the description you give in chapter 2 of 6WC where you describe hormonal havoc, sarcopenia, thick(ish) mid-section, elevated CRP, lack of sleep, crazy cortisol, and so on. This person has great respect for you and MD, Atkins, Taubes, and others, but can’t seem to see his own condition clearly. I think he believes lupus knocked out his pancreas, but has never actually had insulin tested because standard diabetic treatment doesn’t bother with that. Claims not to have a problem with carbs while shooting insulin every day, and suffering all these other problems that seem so obviously carb-related. His doctors don’t seem to be on this. What is the best way to test?

  26. @Ruth Briggs

    I know just enough about the Enova controversy to be dangerous. I’ll dig into it to see what I can find. Fortunately, the Enova was just a small part of the 6WC and can easily be left out.

    @Jeromie

    I’m glad to hear you’re enjoying the blog and books.

    @Hilary

    He needs to get his C-peptide levels checked. That will tell how much insulin he is himself producing. When insulin is made in the pancreas it is made in a form called proinusulin, which is then split into insulin and C-peptide. There is one C-peptide molecule for each molecule of insulin. If C-peptide levels are normal or high, then your friend is making plenty of his own insulin, is insulin resistant and should benefit greatly from a low-carb diet.

  27. I was disgusted by this study as well. At first I was concerned and cautious, but when I looked at the actual data, it was clear what the problem was. At the 2 year time mark, the low fat average protein group was eating 53% carb while the high fat high protein group was eating 43% carb. Fat consumption was also not that different- 26% vs 35%. And these were the two extremes! The two other study groups were in the middle. This is essentially no difference, and as you pointed out, was not even close to being a true low carb diet. It woudn’t be so bad if they had just acknowledged the deficiency of the study design instead of acting like they had actually studied and observed something. I think the study authors should have to pay back the taxpayers for their lousy study! What a waste of money and paper, not to mention continued obfuscation of the truth.

    I am also perplexed by the continued nonsense repetition of dogma. Researchers who truly have established a strong reputation for themselves can go out on a limb and break with the paradigm, and this may be occurring, but only very slowly. Some of these big name guys are in bed with pharma and food manufacturers too, so have zero financial incentive to question the dogma. Everyone else is afraid they will endanger their chances for publication, and getting new grants and promotions, so they continue to spout the party line.

  28. Lee, you can tell the guilt-ridden young woman who fell off the wagon and ate a hamburger that she was probably responsible for fewer animal deaths that day than usual. There simply ain’t no free lunch. Literally. In terms of sheer numbers, probably more animals are killed in the process of raising the grain and legume crops required by vegetarians for their “ethical” meals than are killed to feed persons who eat meat. It’s just that those animals–the mice, birds, gophers, rabbits, snakes, etc., etc., that get in front of the farm machinery in the fields–are invisible to those who eat their “guiltless” tofu-burgers. But those animals are dead, nevertheless. It is unavoidable.

  29. Various studies have borne out the idea that LDL particle size isn’t as significant of a risk factor for heart disease as LDL or total cholesterol. I see the idea that LDL particle size is all that matters in the low carb community. That’s because low carb diets that are high in saturated fat elevate LDL cholesterol.

    This is from over 5 years ago:
    http://www.medscape.com/viewarticle/493610

    Lowering of LDL particle count, not size, is still the primary target in the prevention of heart disease. Triglycerides, HDL and, perhaps, particle size are all secondary.

  30. I want to revisit the confusion about the switching of fatty acids and the conclusions (valid/invalid) that can be drawn. When you switch part or all of one dietary ingredient (A) for another (B), there are two changes that happen simultaneously. If you see just one result, what caused it…. Suppose you see a “good” change. Does that mean that the (B) component is good, or does it mean that the (A) component is bad? You can’t tell because two changes were made together, and one result was observed. It could also be that (A) was neutral and (B) was good or (A) was a little negative but (B) was greatly positive. Note that the positivity of (B) is always present in the above consistent intrepretations, but the negativity of (A) may or may not be true. With just one result, you cannot rule (B) is good AND (A) is bad with only one experiment.

    You can’t tell, two things were changed at the same time and only one result was observed.

    This is pretty basic to diet studies, and Taubes mentioned this difficulty, but I have forgotten in what sense.

    Krauss’s statement is perfectly logical to me, and the reader is reimposing the “Must conclude something was bad” logic from a situation where “something was bad” is not required.

    Here is the original…………..
    I enjoyed the Men’s Health article on the nuances of cholesterol that you recommended, but the following paragraph from the article confused me:

    “If you substitute polyunsaturated [good] fat for saturated fat, you see a reduction in heart-disease risk,” Dr. Krauss says, casting more doubt on four decades of diet advice. “The interpretation of that finding has been that saturated fat is bad. My view, based on the data I have seen, is that it means polyunsaturated fat is good; it doesn’t necessarily say anything about saturated fats being bad. . . . Does that mean saturated fat is bad fat? Or just that saturated fat is not a good fat?”

    Is that first sentence accurate? (Based on the rest of the article, Dr. Krauss seems to have a good understanding of heart disease risk.)

  31. Anyone shocked by this sort of behavior from “trained” nutritionists (or their bureaucratic spokesmen) is probably too young to remember the radio broadcasts of Carlton Fredericks, who, because he so early on dared promote the benefits of carb reduction, had to endure an endless stream of unfounded criticism (not to mention, ad hominem attacks). And anyone who now believes that this uneasy power mix between government and science is unique to the medical profession, somehow missed the “climategate” scandal. Anyway, with the “nanny” state in full swing and nationalized healthcare seemingly inevitable, god help us. No wonder I’m a libertarian!

  32. @Joseph Kindermen

    There are a few papers that finger particle number vs size as the primary risk factor, but I think – based on the sheer weight of the published evidence – that it is the particle size that’s the problem. If you have two people, both with LDL levels of, say, 160 mg/dl, and one of these people has small, dense, type B particles while the other has large, fluffy, type A particles, which of the two is going to have the most particles? The first one, of course. So, given equivalent LDL levels, those who have type B particles are always going to have more particles, so I think the particle-number-as-major-risk-factor idea is a tautology.

    @Jim B.

    Agreed. It’s tough to tell. And, as I’ve always maintained, how do we know that the positive changes that come about from low-carb diets come about because we restricted carbs? Maybe it’s because we ate more fat. I don’t really believe this, but it is difficult in situations like these to tease out the correct answer. Especially in diet studies because there are four variable: fat, protein, carbohydrate and calories.

  33. On the tectonic plate theory;

    I worked at the Naval Research Laboratory and for a time had my office in the same building as the Marine Physics Branch. I got to know one of the scientists and one day asked him about tectonics. As best as I can remember (some 15-20 years later) he told me that the theory was proposed by someone outside the oceanology field. This person had noticed the similarities in the coast lines of Africa and South America. When he heard of the theory, the worlds leading oceanographer at the time was reported to have said. “There is no mechanism to explain that!” completely dismissing the idea. Until he died, no oceanographer DARED to advance plate tectonics.

    Sound familiar ??

    Incidentally, I think the oceanographers still do not know what drives the plates to move as they do. BUT that they move is well acknowledged. Haiti comes to mind immediately.

  34. @Rob

    It’s not a concern to me. As I’ve written many times in these pages, rodents are not just furry little humans. They react differently to macronutrients than we do. If I were a rodent, I would probably avoid a high-protein, high-fat diet. Plus, I hate articles such as this one that don’t give you any clue as to how to track down the study they’re referring to to see if they’ve even quoted it correctly. The Proceedings of the National Academy of Sciences is a huge journal published frequently, so it would be tough if not impossible to track down this article based on the information given in this small blurb.

  35. Hey LarryAJ
    “As best as I can remember (some 15-20 years later) he told me that the theory was proposed by someone outside the oceanology field. This person had noticed the similarities in the coast lines of Africa and South America.”

    It was my hero, Alfred Wegener — who was a geologist, and who was hounded and just about destroyed by the “orthodox” geologists for proposing the intolerable hogwash that “the earth had moving plates.” Just about all the old geologist-guys had to DIE before the younger ones could actually look seriously at the idea of tectonics… {frown}

    In the case of low carb — the question is who will die first: the medical and nutritional orthodoxy — or the public!

  36. HI Dr. Mike,

    Great post… I have been following PP and PPLP for about a year now, and have lost 70 lbs of fat weight. No low fat diet or “waste-watchers” did that for me!

    Hubby and I have recently discovered we are expecting (a side effect that was warned about… :P) and I was hoping you could give me some pointers on following the plan throughout the pregnancy. I did read that the pancreas develops in the first trimester, and am planning to stick to a low carbohydrate and essentially grain-free diet. I also saw MD’s blog about pregnancy and fish oil, as well as krill oil.

    Is there anything else I should know ? is it still safe to lose fat weight while being pregnant, or should I up my calorie intake to stop losing…

    Thanks for your help!

    Wanda

  37. Thank you Dr. Eades. I’ve done so very well eating low carb/high protein and fat – it’s been a life-changer for me (down 50 pounds in a year; all lipid, blood pressure, sugar numbers down significantly, and a diet I feel like I can stick to forever). Much of this inspired by your blog and writings, and by Gary Taubes’ book. These kinds of articles scare the heck out of me despite all the research I’ve done. So I’m grateful, to say the least, for your reply. Rob

  38. “That’s too close to home. Don’t you have something you could be cooking sous vide?”

    according to google maps, Stupidland extends from just below Orange County up thru Ventura. Folks get much brighter in Santa Barbara!

    WIsh I had a portable SVS, haha. The steak I had last night was tough and miserable…

  39. Sorry to rain (a little) on the parade with the continental drift trivia. The Alfred Wegener theory of plate tectonic was proposed in 1912, was debated, but was not rejected out of hand or loughed at. There were a lot of supporters and even the mainstream media of that time presented it. I have myself a 1934 edition of “La Science et la Vie” magazine in which it was explained, that was btw the trigger for looking a bit more in detail about that theory as I had myself swallowed the standard narrative of it. It was not completely accepted because Wegener hadn’t found the mechanism to explain it, but as soon as it was found in the ’50s it became quickly the acceped standard.

    You can read on wikipedia that the story is a bit more subtle:
    http://en.wikipedia.org/wiki/Alfred_Wegener

  40. Stupidland is apt…I am not denying that. But, it is not just the scientists who live there….the general population also lives there.

    I think part of the fat-phobia is due to the fact that many people can not (do not) consistently stick to a low carb higher fat diet. They might eat well and follow it for part of the day…then they might rip into the carbs with a one-meal or one-dessert binge. And, if they are eating more fat the rest of the day….that, with the insane high carb binge…spells trouble….and that fat gets stuck in places where it should not be.

    Just a theory.

    I can tell you for darn sure that if I ate a diet of mostly carbs (esp the grain-form) I would be far less healthy than when I eat limited carbs and higher fat/protein. When I eat too many carbs, I crave more carbs…and I tend to then not eat enough protein…which screws up my amino acids and pituiitary and all the lovely hormones that are regulated up yonder. For me…a Zone-ish ratio tends to work well–flipping the carbs and protein. (40% protein, 30% carbs from fruit and veggies…not grains, 30% fat). That is my magic potion. But….I do NOT think that this is a one-plan-works-for-all world. I’m a big fan of Protein Power (even promoted it on my blog today!) I also respect the work Dr D’Adamo has done in the Blood Type and Geno Type diets and appreciate that there are different things that work well for different people.

    We all live in and are surrounded by Stupidland….and it is up to us, as individuals, to figure out what works best for our bodies.

  41. Following the advice of the 6-week cure I’ve lost 45 lbs in 90 days. I have more energy than ever, and although I wasn’t depressed, people notice I look happier than I have ever been. The difference was so dramatic half my co-workers bought the book and are following the plan themselves with the same results. What will it take to get the truth of this plan out there? I’m 1/4th of the way through Taubes’ book “Good Calories, Bad Calories” and it makes me feel as if we have the answers to cure the modern populations health problems, but nobody is listening. Hopefully the tide will turn soon.

  42. Wanda,

    Congratulations! I have some experience with eating low car while pregnant and it is positive.

    12 years ago (but before I knew about PP) I followed a LC diet during the last trimester of my pregnancy due to a diagnosis of gestational diabetes (the GTT test occurred right when I began to gain weight rapidly). I used a BG meter to fine tune my carb intake and keep my BG levels normal throughout the day. I didn’t enjoy measuring food, counting carbs, and eating “little piles” of separate foods, but I do think my diet improved quite a bit when I was forced to account for every bite I took – no room for surplus & empty carbs. A developing baby is a powerful incentive. I had a fantastic normal 9 hour delivery without pain meds nor an epidural (though I was induced aa day after my due date because GDM moms aren’t “allowed” go much past due dates for fear of delivering huge babies). My son was a healthy 7 lb 9 oz baby, and I gained a healthy 28 pounds during the pregnancy (14 lbs was baby & water weight leaving 14 lbs to lose after discharge from the hospital, which melted off effortlessly in the first 6 mos while I was breastfeeding exclusively even though I went back to my beloved bread & pasta). After weaning, though, I began to put on weight with the carbs. It came off when I sent LC again 5 years later.

    Later I learned I still had post-meal high glucose levels when consuming high carb foods, so the abnormally high BG wasn’t just due to the pregnancy, and it probably preceded the pregnancy. Since 2004 I have eaten a LC diet to maintain my weight and maintain healthy normal BG levels. So does my husband, though our 11 yo son does eat somewhat more carbs than we do (but far less than his friends eat). We all eat a lot of foods that are naturally high in unprocessed fat and fat soluble nutrients. We also no longer eat any wheat or gluten foods, even if they are processed to be low in carbs.

    My only regrets during the LC phase of my pregnancy is that I hadn’t learned about my BG issues earlier so I could have reduced carbs earlier, and that I was still eating far too much processed food and not enough really nutrient-dense foods that weren’t CAFO-produced, like grass-fed meats and grass-fed butter. I was too reliant on Trader Joe’s convenience foods! I wish I’d been on more low carb nutrient dense foods from the very beginning of the pregnancy (and we’d had infertility issues but frankly, the nutrition advice is flawed there, too).

    I do have concerns about epigenetic diabetes effects on my son because his organ development occurred before I knew my BG was very high or got my BG levels under control. And since my pregnancy an uncle, a cousin, and my mother have been diagnosed with diabetes (no known family history of diabetes at the time of my pregnancy). Since my son’s been about 6-7, even though is weight is fine, I’ve stopped the high carb foods (even homemade bread) and encouraged lower carb habits for him, too (we also now eat gluten-free and soy-free as we’ve discovered we are both positive for gluten & soy antibodies, gluten genes, etc.). He probably has somewhat erratic BG levels when he eats high carb items (behavior and well-being declines) so I try to provide foods that keep his BG fairly steady instead of encouraging roller coaster BG swings.

    I also wish I’d been more aware of the importance of old fashioned (not industrially-processed modern foods) foods high in fat soluble vitamins during my pregnancy, particularly Vit A, K2, and D. Today if I were pregnant I’d follow a LC variation on the Weston A Price Foundation recommendations for nutrient-dense foods for mothers and children (I eat these things now – homemade bonebroths, liver pate, grassfed or game animal products, “backyard” local eggs, especially the yolks, etc.). I buy at least half our meat, eggs, and nearly all our produce direct from farmers now, via CSA, co-op buys, local folks who keep backyard chickens, and farmer’s markets. I cringe inside when I think of how I used to eat (any many would have considered my old eating habits better than the typical SAD, ironically).

    I was probably quite deficient in D3 in particular (even having moved to So Cal a few yeas before conceiving, but I was very cautious about midday sun exposure). I should have been supplementing at levels much higher than the RDA of synthetic D2 that was in my prenatal vitamin (now my family members each take 1000iU for every 25 pounds of body weight) to keep our 25 (OH)D levels up – we also test twice a year.

    I also wish I’d not initiated weaning at 9-10 months simply because he was eating a lot of food and breastfeeding had become a snack for him. I’ve learned that shorter length of breastfeeding and lower than optimal fat soluble vitamins (in mother’s diet and baby’s) from Real Food can affect middle face development – leading to dental malocclusion, restricted airways/apnea, allergies, etc. Breast milk from a bottle, while being the best nutrition-wise, doesn’t provide the same sucking action for proper oral development as suckling directly from a breast (www.brianpalmerdds.com). I learned about this as I’ve been investigating orthodontic treatment in the past year for his overbite & lower jaw underdevelopment. We have just begun the treatment and are driving 2+ hours each way because there are no orthodontists in our area who consider the entire facial development in the treatment (without extractions, retraction, reducing airway space), etc. during the active growth stage (ages 7-10). Breastfeeding for 18-24 months+ plus eating ample amounts of grassfed butter & bison, “backyard” egg yolks, raw milk aged cheese, and tasty liver paté to promote proper growth for good oral posture and form are preferable to expensive, inconvenient orthodontic treatment, I can assure you!

    Best wishes to you and your husband for a healthy, happy pregnancy and baby. I hope your baby sleeps as well as ours did, too ;-).

  43. Dr. Eades,

    Sorry to go off topic but I wanted your educated opinion on a portion of my blood work I got recently. I’ve been on a low carb diet for 3 years(I’m 21 now) and enjoy excellent health. Eat mostly meat and fat with a few vegetables and berries here and there. My blood work was awesome. Just a little question about my thyroid hormones. My TSH was 2.1(0.45-4.500). My Thyroxine(T4) was 4.4(4.5-12.0). My T3 was 38(24-39). As you can see my T4 was .1 low. Does that matter? Should I take a little extra iodine or anything?

  44. Slightly off topic but sad to say, Robert Parker, the writer of, among other things, the Spenser mystery novels, died Monday, January 18th, of a heart attack. The one cautionary note in the NY Times obit was the following: “Mr. Parker had been thought to be in splendid health . . .”. And I would bet that was based on his cholesterol numbers. Ya think?

    Marcia

    Probably. And one of the obituaries I read on Mr. Parker said that he loved donuts.

  45. Dear Dr Eades, Thank you so much for all you do, read and write. You and some other LCers have literally transformed my life positively and quite frankly have saved my sanity. I don’t mean to take up valuable space in the comments…….but I gotta, OMG, because I have to thank you, additionally, for the time and attention you pay to these ‘comments’. I suspect that these are A LOT of work. However, I learn a good portion of what I do learn ( Post-Taubes, June 16, 2008) from the comments, in addition to blogs like yours. The ‘comments’ are almost as revelatory and rich as your posts! I CANNOT thank you enough. If you ever get a wee bit frustrated if any of your efforts are influencing for the better our lives out here in the cyberether…….fear not!

  46. Great post as usual, thanks.

    It is a good idea for people to look at their background, because they may have inherited genes that predispose them to function better with certain types of diets.

    A nutrition-related genetic mutation can spread to an entire population in as little as 396 years, or even less depending on the circumstances. I posted about this here:

    http://healthcorrelator.blogspot.com/2010/01/how-long-does-it-take-for-food-related.html

  47. Wow! Such wonderful advice, thank you so much, Anna and Bob! I am so very glad I have such a wonderful resource of support available to me. My greatest gratitude to you both.

  48. This popped up on the RSS reader this morning: “Prevalence of Abnormal Lipid Levels Among Youths — United States, 1999–2006”

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5902a1.htm?s_cid=mm5902a1_x

    From the article (under the heading “What is already known on this topic?”): “Abnormal lipid levels are major risk factors for cardiovascular disease and are associated with greater than normal body mass index (BMI) in children and adolescents.”

    Ah, our gubbermint at work…

  49. Some pretty disasterous stuff in the media today. The stupid NYC effort to cut down on salt, and the even more stupid “7 guidelines” for reducing heart disease risk.

    And of course no one in the mainstream talking about the stuff from Krauss.

  50. More news from Stupidland… here is an article written by the “You Docs” Memet Oz et al. The article analyzes what Rush Limbaugh did right and wrong regarding his recent heart attack.. Of course they dis his low carb diet that led to 90 pounds of weight loss. I have no idea, however, what they are talking about. Can you shed some light Dr Eades? What are progenitor cells and why would a low carb diet produce them?

    http://www.idahostatesman.com/1399/story/1045730.html
    The You Docs: What you can learn from Rush Limbaugh

    “and your saturated fat intake (four-legged animal fat plus palm and coconut oils). We’re less enthusiastic about the low-carb, high-protein diet Limbaugh followed. He says it included a large sirloin twice a week paired with small quantities of vegetables. Yes, it worked for weight loss. But a high-protein, low-carb diet harms blood vessels (including those of the heart) by decimating an army of specialized stem cells (progenitor cells) that keep artery walls healthy and flexible. Four thumbs down from the You Docs. Our point: Check out what’s in your weight-loss program. You, not the company providing it, are responsible.”

    Jesus wept! What a bunch of hogwash. It means nothing. There is no evidence that a low-carb diet harms blood vessels – this is simply wishful thinking on their parts.

  51. @gallier2
    How does this rain on my original comment? Wikip backs me up in substance:

    “In the early 1950s, the new science of paleomagnetism pioneered at Cambridge University by S. K. Runcorn and at Imperial College by P.M.S. Blackett was soon throwing up data in favour of Wegener’s theory. By early 1953 samples taken from India showed that the country had previously been in the Southern hemisphere as predicted by Wegener. By 1959, the theory had enough supporting data that minds were starting to change, particularly in the United Kingdom where, in 1964, the Royal Society held a symposium on the subject.[7]

    “Additionally, the 1960s saw several developments in geology, notably the discoveries of seafloor spreading and Wadati-Benioff zones, led to the rapid resurrection of the continental drift hypothesis and its direct descendant, the theory of plate tectonics. Alfred Wegener was quickly recognized as a founding father of one of the major scientific revolutions of the 20th century.”

    There you have it. Hope this augurs well for the Carbohydrate Hypothesis!!

  52. I echo the gentleman who wanted to know the update of the 6WCure Blog! My dh and I followed it to the letter, we even did weeks 1-4 twice, before starting maintenance. We had been following PPLP for nearly 2 years with wonderful results in weight. HOWEVER, for me, especially, now a post-menopausal woman, I simply cannot get my waist to hip ratio to the desired level that the 6WC suggests. Husband did beautifully. My blood markers are excellent, and my body fat % (calculated from the original PP book) is also within normal limits. What’s up with my waist! I do not desire to use hormone replacement, as my LC diet has lessened symptoms to nearly nothing, which I am very grateful for. It is just this stinking gut AND those last 10 pounds!! Which markers are the most important? Blood levels, body fat % or waist/hip ratio?? I have very narrow hips for a woman, thicker waist and broad shoulders. My waist/hip ratio fits fine for a man (.93) – ha ha!! Do I really have early metabolic trouble brewing, with all my other markers signifying very low risk? Surely I can’t be the only woman with this problem!

  53. I keep getting here a day late — but I don’t know how else to get this note to you, Dr. Eades. The NY Times (not the Brody scold this time) has now started to pick on salt: http://www.nytimes.com/2010/01/21/health/nutrition/21salt.html?ref=health

    Jesus wept is right. When are they going to go after sugar, ever? (Okay – rhetorical question.) And if the answer is “never,” what I want to know is WHY?

    Thanks again for all you do. Amazing. That’s all. Just amazing.

    Marcia

  54. you are too angry to think clearly. I see that their low carb design wasn’t low enough for you.

    well, call and ask them to try with a modified design next time. or at least present your critiques in a way that is serious and understandable. this rant is hard to take serious because it isn’t serious.

  55. @Michael Richards

    My comment was only to tell that continental drift was not a theory that was so heretic as low-carb still is. The theory was well known before the ’50s, as demonstrated in the article from the early ’30s I read in the “La Science et La Vie” magazine (french science magazine still existing today).

    The global acceptance of the “low-carb” theory will be much more difficult than the gloal acceptance of continental drift.

  56. “Take any of these folks individually – or, heck, take ‘em together – and they’ll tell you that low-carb diets are bad because they give you too much fat. Yet they admit that their beloved HDL goes up when carbs go down. Doesn’t make a lot of sense, does it? … I am quite sure that there is not a single one of them who is unfamiliar with the work over the last 15 years or so of Ronald Krauss, the researcher who made the discovery of the differences between LDL particle sizes. … I don’t know what the deal is with these folks. Why don’t they simply tell it as it is?”

    When you stop lying to yourself, the whole world starts to make sense. There is a widespread belief that almost all doctors genuinely want to help people; so then, when the majority of doctors oppose what actually makes people healthy, we grasp at straws – they are too busy to learn the truth, they are influenced by drug co. sales reps, they don’t want offend their elders, etc.

    But the medical business is not a health care system. They recommend the high-grain, low-fat diet BECAUSE they know it makes most people fat and sick. They try to get you to believe that the amounts of vitamins and minerals you need to be healthy (sometimes as much as ten times the RDA) are dangerous BECAUSE you have to be sick, so they can treat your diseased condition with drugs and surgery. That’s the business they’re in.

    There are millions of people in this country who obviously feel just fine telling any lie and harming anyone in pursuit of their goals. They are doctors, lawyers, nurses, teachers – every kind of person. They train us to lie to ourselves because that’s what’s best for them.

    Will you observe it?

  57. In regards to the hardliners re low carb, AGW, tectonic plates, etc: Many years ago in an Air Force management class I was given a saying I’ve never forgotten.
    “The greatest obstacle to change is resistance to change.”

  58. First you tell us that the study has a serious weakness because, over the course of 2 years, the participants in each group all converge on a similar diet. That is, they’re all pretty much eating the same thing after a while since people find it difficult to stick to these diets in general. And you tell us conclusion about weight loss and diet composition is therefore not warranted.

    Then you tell us that the study revealed a plausible finding about low carb diets and higher levels of HDL. Somehow, that conclusion is warranted.

    Is this study bogus or isn’t it? You can’t have it both ways.

  59. I don’t know what the deal is with these folks. Why don’t they simply tell it as it is? Do the long-term lipophobes who have ridiculed low-carb diets for years and built their careers on the rickety edifice of the low-fat diet not want to admit they were wrong? That’s understandable, I suppose, but what about the young ones? Why are they stampeding over the low-fat cliff like Gadarene swine? Do the younger lipophobes not want to offend the older ones? Why do they fail to reconcile their theories with what amounts to basic biochemistry and physiology?

    I don’t think we can ever underestimate three things:

    First, the young usually identify as liberal, which means that encouraging the eating of more animals seemingly means they’d also be preaching increasing one’s carbon footprint and the mistreatment of animals. (Though many of us here, including myself, believe those are faulty assumptions). Many vegetarians I know don’t do it to be more healthy, they do it because they don’t like the idea of killing animals and all that carbon that those cows add to the atmosphere.

    Secondly, people who are in their twenties and younger grew up in the age where fat, even if unsaturated, has been seen as evil and fattening to the point where many of my peers look in disgust at the fat on my rib-eye or the grease on my plate surrounding my burger. It’s so hardwired in us, and we’ve been so raised on low-fat, that the sight of significant amounts of visible fat literally turn people’s stomachs. When I switched to low carb, I, too, at first cut off the fat on the rib eye, not because it didn’t taste good, not because I thought it would do me harm (I’d read it wouldn’t) but because I was simply not yet used to the texture.

    Third, never underestimate the power of funding from grain agriculture. I’m sure change would occur far more quickly if there wasn’t so much money involved in carbs. What would happen to the middle isles of the grocery store if people realized that the 3,000 varieties of low fat crackers aren’t healthy snacks? Sure, there could be money to be had in low carb processed food, as we saw the boom in them around the early 2000s, but from what I remember of their ingredients, they still had less wheat and corn (though not less soy) than low fat foods. Certainly much less corn syrup.

  60. It’s extremely difficult – virtually impossible, I would say – to conduct accurate studies on diet over a long period of time with a large number of subjects.

    This is why I would suggest doing a long-term randomized study involving prisoners. In California alone, there are 170,000 prisoners. With enough funding, you could do a randomized study involving, say, 1,000 prisoners; give them all some extra spending money for participating (voluntarily, of course); and then carefully control what they’re allowed to eat. It wouldn’t be perfect, but it would be far better than other diet studies.

    • I don’t think much of either one, especially the blood type. My exposure to The Gabriel Method has been pretty cursory, but from what I’ve seen, I’m not sure it would work for many people.

  61. I believe that “researchers” like this make these studies and statements because they get paid better to uphold the status quo. If they were to go against the popular belief, they would be ostracized and their careers would be over. There can be large grants available for those that “study” what the people in control of the money, prestige and fame want studied.

  62. Simple answer to why no one wants to talk low carb – then not only have I been poisoning myself unwillingly, and if I’m a parent, poisoning my children – suddenly all the people I’ve lost from diseases of civilization potentially didn’t have to die when they did. That’s a giant burden, and I imagine if you’re in healthcare, it’s probably evevn bigger (larger sphere of influence.) Until we find a way to provide an honorable out for people, even the grass roots revolution will have a hard time taking off.

  63. Rice Carbs vs Processed Bread and Poison in the Food Supply:

    So, I gather from above carbs are bad. I don’t know if all carbs are bad, or it’s the bread…I’m scared of rice, the carbs are listed as so high, as much as maple syrup…or close. I’m scared of rice and I want to know why the Asians are so thin when they eat rice all the time? The Asians think what is messing up the American metabolism the most is chemical poisons, which causes persons to overeat. The poisons come in the foods designed to addict people. I don’t know all the ingredients in McDonald’s, Colas, and Kool-Aid and all the chemicals in wheat and grains such as bromines in wheat. It is said that wheat is the main guilty party that makes people fat. The bromates or bromides (I don’t know the chemistry)? They will destroy the iodine function which regulates the thyroid gland so one get’s fat from bread or bread dough like egg rolls and pizza and the chemistry imbalance it causes. I would say it’s also milk and bread making glue and fungus in the colon. You know it stinks….Substituting fries and potato chips causes more disorders in the guts, it coats and clogs the intestinal walls with a bad oil film that sticks in there and can’t come out. It’s been known for so long that when the thyroid is tweaked, virtually anybody out there can be skinny in no time. It’s also known it won’t take the chemicals out of the body, just to tweak the thyroid, and if the doctor’s gave you that solution under those toxic conditions causing you to overeat to begin with, you will die, not from thryoid medicine but MD’s know you are toxic and obviously stupid on the issue and when skinny you will eat the same stupid way thinking you just had a weak gland, and they will get blamed for your death. They won’t say “your body chemistry from junk food and poisoned food is a nightmare.” They are most often looking for some quick fix trick to make you feel better for making quick $$$ when you walk in the door, not get you a degree in chemistry and nutrition. It’s them against you. The system is designed for independence and victimizing people out of their money. Also working like a miracle, is growth hormones, and steroids…these things work if you get good products. There are many bad products sold, either stale, or just lies. After one has already gotten fat they are most likely so full of chemical poisons they will regain the weight because it’s being poisoned that makes you overeat. Your not getting fat because your overeating, your overeating because your getting fat. The correction needs to happen as to the reason the person is storing fat and not using it as they go along. Asians have their own stores and don’t even touch American foods because they KNOW full well how adulterated the products are. They don’t eat at McDonald’s. They want their vegetables and soy and green tea and ginseng and they have their teeth and they don’t like milk. I worked with the best Asians, and they won’t touch an American labeled box of soy milk, they love the chinese soy, sugar and all, as long as it’s labeled with Chinese words. I was drinking the American sugar free soy and thought about it. What get’s in American food is a lot of problems of trust issues. False labeling. Ingredients lies. Chemical Warfare with the Foods. Chinese don’t have all the answers and they eat some disgusting stuff like spiders, crickets, or human placenta, but they know something big about lies and poison in American foods and drugs. They work with their own herbal and root cures also. It’s kind of strange why they would not prefer McDonalds to eating spiders and rice with soy and oil and they have far more home cooking…..but it’s working for their longevity, not to be poisoned by the secret chemicals sprayed on farms, and put into factory packaging and processed foods by big companies. They love greens too. Americans don’t want to eat green vegetables too much. The don’t even have a craving in so many cases, people just ignore greens. McDonalds doesn’t think greens matter in a meal. The Asians don’t feel fed it they go there and eat. Back in the days, Chinese was the cheapest restaurant meal around. Now it’s as costly as American food. The Chinese never got rich, they just keep making more Chinese. As far as MSG poisoning goes, I believe this is for the American Chinese and Chinese restaurant food, I don’t know that they are big on this in China. Addictive substances to oversell sell restaurant and processed foods should be illegal. It’s a dirty rotten trick that never should have happened. And I’m not sure how trust worthy some Asians are to Americans. It is the Chinese selling shiploads of fluoride to put in American water supplies. It can be possible that the Chinese know so much about poison in American food because they are the one’s doing it to the American’s. The world has been envious of Americans and their lifestyle and I do wonder how many corrupt persons are after the Americans.

  64. To get back to the low carb/continental drift comparison, and the posts here that say Wegener proposed his theories in 1912 and was being accepted by 1953;
    I studied geology in school in 1976 and none of our so-called up-to-date textbooks even mentioned continental drift. Bad news.
    The good news is, my school teacher was so newly qualified and so enthusiastic that he never taught from the textbooks and inspired me to study geology at university level myself.
    So keep up the enthusiasm, Dr Eades…people need inspiration!

  65. Mike, to (cynically) answer the questions you posed at the end of your post, I believe they are ‘seeding’ the literature with little bits and pieces of of low-carb truths (or hints of the truth). In 5 to 10 years, when the younger lipophobes finally start admitting the superiority and scientific validity of the low-carb approach, they will cite the ‘ground breaking work’ of their former masters (Bray et al). In 20 years, grad students in Public Health and Epi programs will be learning how Bray and company led the ‘new diet revolution’ by identifying the real culprits in obesity and other diseases of civilization – carbs.