The pitiful state of medical ignorance

In 1976 the classic film Network starred Peter Finch as crazed anchorman Howard Beale who launched into his now-famous rant “I’m mad as hell…” on air and galvanized movie goers everywhere.  Even though Howard Beale is fictional, I often share his sentiments.

I got a call yesterday from an acquaintance who wanted to get together and talk to me “face to face.”  I’ve played golf and had a few drinks with this guy over the last couple of years, but that’s about it.  I agreed to meet him at a local coffee shop.

When we had our coffees in front of us – I, a full-strength, scalding hot Americano; he, a non-fat, decaf, double shot latte, just in case you’re wondering – we made small talk for a few minutes then he cut to the chase.  A look of despair came over him, and he confided to me that he was a type II diabetic and was in real trouble.  His doctor had been monitoring his HgbA1c levels for a couple of years, and lately they had been inexorably on the rise to the point at which drastic action was required.  What drastic action?  His doctor told him he was going to have to start insulin injections.

The guy had begged his doctor for a reprieve, which he got until the end of the year, then called me in desperation.

I went through all the quotidian doctor questions and discovered that he was taking three different drugs for his blood sugar, a high-blood pressure pill, a medicine for his GERD and, it should go without saying, a statin.  I asked him about his typical diet, but I already knew the answer.  He ate pretty much what he wanted to eat, but he did try to avoid desserts because he knew sugar wasn’t good for him.  I then inquired as to whether his doctor had discussed diet with him as a part of his treatment.

He said the doctor had advised him numerous times to cut the fat from his diet.  His physician had told him that his diabetes put him at a greater risk for heart disease – which is indeed true – and that, consequently, he should cut the fat, especially the saturated fat, from his diet and live mostly on complex carbs.  He said he had tried, but just couldn’t seem to stick with it for any length of time.  With a What-can-I-do? kind of shrug, he divulged that he was a real meat-and-potatoes kind of guy who felt he would always be hungry if he couldn’t have a steak or a burger from time to time.

I asked if his doctor had perhaps suggested a low-carb diet when the low-fat diet hadn’t worked for him.  No, not really.  In fact, he, himself, had asked about the South Beach Diet since he had a friend who had done well on it.

“Absolutely not, replied his physician.  Too much fat.  Remember, you’re at increased risk for heart disease.  Besides, you don’t want to go on a fad diet.  You’ve got a serious health problem, so you need to go on a diet that might make you better.”

For the most part I face widespread medical/nutritional idiocy with a fair amount of equanimity, but every now and then, when I brood on the cost in human suffering this idiocy all too often causes, I want to do the Howard Beale and scream “I’m mad as hell.”  Problem is the idiocy is so widespread that my pitiful efforts to counter it are on par with King Canute’s trying to hold back the tide.  If I can make a little difference here and there, I suppose it’s worth the effort, so I keep trying.  But I still want to scream.

I started ruminating about all the misery this seemingly universal lack of nutritional understanding engenders when I read on Fred Hahn’s blog an email he posted from one of his readers.  In short order, I came across a brief anecdote in a book I was working through.  If that weren’t enough, I got a copy of Robb Wolf’s new book and read about his medical experiences.  Then, hard on the heels of that, the meeting with my friend almost put me over the edge.  I was ready to lean out the window and start screaming, “I’m mad as hell…”

First the email, which I have excerpted.  You can read it in its entirety here.

I also want to really thank you personally for being a part of a program that has saved my life.  That may sound dramatic, but here is my story.

I am 42 years old and 6 foot tall.  A little over ten years ago I was diagnosed with Type 2 diabetes and given medication to deal with it.  I was also told to lose some weight.  I weighed between 200 to 205 at the time.  I was also told to lower my fat intake and I could eat as much fruits and vegetables as I wanted.

Over the years, the weight stayed relatively consistent.  I am not athletic at all, but am fairly active.  However, the quantity of food has consistently gone down in my efforts to lose weight.  Additionally, my blood sugar has constantly gone up.

In these last two years, my weight started creeping up some.  As a result, I stated running fairly regularly.  It had no, or very little effect on my weight.  I pretty much stopped eating a regular dinner at night after work.  All I would eat is some yogurt or some fruit cups at night. Remember, I could eat all the fruit I wanted.  I still kept gaining weight, but my fasting blood sugar that I measured in the morning did come down a little.

On March 14th of this year, I weighed 215.  I was taking 4 different diabetes medications, one blood pressure drug, pretty much taking a Prilosec everyday for heartburn as well as Tums fairly regularly.  My doctor did not seemed concerned with the heartburn.  I assumed it was from stress at work.  I would also vomit fairly regularly.  I assumed from the various drugs, maybe stress.  My cholesterol as indicated from my blood tests when I visited my doctor were higher than recommendations as well as my blood pressure.  Neither super high, but higher than what is considered normal and healthy.

I visited all the normal diabetes type web sites and none of them said anything or recommended anything that seemed to offer anything of value.  I was mostly doing what they said.  Lots of fruits and vegetables, lots of whole grains, try to lower fats and some exercise.  Yes to all of the above.  Yet I continue to get worse.  I was beginning to believe this was just a part of aging and having diabetes.

How long was it going to be until I started having real health issues?  For the most part I very rarely get sick.  When was I going to start going blind, lose a foot or leg, have a heart attack, kidney failure, stroke out???  I was getting to be resigned that it was just a matter of time.  Inside my head I secretly hoped that I would have a fatal heart attack at a relatively young age so I would not have to deal with the real issues of diabetes.

On March 14th in a round about way, I found the Protein Power book.  It was opposite everything I knew to be true, yet it seemed more true about nutrition than anything I read before.  How could everybody else be so wrong?  I instantly started following it, cutting my carb intake to next to nothing or at least less than 30 grams a day.  Before stating this, knowing what I ate, I am fairly certain my carb intake was close to 60 to 70 percent of my total calorie intake.  I bought your book a couple weeks later.

I am sure you will not be surprised at all by the results.  As of this morning I now weigh a little over 190.  It has been close to 20 years since I have weighed that little.  I have stopped taking two of the diabetes drugs completely, one of the others I am taking 80% of what I was taking, the other I am down 30%.  I have not taken a single Prilosec or a Tums since I have started this change and this is the most stressful part of the year for me as it relates to work.  I have only vomited once and that was on March 16 or day 2.  Six weeks in, I had a doctor visit and blood test.  Blood sugar way lower, bad cholesterol way lower and in the normal range, good cholesterol way higher and also now in the normal range.

Five weeks after I changed my eating habits, I started my slow burn routines based on your book.  With some of the exercises I really struggled at first, but now am fairly comfortable with most of them.  I am still learning and refining a few things, but I can say my increases in strength are just as dramatic as my weight loss.  In the case of the chest press, the very first time I did it following your slow burn book instructions I did 3 reps at 100 pounds and was wiped out.  Yesterday, at 130 pounds I did 6 reps in a little over 2 minutes.  Time to increase the weight again.

As I said before, I was running fairly regularly for a few years.  Not that fast, and really, not that far, 3 to 4 miles in around 45 minutes.  Generally 3 or 4 times a week to do “some exercise” as recommended by my doctor and everything I had read about diabetes.  I have cut back on the running since I started your workouts, but when I do run, I run significantly farther and significantly faster than I have run in years.  I hated, hated, hated the running, but did it to do my exercise.  Now when I do run, it is almost fun.  I am so amazed at the changes in me.

So that is how you have had a part in saving my life.  I do not know how to say thank you any more than that.

Not long after coming across this email, I was reading a book on TRIZ, a methodological approach to engineering problem solving that can be applied to other realms, when I came across a report of a disturbing doctor-patient interaction.  The author is using this story to illuminate a problem solving technique called peeling the onion, which means to continue to dig deeper and deeper in the quest for a solution.  Instead of illuminating anything for me, it just made me mad as hell.

One day, I was sitting in my doctor’s office anxiously waiting to hear the results of my most recent cholesterol screening. The previous year my cholesterol had gone up just slightly, which was very depressing. I essentially had no exercise regiment prior to that, but afterward I went into fat-free mode and started walking 4 miles a day. In spite of my protests, a couple of years earlier my doctor had put me on a low dose of blood pressure medication. I don’t even like to take aspirin.

As a result of my hard work, I was certain my current cholesterol level would be outstanding. I couldn’t wait to hear the great results.

Unfortunately, the test results painted a different picture. My cholesterol level was 30 points higher.

“That’s impossible. I don’t eat beef brisket anymore… ever! I don’t eat any sausage, never go to McDonalds, buy fat-free everything, and walk 4 miles a day. It can’t be true.”

“Yeah, it sucks getting old doesn’t it? Aging is that one thing you can’t control. Even though you’re trying to eat better and exercising, which is a great thing, these efforts are obviously not enough.”

“What? Older? It has only been a year! Urrrrrrr…this doesn’t make any sense. It’s not fair.”

“I think we should put you on Lipitor.”

“No. I don’t want to take anymore meds. Let me think about it for a while. This makes no sense.”

When something makes no sense to you, your curiosity needs to kick into high gear. Well, this surely qualified as nuts to me. Yes, I was a year older, but… come on. The test results couldn’t be right. Most people would probably just do as the doctor ordered, but I almost never take anything at face value.

The author then goes on to describe how he “peeled back the onion” by doing internet searches for cholesterol and found that one of the supplements he had been taking for his joint pain – glucosamine – had been found in some cases to raise cholesterol levels.  He went off of the glucosamine, and as he tells it:

Two months later, my cholesterol was 30 points lower and back under the limit.
If I did not have a curious nature about most everything I would have been on another needless medication. It pays to peel the onion back.

I don’t think his glucosamine had anything to do with his cholesterol – the 30 point drop in his cholesterol was probably just the normal roaming range of his cholesterol levels over time. The take home lesson of this story is that this guy’s doc was ready to put him on an expensive medication with a number of pretty severe side effects because of one cholesterol reading above a particular number.  The doc wasn’t treating a patient, he was treating a lab value.  In this case the patient is a young man (mid 40s) with no history of heart disease, the very kind of patient for whom no benefit has ever been found for statin therapy.  Why, when this patient’s low-fat diet failed to lower his cholesterol, didn’t his doctor suggest a low-carb diet?  Studies have shown the low-carb diet to be more effective in solving lipid problems than the low-fat diet.  So why wasn’t it suggested.  Had this patient gone on his doctor’s statin of choice and not had his cholesterol fall, his doctor would have tried another statin.  Why not try another diet?

If you read the entire book, the author mentions throughout how his days of red-meat eating are over and makes numerous references to his much-despised (but in his mind, therapeutic) low-fat diet.  It’s really sad that he’s such a victim of medical ignorance.

I got a copy of Robb Wolf’s new book The Paleo Solution and started reading the first chapter, which describes Robb’s own story.  In short, he spent years as a vegetarian, getting sicker by the day.  All his physician’s told him that he was lucky he was able to follow the diet he was following because he would have really been much worse had he been following a standard diet.  Robb ultimately came around to the low-carb, high-meat Paleo way of eating and solved his own health problems.  When he went back to his various physicians to get blood testing – all of which was perfect for the first time – he was ecstatic.  He told his doctor he had completely changed his diet.

“Doc! Have you ever heard of the Paleo diet?” I asked.  “How our ancestors ate for millennia?”

His answer was typical of what I would encounter in the years to follow.  “That is pseudo science.  There is no proof.”

When Robb describes the remarkable difference in his health to yet another doctor, he is told:

It must be something else.

Why do these stories make me mad as hell?  Not just because the people involved suffered as a consequence of medical hubris, incompetence and intransigence, but because so many millions of others do suffer miserably and aren’t lucky enough to escape their fates as these few were.

It’s difficult to imagine the number of people who go into doctor’s offices every day with weight problems, elevated blood sugar, high blood pressure, and abnormal lipids and are told with great authority to eat less and exercise more.  If the patient asks the doctor for a specific diet, the doc usually has the nurse give the patient the standard 1800 kcal low-fat diet sheet.  Depending upon the motivation of the patient, this diet may or may not be followed.  If the patient does suck up and follow the diet, many, of not most, will fail. When these poor folks come back for their recheck, their doctor then wants to put them on some sort of drug.  Believe me, the stories above aren’t atypical.  This is happening all across the country thousands of times every single day.

And I’m mad as hell because it doesn’t have to be this way.

There is another option.  These poor people could be given a low-carbohydrate diet to try.  Most of the doctors who prescribe the 1800 kcal diet (along with a recommendation to exercise more) could give people the choice.  A low-carbohydrate diet or a low-calorie diet.  But the vast majority of them don’t.  They simply opt for the low-calorie diet, then resort to drugs when it doesn’t work.

There is plenty of good research available now showing the low-carb diet to be at least the equal of the low-fat diet in virtually every parameter with most of the studies showing the low-carb diet to be superior.  With this research backing the efficacy of the low-carb diet, why don’t more doctors offer it as an option?  Naiveté? Stupidity? Pigheadedness? Who knows?  What I do know is that it’s a real problem.

Lately the web has been full of various health gurus (mainly those involved in weight training and/or bodybuilding) making the case that the only reason the low-carb diet works is that it is satiating and spontaneously causes its followers to restrict calories.  It’s the calories, say they, not the carbohydrate restriction that does the job.  I say, So what? Who cares as long as it works?  And countless studies have shown the low-carb diet to be as efficacious (if not more so) as the low-fat diet, so why isn’t it offered as an option?

If a doctor treats a patient with a specific drug for high blood pressure, and the patient’s blood pressure doesn’t respond, the doctor switches medications.  Most doctors will fiddle with the medicines to get the problem solved.  Why not do that with diets?  Why just go with the low-cal, then move immediately to drugs if that diet fails?  Years ago, during the interim in which low-carb diets were out of favor and not much good data existed on their efficacy, I could understand it.  But why now?

It seems that almost every week a new study is coming out showing the superiority of the low-carb diet.  Over the past couple of years we’ve had a trifecta of well-done studies published in major scientific journals demonstrating the effectiveness of low-carb diets.  There was even a meta-analysis published in Obesity Reviews, the most mainstream of mainstream academic journals** showing low-carb diets work better than low-fat diets.  So why don’t more doctors recommend them?

I’ve been infused with a little hope by a recent totally unscientific poll published in the Annals of Internal Medicine.  Readers (primarily physicians) were presented with the following poll.

Surprisingly, the majority answered that they would give a low-carb diet a try first.

The particular issue of the journal publishing this poll was the one containing one of the more recent papers on the benefits of low-carb dieting.  (I’ll post later on this amazing study that was designed to fail.)  As a consequence, I would bet docs taking this poll were skewed in the low-carb direction.  But who knows? I can always hope it means there is a light at the end of the tunnel, and that physicians are beginning to discard their low-fat tunnel vision.  The fact that this poll even exists in a major mainstream journal.  We should all take heart.

But until docs start changing diets that don’t work at the same rate at which they change blood pressure medicines, many, many people will suffer.  And I’ll continue to get mad as hell every time I hear about travesties such as the ones I wrote about above.  Too bad there aren’t diet reps that go into all the doctor’s offices like the drug reps do.  Maybe if there were, things would change a little faster.

Since most of you reading this blog visit your doctor from time to time, perhaps you can play the role of diet rep.  You can do it by telling your doc how your low-carb diet is working for you.  And you can provide literature just like the drug reps do to add substance to your report.  Here is a pdf file of the Obesity Reviews meta-analysis showing low-carb superiority. Meta-analysis of low-carbohydrate diets

So, be ambassadors for the low-carb diet so that more physicians might give it a try. If enough of you do that, your actions will provide a gentle but steady invigilation that will ultimately bear fruit. When physicians do gingerly recommend low-carb diets a few times, they’ll see the same astonishing results you have.  More and more will start recommending low-carb to their patients as a first line therapy, which will decrease the number of tales of woe I’ll have to sit through.  I can then dodder off into my dotage in a much more sanguine frame of mind.

If you haven’t seen it, here is a clip of the famous I’m mad as hell speech from Network.

** How mainstream is Obesity Reviews? It is the journal that published George Bray’s unfair and almost incomprehensible review of Gary Taubes’ book Good Calories, Bad Calories.

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

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246 thoughts on “The pitiful state of medical ignorance

  1. More people–everyday Janes and Joes–are getting it. There are a lot of women in their 20s and 30s on a vintage-interest forum I belong to, and many of them have been losing weight their great-grandmothers’ way: cut the sugars and don’t stuff yourself. Even a vegetarian member wanted information on a low-carb diet. I help spread the word there and through my humble blog.

    BTW, one of your posts enabled me to get off proton pump inhibitors–the one about Norm Robillard, who wrote Heartburn Cured. I was skeptical of his theory, but I was going through acid rebound and desperate enough to follow his advice–and it worked! I just wanted to say thanks.

    • I certainly hope you’re right that people are beginning to get it. I just hope the medical profession follows suit.

      Glad you got relief from GERD; it’s a miserable business.

  2. I’m shocked by how many doctors no longer employ basic logical reasoning. With diet or anything else. I respect the profession and know there are long hours and they’re overworked, etc, but still.

    Recently, my brother started having joint pains they initially said were gout, but when that tested negative, they thought it was RA. When that was negative they just shrugged their shoulders and offered meds. The first week, after the negative gout test, I told him to stop taking the anti-depressant he had just started, which listed as one of its dozens of symptoms, joint pain. But his doctors wouldn’t believe that could cause it. Told him to keep taking it. Not switch to another. (It’s a needful but not essential med!) Finally, when he couldn’t take the pain and the stress of not knowing what was going on (our mother has RA), he listened. Pain was gone in a week. Nothing in the months since.

    I just don’t get it. Two different doctors refused to think. Refused to acknowledge possibilities that I could see within 20 minutes of reading a side-effects list.

    So it’s no wonder diet gets no careful consideration. And no, they didn’t address his diet at all.

      • Did you form that generalization after examining state curricula and observing in thousands of classrooms across the country or are you just repeating CW?

        • I attended four different public school systems in the United States and a fifth in the Philippines that was under the aegis of DOD. I can’t speak for the DOD school because that was kindergarten and first grade (although I did have reading and math in kindergarten–see, sometimes the government does something right), but I can say with some authority that while we were put through the occasional logic exercises, we were never given formal training in logic in any of the stateside schools I attended. And those ranged from the very worst (Mississippi) to moderate-to-good (Washington state and Missouri).

          It’s not something that can be measured on a standardized test, not even in the essay section. The most you can test is a student’s ability to form analogies and I hate to be the one to crash the party, but that’s not all there is to logic.

      • Of course not, the government mandated that schools stick with the curriculum so students can be standardized tested. Logic and reasoning don’t fit anywhere on a bubble sheet.

        I’m an ex-teacher for this very reason, I couldn’t change it (no one listened) and I couldn’t stand it anymore.

        Now that student’s scores on standardized tests will decided their teacher’s pay… just a reminder that teachers usually proctor these exams and have access to the answer keys.

        • Teacher proctor these tests with a monitor (to monitor the teacher) and NO ONE has access to answer keys. Test are sent off to a company to be scored. Only a portion of the test items are “the test” with others mixed in. In recent years, mandated tests are given on computer with a counselor or testing administrator with a teacher working to monitor student behavior so they won’t talk or look at each other’s computer screens.

          The big downside to testing is it consititutes a limited view of the student’s understanding of the subject with no information about progress, encourages teacher to teach to a test in order to keep their jobs or keep away the threat of losing their jobs and limits curriculum. Students as young as 3rd grade have begun to acclimate to testing by working toward a test and then forgetting what they learned to prep for the next test; seeing no value in learning to know something and building on previous knowledge.

          I suppose for the slacker teachers who might just have kids copy vocabulary, it makes them take their job more seriously but for those teacher, such as myself, who wish to educate young people to think, problem solve and make decisions based upon logic and evidence, and to ask “why” questions instead of just “what” questions, it is a bureaucratic hoop jump that sucks the life out of education. My school spends a MONTH testing which certainly limits instruction time. The school does not choose to do this…it is mandated.

          I don’t usually spend my precious time responding to such comments but to make a statement implying teachers are cheating on the test by giving students answers is just not fair. There are cheaters in all professions but teachers really don’t have the access to answer keys. We should know the answers because we teach the subjects but some of the tests items I have seen on released test items are so badly written, we might be hard pressed to answer them “correctly” ourselves.

          The big winner of mandated testing is the testing companies. They make lots of money. while we could determine student understanding and progress by departmental bench marks more cheaply and with less instructional time lost.

      • They never did.

        I think your perception is due to the trend of teaching science less. Only a few subjects excel at honing critical thinking: science, philosophy, and at lesser levels, the humanities and math.

        Just my opinion.

    • When I first talked to my doctor about low carb she had no clue. She told me all doctors get basic nutritional education, but it is something most doctors don’t spend any time on nor interest. And out of medical school, they forget it sooner than later.

      Sad, really, given what effect food has on health.

  3. That’s an amazing poll result. Perhaps the poll-takers were on the younger side, more open-minded and aware of the latest scientific advances.

    How many cardiologists still believe saturated fat causes coronary heart disease? I’d guess 99%.

    Funny how your physician acquaintance, Dr. Eades, had been eating pretty much whatever he wanted except obvious added sugars. I bet that describes at least 50% of all type type 2 diabetics.

    -Steve

  4. I watch postings on the diabetes forums and those forums are massive.

    There is a huge disconnect between the doctors and their diabetic patients. Not only are they ignoring their doctor’s advice they are laughing at the advice.

    All knowledgeable diabetics are eating very low carb and are achieving amazing results. The type two diabetics are having normal blood sugar levels and getting off all medicines. Type one diabetics are achieving normal blood sugars and drastically cutting down their insulin use.

    Most of the doctors when confronted with the amazing results, show no interest on how the patients did it. OR they try to talk their patients out of the low carb diet and insist that they increase their carb usage and go back on the medicines.

    • My grandmother lived to be 92, she died this year from heart problems. For 40 years she controlled her diabetes with a low carb diet. She was put on it when she was diagnosed with diabetes at the age of 42, she was over weight and out of shape. She started walking and cut the crap and carbs out of her diet, within no time she had gotten the diabetes under control and until much later in life she never took any meds to control it. I figure if it kept her healthy that long it can work for the rest of us.

      • What an amazing story, it’s the people who live well into old age since changing their diets that really show eating like this makes a difference. My father had heart bypass surgery when he was 55. He went high carb and low fat at the hospitals recommendation. Nothing improved. When he was 65 he switched to moderate carb and much higher fat. His cholesterol improved out of site. now at almost 80 he still works part time and has no return of any heart symptoms. None of the men in his family lived past 60 due to heart attacks.

  5. It is not only in the area of medical medicine that this idoicy plays out but in the mental health field as well. With so much literature showing that several mental conditions including severe types of bipolar and other “disorders” being down to nutritional deficiencies I cant believe that they prescribe dangerous drugs with horrible side effects which only mimic the real nutrients anyway. Medicine and the drug pushers that abound in its ranks has a lot to answer for. Thank goodness there are doctors out there like you Mike who actually care about the health of people.

    • I was going through horrible mood swings between 2000 and 2006 that were only briefly improved in 2003-2004 when I first experimented with low carb. Had no idea it could be diet causing it; figured I was just going crazy and would have to be on antidepressants the rest of my life. I was even on Lexapro during my pregnancy with my daughter, with the knowledge and approval of my medical providers, and God only knows what that’s done to her.

      Come to find out I was getting too much grain and not enough minerals or saturated fat in my diet. I am not where I need to be yet, but just increasing mineral supplementation and my intake of butter and coconut oil and dairy cream has helped me even out drastically.

      SSRIs are known to cause neurological damage. Minerals and fat, at proper intake levels, do not. Guess which is more likely to be recommended to depressives.

  6. I believe I would have been very very much healthier throughout my life if I had never seen a doctor.

    Why do I need to become an expert to defend myself in debates with doctors?

    Are the vast majority of doctors not *in business* to keep you ill and buying more of their product — tests, drugs, surgeries?

    Thank you for low carb and other health information. And your kind treatment of respondents.

    • The saddest part of Super Size Me was that overweight, diabetic man getting gastric bypass surgery unnecessarily. Those surgeons were more than happy to cut him open.

      • An old high school buddy of mine is about to get bariatric surgery. Not even lap band, which is reversible; the docs are insisting on bypass. She has something like four or five children. That’s an awful lot of motherless children if something goes wrong on the table.

        I tried to talk her out of it. Nothing doing. She’s known to have hypothyroid issues, or so she told me, but if I know anything about how hypothyroid is typically treated, they aren’t doing enough for her. She’s been struggling with her weight since childhood. It isn’t fair.

  7. An excellent post and I share your frustration (from the UK). As nurse (now working in management, I am always asked for advice a wide range of issues – diet and weight loss being the most popular. I accidentally came across ‘low carbing’ and read the Taubes’ book – it was a total shock. After reading more information (including your top quality site), I have completely changed my views – and lost 30lbs since January. You can imagine that advice about diets has rocketed and I’ve had some real success stories.

    What infuriates me is directly related to you excellent post above – people with diabetes getting the standard poor advice. It’s very hard for me to contradict diabetes professionals, so i have to be very ethical in my approach. What is even more astonishing is that a lot of these professional actually know all about the benefits of a low carb diet, but are constrained by their professional and current UK guidelines.

    My own (private, not NHS) GP has been totally supportive – she applauds my weight loss as being the best health improvement for me – my triglycerides have plummeted and my HDL has gone up by 20%.

    The word is definitely spreading and I think this is the way it will keep on working – but so slowly it’s criminal.

    Thanks for all you advice and long may it keep on coming.

  8. Last year I lost 40 pounds following Protein Power and then 6 Week Cure, but around the holidays I managed to gain some of it back. Anecdotal evidence only, but I eventually figured out that around the holidays is also when I switched to a soy based protein powder. I switched back to a no soy protein powder in early January, and within a month, while not losing much additional weight, I found out I was pregnant, after years of trying.
    My frustration with the medical community (or at least the members of it that I’ve visited so far) is so high it’s not funny. The reproductive endocrinologist I was seeing strictly forbade low carb if I wanted to get pregnant. The primary care physician had concerns about my getting information off the internet, while admitting that at 50% heavier than she is, my cholesterol levels were better than hers. My ob required me to take the one hour and then the three hour glucose challenge test, and I was told not to change my diet at all before hand. When I point out that eating low carb affects those tests, and I have studies to prove it, I’m told the numbers don’t lie, I failed, I have gestational diabetes, and deal with it. I started recording my blood sugar, and it seems to show quite well when I’m not getting enough sleep (my glucose goes above 95 fasting) or when I do go face down in the donuts (high post meal results), but since only a couple times has my post-meal blood glucose been above 120, they’re quite happy with how I’m dealing with my diabetes. I found the study that says lowering carb intake up to 15% doesn’t affect the glucose tolerance test results, so don’t bother telling people to carb load to at least 150g/day before the 3 hour test that likely informs this attitude, but since I’m eating at most 1/3rd that level most days, this is frustrating. Particularly since they will require me to take the OGTT again 6 weeks post-partum. And they won’t even look at the study that shows that a single low carb meal before the OGTT can cause a high false-positive rate.
    The most frustrating part is that I’m an engineer, not a doctor. There’s a lot I don’t know, and a lot I don’t know that I don’t know. I wish more doctors had time to keep up with studies, and knew enough to tell good studies from bad studies, and that more doctors like you were around here.

  9. Your back! I thought you were lost! I was getting ready to send out the search and rescue team! Good to hear from you again even if you are mad!

    Another great post! I’m so glad to have a team of docs who support me. Well my cardiologist always asks me if I will take the statins but he asks with a smile at least. My endo refers to me as her “low carb pumper”! I’ve done this for 10 years, meaning low carb so they pretty much have all the results in the charts. Last A1c was 6.3 Insulin use is now down to 28 units a day.

    Low carb did not prevent me from going on insulin because I was a type 1.5 who converted to a type 1. It did prevent me from needing the insulin for 7 years and avoiding all the drugs that are normally given early on. It is now keeping me from dealing with all the issues of over insulin use.

    Glad you are back!

    Ressy

  10. Over about 3 months I lost the 25 excess pounds I’d gained during the pregnancy with my second child. One of my patients, a type II diabetic, asked me how I did it – I told her I had been on a lower carbohydrate, paleolithic-style diet. She asked me if she could do that too. I told her she should start very slowly and definitely talk it over with her primary care doctor and diabetes nutritionist, given her diabetes medications, but gave her basic instructions and suggested she start with maybe one lower carb meal a day and watch her sugars very carefully. Her diabetes nutritionist told our patient in no uncertain terms that she should NOT do this, as her blood sugar would drop too low without the carbs!!! When I suggested (gently) that perhaps the medications could be lowered, the nutritionist said nothing. The primary care doctor thought we should defer to the nutritionist. She is treated at one of the premier diabetes institutions in the world, by the way. Why would they listen to a psychiatrist like me?

  11. Fantastic post. I am a low-carb lifer since losing 75lbs on Atkins in ’98-99, and then easily maintaining that loss for many years. 4yrs of pregnancy and nursing had me raising my carbs a bit, and I gained a bunch. Now that my youngest has weaned, I’m back to my comfortable lower levels and the weight is coming off–I’m only 12lbs from my happy weight. I know LC is right for me because I feel great.

    While I’ve never tested as pre-diabetic or had any other significant weight-related health issues other than carrying the weight itself, I can say that at 39.5yrs old my cholesterol hangs around in the 160 range, HDL ~90, Tri’s in the 30’s. Hypercholesterolemia runs in my family but my LC WOE (way of eating) allows me to control my lipids easily & without drugs.

    I have countless friends who have been able to drop their diabetes, reflux, and BP meds simply by eating LC. It works. It’s not even that hard, especially for those of us who find that sugar/starch triggers compulsive eating (the carb addict angle.) After 2 days back to induction/SB Phase I levels, I’m not thinking about food, I’m not tempted by candy, and I have all the control I need to stick to the food choices that will get me closer to my weight goal.

    Sing it! It’s a message that needs to be heard.

  12. I don’t see a facebook share button! I would love to share your article. I think you may be missing out on lots of sharing and spreading the word.

    I don’t twitter. I would guess that more people do facebook.

    I found this share button underneath your article but it doesn’t include facebook

    “Share This Post If You Enjoyed It”

    * Digg
    * del.icio.us
    * StumbleUpon
    * Reddit

  13. I’ve lost 332,500 kcal’s of FAT (95 pounds) since going paleo/Primal/PP/low carb.

    I got my annual lab results back yesterday. My total and LDL was higher, although not catastrophic. But what had to wait until I got home to check my notes was the method of calculating LDL. My trigs were so low (50) that the standard equation no longer works. I plugged in the data to the Iranian equation, and voila!

    I also ran all the ratio equations and the results varied from what I would call “Excellent” to “Outta Sight!”

    I’m able to hit 172 PPM on my bike, theoretically either unattainable or Heart Attack City for a 64 year old man. No problemo!

    If you want to read up on the ratios, what my diet is like, and how I knew more than the lab, here is a post: http://www.marksdailyapple.com/forum/showthread.php?15695-Another-Way-Outstanding-Blood-Panel!&p=219338#post219338

  14. Trying to Spread the Word!
    Thanks Dr. Eades for your wonderful post. I had a conversation with my doc last week and sometimes in the face of a real person, they say the success is just genetics.
    I have PCOS and have battled the symptoms my whole life. I finally have had the most success on a low-carb Paleo diet.
    In my exam last week to check blood level my doc said I should have no trouble getting pregnant because I have the “skinny” type of PCOS. I am currently 5’8″ and 148 lbs., with some muscle tone.
    I said to her, “When I was back in college (ten years ago) I weighed 175 lbs. and my cholesterol numbers were hovering around 400, I didn’t have skinny PCOS then. I am very deliberate about what I eat and my lifestyle and that is why I look the way I do.”
    I still don’t think she bought it.

  15. Don’t despair Michael, something is afoot and it could quite well turn into a groundswell. I guess you must have been following Denise Minger’s continuing adventures with the China “study” (I got the first link from you) and although I really enjoy her clear and lucid foray into this whole thing, it is a real eyeopener to browse through all the comments.
    Realize though at the same time that we’re still dealing with the aftermath of Keyes and Stare, and they are not done yet. In The Netherlands we got Martijn Katan who still appears to run the nutritional advisory. As if that is not enough another “study” was presented in Stockholm on August 24 for European cardiologists in which Omega 3 was discarded as not very helpful. Guess what they used? Unilever’s Omega 3 margarine. And guess what the Omega 3 in margarine is based on? Right, plant based . I don’t have to tell you the percentage of DHA en EPA can get out of that.
    We all do our little bit to change this whole thing around and I can happily attest to the fact that it does work. Thanks to the Internet and easy access to a wealth of information, and a growing yuppy population that is getting better informed, there could be sormy days ahead for the grain and vegetable oil industry

  16. Hi Mike,

    I agree with Ressy – good to see even a mad Mike!;)

    Sadly I don’t see the situation you describe changing any time soon. I think the low carb ‘movement’ for want of a better term has been going backwards for the last 5 years or so … regardless of research validation which struggles to get any mainstream exposure.

    Like everyone else I’m sure, I have quite a few diabetic friends and family members. In seven years I have managed to help just one … and like Fred’s success story, he only turned to me in desperation. When I was in the initial low carb evangelising mode he was prediabetic (A1c in the low 6s) and didn’t want to know. A year or two later he said he needed to talk – A1c now 9.6 … I’m ashamed to say the first thing that I said was “I told you so!” Even then I had to buy him a copy of Bernstein (sorry!!) … but now he quotes it to me and regularly tells me how much he owes me for saving his life (I think I will be milking that in fine wine for some time to come!) A1c now in the 5s and I’m sure you will be astonished to learn he no longer requires the blood pressure medication he has taken all his adult life … at this I managed to stifle another ‘told you so’ … I am learning too!

    But this is the exception. The rule is exemplified in a media report a few days ago her about how your mate Bill lost 10kg for Chelsea’s wedding. The reporter found a diet ‘expert’ who described his low fat, largely plant based regime as “bizarre” and “extreme” and unlikely to be sustainable … all true … but then said what he should be doing was adding low fat dairy and surgically de-fatted meat and yes, 30 to 60 minutes of exercise a day … and it would be perfectly fine …

    A very long road still ahead I’m afraid no matter how mad we are.

    Cheers,

    Malcolm

  17. Dr Eades,

    I want you to know that your efforts to educate people is not in vain at all. It has much effect that you may not hear. This is my story of how your book started a revolutionary change in me – one who was a complete vegetarian all his fifty years. Despite my healthy life style and regular exercise, I ended up with high LDL, low HDL, high trigs and pre-diabetic. Needless to say, my doctor also put me on Lipitor.

    For some weird reason, I bought your book from Amazon and as soon as I leafed through the first pages, I regretted buying it so much that I wanted to sell it on Amazon (and, I never like to sell my books!). Let me just say, my laziness got in the way of execution and I still have it. Despite my initial reaction to it, your book started a thought process and I started to wonder how a doctor could be recommending this kind of diet/food which I have avoided in pursuit of good health. Well, in the mean time, I ended with a hip fracture at a relatively young age and forced to reevaluate my life style. More self-education led me to shed the fear of fat and protein. Now, I am a slowly recovering vegetarian, I eat plenty of eggs, fish, coconut and nuts. I still cant bring myself to eat meat or fowl but I no longer eat wheat or rice. My doctor is amazed at my lipid profile and wants to bottle my secret and sell it (but he still wants me to continue with Lipitor and I hope to convince him to stop it soon). Of course., he reacted with horror when I told him I eat six eggs per day!

    It was your book which started me on this journey of critical evaluation of nutritional and health advice that is dished out everyday. It is scary to see so many doctors and other health advisors not tracking the advances in recent findings and rediscoveries of metabolism. It is even scarier to hear and experience the doctors advice to continue doing exactly that which is unhelpful and even harming. I thank you and others like you who are trying to bring science and reason to an area overrun with profit and activism. Thanks to people like you who are trying to educate the public, I feel I am in a better position to help myself in the fight with my health challenges.

    Phil

  18. My thoughts on the doctor’s poll is that many of them would consider low-carbohydrate diets to be 30-50% carbohydrate, made up primarily of those “healthywholegrains”. So while they are probably telling their patients to avoid white bread and sugar, I’d bet they’re still pushing whole grains, legumes, etc in far higher amounts than any of us would consider “low-carb”. I would also bet they’re still recommending avoidance of saturates, and increased consumption of vegetables oils. I believe this “low-carb” diet they are probably recommending is pretty much in line with the “Dr. Oz” diet – whole grains, legumes, fruit, vegetables, chicken, fish, low-fat dairy. Obviously, a recipe for disaster.

  19. You and MD sure saved my family. One at a time still makes a difference. I haven’t yet converted my whole family, but I am making a dent in their thinking. Thank you for all your effort and for being mad as hell!

    Regards,
    the Coutu family
    Sault Sainte Marie, Canada

  20. My sister and brother-in-law are both type II diabetes. Two different nutritionists told them to *restrict* their carbs to 60g per meal (plus a generous few more for snacks). More meds, more weight gain, more b.s. And hearing anything from me just makes my sister do the la-la-la-I-can’t-hear-you thing while flapping her hands over her ears. I have a sister-in-law who died two years ago after suffering with type I and endured multiple amputations … YOU’RE mad, Dr Eades? We go to these experts for help for life-threatening problems and the cure is worse than disease itself. When the sleeping giant of the American public – and a bunch of lawyers – wake up to the damage that’s been wrought by med schools and pharmaceutical companies – well … can anybody say *class action*? Seems to me, a smart doc or nutritionist would pay attention, get really educated and make sure (s)he isn’t caught in the tsunami.

  21. I’ve been low-carbing on and off for ten years. It’s fairly obvious when I’m not on the wagon, my weight climbs, my sleep quality declines and I feel puffy all the time. Recently, I decided to run an entirely unscientific experiment on myself to see whether the low-carb benefits were simply related to caloric restriction. I made a special efforts to eat ~3000 Calories a day while keeping my carb count around 50 g/day. I was pleased, though not really surprised, to find that at the end of the week I had lost almost 5 lbs and had a ~1% drop in body fat.

    Pretty cool stuff, IMO.

  22. I tried the “ambassador” thing earlier this year. My doctor just shrugged his shoulders and said “well, that all sounds good but, none of that information has come through the proper channels and landed on my desk yet” Too bad his TV is tuned in to the 70’s!

    Thank you for your post.

    Chris

  23. … you are a dear man – but do take this burden off your shoulders! you have done a HUGE service by making all this knowledge available (your books, your blog, etc etc) and the internet makes sooooo much more available for those who what to learn and use their own judgment. (and removes the most-used excuse for not knowing for oneself)

    **doc, you are not responsible for your compatriots ignorance, subservience to big pharma or their loss of any contact with their own intuitive best judgment**!

    there are no victims, only the choice to be a victim. if becoming fat, heart-diseased, diabetic and legally drugged out when possible solutions are (literally) at your fingertips, and if you choose to put your power and health destiny in the hands of others (regardless of the many funny letters behind their names) – you do, in fact, deserve what you get as you have given up your self-determination and free will.

    Thank you sincerely Michael, for your knowledge, guidance and intelligence with which i can go on to make so many better informed decisions for myself and my family!

    (loved your books – just read ’em…)

    • Um. Hate to be the one to break it to you but it’s still self-determination and free will if you choose to listen to your doctor because, as far as you know and to the best of your knowledge, he or she knows more about diet and health than you do.

      It’s not like all the diet and health books out there deliver one consistent message. The message is all over the map and constantly shifting. It’s a miracle anyone ever stumbles across the best information at all.

      I don’t blame the patients. It’s the doctors’ jobs to know this stuff. They and the AMA put themselves in the position of dictating to everyone else and, for the most part, it is a power that has been abused. They did it with midwifery and now they’re doing it with eating. What’s next, will they tell us to breathe carbon monoxide three times a day for maximum lung capacity?

  24. My wife has been struggling with weight most of her adult life. She’s tried low-fat, low-calorie diets, and while she has lost weight that way, she couldn’t keep it off. She’d usually go ‘off her diet’ and once there, she’d put on all the weight she’d lost on the diet, and more. Yo-yo dieting!

    Like your friend, she is a meat-eater at heart, and just can’t live with a diet that keeps her away from her steaks and pork chops. She calls herself a ‘carb addict’ because once she starts eating carb-rich foods, she always seems to want more a few hours later.

    She’s been on a low-carb diet for the last few years, and has lost 80 lbs, with no cravings, totally satisfied, never starving.

    Her blood chemistry is picture perfect, despite her doctors’ advice to cut the fat, up the carbs, etc. She’s finally found a diet that she believes she can stick with the rest of her life (so that she can maintain her weight once she hits her goal).

    The proof is in her before-and-after photos:
    http://lowcarbcompatible.com/blog/lowcarbforlife/teris-and-after-photos

      • Thanks – she saw your comment when she read the article. She’s thrilled with the progress, believe me. She says this is the easiest weight loss plan she’s ever used.

        I’ve dropped about ten pounds myself, though I’m not as serious/dedicated as she is (and I’m more interested in the paleo diets, anyway). I’m now at the weight I was when I left high school (and I’m 50).

        Frankly, I can’t understand why _anyone_ would go low-fat/low-calorie. It’s just nuts.

  25. I’M MAD AS HELL AND I’M NOT GONNA TAKE IT ANYMORE !!!!!!!!!!

    Just a little question since you are actually a doctor.I”ve always wondered whether doctors actually do know the truth but dont want to deal with it because they are paid off by drug companies to keep on prescribing drugs.Or are most doctors really , truly ignorant ?
    My mother suffers from diabetes thanks to her vegetarian diet that has a halo around its head.She has had breast cancer . Yet when I try to convince her to change her diet she doesnt see eye to eye with me.Why ? Because her doctor told her to stay low fat.It is sooooo frustrating that I dont know whom to turn to…! Incidentally she also has macular degeneration and wont stop eating mounds of fruit because the ‘doctor’ told her to get her vit c and beta carotene.

    I’m now unfortunately at a point where I question EVERYTHING the doctor says ! How do you trust someone who doesnt know ABC ?

      • First off; Dr. Eades *hug* and thank you. Don’t ever doubt for a second that publishing this site is helping many people.

        Re: “Mad As Hell,” …
        I’m surprised that posts like this don’t cover MDs as self-interested actors in an economic way –

        My story: Biology Major @ UC Irvine in the 80’s, not a pre-med; even though it became apparent that the institution was a “turn the handle, crank them out,” pre-med mill, for their Med School. Undergrad coursework was full of “cut throat” competition between people who’s real goals were the Cadillac and the Country Club membership… I’m trying hard to remember a fellow student who had a zeal for the truth, or healing… can’t remember even one.

        So many medical practitioners today are… well… businessmen. Like car mechanics – the kind who might say, “There’s this oil additive I can sell you; manufacturer’s studies have shown amazing results! It’s called Silicon Dioxide… just let me put some sand in your crankcase, come back if there’s anything more I can do.”

        ie, I’m not sure that it’s always medical ignorance, sad to say.

        Keep up the good work!

    • I had an online friend with recurring breast cancer, stage four I think. Some quack told her to go on a macrobiotic diet. (I do not use that word lightly, thanks to other quacks like Stephen Barrett.) The type of diet called “macrobiotic” here in the States, by the way, bearing no resemblance whatsoever to the original… anyway… no big surprise there, my friend got worse and died.

      I tried warning her, sharing some of what I’d learned about cancer gobbling up sugar like it is candy. To no avail.

      The sad part is, what the mainstream doctors typically tell patients like this about healthy diets isn’t too far off from that fakey macrobiotic stuff. Grain-heavy, low-fat, “plant-based.” I read something at the CNN site recently that said if you eat 200g extra of fruits and vegetables in your daily diet, that’s only a 3 percent reduction in cancer risk. Good grief.

      • The founder of the Macrobiotic Diet, Michio Kuchio, had both his wife and daughter die of cancer. I think that put the final nail in the coffin of that diet.

  26. I’ve been on a low-carb diet since 1999. In addition to the loss of 100 lbs, I have experienced several side-effects, including, but not limited to:

    Better night vision
    Normalized blood sugar
    Lower blood pressure (although it comes back up every time I slip off the plan…)
    Acne went away
    Restless leg syndrome went away
    No longer use Tums or Rolaids at all

    In fact the only major negative thing I have experienced from my low-carbbing is the fact that well-meaning fools (including my primary care doc at the VA) lecturing me about how low-carb is unhealthy and dangerous.

    However, I have concluded that low-carb, while beneficial, is NOT sufficient. I still have 50 lbs that I need to lose, even after 2 iterations of the 6-week cure (net loss of 10 lbs in 12 wks). So, I’m still searching for “the answer”.

    I’m beginning to suspect that all those years of eating sugar, gluten, and plastic butter have permanently damaged my metabolism, and it’s going to take something either in place or or addition to the 6wc to fix it.

  27. Dr. Eades,

    I’m glad you mentioned Robb Wolf’s book in the blog. His site led me to yours; I read Protein Power and I’ve been trying to read all the posts on your site that I can get to. I appreciate the links to studies so that I can evaluate the information myself. Although I will admit that reading studies is not the most fun I’ve ever had, I think that it’s important to evaluate the information for yourself and take responsibility for your own conclusions. I don’t care if it’s anecdotal, but I started giving dietary advice to my friends and relatives; my fiance’s father lost 40 pounds, my uncle stopped his blood pressure medication and lost the unexplained joint pain as well as his symptoms of pre-diabetes, my mom’s blood pressure returned to normal after years of struggling with it, I kept my dad off of cholesterol-lowering drugs and he feels better now than he has in a long time. I’d like to thank people like you, Robb Wolf, Dr. Kurt Harris, Dr. Stephan Guyenet and Gary Taubes for sticking to your conclusions and presenting it publicly for those of us so inclined to actually evaluate for ourselves.

    Think you’ll do a book review of the Paleo Solution? I’m excited to get back home from Afghanistan so I can read it. Take care.

    -Erick

  28. Great post, as usual.
    I am glad that some time ago I decided to learn more about nutrition and generally how my body works. Now I know enough to at least question my doctor’s comments and ideas. I know that since going low-carb paleo my health has improved dramatically.

    But when I first told my rheumatoligist that I cut on carbs and eat more protein and fat, he asked me if I wanted to put on weight. I went again just two weeks ago and repeated that I felt great and most symptoms of my fibromyalgia were gone. This time he was mildly interested, but still doubtful it could really be the diet.

    Thank you for your posts!

  29. I am definitely an ambassador of the low-carb “diet”. Not for my doctor – he has achieved some recent success with losing weight by vigorous and frequent exercise. I am pretty sure that he will not be receptive to hearing about an easier and more sustainable way to manage weight until his recent enthusiasm dies down ;-).

    I stumbled upon your website and spent days reading each and every one of your posts, catching up and having my eyes opened. It has been approximately two months.

    I am a 36 year-old female and have never been overweight. However, I watched my weight slowly creep up from a BMI of 21 when I graduated in high school to 24 – a state I was very unhappy with. Since hitting the age of 30, I tried to combat this weight creep by restricting calories. Each year I ate less and less, and each year I gained just a little more. I ate tons of low-fat “fake” food. It got to the point that for dinner, I would eat one bag of low-fat microwave popcorn – not for the taste, but just for the feeling that I could eat a lot of food and not intake too many calories.

    I stopped all this nonsense after reading your website. I have since dropped 11 pounds effortlessly, eat real food, eat so much more than I have in years and I feel wonderful! I feel full for the first time in ages. I sleep so much better, am more alert – well you’ve heard all this countless times. I don’t have any information to share with regards to blood panels and cholesterol, because at my age and weight, I have never been tested. Here in Canada those kinds of tests are only administered to the overweight or unhealthy, and I was not there – but I can assure you I was heading there, kicking and screaming, with heels dragging! My current BMI is 22.

    My ambassadorship started with my husband. I told him about the way I was eating, but he was not really interested until I started losing weight rapidly even though we were eating giant steaks and salmon fillets drowned in butter. Suddenly he got real interested ;-). He has since lost 19 pounds. My friends also noticed the difference, and after a few weeks, I started getting emails from them (separately) asking about more information about my “diet”. I now have four low-carb converts (and still counting).

    Thanks Dr Eades. It’s nice to see you posting again – can we forward articles to you so you’ll be angry enough to post more often? I see a ton of them every week…

      • Actually, I don’t always agree with you 100% of the time, but the points of disagreement have been minor (e.g., sorry, but a steak cooked to 125F is not ‘perfect’, it’s overcooked). When I first saw _Protein Power_, my first thought was that you were just another diet-guru-wannabe with an MD who had observed one or two things that seemed to work, and immediately concluded that you had all the answers. Similar to Atkins (whose dietary advice fails to account for differences in types of fat), Bernstein (whose advice on weight training would get you kicked out of just about any gym), and Ornish (a classic case of an MD in *serious* need of an ego-trim).

        I am happy to have discovered that you aren’t really cut from the same cloth. Rare indeed; I do not recall any other MD I have ever known or read who actually admitted making an error, no matter how minor. I suspect that the medical schools teach that admitting error is not allowed.

        P.S. You haven’t finished The Paleo Solution? I thought you read something like 4 books a day…

  30. Amazing how timely that clip is today, except perhaps for the comment, “I don’t know what to do about the Russians.”

    I welcome you Dr. Mike as our ‘mad prophet’ calling for outrage.

    Network is a movie about disillusioned ideology, the corruption of modern life and a declining humanity that has been replaced by the greed of both big business and an overzealous media entity. Together they have become our God—their claims have become our reality; we have succumbed to the illusion and become the product of their manipulation. It is likened to our medical beliefs and healthcare being driven by the pharmaceutical industry. It represents a loss of freedom on so many levels.

    Flawed as we are, greed gets us off as individuals and gains power as it climbs up the ladder of corporate deity. Sounds dramatic, however, the movie’s point is not made without some satire and comedy. There is a sex scene in which Faye Dunaway’s character thinks of the huge ratings from a new show she helped launch—this actually becomes her foreplay and brings her to orgasm.
    We all know any effort to improve the situation will be met with suspsion and scorn. Regardless, stay mad as hell—we all should. Lets just hope being mad as hell doesn’t lead to madness, as was the case with Howard Beale.

  31. One thing that might need to happen: when a doctor’s low-fat, low-calorie, statin-filled recommendations cause someone’s health to get worse and worse — even by the doctor’s own standards — and then the person gets desperate enough to do his own research and improves his health drastically by doing the opposite of what the doctor said, that person should get up a good head of that ‘mad as hell’ steam you’re talking about, and let the doctor have it right between the eyes. Tell him exactly what you think of the unnecessary expense, the damage done to your health, the implications that you must have failed or cheated somehow, and the fact that you were able to figure out why his recommendations made you worse with some amateur online research.

    Imagine you take your car to a mechanic for a knocking noise in the engine, and he tells you it needs new valves and says you need to stop driving it so fast. You weren’t a real speedster but you’d speed now and then, so you make an effort to keep it under the speed limit. After a month, the knock is still there, so you take it back in. He says you need new valves again, plus the pistons need to be bored out, and you really need to stop driving so fast. After another month, the knocking is getting worse, and he says the whole engine now needs to be rebuilt, and you have to start using the expensive premium gasoline plus an additive, and he really wishes you’d cooperate and stop racing around so fast.

    How many such visits would it take before you’d read the mechanic the riot act, demand your money back, and tell everyone you know to avoid the place like the plague?

    If you went to a doctor for a broken leg, and at every visit not only was the original break still there but there were new fractures popping up, how long would it be before you’d accuse him of malpractice? I know it’d be hard to prove malpractice on diet-based issues, and even harder to convince a jury, so I’m not suggesting actual charges. But doctors at least need to be told about the harm, fear, and frustration they’re causing people by pushing the big-pharma party line and refusing to educate themselves about the drugs and lifestyle changes they advocate.

    • I had to laugh at your examples – because it was all so familiar. A couple of months ago, I fell hard on my knee (ironically, while out walking during my lunch hour “for my health”. I had an xray of the knee and saw my HMO doctor the next day. He barely touched my leg, said the xray was negative and proceeded to lecture me about my recent lipid results (TC 252, LDL 170, HDL 65, Trig 72). I told him I didn’t believe in the lipid hypothesis; no thank you on the statins; and besides, while the TC and LDL were higher than he might like, my ratios were fine, thank you very much. When he got nowhere with that tack, he proceeded to attack my BP, until I convinced him the 148/94 was more a reflection of knee pain, stress, and white coat reaction (since my BP at home routinely runs about 115/70).

      A week later, when my knee was no better, I returned to the doctor’s office. Once again, after barely touching my leg, the doctor finally relented and ordered an MRI (which showed a meniscal tear and damage to both the PCL and ACL). But before I could leave the office with my MRI order, I was again treated to a lecture on my “horrible” lipids and BP.

      I’m thinking it’s time to look around for a new doc, but it’s such a daunting process. I’m afraid I’ll end up jumping from frying pan to fire. For now all I can do is continue to stick to my guns and refuse the statins and BP meds and continue sticking to my low carb lifestyle as much as possible.

    • The most insulting part is, you could take the mechanic to small claims court to recover some of your losses and the judge would probably sympathize with you, and so would most of society. Everybody’s had the bad mechanic and knows how it is.

      But they’re trying to restrict our ability to sue a doctor who’s led us down the primrose path, amputated the wrong foot, broken the baby’s neck by yanking too hard during its birth, passed us a drug-resistant germ or what-have-you, on the grounds that malpractice suits make medical care more expensive for everybody. Well, no, if you took the idiot’s license away from him and gave it to someone more deserving, they wouldn’t. Sort of like driving that bad mechanic out of business. Pun very much intended.

  32. Forgot this part of my third paragraph: How mad would you be if, after all that, you spent a few hours researching your car’s symptoms online and found out the most likely cause was a belt you could replace yourself for $24.99?

  33. @Tracy

    I had a similar experience during the pregnancy that I just had. I did not find out about low carb until about a month before I had to take the glucose tests at 20 weeks. I thought the low carb philosophy sounded plausible but I was pregnant so I didn’t think I could do it, but my husband started on it hard core and so my carb intake went way down but I was still consuming some carbs. I realized that I felt better and had more energy.
    Then I went for the glucose challenge test, initially just the 1 hour test but after the results came back high, I was told that I’d have to take the 3 hour test the next week. I went home nauseated more than I had been in years from the glucose mixture and depressed about having to go through that hell again the following week. The second test had the same results and my doc said I had gestational diabetes and I had to go see a nutritionist and record my blood sugars and change my diet to whatever the nutritionist said. If the levels didn’t stay below 120 or my fasting levels were consistently high, he’d have to put me on insulin.
    Now, I have been on medince in years past for consistently high insulin levels and I am very overweight so I knew in the back of my mind that I have been edging steadily towards type II diabetes but my pregnancy motivated me to find some answers; at 25 I just couldn’t be falling apart so fast and now I had to get healthy to be able to raise my child.
    I started reading everything I could get my hands on about low carb and went armed with questions to the nutritionist who dismissed just about everything I said as unhealthy and regurgitated everything about diet and nutrition that I’d heard my GP tell me years earlier when I was put on the insulin lowering medicine.
    Thankfully my OB supported my idea to lower my carb intake as a way to keep my sugars in line and he may have been convinced solely on the numbers in my blood sugar diary that he looked at whenever I saw him.
    At the end of the pregnancy, I had a net gain of 8 lbs in total weight and my son was 7 lbs 9 oz at birth. At the 6 weeks checkup afterward when I had to take the glucose test again, I found that I weighed 25 lbs less than I did at the start of my pregnancy. Some of that is baby and fluid weight but the rest was what my body had burned off by just eating low carb (and not even too strictly sometimes).
    I volunteered for a study that wanted to follow women who had gestational diabetes. I had to take the glucose 3 hour test at 6 weeks affter my child’s birth and they would do a complete blood work up at intervals after I drank the glucose to see what my blood levels did and they’d run tests to see if the thyroid was functioning correctly and lipid levels. Then a year later, I’d do it again and they would see if being gestationally diabetic led to full blow type II diabetes.
    I have done the 6 weeks test. Everything came back in the normal range except my total LDL was high but they didn’t run the test to determine the particle size which I pointed out to the doctor giving me the results and she looked surprised that I knew anything about cholesterol. She actually went and got an older copy of one of Dr Eades books off of her shelf and started talking to me about my low carb diet. I’ll have to follow up with everyone in about 6 months after I do the one year check.
    To date, I have been doing low carb seriously for the last month. I am in ketosis constantly and have no hunger or carb cravings and have tons of energy. My next step is increasing my physical activity so that weight loss will continue.
    My advice to Tracy is to do low carb but at a level that you feel comfortable with during your pregnancy and keep track of how your blood sugar responds to what you are eating. If you are consuming fats and a multivitamin daily, your child will not be suffering nutrient deficiencies. In fact, fat powers our brains and one of the few things the nutritionist told me was to absolutely not go on a low fat diet because it would impair my child’s brain development.
    Thank you Dr. Eades for all that you do. My husband and I have been spreading the word about low carb to almost everyone we know and meet. My parents have benefited alot in the past several months after they started following low carb. I know it’s all anecdotal evidence but if it works for us it can work for others too.

    Laurie :)

    • I am lucky to have strong support from my husband, as over the last couple years I have sold him quite well on low carb. He went with me to the diabetes education class, and on the review afterwards, I said that it was everything I expected. It was, and there was no way I was about to eat that much carb, or I would surely need medication. I have been eating low carb (regularly under 50g a day) throughout my pregnancy, since I am quite sure I would have never gotten pregnant without it, and I did not believe increasing my carb intake beyond that could help me or my baby. I chart my blood sugar and track what I’m eating regularly, since it makes my doctor happy, and so I see the effect quite easily when I do stray.

      I have gained pretty close to no weight this pregnancy, and my doctor is happy with that. My weight has fluctuated up and down a few pounds, which really means I’ve lost weight, since I’m at 34.5 weeks, and some of what I weigh now is baby/fluid weight. I did show my doctor the gestational diabetes diet, and said I wasn’t going to follow it, as it was much too high carb, and he said he was fine with my continuing to do whatever I was doing as long as my blood sugar stayed fine.

      Because I take additional vitamin D, and eat a mostly meat/fat diet, I have been avoiding normal pre-natal vitamins, as I’m concerned about getting too much calcium. I do take a multivitamin, as well as metafolin. And I started taking more fish oil as soon as I found out I was pregnant, as I want to do everything I can to make sure there’s plenty of saturated fat for baby’s needs, as well as my own.

      Dealing as much as I have with doctors who don’t listen is frustrating, and I’m probably less tolerant right now. Trying to convince my family, who have diabetes, high cholesterol, high blood pressure, etc, and are blindly following SAD, of the benefits of low carb has been frustrating as well. I bought two copies of 6 Week Cure when they came out, and gave one to my mother-in-law, whose partner has NAFLD, and one to a co-worker, who has it as well. But their doctors say it’s dangerous, and so many of the people I know are reluctant to question their doctors. I occasionally hope it’s a good sign that they haven’t given me the books back, and I’ve had to buy a third copy for my kindle so I’d have my own copy to refer to.

      I would not be where I am today, pregnant in my mid-40s unassisted, 20 pounds lighter than I was a year ago, without the Drs Eades’ books and blogs and twitter. My husband & I are both evangelists, and we’d like our families to get healthier. His doctor will listen, so while that doesn’t help me, it is a good sign. My sister has lost 40 pounds listening to me, as well. So, more positive note.

      • FWIW, I had a healthy little girl just under 7 pounds, 5 days before my due date. She had no blood sugar issues, and every doctor and nurse I ran into in the hospital seemed astonished I had been managing my blood sugar with just diet as well (low carb, of course). The delivering doctor also was surprised that she wasn’t a bigger baby, of course. All the doctors tell me she’s perfect.

        Now I’m off to try to find a doctor who will deal well with thyroid issues, although I’m going to try again at my 6 week visit to educate my doctor.

  34. Perhaps the moral here is ‘doctors are people too’. To wit, the story of the Engineer Mark Fox. Perhaps because I too am an engineer, I tend to hold them (us) to higher standards, but how does a trained engineer, anxious to reach the root of a problem, dig deep enough to find a correlation between glucosamine and cholesterol and totally miss the whole carb and fat debates?

    You don’t. Which means the logical answer is he came, he saw, he rejected. Which is what the doctors are all likely doing.

    What causes that rejection is the key to the whole issue. I think it is influenced very largely by the governmental (at every level) involvement in nutrition, food programs, restrictions, regulations etc. If the government is for it, not many of us want to be against us. Especially those that got/get their livelihood from the beast, e.g. doctors from health programs and Mr. Fox from the space program…

  35. You’re a doctor. How much freedom are you actually allowed? It must take years for a doctor to start to question all his training, even longer to do the research, and then more time to screw up the courage to go it alone against the system.

    • It was relatively easy for me to question the lipid hypothesis since I’m in ophthalmology rather than internal medicine, cardiology and family medicine where that hypothesis is accepted as fact. I was introduced to it by a friend of my wife who advised us to go on a low carb diet when we both wanted to lose weight. I was skeptical at first but decided to try it out while researching low carb diets, which made me reconsider some of the standard advice about how to lose weight (low fat + aerobic exercise). It also helped that I lost 20 lbs while on the low carb diet, which convinced me that there was some validity to Atkins style diets. Gary Taubes’ book was what finally convinced me that the current mantra of low fat, low cholesterol for heart disease, diabetes and obesity was wrong and dangerous to one’s health.

  36. Welcome home! I am so glad that you are alive and (seemingly) well. I have been checking for a new post almost daily.

    I have a question kind of off topic. I visited my cardiologist yesterday and he prescribed a new drug called Livalo and ask me to try it. I have had a bad reaction to all statins, and I believe I have on his insistence tried them all. They make me cough choke gag day and night and not be able to lay down and keep me from getting any sleep at all. So I have refused them. But each new one that comes out he wants me to try.

    I checked on line as far as I am able but find almost nothing about Livalo. Can you enlighten me? Any information would be appreciated. At my last test in March my total cholesterol was 357 what my Dr calls hyper lipidomic. Triglycerides 62, and my HDL 83. Leaving my estimated LDL at 262.

    I can’t bring myself to try the Livalo without knowing a little more about it. Thank you for any help or knowledge that you can give me.

    Rozi
    PS I sure do wish my Dr. would read your blog!!!

  37. One of the reasons for medical doctors to reject the low carbohydrate approach that I have heard is the personality and behavior of Dr. Atklns. These stories allege that Atkins was angry at his profession for low standards of diet recommendations, and rebelled by doing his own research leading to his eventual low carbohydrate approach. In other words, by going against the established grain in a very public (and successful) way, he managed to gain the resentment of the bulk of the medical field.

    It is an interesting story. Being carefully politic is like catching more flies with honey.

    • Reminds me of a line from _The Hitchiker’s Guide to the Galaxy_, describing the invention of the Infinite Improbability Drive:

      “It startled him even more when just after he was awarded the Galactic Institute’s Prize for Extreme Cleverness he got lynched by a rampaging mob of respectable physicists who had finally realized that the one thing they really couldn’t stand was a smart ass. – The Hitchiker’s Guide to the Galaxy”

      Going against the grain always has its costs — this is certainly true in medical profession. There is a conventional (received) wisdom; concensus rules the day.

      Pointing out to people that they have willingly accepted falsehoods is a sure way to raise hackles… at least for a while. Eventually, they come around.

    • You may catch more flies with honey than with vinegar, but you catch even more still with cow patties. Which would be why so many docs still stick with the low-fat approach.

      I have three versions of Dr. Atkins’s most famous book, and he was definitely more acidic in his approach way back when. But I would guess he was as angry then as Dr. Eades is now. And he had quite a lot to be justifiably angry about.

  38. I have done this….and am pleased to say most of my current docs are very much in favor of low carb. I don’t know if they prescribe it (except one who does….Dr. Westman), but they are very happy I am on it. I try to follow as natural/primal as possible.

    My favorite, most impressive change has been my inflammation markers, I am 56 yrs old and for the past several years (since starting/sticking with low carb) have had low normal CRP and other markers. In my 20s I was first told I had elevated CRP, probably due to osteoarthritis…but they have always been elevated since then….until I stopped eating grains, keeping very lc and high fat.

    I am still hearing, however, from friends and co-workers, that it seems like the majority of docs still prescribe low fat and calorie with increased exercise! On co-worker is living on 2 DM meds and just started insulin….and I heard her tell another woman, how is on low carb and no meds, that low carb was dangerous!

  39. Dr. Eades,

    Speaking of ignorance, I just had an ‘interesting’ encounter with my HMO’s doctors. I had been taking high-dose naproxen sodium (500mg 2x per day) for a few months, in order to reduce inflammation (I’ve been diagnosed with cubital tunnel syndrome, I chose the least-invasive treatment to reduce inflammation in my ulnar nerve). I’m also on long-term Terazosin 5mg to deal with BPH.

    I had a night of intense gastric pain in my lower abdomen, so bad that I couldn’t sleep. I stopped taking the naproxen sodium the next morning, since I knew that the naproxen sodium can cause several serious stomach problems (I knew this from internet research using reputable sources, as well as the side effects warnings my doctor provided when prescribing the naproxen).

    Upon visiting the doctor the next day for the stomach pains, I ended up with an ultrasound scan a week later to check my kidneys, liver, and gallbladder. Yep, they found some gallstones.

    A follow-up with a surgeon resulted in the unsurprising recommendation that I have an immediate cholecystectomy (gallbladder removal), though there are no other indications (and there have been no subsequent symptoms since stopping the naproxen). Medicinal side-effects were never considered by my doctor or the surgeon, as far as I can tell.

    The surgeon said that post-cholecystectomy (well, after recovery) I could resume eating “whatever I liked” with no ill effects. He said “the body adapts” to the missing gallbladder. I’m a bit skeptical.

    My question to you and your audience is this: What kinds of long-term negative side effects are likely if a person follows a low-carb, high-protein diet (including a variety of fats the lipophobes all seem to despise), and has his or her gallbladder removed? I have a basic understanding of the role the gallbladder plays in fat digestion, but I’d like to know what people have actually experienced after removal.

    I’ve found this study, but it’s not exactly what I’m looking for (it does seem to indicate that not all cholecystectomy procedures are necessary or result in symptom relief).
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324835/

    I’ve seen a variety of opinions on the internet, but I’m looking for reputable sources. Any and all helpful comments will be appreciated.

    Thanks.

    • I can give you a bit of anecdotal data. My little girl’s dad had an appendectomy and apparently they nicked a nerve that is shared between the appendix and the gallbladder. Six weeks later he had his gallbladder removed because it wasn’t working properly anymore. Dyskinesia, I think they said it was?

      He has trouble eating quite a few of the types of dietary fat out there but he seems to do well with medium-chain triglycerides, such as the saturated fats found in coconut oil. We have both heard that MCTs bypass the gallbladder and his experience would appear to bear that out.

      Can they not do some kind of ultrasound therapy to break up your gallstones? Why cut the organ out entirely if it’s still working?

      • There are drugs that can dissolve gall stones, but they aren’t often used because the stones tend to re-form in time. The definitive treatment is GB removal. If I were dealing with GB patients today, I would have them use the drug and change their diet. If the stones recur, then it would be time for surgery.

    • I had my gallbladder removed 7 years ago(I was 43)and my body indeed adjusted to it. Before the surgery I had trouble eating fat and spicy food for an obvious reason. After surgery at the beginning I had diarrhea after eating fat. Then it very slowly started to diminish. I started low carbs eating 3 years ago. It was possible because my inflamed gallbladder was not there. I am glad that I had surgery at the age when it was easy to bounce back My mother in low was not so lucky. Her gallbladder was removed at 77 and the surgery became the real set back for her health. Your gallbladder will never be 100% healthy again. Do the surgery without unnecessary delay. There is nothing to gain by waiting.

  40. I’m always curious about stories, like Robb Wolfe’s, where people start eating Paleo and their cholesterol/Lipid levels improve. After eating Primal/Paleo for 6 months my total went up 80 points (to 318), LDL went up by 80 pts and HDL went up by 10pts. Sure the LDL is mostly pattern A, VLDL and TRGs are low, but it seems to be the opposite of what’s supposed to happen.

    This made my argument for eating a high fat, low carb, adequate protein diet a tough sell for my doctor… who wrote her dissertation on something to do with cholesterol.

    Naturally, she recommended a statin.

  41. We hear you Doc! And it’s much worse when the person is a loved one. I am SO GRATEFUL to the Dr. that originally diagnosed my mother’s diabetes. This was in 1997 and he told her to immediately drop her carb intake to 30 grams a day. He also explained it to her simply as Carbs=Sugar. She did well for about 8 or 9 years then started letting the carbs creep back up and her new Dr. just gave her meds and wouldn’t even discuss a low carb diet. Of course she got worse and then he put her on a statin when the cholesterol numbers were up. That’s when I really started the low carb preaching and I begged her not to take the statin. Printed out articles [including yours] and sent them to her. She wouldn’t listen to me over her Doctor [shock and surprise!] After almost a year she noticed she was losing feeling in her fingertips and they all started to feel like sandpaper. She weaned herself off the statins and immediately felt better. Now she has fights with the Dr. when she tells him she just isn’t gonna take them anymore. She’s finally gotten back to low carb eating and is slowly lowering the amount of diabetes meds she’s taking. If she takes a full dose her blood sugar levels drop way down and she feels faint. Ya think? And she’s noticed that she’s lost some weight too. SIGH.

  42. Doc, I totally agree re: Phil Mickelson. The problem is that when his performance inevitably gets worse, the media and so-called “experts” that they find (who they heck are these people anyway? The quality of science/medical/nutritional info I see in major publications and TV news is horrifying) will say that it’s all because of the arthritis and it’s a darn good thing he’s eating so well, or his game would be totally done for sure!

    It’s just like how Robb Wolf describes in his book that when he was literally dying in his 20s, but was following a letter-perfect low fat vegetarian diet, all the doctors kept saying the diet was the only thing keeping him alive. We know the truth, but, as pointed out in “Mistakes Were Made (But Not by Me)”, once you go down the pyramid, you can never go back.

    All of the government officials, doctors, nutritionists, trainers, well-meaning relatives, etc. that have spouted the death-by-carbohydrate diet will likely be LESS willing to change their stance even if they are presented with irrefutable evidence that they are wrong, because no one likes cognitive dissonance or wants to believe that they made that big of a mistake. As a lawyer, the starkest example I see of this is when prosecutors and cops continue to maintain that they are 100% sure a person is guilty even when DNA testing conclusively proves he/she didn’t do it. If it was a rape, all of a sudden, they say, maybe the victim was promiscuous! If it was a murder, they say, maybe he had an accomplice! (Never mind that in the 10, 20, or 30 years since the crime occurred, these theories had NEVER been mentioned before…) They will do anything and everything to avoid recognizing they were wrong, because that would require them to admit they: a) ruined someone’s life, b) let a rapist/killer walk free for all of those years, and c) completely let down the victim, his/her family, and society. It almost never happens. I think we as a society are suffering from the same exact thing regarding nutrition.

    How hard would it be for a doctor to admit that he/she inured maimed, or killed hundreds–or even thousands–of patients by subjecting them to a diet that was feeding their diabetes, or obesity, or cancer? To realize that type 2 diabetes CAN be put into remission by DIET alone? To realize that they were CAUSING more harm than they were helping? It goes against everything that doctors are trained to do (“First, do no harm…”), and would be incredibly hard to swallow.

    It’s much easier to bury your head in the sand at every new positive low carb study that comes out…particularly when that action can be justified by what’s recommended as the gold standard by the USDA, ADA, AHA, and now the ever-popular Michelle Obama!

    There is hope, though…After all, Robb Wolf is now a New York Times bestseller. All we need is to have him picked up on Dr. Oz or Oprah and well received, and paleo/low carb will be the Next Big Thing!

    • I’m a little confused because I thought the trendy thing to do was to follow a Zone and Atkins type diet 10 years ago. Everyone I know was doing it or tried it but nobody I knew could stay on it. I know there are people that do, and I think that’s great! I agree if you try a diet and it isn’t working for you, you should consider doing something else. I’m getting a little sick of every stupid and trendy diet book that comes on the market place though. Zone diet? South Beach Diet? Paleo diet? No thanks. Don’t need to try that one but I and many people actually do really well on a mostly natural foods vegetarian diet in spite of what Robb Wolf writes about.

      It’s no big surprise to me that MD’s are leery of low carb diets. People took home the complete weird message that they could be low carb and still eat all the processed low carb junk food that was all made from soy but it was unhealthy to eat a carrot. Hmmm. It did not help that some of the major advocates of these diet plans built empires on selling snack food and products.

      Well, I’m glad that fad is over. It appears the paleo diet is the next bunch of fanfare people will be talking about. Any diet that shuns healthy foods like beans and oatmeal that have been shown to lower cholesterol leaves a little something to be desired in my opinion, but I bet it works because the people who are on it won’t be eating too much junk food.

      • Low carb is actually a pretty good starting point. Unfortunately, the late Dr. Atkins was one of many diet-guru-wannabees with an MD who observed one thing that seemed to work, and immediately concluded that he alone had all of the answers. Roughly the same attitude as Ornish, just different answers. The biggest shortcoming of Atkins was his relative lack of understanding of the fact that some fats were really bad, in much the same way Ornish is unable to understand that some fats are really good for you, and that very few carbohydrates are actually essential, or even remotely healthy.

        If it hadn’t been for low-carb, I’m pretty sure I wouldn’t be alive today. But, as I’ve encountered various problems (and overcome them), I have been more or less forced to conclude that low-carb is not the Answer to Life, the Universe, and Everything. It’s just a general guideline that works well, and sometimes for reasons not well understood. At least by me. But I know it works well enough to continue with it since 1999.

        I don’t think Paleo is a passing fad. One reason for that is that it is *really* hard to come up with a Paleo junk food (which is basically what did in the low-carb folks). Junk food is junk, whether low-carb Atkins crap, or low-fat Ornish crap, and I found that I do best when I actually prepare my food from fresh, whole ingredients that don’t contain things like plastic butter (margarine). Yummy meats, eggs, and real butter work very well for me. I do think that Paleo will evolve as we slowly learn what works, and why. I think of Paleo as a refinement of low-carb.

        100% Paleo isn’t really available to everyone anyway. When was the last time you ate an animal you personally killed? Where do you get veggies that have zero pesticide residue? (answer: you can’t, and that situation is getting worse) But the idea and goals are sound, and Paleo works even better than Atkins-style low-carb.

        • No disrespect intended, TxCHL, but some of this makes me a little cross, speaking as a Taubes-GC, BC-inspired low-carber.

          If one studies GC, BC carefully, one sees that the original proponents of low-carb (and Atkins wasn’t actually original), were slight variations on the theme of meat, fat, and green vegetables.

          I’ve been having a discussion with a paleo-person on Jimmy Moore’s forum who seems to be under the impression that most low-carbers still eat grains and consume lots of fructose. Educated ones do not, for sure. Then there is Dr Jack Kruse (a smart chap, no doubt) who seems to think that “Atkins-esque” low-carbers consume lots of PUFAs. Well, those who read Gary Taubes wouldn’t (or shouldn’t), similarly those who read Barry Groves, to name but two (and probably those who read Michael Eades, also).

          I’m getting the impression that paleo people think that “paleo” is a kind of “purer” version of low-carb, or actually, something on a higher plane altogether. Well, good luck to them, but I’m happy with my meat, fat, and optional (very optional) low-carb vegetables, and I call it “low-carb” – I don’t try to pretend I’m a 21st century caveman.

          • “I’m getting the impression that paleo people think that “paleo” is a kind of “purer” version of low-carb, or actually, something on a higher plane altogether.”

            Well, I certainly think so. For starters, the original “low-carb” did not differentiate between types of fat. Paleo does. Low carb, at least the early versions, simply noted that the less carbohydrate you ate, the easier it was to lose weight.

            The main thing that Paleo does is eliminate neolithic “non-foods.” Pure paleo is not something that is attainable for most people (the last time I ate an animal I killed myself was over 40 years ago), but the principle is quite sound.

            I don’t think that Paleo is the answer to Life, the Universe, and Everything. Just a good strategy for better health. Can we do better than Paleo. Probably, but that does not invalidate the strategy, it merely augments it.

      • @Amy. I don’t think paleo is a fad, but it may eventually modify a little bit. It does take a bit of getting to the real meat of the story. No pun intended, because the real”meat” turns out to be animal fat, which is not all saturated. However as long as we keep producing our food in the way we are doing (feedlots, pork and chicken and egg laying factories) we will still be eating unhealthy. The only solution as I see it is the local farmer’s market. All is not well in the produce section in the grocery store either. Soils have been depleted to such an extent that plants can’t get the minerals they used to.
        I’d keep a close watch on my magnesium levels though when you go heavy on oatmeal. Oats, though one of the healthiest grains, is the highest in phytic acid, which prevents you from getting the magnesium you need. You may end up a very healthy middle aged woman with very brittle bones. I call them the holy trinity :calcium, magnesium and vitaminD.

  43. I am the guy who wrote that email to Fred. Here is an update of where I am today.

    Of the 4 diabetes drugs I was taking before I changed my diet to the one you recommend, I am now only taking one and it is 50% of the dose I had before. I no longer take a blood pressure lowering drug at all. I have not had one Prilosec or Tums since I started. I no longer have any issues with vomiting.

    My weight is now down to 180 pounds, and which is only 15 pounds more than I weighed in high school.

    The only negative I can think of is that I had to buy all new clothes, because none of my old clothes fit anymore.

    Thank you Dr. Eades, you and your books have literally saved my life.

    • I’m delighted to hear you’re doing so well. Sorry on behalf of my profession for your mismanagement for so many years. It’s great that you’re on the right track now. Keep it up.

  44. As I’ve said on my website, change is not going to come from the “experts”, it’s going to come from a ground swell of people who do the research and experience the health benefits of switching to a low carb diet.

    When enough individuals experience the amazing health results of what a change in diet can do, and doctors and dietitians are left without patients because the advice they give is outdated and ignorant, then we will see the tide turn. In that way, you are helping tremendously because you are giving each individual the tools to learn about and experience the low carb way of eating.

    Thanks for the link to the meta-analysis. I’m glad to see another great post, and I hope the sous vide tour and your other endeavors have been good to you.

    PS.. typo in the paragraphs just above the video “Since most of you reader this blog visit your doctor from time to time”

  45. @Lucy
    Being a fellow engineer, I share your opinion. I get very frustrated when I read stories of other professionals educated in the ‘hard sciences’ who fail to ask ‘why’ and drive to the root cause.

    Beyond government influence, you have (what I have heard referred to as the 4th branch of government) big business providing influence. I don’t remember if it was in Fast Food Nation or another book (I have been reading nutritional books at an alarming rate lately), but the largest donor (at the time of print) of the American Diabetic Association was Cadbury Schweppes, the world’s largest candy and soft drink maker. Tell me that isn’t a conflict of interest.

    My wife had an interesting experience during our last pregnancy with gestational diabetes. Her dietitian instructed her to eat the conventional wisdom of eating (USDA food pyramid). My wife noticed, during her routine blood sugar monitoring, that she wasn’t able to maintain the correct blood sugar levels. So she started dropping her carbs (this was prior to us becoming ‘enlightened’ to paleo eating). She noticed with the reduced carbs she was able to better control her blood sugar (duh). She was able to stay off of insulin shots, which helps keep the chances of c-section down. It is sad when your primary caregiver is ill-informed to the best practices.

  46. At the multispecialty clinic where I work, they had a big poster in the lobby proclaiming to patients that sugar doesn’t make you diabetic. I try to avoid passing by that thing in order to not spoil my day.

  47. Livalo is one of the newer statins. Unless you’re a male who is under 65 and who has had a heart attack already, research shows that statins will provide you no benefit in terms of decreased all-cause mortality (the most important statistic) irrespective of what your lipids are.

  48. @ Michael Curry

    In regards to gallbladder removal –

    I have had no issues with fat digestion since my gallbladder was removed, but I did have some issues for about 3 years prior to removal, which I thought at the time was just occasional IBS. I think I adapted in that time period.

    My sister has had issues however. She has heartburn and occasional “dumping”.

    My gallstones were never really that painfull, but they lead to the discovery of other bile duct issues. We decided to remove my gallbladder to help isolate whether the symptoms were gallstone or bile duct related.

    If the gallstones are not causing discomfort, I don’t see any reason in removing it in your case.

  49. Pingback: 9/25/10 «
  50. The following link is a blog written for my health club’s website. I bring it to your attention because it is for a very mainstream health club (they have numerous locations in numerous states), and the blog is surprisingly very low-carb supportive: recommends Good Calories, Bad Calories “to every Registered Dietitian we bring onto the Life Time team”; denounces sugar, especially fructose; espouses the merits of intermittent fasting; and thinks of health in terms of paleo reasoning.

    http://lifetimefitness.mylt.com/blogs/nutrition-for-fitness

    I’ve seen lots of change in recent years. They’re small, but they’re there. :)

  51. You know what makes me mad is when people believe they have no choice but to take a certain drug because they’re GP wanted them to.

  52. It makes me mad, too. But, you can be in a more sanguine frame of mind in knowing you have helped many. It reminds me of this story…

    Once upon a time there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work. One day he was walking along the shore. As he looked down the beach, he saw a human figure moving like a dancer. He smiled to himself to think of someone who would dance to the day. So he began to walk faster to catch up. As he got closer, he saw that it was a young man and the young man wasn’t dancing, but instead he was reaching down to the shore, picking up something and very gently throwing it into the ocean. As he got closer he called out, “Good morning! What are you doing?” The young man paused, looked up and replied, “Throwing starfish in the ocean.” “I guess I should have asked, why are you throwing starfish in the ocean?” “The sun is up and the tide is going out. And if I don’t throw them in they’ll die.” “But, young man, don’t you realize that there are miles and miles of beach and starfish all along it. You can’t possibly make a difference!” The young man listened politely. Then bent down, picked up another starfish and threw it
    Into the ocean, past the breaking waves and said – “It made a difference for that one.”

  53. Michael Curry, I’ve been without a gall bladder since 1981. I wouldn’t say there was any change one way or another for me. The digestive problems I had before were still there afterwards. Low carb, plus the elimination of foods that give me grief–even the low carb ones–has worked better than anything else. High fat doesn’t bother me.

    I’d certainly get rid of the naproxen first. If I took one tablet of that stuff (I took it briefly years ago), the pain in my stomach would be so bad I’d forget about any other pain I took it for.

    Good luck.

    • @Marilyn,

      Thanks – I’m taking a wait-and see approach. I need more definitive diagnostics (some sign that the symptoms couldn’t have been caused by other, more likely factors) before I have my gallbladder yanked!

    • I’m glad to hear of this discussion on post gall bladder removal.

      I spent Aug20 to Sept 10 in the hospital for acute pancreatis with subsequent gall bladder removal. I had heard many times that the gall bladder was critical to the digestion of fats and the subsequent dietary recommendations were to be on a low fat diet.

      When I got home, I opened my copy of “The Merck Manual HOME HEALTH Handbook, 2009 edition” and looked things up.

      Page 211 “The gallbladder, though useful, is not necessary. If the gallbladder is removed, for example in a person with cholecystitis, bile can move directly from the liver to the small intestine. ”

      I can’t find it now, but elsewhere in the book it says that after the removal of the gall bladder, no special diet is needed.

      This appears to be consistent with the notion that one can resume a low carb lifestyle even if you have lost the gall bladder. It would be nice to gain more confirmation of the basic facts as well as some personal long term experiences.

      • I have read that in a singnificant proportion of cases the gall bladder reforms over time (just as appendixes regrow in 1/4 of cases). The difference is that without a gall bladder large amounts of bile cannot be stored and released at one time; so fats and vitamins from single large meals are not so well digested, but those from more frequent smaller meals should be as well digested as ever; the actual bile production remains the same (may even increase if obstruction was severe).

        • The remnants of the cystic duct and part of the common duct often reform into a primitive gall bladder, which doesn’t hold as much bile as the gall bladder. The bile is produced in the liver where it travels to and is stored in the gall bladder. The remnant faux gall bladder can’t store as much bile as can the real gall bladder, so sometimes large fat meals aren’t digested as well.

  54. I just read the latest book by Uffe Ravnskov, titled “Fat and Cholesterol Are Good For You”. In it he presents what I call the Ravnskov Hypothesis, which states, among other things:
    1. Artery disease begins with an inflammation of the endothelium, caused by microorganisms–both bacterial and viral–as many as 50 varieties.
    2. LDL particles are part of the immune system, with the ability to capture microbial toxins.
    3. LDL particles enter the arterial wall, not through the endothelium but from the outside of the wall, through tiny passages called vasa vasorum. In arteries they therefore have to work their way inward against a pressure gradient, whereas in veins there is no pressure gradient.

    The Ravnskov Hypothesis is the only one I’ve found that explains why arteries get plaque formations and veins don’t. It also explains how LDL particles get oxidized and why LDL particles are found deep in the arterial wall, not immediately outboard of the endothelium.

    What causes artery disease? Anything that damages the immune system.

    I’d love to hear your comments.

    • According to the study I’ve seen (this was probably 20 years ago), the bacterial plaque found in affected arteries is of the same type (same array of species) as is found in your mouth. The conclusion was that gum disease, by giving these bacteria a direct route into the bloodstream, was the ultimate culprit. The bacterial colonies formed in the blood vessels tend to collect crud (mainly in the form of fatty plaque) and voila, heart and arterial disease.

  55. Hi Dr. Eades,

    I’m glad you wrote this, because I’ve been at a point of despair lately when it comes to my attempts to be an ambassador for low-carb and/or Paleo diets.

    In short, no one wants to hear it. I’m not a doctor, nurse, or nutritionist. I’ve just read a lot – in books and on the Internet. I’ve read all your books and have been a follower of this blog since Day One. I’ve read many other books and studied sites and papers to the point where I can support my ideas with facts of physiology and metabolism. I can see through a faulty study or news report with no trouble at all and explain why I know what I know. I can ask “Have you heard of gluconeogenesis?” without even thinking about it. But with no cred, I’m met with the same comments, over and over and over:

    “Weight loss is strictly a matter of calories in, calories out. It doesn’t matter what kind of calories they are.”

    “Diet is a matter of opinion. There are a lot of theories out there and they all have some validity.”

    “What you say is interesting. I’ll talk to my doctor and see what he thinks.” (He always rejects what I’ve said or says, “I’ve never heard of that” or “that’s not proven.”)

    It’s very discouraging. And I begin to feel obnoxious and overbearing, when what I really am (or used to be) is happily enthusiastic and confident that others will want to know these fantastic secrets to good health.

    But you have a good strong voice and have made major contributions to the subject. You’ve changed my life (and that of my husband) just as much as that guy who wrote to Fred Hahn said Fred changed his. For that I will always be grateful. And because of this post, I’ll renew my efforts to speak out when I can, or at least when it seems someone might want to listen.

    Anne

    • Anne,

      I know how you feel. The old saying “You can lead a horse to water but you can’t make him drink” seems appropriate, no?

      Anyway, I think one very effective way to help is to write about your experiences and results, sharing them with others on blogs, twitter, whatever… or on your own site. My wife has had excellent results with low-carb diets (and no other kinds) — she’s had such good results that she and I decided to start our own site to share those results with the larger world.

      I find it best to wait for those who are open to learning to come looking for the information.

  56. Welcome back to blogging! I find it extremely disheartening that in order to be on a path to good health, one has to completely disregard any advice from doctors who won’t question the conventional treatment memes, or do more thinking for themselves. The amount of harm that is being done with the bad advice, tests, drugs, surgical interventions and the associated costs of doing so is truly mind-boggling!

    Of course, all individuals must take responsiblity for better informing themselves and making more of their own decisions, but the docs have been putting tremendous pressure on patients to follow the standard protocols while never questioning the efficacy. Saying “no” to a doctor is never pleasant….

  57. I don’t know how you’ve stayed sane all these years, what is it, more than 25? Especially in the early pre-internet years. And all this while this mindless slaughter going on.

    If it wasn’t for the internet, Gary Taube’s NYT article in 2002, and the fact that I hate being fat and had tried everything else already, I would never have started on the low carb path. And then there’s the support forums and blogs like yours that keep me going. So thanks, and try to post more than twice a year, aye?

    I’ve tried talking to a few doctors, and friends, but I just end up sounding like a crank to them. These are people with diabetes, heart conditions, etc. who could really stand to lay off the sugar. But noooo, its the egg-white omlettes for them. Jeeezzz.

  58. Dr. Eades, don’t you remember your days at medical school?

    I used to work at one, as IT staff. Doctors on faculty who are considered uber-gods, working hard to turn graduate students into little gods with MD after their name. There is not room for a god to consider that what he is teaching, which is what he was taught, might possibly be wrong. The faculty needs to spend their time keeping residents from killing patients, and fighting the administrative battles of a highly political educational environment.

    Doctors such as yourself, who actually care about patients, and have an open mind, are more rare than you imagine.

  59. One teeny data point: My doctor knows all about my diet, and considers me to be one of her patients with the healthiest possible habits. And she asked me if she could occasionally contact me with nutrition questions.

    Oh, and we have an agreement: If she ever wants to stop being my doctor, she’ll suggest I take statins. 😀

  60. I’d love to be a diet rep!! After several years of dedicated low carbing, my husband and I are outwardly good advertising. However, really, really high LDL for both of us seems to negate all the good stuff, including stellar levels of HDL and trigs, and sends our Dr. scrambling for his prescription pad and/or a referral to a cardiologist. I’m worried that this one thing will be enough for him to view our diet with suspicion rather than respect.

  61. Mike,

    Great piece as usual.
    A perfect example of your point comes from a Doctor and his reply over at 4 Hour Work Week.
    Tim does an extraordinary job on distilling what Robb’s book is about.

    Here are the Dr’s comments:

    This article contains a good amount of useful, practical information, as well as a considerable amount of misinformation.
    This is truly amazing! We have here two guys who *do not* have any formal medical training… offering medical, health and nutritional advice.

    Excuse me, and you may not agree with the fact that a degree in Biochemistry does not qualify anyone to give medical advice, but this is *reality* You do it at your own risk… MDs referring patients to a biochemist because they “are not able to handle a given situation”? Please, give me a break.

    This reminds me of Larry King, who had coronary bypass surgery, and, of course, he is now an expert cardiologist, offering medical advice to anyone who wants to listen.
    Once again, a “little” information [about anything] is truly dangerous.
    Thank you!
    Paul Green MD PhD

    PS: 1- Ease off on the eggs. They are an identifiable source of high blood cholesterol levels. You ever heard of atherosclerosis, heart attacks, strokes? Eat only the ‘white’ part.
    2- You fail to mention other causes of digestive problems, particularly Chron’s Disease, Irritable Bowel Syndrome [IBS] and several others that may be caused by infections agents such as bacteria, viruses, fungi, prions, etc. Or genetic and metabolic defects?
    I guess that mentioning only gluten as a culprit would help to sell more books…

    • This guy makes my point better than I ever could. Total ignorance combined with unshakable hubris – that’s the medical profession for you when it comes to nutrition.

  62. Glad to see you are back Dr Eades, you have been missed. Hope you will have the time to resume blogging regularly soon. Hope all your hard work and travel is paying you rich dividends in material and spiritual rewards. Thank you for your work that you and the other Dr. Eades do for the low carb community and everyone in general. I started the 6WC and hav lost 4 lbs in the first 9 days. The liver detox and extra sleep seem to make a difference. I feel great and cannot wait for the meat weeks. When is the book comming out in paperback and I hope you add some more info, love your work.
    thanks again
    VN

  63. I think lower carb diets are catching on with physicians. My elderly small town midwestern mom was given a diet that restricted high carb foods like bread, potatoes, and pasta. She does a pretty good job sticking to restrictions on those foods but then rewards herself with a bowl of lowfat yogurt almost every evening. No wonder she is 60 pounds overweight. When I talked up the benefits of low carb, she told me sadly, “Well, I won’t enjoy life if I can’t eat the foods I love.” I responded, “You have a choice. You can keep eating the foods you love and stay the size you are or you can change your diet to lose weight.” She chooses the former but still hopes she can lose weight somehow anyway.

  64. Just to chime in that insulin is a godsend for diabetics. I wish people didn’t think it was an admission of failure. It can be used in conjunction with a low carb way of eating and allows much better control of blood sugars almost immediately.

    • Sure, if you aren’t making insulin already. But if you’re making insulin and can’t control your blood sugar, it’s time to lower your sugar intake. Excess insulin does so much damage in the body that if I were diabetic I’d take it only as a last resort. As in my beta cells are all dead and my muscles are in danger of wasting away (insulin’s needed to get amino acids into them).

  65. Glad to see you are looking into TRIZ, Doc. I find Genrich Altshuller’s story hugely inspiring. He knew his work was important when the secret police came to arrest him for it !

    Please post on what you learn from the book.

  66. My gallbladder was removed 6-8 years ago. I follow a low carb diet for two years. My trigs, cholesterol and sugar remain elevated although I have lost some weight (was never fat). I believe the body may have difficulty dealing with large amounts of fat without a gallbladder. I remain with the diet due to low CRP and tremendous cognitive improvements. I believe I was probably an undiagnosed Coeliac. Gluten sensitivity could be a major cause of gallstones.

  67. As an avid reader of your blog, I know your opinion of observational studies, but I have some observations to share. I am an RN and have been in the home health field for many years. I am absolutely stunned by the sheer number of medications the patients I see are taking. A large percentage, probably in the 85-90% range, are diabetic and ALWAYS have other comorbidities such as HTN and some type of cardiac involvement as well as on a statin.

    When admitting these patient’s for service, one of the questions is “are you on a specific diet”. Almost all answer no and have not received any info despite having had diabetes for years. Most say they know to try and avoid sugar but a surprisingly large number say they continue to eat what they want and just adjust their insulin dose accordingly.

    I have come to some conclusions in my non-scientific study. One is that even though doctors play a part in some of this gigantic (no exaggeration) epidemic of diabetes, it is also the patients themselves – people are choosing the path of least resistance which is to take a pill or an injection.

    As a follower of the low carb lifestyle for years, I am trying to help in the fight for converts but feel I have to watch what I say and teach to the patients as, unbelievably to me at least, low carb really is still considered radical by most while combination’s of 10-20 meds including daily injections is mainstream.

    Amazing.

  68. My introduction to low carb was actually through an effort to get my ill dog healthier. I stopped feeding kibble and went to a completely home-prepared diet. Then to a raw diet. Veterinarians are taught very little about nutrition, and the little they do know is taught by a rep from a kibble company. Benefits for the dogs were better skin/coat, cessation of itchy skin and lesions, less joint pain/ arthritis symptoms, less (almost non-existent) tooth tartar, and dramatically reduced stoop size and flatulence. 3 of the 4 Veterinarians at the practice I use were horrified of the changes in diet while applauding the benefits to the dog, one was supportive.

    After some health problems of my own, I read up and started low carbing. I lost 50 pounds. I went off it and most of it back. Now I am on it again and have lost 10 pounds in two weeks.

    Don’t forget your canine friends when being skeptical to mainstream dietary advice.

    You’ll pay more for the food they eat but you’ll recoup it in fewer dental/ vet bills.

    BTW- soy and corn were the two big baddies my dog had issues with. Wheat to a somewhat lesser degree.

  69. Glad you guys are back. Great post, I enjoyed reading it alot. You deserve some real kudos for the work you do illuminating and promoting nutritional soundness.

    I first got into LC 7 and a half yrs ago, at 316 pounds. I lost 76 pounds in a yr and a half with strict low carb. Eventually I fell off the wagon somewhat, but am back on it for a little over a yr. I’ve been losing consistently (though slowly) never feel hungry and my labs are good.

    My main concern is my wife, who is diabetic but doesn’t quite have my perspective on diet and nutrition. She worries me and I don’t want her to fall into one of the scenarios you’ve presented. But I keep working at it with her.

    BTW, I don’t really see that the average American is interested in low carb. Maybe it’s just me.

    Regards, Jim

  70. Recently I noticed a new low carb yogurt at Krogers, Carbmaster. Hadn’t seen one since Blue Bunny quit making theirs. Bought some and it was good, asked my SO to get me some more as he was going to Krogers. He came back with two containers (they’re single servings) and reported that the store manager said that all the stores were sold out of them. So there must be quite a few low carbers out there. Very encouraging, maybe some of the useful products will come back.

    • Read the label carefully; Carbmaster ‘yogurt’ is not actually yogurt. Plus, I personally found that it was a problem for me — it caused me to gain weight. My wife and I ate the stuff for a long time, but we have discovered that we do better without it.

    • I don’t bother with it. Kroger also has a variety of Greek yogurt (not store brand) that’s 5g carb per serving. And I suspect at least some of that is lactic acid, which doesn’t impact insulin levels as far as I know. That’s what I go with–the full-fat version, mind you.

      • The yogurt another poster found at Kroger with only 5g of carbs per 4 oz. serving might be the “Greek Goddess” brand. Comes in an olive green and white tub. It’s full fat (oh noes!) and unsweetened. It is TO DIE FOR! I eat 1-2 helpings a day with a few raspberries and a dollop of coconut milk and have no trouble staying under my 30g of carb per day limit.

  71. Have you seen Bill Clinton lately? He’s beginning to look emaciated … face way too thin. Makes me wonder how low fat he’s eating. Someone needs to advise him to increase the fat!

  72. I agree with Malcom (near the top) when he says: “Sadly I don’t see the situation you describe changing any time soon. I think the low carb ‘movement’ for want of a better term has been going backwards for the last 5 years or so … regardless of research validation which struggles to get any mainstream exposure.”

    Did you notice that Bill Clinton, in his desparation to lose weight, went straight to the LOW Fat diet. And Michelle Obama is pushing for low-fat foods incl. fruits/vegetables and healthy grains? It’s just so “logical” to most people that “eating fat makes you fat.” Even if many studies prove otherwise.

    There is another aspect to this that I never see anyone mention, which is that low-carb eating is quite inconvenient unless you are at home near your refrigerator. Because most of the food has to be cooked or refrigerated or frozen.

    And for emergencies like hurricanes and earthquakes it makes a lot more sense to stock up with bags of rice and beans, than meat in the freezer. How would you have fed the Haitians after their earthquake – bring eggs and chickens and cows?

    I’m not against low-carb and started eating this way (lowER carb) myself about a year ago – but only for blood sugar control – since i’ve been slender all my life with low BP and no other problems. But this has allowed me to see beyond the weight loss aspect.

    I enjoyed the write-up Dr. Eades – glad to have you back! I realize all this takes a lot of your time, but I appreciate it.

    • Plains Indians had pemmican, which was basically meat jerky in bear fat with berries added. White settlers noted that the pemmican stayed good to eat even in high summer temperatures.

      Nowadays we have jerky of all types, beef and poultry and salmon, and also canned meats and fish.

      I’ve even seen canned butter. And, of all things, freeze-dried meat for long-term emergency storage. Just the meat, no gravies or anything added.

      It is well worth it to solve these problems ahead of time so you aren’t caught with your pants down when a real emergency arises.

  73. I can’t get over that “glucosamine elevates cholesterol” thing. It’s not exactly consistent with the recent finding that people taking glucosamine plus chondriton supplements have a significantly lowered 5-year mortality.
    But it’s typical of how medical knowledge is selectively transmitted.
    Suppose there is one or two incidences of an adverse reaction that might be attributed to a popular supplement. The Linus Pauling Institute micronutrient resource even mentions a case of kidney failure that occured FIVE MONTHS after a six-week course of chromium supplements. http://lpi.oregonstate.edu/infocenter/minerals/chromium/
    Obviously this degree of caution is never ever applied to drugs – imagine if it was. Of course there is no reason to pull up adverse reactions that happen five months after you take a drug, because what can happen while you take it may be bad enough. The doctor will never warn you about every adverse reaction that has ever been linked to a drug he prescribes (it would take up most of the consultation to do so), but tell him you’re taking a supplement, and the chances are good he’ll fill you in on a few of the urban legends about it.

  74. About the five-month later case of alleged Chromium toxicity – found more details – the patient was also taking Terazosin, hydrochlorothiazide, and Verapamil. Thiazides and Verapamil are both associated with the type of renal problems seen in this case, yet the doctors ruled them out and attributed the case to chromium piccolinate. Nice work docs; the attribution will live forever in the literature. Three of five attributions of chromium side effects in the literature ignore the concommitant administration of drugs that were already known to cause the effects attributed to chromium in each case (the cases are analysed in detail in “The Safety and Efficacy of High-dose Chromium”, The Alternative Medicine Review, Vol 7 Number 3 of 2002).
    Similarly, supplements that inhibit platelet aggregation, such as ginkgo, vitamin E, are easily attributed with symptoms that are actually due to vitamin K deficiency (and vitamin K antagonism by drugs).
    I tested this myself when I had my upper teeth extracted; I ate enough alfalfa sprouts (and fat) to supply 10mg vitamin K1 daily and continued to take “blood thinning” supplements including 2,000iu vitamin E and 160mg co-Q10 on the day of the operation; my blood clotted normally, well within the time predicted by the dental surgeon, and wound healing was fast and sound. Vitamin E at these doses may slightly increase the need for vitamin K, but this is probably only relevant to people who don’t eat green veges, or who eat a diet that is too low in fat to absorb either vitamin.
    The details, though fascinating, are not important. The point is that the safer something is, the lower the standard of evidence becomes for proving harm; while the more dangerous something is, the more the expected harm will tend to be overlooked.
    That’s human nature, not science.

    • Reminds me of the brouhaha over creatine supplements because some athlete overheated himself on an exercise bike after taking them. Of course people overlooked the fact that he was wearing some kind of body suit that trapped his body heat. Whoops.

      I’ve actually looked up what creatine is–it’s three amino acids grouped together. All it does is put more water into your muscles, making them look larger. I’m not sure how moving water into your muscles is supposed to overheat you, but whatever.

  75. @ Katie, I think you have hit the nail on the head; this is also the real reason N.Z. hospitals don’t want to use intravenous vitamin C, especially now it has recently been proven to work in some high-profile cases, why psych hospitals here won’t use simple nutritional interventions like fish oil to prevent recurrence of psychoses; once you admit that these things are worth trying, you’re left with the fear that what you’ve really been doing all these years instead will look genocidal by comparison. It’s not like these are all brand-new discoveries – they’re things the gatekeepers have been opposing or sitting on.
    It’s more than admitting mistakes, it may involve admitting criminal or moral liability for unnecessary harm, at least in one’s own mind, and in effect, accusing others – one’s peers, mentors, in-laws – in other words, a social impossibililty for most people.

  76. Great post! I feel so frustrated with the medical profession most of the time (present company excepted of course). I have a friend whose husband is diabetic, severely so. This was a man who was getting blood sugar readings in the 300-500 range for most of last year, and had not seen a reading below 200 in over 10 years! His high-priced fancy endocrinologist just kept through more meds at him – metformin, insulin, Actos, Avandia, Januvia, on and on – to no avail.

    Until he was diagnosed earlier this year with prostate cancer and needer surgery, but the surgeon refused to operate because of the high blood sugars and risk of infection. My friend was at her wit’s end. *I* was the one who suggested they try a strict LC diet for a couple weeks. She had refused to consider in the past but now times were desperate! Not to mention a mutual friend who is a medical writer emailed her to say:

    ** “As you will have seen from Debbie what we’re dealing with here is not so much science as faith. I think the whole low-carb approach is codswallop. The so-called science behind it is very poorly grounded…We’re built for carbs. Evolutionarily, the whole meat-eating thing is a recent fad!” ***

    And apparently she also emailed my other friend privately to tell her she thought I was a kook and blind fanatic.

    However my friend decided to try to LC approach with her husband anyway -and by the second week he was having FBG numbers of 100! Over the next few weeks he kept having to cut and cut and cut his insulin, drop the other meds, cut the insulin again – and still kept getting numbers that were perfect to even too low at times. At the end of a month the surgeon though the numbers were good enough that he could operate, and the surgery was successful. No spread of the cancer, all removed, all follow-ups perfect. He he continues to be low-carb, continues to keep slowly dropping his insulin. They are now a “for life” low carb family.

    Yet none of the doctors they had seen, including their high-priced out-of-network endo that they paid thousands too, ever once suggested any dietary changes and has said his previous diet was not harmful.

    So I take it with a grain of salt when a doctor says something like “Are you going to listen to *me* or to someone you read about on the internet?”

    To MB: I’m in the same cholesterol boat as you. Since being strictly LC, grain-free, sugar-free, PUFA-oil free, my cholesterol has gone through the roof to 280, with very high LDL (though the NMR test shows it’s 90% the harmless pattern A) – though my triglycerides are certainly fine (49) as is my HDL (66), yet all my doctor says is STATINS, STATINS, STATINS. In fact she didn’t even ask, just said she was prescribing a statin, and looked a little shocked when I said “no way”. Told her that all the studies showed statins were useless for women. She just told me I was totally wrong and that study after study showed how wonderful they were. I didn’t even tell her about my diet and she didn’t ask. I figured my cholesterol numbers would be the nail in the LC coffin to her. :-)

  77. If I’m the one telling my doctor about diet and nutrition, why do I need that doctor at all? Shouldn’t the “doctor” be the one telling me these thing?

  78. I’m facing the same problem in my family. My mom has type 2 diabetes (controlled by what she considers low-carb: typical high carb, but low sugar recommendation. At least no drugs) I keep telling her there is no evidence that low fat is helpful, but she has heard from her doctor (and professors when she went back to college 10 years ago) that low fat is the way.

    She keeps telling me “you need to get your cholesterol checked, your grandpa’s was over 600 (this was before they measured anything other than total) when he had his heart attack.” (Never mind that grandpa also smoked, cholesterol had to be the problem)

  79. Dr. Eades,

    I want to add my thanks to the chorus for all of your work. My son would probably be one sick little boy if I had not read about Leaky Gut in PPLP. His doc did not think to test for celiac after we discovered his extremely low iron levels.

    After reading PP and doing more research about celiac, we changed his diet. Two months later his iron levels returned to normal. We became a little complacent over the last year and let too many GF grain products back into his diet which led to lower iron levels again. But now we are back on the Paleo wagon!

    Thanks again for all your and MD’s work.

  80. My thoughts exactly !!! Can anyone visualize a situation where the government was to wake up one day and admit that they were wrong all along ? Can you imagine the state of the whole wide world staring open mouthed….ready to kill the establishment….and can anyone imagine the fate of the drug companies ? What would it do to the U.S. economy ?? No, better still what would it do to the world economy????
    Better stay quiet Michelle Obama….Let the next government handle that, we have enough problems already…who cares about a little heart disease and cancer and arthritis and …..?????

  81. I read this article today on News.com
    http://www.news.com.au/entertainment/television/butter-spreads-wrong-message-for-masterchef-viewees/story-e6frfmyi-1225929711745
    I was saddened as I have been low-carbing (and for a week or two almost zero-carbing) for a month now and the positive effects are illuminating and unmistakeable.
    I am glad I have so much information on the internet to support me – I was quietly going crazy through being absolutely unable to control my weight through low-cal, low-fat and exercise. It was so very demoralising that I was wondering how I could possiby go on…
    Thanks to you Dr Eades and others who are able to tell us the low-carb truths, I am positive and cheerful again and feel physically great!! I shall keep buying butter :)
    Many thanks.

  82. Just to make you laugh and to inject a bit of optimism, I think we’re helping to get the message out about Taubes’ GC,BC and that ‘wheat is murder’. I believe this is percolating outward and upward. I have pressured several people in my orbit to read GC,BC and ‘The Vegetarian Myth’ and ‘The Six Week Cure’- and those who have have been CHANGED. One friend is an OB-GYN. She doesn’t mainly counsel about nutrition but being a woman women’s doc, she frequently finds herself talking about GC,BC— while she’s doing a certain womanly exam and therefore has the patient’s undivided attention. If the patient is interested and because she knows GC,BC and even ‘Protein Power’ is not accessible to all, she gives out a book list and suggests a visit to a book store. She wants them to read a few pages and then to purchase if they like what they see. She also recommends renting “FAT HEAD” and “My Big Fat Diet”.

  83. As I was browsing some of my favorite blogs (of which protein power is one), I thought I might browse the American Diabetes Association website…just to see what they have to say.

    Here is a statement they make in the ‘Genetics of Diabetes’ section of their website. “Americans and Europeans eat too much fat and too little carbohydrate and fiber, and they get too little exercise. Type 2 diabetes is common in people with these habits.”

    Is this for real? It certainly sounds like the ADA is claiming that a high fat diet is a significant cause of type 2 diabetes. Any thoughts. I have read my fair share of pro low-carb/Paleo books and this is the exact opposite of the message in those books.

  84. It doesn’t help when the t.v. shows “The Doctors” AND “Dr.Oz” continue to promote low fat dieting to millions of Americans… Every time I hear the young Dr. Stork say “lower your fat intake” I want to jump through the t.v. and pummel him. LOL

  85. I am mad as hell too. Visiting doctors was mostly a traumatic experience for me. I learned about “The Pitiful State of Medical Ignorance” when I looked for help with some health problems. Don’t expect the government or the medical disease management industry to help with your health problems. You are on your own. I learned this lesson the hard way – in despair about the ignorance and indifference of the medical establishment. But I am stubborn. And luckily there is Google and the internet. I searched and searched and found all the good blogs and websites about nutrition,physiotherapy, body therapy, training, holistic medicine.
    I ignored the docs who didn’t understand what I am talking about and learned from your blog, from Robb Wolf, Mark Sisson and all the paleo bloggers, from Paul Chek, Jimmy Moore, Dragon Door and RMax Forums, Scott Sonnon, Clarence Bass and a bunch of other ressources.

    After reading Robb’s book I recently cutted out my beloved almonds and walnuts out of my paleo diet because of the antinutritients and calories. They make you fat if you eat them as a bread substitute. Too bad…..
    I try to get the sleep, cortisol/stress and training parts in order which for me is much more difficult than the food part of the whole concept. Well – the most part of stress was the ignorance of the medical system.

    As I said I am stubborn. And not impressed by science because I know how it works. I alwys told my docs that the so called “chronic deseases” are not a disease but failure of self regulation in your body. Even if they believed me they shrugged their shoulders. They were not interested because they only had drugs and surgery as tools. And if you only have a hammer as a tool every problem looks like a nail.
    Arthritis, joint problems or vision problems for example are preventable and in many cases curable. If anybody in mainstream medical establishment would look for the causes…….there would be solutions. I am mad as hell!

    But here’s the good news: The docs slowly change their mind, even in Germany. Surprise….. Prof. Dr. Henning Madry, Arthritis Research, Saarland Medical School, Germany, says: Osteoarthritis is no wear and tear but a chronic disease like asthma and diabetes. Cartilage is damaged by accidents or sports injuries but very often it is induced by internal processes which are not understood. Cartilage gets weak and finally destroyed.
    This has nothing to do with aging per se. Many young people have OA today and many old people have no OA says Prof. Madry.
    http://idw-online.de/de/news377579

    Hey – that’s what I said for years! But I am not an MD – only a person with a brain. Sociologists ask the question: “Who has the power of definition? Only the members of certain institutions. ” If you are a golf player who happens to have an MD you have the power of definition, whether you are a critical thinker or an idiot. But critical thinking helps deconstructing idiocy. As Sociologist Pierre Bourdieu said: “La sociologie est un sport de combat”. (Sociology is a martial art)”.

    Why are the causes of symptoms like OA not understood? Because nobody in the medical establishment looked for them. Big Pharma has no interest in research about the causes and definitively not in prevention or healing. Healthy people who are not drug junkies? Terrible for Big Pharma!
    Dr. Ron Rosedale, MD, says: “If you are going to treat a disease you need to get to the root of the disease….But the problem is that we don’t know what the root is, or we haven’t. (…) the problem is that medicine really isn’t a science, it is a business.”

    Nothing in the human body “just wears out”. Your pancreas doesn’t ” just wear out”. Your liver doesn’t “just wear out”. Your eyes don’t “just wear out” – stop misusing and poisoning them. Read optometrist Jacob Liberman, PhD., or Leo Angart on why eyes get bad, you’ll be surprised. Liberman and Angart are seniors and don’t need the glasses they had as young men. Liberman’s deconstruction of “medical idiocy” in ophtalmology is great.
    I am mad as hell!

    The reason for all degeneration is: the body is overloaded with physiological and /or psychological stress. And nobody can avoid all this unhealthy stressors all the time. So nobody can be in perfect health. But we can get closer than we are today. Degeneration of connective tissue, eyes, liver or whatever is not a mysterious fate that just happens but there are reasons we can change, not individually of course, but as human society.

    Keep up the good work Dr. Mike. You and other MDs with books and blogs provide me with education material for the docs who are really smart and willing to learn from their patients. Yes such smart folks exist. They don’t experience my disagreement with their opinions as personal offence . There are well-intended, decent MDs out there who have just not the time to educate themselves. And even if they had: most of them are slaves of the insurance companies and Big Pharma.

  86. Doctor,

    This may be off-topic for this post (but maybe not for this particular post….) if so, feel free to not approve it, but I wanted to all call your attention to something that I thought you might be interested in and I don’t have your email address.

    I know that you are extremely well read you may already be familiar with this, but I just heard a very interesting interview on (Russ Robert’s) EconTalk podcast with Gary Greenberg, author of The Noble Lie and Manufacturing Depression. It is about using (or more accurately misusing) science to change the way we think about our world.

    Although it doesn’t sound (from the interview) as if he takes on the very poor state of nutrition science, but stays mostly in his area of psychiatry discussing issues such as depression and addiction. None the less, the interview made me think of you and the book sounds right up your alley.

    Thanks

    Jon

  87. Doc
    Do you think that people should try to make drastic changes to their lifestyle when switching over to a paleo diet, or should it be done slowly?
    I ask as I suffer most of what people have talked about, I’m a PhD student (finishing soon) who is probably pre diabetic, obese, suffer from joint pain and GERD and whatnot. I’ve decided to leave my program as changing a lifestyle in grad school is almost impossible. I’m taking about six months off to get my lifestyle changed around before taking up teaching as a highschool teacher next summer. I guess I’m looking for the best way to implement the plan.

  88. I am confused! I have been Low Carb and sometimes Zero Carb since January 4th 2010. I lost 36lbs immediately (first 2 months) but have been steady (for the most part- fluctuating 10lbs ) since then. However, lately my sweat smells like ammonia almost immediately. Sometimes it will smell like sourdough bread. I started eating more veggies and fruits and the smells has subsided. Also- when I first went LC my resting blood pressure dropped from 84 BPM to 64BPM, again, for the last few months it has been back up to 84. Since introducing more veggies and fruit, I am at 72 BPM this morning.
    I am concerned that I might getting too much protein and that it is effecting my liver and kidneys. Any advice?

    • Laywoman’s opinion: You might be in ketosis. Go to the pharmacy and pick up some Ketostix and follow the directions. If it changes color, you’ll know. It simply means your body is in a mode of burning mainly fat for energy, either the fat you eat or the fat you have stored. Our bodies are evolved to deal with being in that state; it’s how we survived periods of low carbohydrate availability before we invented farming and grocery stores.

      As far as I know there’s no evidence to indicate that high protein damages healthy kidneys. But you don’t want to eat too much protein without backing it with dietary fat. Too much protein + too little fat/carb + episode of major stress = rabbit starvation and you could get really sick. In your shoes I’d favor saturated fat and monounsaturated fat above other types. Butter or ghee, dairy cream if you can tolerate it (heavy cream is best), coconut and palm oil, olive oil, lard, tallow, and similar.

      • The processing of protein and fat, including excretion through the kidneys, depends on the vitamins and trace elements being adequate. B6 is especially important for breaking down protein, B5 for fats. It’s probably a good idea to supplement (at the very least) a good quality (iron-free) vitamin and mineral supplement when changing diet, until you know what your requirements are. Carnitine or acetylcarnitine can also help burn fats. Many people switch to low-carb because they have inflammation that reduces levels of essential nutrients or effectiveness of enzymes (e.g., the methylation cycle, which helps to make carnitine, choline and creatine, is easily impaired by oxidation of B12).
        I think the supplement recommendations in books like Protein Power and Atkins diet are as relevant as the diet recommendations.

  89. I’d advise people to let their dentists in on it too! I recently went to the dentist after about 6 years of not going, because a cavity that had started 6 years ago (before I went low carb… it was teeny) was starting to bother me slightly.

    My new dentist was appalled that I hadn’t been having my teeth seen to in so long, but when he looked in my mouth he was surprised to see that the only problem lurking in there was the one I came in for… the teeny cavity, which had been coated with sealant 6 years before. The sealant had worn away, so he filled it. No other trouble.

    I told him that I ate low carb, so no sugar or starchy foods… he said ‘wow, I can tell!’ Then we had a good conversation about how teeth are made from the inside out, etc etc. He was really enthusiastic about my dental results from diet.

    So tell your dentists too!

    PS: Incidentally, I am a former smoker. He told me that smokers usually have bad to severe bone loss in their gums from smoking. When he checked my x-rays, he said I barely have any… and that it was surprising considering I’d smoked for 20+ years. I can’t make any claims here, but I suspect that getting gluten out of my diet and eating low carb has helped protect me from bone loss, despite other risk factors. (or that bone loss in the gums is also due to dietary factors, along with the smoking factor)

    • If I eat low carb, my teeth stay cleaner even if I don’t brush them for days (which sometimes happens–I get distracted a lot). Not absolutely clean, but cleanER and I get hardly any tartar at all.

      My daughter is not low-carb per se but I do make sure to get a good amount of saturated fat into her diet. She had had a tiny cavity starting on a tooth two dental visits ago. The last time we went, the dentist didn’t see any new cavities. I think we healed it. We’re due for another appointment soon so we’ll see.

  90. I’ll echo everyone’s comments here, I’ve been LC for about 7 years. I’ve never felt or looked better–people tell me I look about 32 (I’m 44). No health problems, on no meds. Since starting LC my skin looks better, no digestive problems, eyes are fine, teeth are healthier, and my seasonal allergies have virtually disappeared. Im never hungry and I never eat anything I don’t enjoy. I maintain less than 10% bodyfat with 3-4 workouts per week. My physician (who I see just every few years for a checkup) was initially skeptical but has told me to “keep on doing whatever it is you’ve been doing.”

    I’ve thought a lot about why more physicians don’t recommend carb restriction, especially since my stepfather recently died due to various medical problems. He was diabetic and never really got his blood sugar under control. His Dr. of course thought his diet was just fine, even though he ate bread (“whole grain” of course), potatoes, rice, pasta, etc. I tried over and over again to talk to him about cutting out starches but it never sunk in. I think there are a few reasons doctors dont recommend LC:

    1. They haven’t done their homework, and instead buy the myths about LC being unhealthy, saturated fat causes heart disease, the protein will asplode your kidneys, etc.

    2. They don’t want to admit they were wrong. I think this is especially true of the major medical organizations. If they admit they were wrong people will be more skeptical about their advice in the future (a good thing, IMO).

    3. There is indeed a great financial incentive in keeping people sick. If people knew that statins are mostly useless, and that T2 diabetes is largely preventable and curable with proper nutrition, a lot of livelihoods would be threatened.

    4. I think some professionals are aware of the superiority of low carb diets but they believe people just will not follow them because no one will give up bread, cereal, pasta, potatoes, etc. Most people probably won’t but it seems elitist to withhold information because people might not follow it. Why not explain all options and let people decide for themselves what trade-offs they are willing to make? And if “professionals” were supportive of low carb diets, and assisted patients in coming up with recipes and meal plans that suited them, perhaps more people would be willing to stick to LC diets.

  91. I watched a TV show the other night that I thought interesting regarding paleo/low carb eating and farming. A guy by the name of Les Stroud has a show were he travels the world in search of indigenous tribes. He lives with them for awhile, filming their life style.

    The show the other night was about two tribes living on the island nation of Madagascar. One is a group of people that live on a beach hunting and eating sea food – basically a low carb/paleo life style. The other is a farming tribe.

    Les made a comment that all the males in the tribe residing on the beach appeared to be professional boxers in size. From what I saw they were lean, tall, and healthy looking. No comment was made about the farming group but from what I saw they appeared thinner, less strong, and shorter in size – as would be expected.

    http://lesstroud.ca/beyondsurvival/ep5.php

  92. Doc, I have some hope that the study you were planning to review shortly and that in your view was ‘designed to fail’ concerns the recent article published in the Annals of Internal Medicine on 7th Sept which purports to show that only a vegetables based low carb diet leads to a decrease in all cause mortality – an animal foods based low carb diet would allegedly lead to an increase in all cause mortality. See
    http://www.annals.org/content/153/5/289.abstract

    Being an enthusiastic (animal foods) low carber myself I wonder whether I can just ignore this article.

  93. So glad you are posting again. We missed you!

    Completely off topic…do you have any idea why taking a multi vitamin would make my daughter turn silver jewelry black in a day? (The silver turns black, not her skin.) I can’t find anything about this.

    I’ve been talking up low-carb, but people are so set in their ways. But I’ll keep trying.

  94. I’m going to suggest something fairly radical here. Let’s give these doctors some credit for having to deal with many patients over years.

    ‘ Most doctors will fiddle with the medicines to get the problem solved. Why not do that with diets?’

    The simple answer is: dieting is difficult. Low-carb dieting is simpler than most but it’s still difficult. People go off low-carb diets ALL the time (they even have trouble staying on low-carb diets in studies that compare a low-carb diet with a low-fat diet; not that there isn’t a similar drop-out rat for the low-fat!)

    It’s easier – and often more acceptable to the patient – to have a pill that regulates or changes something. Easy-peasy. I’m pretty sure every doctor on the planet knows this from experience, including you, Dr. Eades!

  95. I just stumbled onto something which is the big hole in the cholesterol-statin-mediterranean diet paradigm.

    Cholesterol is bad; olive oil is good for you; statins lower cholesterol.

    Statins inhibit HMG-A reductase, which starts cholesterol synthesis; a further product is squalene; squalene is cyclised to lanosterol and then cholesterol.

    Cold pressed or processed olive oil is 0.7% squalene. Statins cannot inhibit the conversion of squalene to cholesterol. They can however inhibit the formation of the isoprene side chains on Co-Q10 and vitamin K2.

    Squalene goes to the skin where it protects against skin cancer. It also plays an important role in immune function and is included as an adjuvant in some vaccines. Squalene supplements from shark oil are used to boost immunity.

    I imagine people on statins are advised to consume olive oil instead of other fats. The squalene in olive oil ought to make the statins less effective, meaning the dose and non-cholesterol side effects will be increased.
    If the “med diet” is low in cholesterol (I doubt the real med diet is low in cholesterol at all) that’s OK, because olive oil makes it easier to produce cholesterol!

    BTW, palmitate is essential for lung surfacant, people with asthma have low levels. This is one reason sat fats are recommended for kids. But adults get asthma too. It takes 14X NADH to make palmitate de novo, plus biotin, B5 and sulfur. The NADH comes from B3 and glucose-6-phospate, the pathway that also reduces glutathione; and glutathione also protects the lungs, with low levels in asthma.
    Squalene

    Squalene, ubiquitous in nature, is a triterpene

    hydrocarbon (Figure 3) and a major intermediate in

    the biosynthesis of cholesterol. Although found in

    both plants and animals, it is found in vastly different

    amounts.

    9 While olive oil is composed of approximately
    0.7-percent squalene,

    9 other foods and oils typically
    have squalene levels in the range of 0.002-0.03 percent.

    Only a slight difference is observed between the level

    of squalene in extra virgin and refined virgin olive oils

    (extra virgin having higher levels).

    7
    Although squalene is widely distributed

    throughout the body, the majority is transported to the

    skin.

    9 Sebum has high levels (12%); whereas, adipose
    tissue has much lower levels (0.001-0.04%).

    9
    Due to squalene’s structure, it is more likely to

    scavenge singlet oxygen species than hydroxyl radicals.

    9
    Exposure to high levels of ultraviolet radiation causes

    the formation of carcinogenic singlet oxygen species

    within the skin, where a high concentration of squalene

    may provide a chemoprotective effect.

    9 Squalene, found
    in high amounts in the Mediterranean diet, is believed

    to be responsible for the lower incidence of skin cancer

    seen in epidemiological studies of populations consuming

    this diet.

  96. A doctor who admits he got it wrong will also be blaming his colleagues, his mentors, even in many cases his in-laws. For someone entrenched in Junk Science, it will be both career and social suicide.
    George Bernard Shaw called it The Doctor’s Dilema. I recommend the play and (especially) its preface as being even more relevant today than it was in 1904. It’s spooky how much his critique is still on the money. “Stimulate the macrophages!”

  97. If you want to know WHY so many Doctors dispense bad dietary advice, and refuse to believe their own eyes when their patients improve after going low-carb, you have to look at the big picture.

    Low Carb is the exact opposite of what the USDA advises with their High Carb Pyramid.

    Follow the money.

    Who regularly gets appointed to the highest echelons of the USDA? Big Agriculture execs for the likes of Monsanto and Cargill.

    And who profits from having a populace deliberately mislead, literally slowly poisoned by their high-carb, processed food diets?

    The Pharmaceutical industry (Who get there execs appointed to the FDA…are we starting to recognize a pattern?)

    Big Money corporations buy influence by giving their money to politicians who than appoint their lackeys to the regulatory agencies who literally control the messages being promoted by our mass media and medical community regarding diet and nutrition.

    Most Doctors are not deliberately prescribing these diets because they’re happily rubbing their hands together because they are receiving perks from Pharma reps for prescribing statins (although that does play a part), you also have to understand that most of the Doctors are reading peer-reviewed journals and/or given the latest “results” provided by the Pharma companies themselves with deliberately misleading results that all promote the same outcome – keep the sheeple eating the grains and prescribe the profitable drugs that mask the symptoms that result from the long term consequences of the conventional wisdom’s dietary advice.

    My own personal family physician recently retired. He’s close to 90 lbs. overweight. He has chronic asthma. When I related my own discovery of low carb dietary knowledge, and how I lost 35 lbs. in 4 months and have kept it off for 4 years straight now by “eating bacon and eggs cooked in grease and butter” every morning, it simply did not compute with him. It was like his eyes glazed over and he simply tuned out what I was saying.

    He simply could not come to grips with a living, breathing example of a person who was doing everything contrary to what his medical journals and professional nutritionist guidelines of our HMO direct him to apply to his own medical practice.

    Quite simply, Doctors, like most people that have imbibed a lifetime of government/corporate propaganda via our mass media and public school curriculum, can’t deal with the cognitive dissonance of real live examples that are contrary to their own indoctrination that is repeatedly reinforced both inside (pharmaceutical sales reps sales sheets and peer review journals touting bad diet advice and pharmaceutical remedies) and outside (our mass media dietary zeitgeist) of their professional environment.

    Most Doctors that prescribe bad diets and even worse medication to ameliroate the symptoms of those bad diets, are simply nothing more than highly educated and licensed useful idiots.

  98. Wonderful post. Thank you once again.

    Great idea for all of us to be ambassadors. I take every opportunity I get to promote this way of eating which I call our “live-it”, not diet. People notice that I’ve become slimmer and usually ask how I do it. On our recent trip to Colorado, the airline agent checking my husband’s passport photo told him he had lost A LOT of weight. He was thrilled.

    I agree with Emily Deans, though, that we have to meet people where they are and unfortunately it doesn’t work to beat them over the head with your excellent books!

  99. Since being diagnosed with type 1 diabetes, 9 years ago, I’ve become conscious of what I eat and have reduced the amount of carbohydrates I consume. (Pasta, pizza and fries became a something of a side dish for me.) Although I reduced the amount of carb and tried to eat lo GI foods my A1C levels remained around 7and I constantly suffered from highs and lows.
    Four months ago, after reading a article on http://www.asweetlife.org I decided to go on the Paleo Diet. With in a few days I was completely off short acting insulin and lowered my Lantis (long acting) by 2 units (from 20 to 18). I also lost a few pounds.

    The problem is that I’m a long distance runner and the lack of complex carbs left me without enough energy to run any longer than 5-6 miles.
    So I’ve added some quinoa, sweet potato and lentils to my diet trying to consume 100g-200g grams of carb a day. This of course call for insulin.

    I wish there was a way around this problem.

  100. Dr. I just started nursing school three weeks ago. I’ve been health and nutrition concious for several decades. Your book Protein Power is the best book on health I have ever read, period! Question: what kind of opportunities are there for nurses who are not so keen on the poly pharmacy that seems so prevalent in medicine. How many Doctors such as yourself are out there, and need to hire nurses?

    • There are more doctors the practice the way we do than ever before. And I think their numbers will keep growing. You’ve just got to look for them because there are still a lot who practice the old way.

  101. Great post, Dr. Mike. (I’ve missed you!)
    I’m an undergrad professor and I talk about low-carb and the mechanisms for why it works all the time. Undergrads are pretty open-minded, so this is a good group to target. As a result, my college now has many low-carb items in the cafeteria and advertises that students can eat “paleo” here.

    I’m working on the new Study Guide for the new “Stryer” Biochem text so I hope to include some problems that illustrate why low-carbing works. I would love to use a case study from a real patient. Do you have any suggestions?

    Doctors find my Powerpoint slides on the internet and I get emails from them routinely saying “I learned more about nutrition in 10 minutes with your slides than I did in three years of medical school.” That’s not to brag about my slides, but to decry how lousy nutrition education is for *the people who need it most.!!!*****

    Keep up the good work.

    • Hey Dr. Wendy–

      I don’t know if you read this post or not, but there are a number of patients who could serve as case studies

      Why don’t you provide us with a link to your slides. I’m sure readers of this blog would love to see them.

  102. Just an FYI for your diabetic friend: Most diabetics that have a Vertical Sleeve Grastrectomy are able to go off their insulin and many all meds. Something to consider.

  103. “the late Dr. Atkins was one of many diet-guru-wannabees with an MD who observed one thing that seemed to work, and immediately concluded that he alone had all of the answers”

    And you conclude that on the basis of your own N=1 self — and so insult Dr. Atkins for his observations of (and success with) (N=) hundreds, if not thousands, of patients? Do you believe Dr Mike and Mary Dan are diet guru wannabes also? THEY have concluded “one thing” that “seemed to work” and they do have the answers. Just as Atkins did — for his time, and the state of medicine back then. (His personality flaws notwithstanding.)

    I don’t understand the gratuitous insult to a man who tried very hard to push “medicine” into reality. (And “because it didn’t work well enough for me” is not sufficient reason!)

  104. @Elenor: You read more into that than what I actually said. I do consider the only important difference between Atkins and Ornish to be the fact that Atkins got considerably more right. The attitudes are nearly identical on both sides.

    Atkins may have tamed his arrogance enough a bit to learn about good vs. bad fats if he had lived long enough, but there is no way to know for sure. He basically undid most of the good that he did by pushing a line of commercial low-carb junk food. The consensus of most low-carbers is that the low-carb junk food just doesn’t work very well, even if it *is* labeled “Atkins”.

    As for n=1, I’ve been at this since 1999, which includes a lot of reading of actual studies (and not just the summaries, which are the only things the typical practicing MD ever reads), and picking them apart, sometimes with the help of those with whom I disagree. My observation on Atkins is not a gratuitous insult. It is based on quite a bit of research over more than a decade.

    I basically said nothing at all about Dr. Eades, pro or con, but you immediately leaped to the conclusion that I had. Dr. Eades is one of the very rare MDs who isn’t so full of himself as to need a serious ego-trim.

  105. James and TX,
    I am in agreement with you both on most of the above points. Perhaps the reason I am wondering if the Paleo thing is a fad is I am just now hearing about it. If it helps to get people healthier I consider that to be a good thing. People need to be eating higher quality food and no junk food at all, and also exercise. That would solve a lot of our problems, I think. You just can’t pick a diet and lose weight by eating junk food, whether it’s low carb, low fat, or the regular variety. Maybe some people do better on a low carb diet, and some people do better on a higher carb diet. To my understanding the big evils to avoid are sugar and white flour.

    Tx – Regarding Ornish, he has recently come out and started telling people to take fish oils so I think he has changed his tune some regarding fats and the fact that we need Omega 3-s. I totally avoid margarine in favor of butter so I would evidently make a really lousy vegan. =)

    James, you make a brilliant point. Some people want to eat meat, others don’t, but we all need to focus on the quality of our food, where it is coming from and how it is produced or none of us will be too healthy. Factory farming is really bad and the produce is also getting dismal. I hope the MD’s start telling people that!

  106. To anyone and everyone who worries about cholesterol:

    Uffe Ravnskov, MD, PhD has written several books on the topic: “The Colesterol Myth” being one. “Fat and cholesterol is good for you” is another.

  107. P.S. I forgot to mention the presence of GMO in our food. Since October is non-GMO month I might as well mention that here. There appears to be a whole lot more wrong with genetically modified foodstuffs than Monsanto and the FDA want us to believe. Most recent research has hamsters in the second generation producing sick or non viable offspring and in the third generation hardly any offspring at all. Maybe a way to lower the world population? For those who want to avoid this mess as much as possible, you can download for free a brand new app for i-phone and android :http://livingmaxwell.com/organic-nyc-iphone-app-true-food-shopping-guide

  108. “…The global prevalence of obesity is increasing across most ages in both sexes. This is contributing to the early emergence of type 2 diabetes and its related epidemic1, 2. Having either parent obese is an independent risk factor for childhood obesity3. Although the detrimental impacts of diet-induced maternal obesity on adiposity and metabolism in offspring are well established4, the extent of any contribution of obese fathers is unclear, particularly the role of non-genetic factors in the causal pathway. Here we show that paternal high-fat-diet (HFD) exposure programs β-cell ‘dysfunction’ in rat F1 female offspring. Chronic HFD consumption in Sprague–Dawley fathers induced increased body weight, adiposity, impaired glucose tolerance and insulin sensitivity. Relative to controls, their female offspring had an early onset of impaired insulin secretion and glucose tolerance that worsened with time, and normal adiposity. Paternal HFD altered the expression of 642 pancreatic islet genes in adult female offspring (P < 0.01); genes belonged to 13 functional clusters, including cation and ATP binding, cytoskeleton and intracellular transport. Broader pathway analysis of 2,492 genes differentially expressed (P < 0.05) demonstrated involvement of calcium-, MAPK- and Wnt-signalling pathways, apoptosis and the cell cycle. Hypomethylation of the Il13ra2 gene, which showed the highest fold difference in expression (1.76-fold increase), was demonstrated. This is the first report in mammals of non-genetic, intergenerational transmission of metabolic sequelae of a HFD from father to offspring…"
    http://www.nature.com/nature/journal/v467/n7318/full/nature09491.html

    Anybody care to explain this????

    • I don’t think there is any question that maternal diet has an influence on progeny. The study you cite, however, is a rat study and has very little, if any, implications for humans other than the fact that mammalian mothers can ‘program’ their fetuses for trouble later on.

      • You mean rats can get fat on fat and saturated fats impair insulin sensitivity in rats? That’s what bothers me. I would think the mechanism is the same in all mammals, so why would that not be the same for rats???
        Quite frankly I am not too happy with this study…unless …there are confounders that have been left out of the picture

        • Uh, yep, that’s what I mean. No, the mechanism isn’t the same for all mammals. Rats are not furry little humans. They’ve evolved to metabolize different diets than we have – when you give them diets they’re not designed to eat, they have problems, just as we do.

          • Actually, Crisco poisoning *does* have similar effects in humans as in rats. While I don’t recall that particular study (I quit reading nutritional studies about 8 years ago, after coming to the conclusion that there wasn’t any real science being done in that field), but I do recognize the effects of trans-fat poisoning. I suspect that most of the studies “proving” that fat is bad for you use Crisco or some other hydrogenated veggie oil. And sure enough, Crisco is bad for you.

            The studies that don’t use hydrogenated veggie oils just manage to ignore the results, or assign any positive results to something else. That is religion, not science.

            The study that caused me to quit reading them was one in which they removed sugar from the diet, and then concluded from the remarkable positive effects that “animal fat is bad for diabetics”. And yes, I just did to that study what they did to science… Most of what passes for research in this field would not get a passing grade in any rigorous college-level biology course.

    • “Having either parent obese is an independent risk factor for childhood obesity”

      This doesn’t mean it’s genetic; children usually eat the same meals as their parents in the same house, and learn the same dietary habits from their parents. If a parent eats high carb they’ll likely teach their child to eat same.

  109. 4 years ago I was DX’ed Type 2 diabetes. I also had high blood pressure – off the charts high and high cholesterol! My doctor told me to eat more carbs, I knew then that I had the wrong doctor. I started the Dr.Atkins diet and I started a walking program. 1 mile at first with hills included in my routine. Now I walk 4 miles a day, stay low carb – about 20 – 30 carbs per day. I’m off of all diabetes pills and my blood pressure is now normal. I have raised my HDL to 110 – off the charts but my new doctor is pleased with my progress. I tell the doctor what I am doing and he tells me to keep doing what I am doing. You have to take your health into your own hands. There’s very little your doctor can do for you except put you on more pills. You can do this yourself, it’s up to you.

  110. Just to throw in two cents gleaned from scientific meetings and to back up what Dr. Mike is saying – I’ve no direct experience myself, but I’ve heard from other researchers that rats/mice “don’t do well” on high-fat diets. Their physiology in bile secretion (to solubilize fats) is different, I’ve heard. So it seems very probable that rats and mice are good models of humans for some genetic studies but not for metabolic studies.

    • Thanks Wendy, that’s quite a bit more than two cents worth. It seems to open up a can of worms that is either being glossed over or presumed to be a widely accepted a priori. It is my experience that if we want the low-carb benefits to be accepted by a larger public we have to be quite specific about our scientific endeavours. I know I will comes across quite a number of people who will quote this study. Never mind how much I admire Dr Mike, I can’t say that his explanation was much of an explanation.
      I was not aware of rats/mice anomaly, if you can call it that, because it is a fairly well known given that these are the animals that are used in a lot of these studies. I think I will spend some time researching this. Thanks

  111. I looked into the rat-human divide and found heaps of evidence of differences in lipid metabolism;
    I posted the following in more detail under another blog:
    rats have no gall bladder (so obviously are not adapted to high-fat meals as we are);
    LDL and HDL have different roles re: supply of cholestrerol to gonads and adrenals;
    rat liver oxidises choline to betaine, human does not;
    many enzymes relating to lipid metabolism vary greatly in effectiveness between the species, some are missing altogether in one or the other;
    Size of human brain, a very cholesterol-and-phospholipid rich organ, means more LDL is needed by humans than in any other species.
    Rodents, it appears, are a poor choice for experiments in lipid metabolism. The results cannot often apply to humans.
    An example of more relevant science might be antioxidant research; antioxidant defenses are primeval and exist on the cellular level, so rodent research might well apply to humans – where it does not concern carb-lipid metabolism.

  112. Every time I go to the doctor for a physical he takes one look and suggests a statin drug even though he has already indicated that my cholesterol isn’t high. I figure he’s getting a kickback from the drug company. My diet is mostly meat, eggs, green vegetables, nuts and berries. I like to think I’m on a hunter gatherer diet. I walk a lot. I don’t weigh myself as most scales don’t go that high. I’m 6 foot 6 and when I get on the doctors scale usually weigh around 400. I’m a little plump around the middle but compared to people I see all the time who are FAT I don’t think I am. Why is it that Doctors feel they have to fit my round peg into their square hole. Oh and can you suggest a type of nut that comes in cans like peanuts but that have lower carb but equally high fiber. Its nice to have a source of fiber thats a good snack food.

    • I doubt that your doctor gets a kickback from the drug company, but I don’t doubt that he has been brainwashed by them, which is why he always wants to put you on a statin. I have no way of knowing what your body composition is, but NFL players who are 6′ 6″ and heavily muscled usually don’t way much more than 300 pounds and often weight significantly less, so I doubt that at 6’6″ your are just a little plump, but, as I say, I don’t know. I’m sure your doctor thinks due to your weight that you are at risk for heart disease and wants to avoid a malpractice suit should you have one. If he recommends a statin, then he feels he’s safe.

      As far as I know, most nuts have the same amount of fiber. I haven’t really paid much attention to the fiber content, however, because I don’t think fiber is all that valuable.

  113. ” If I can make a little difference here and there, I suppose it’s worth the effort, so I keep trying”

    You do. I first noticed low-carb diets via Amy Alkon’s blog, who in turn seems to have been influenced largely by you and Taubes. Instinctively I was highly skeptical, but since Amy tends to generally stick to rationality and science, I thought ‘maybe there’s something to it’, and decided to dig deeper. So I spent literally several day studying up on the science – the actual science – behind low-carb diets, and the more I learned, the more convinced I became that it wasn’t such an absurd idea after all, in fact it all made sense. So I tried it, and it did wonders for me. While I’ve never been particularly fat, for the first time I understood the link between what I eat, and whether or not I gain weight, and for the first time feel ‘in control’ of my weight. More importantly, I used to have major problems with tiredness that would come and go, I would often get to tired I would feel close to passing out. And I’d given up on the idea of being able to work after meals. I finally discovered that the tiredness spells were being triggered by sugar and refined carbs, and I have much more energy now, and can even work after meals. Now I’m a ‘low-carb advocate’. Still trying to convince my wife though. There is so much misinformation out there, and she is scared because she ‘heard it is dangerous’.

  114. My husband was prescribed a cholesterol lowering medication, and like puppets on a string, we blindly trusted his advice without doing any research on it. Now that I have done a lot of research on it, he quit taking his medication this week. I’ve studied the very best way to lower it naturally, but after reading some info on your website, his may have been just fine in the first place. I’ve thrown out all processed foods and have started on a much healthier diet for him. I was mixing cottage cheese and flax seed oil together thinking this was the best omega 3 supplement I could do for him, but am now assuming it’s the krill oil? Because of his use of these drugs, do you suggest he also take the CoQ10 supplement? The last couple of weeks is the first time I’ve come across this. His doctor never mentioned supplementing with this. Thanks for all the information on your blog. Linda

  115. Hi Doc
    I am so glad that you have started to fly the flag. After going to Weight Watchers for 2 1/2 years my cholesterol sky rocketed on a low fat diet. I did lose 12 kg and have kept off most if it, I know the 4 kg that crept back have been from stress eating of lollies and sweet stuff! My doc wants me to start taking statins but I have refused to date. The three people in my life that take them have all had terrible muscle pains and muscle weakness and no doubt some of the gut problems are related. Two were on the same statin and one on another and I researched the side effects in MIMS when they all started to get the symptoms.

    So I started to eat the Jon Gabriel way – probably similar to the paleo diet but no low fat stuff, but he also is very big on reducing stress in your life. So I have to have a cholesterol test this week after going off low fat foods since August 2011. I still need to lose a bit of weight, my BMI is just over 25, but hopefully my insides will be a lot healthier.

    Even Weight Watchers this year have added in that you can have 2 teaspoons of fat for 0 points for which I commend them. I loved WW and it really got me back on track and WW isn’t really specifically a low fat diet, but unfortunately they are just going by the Australian Dietary guidelines.

    I do think the low fat dieting fad has a lot to do with our health issues today.

  116. Dr Eades,

    Just came across your website, and will be looking for your book. I have a question: in this article and subsequent comments you allude to sugar avoidance as being bad, or a pitfall for diabetics. Why is this so? I’ve come across much information stating that avoiding fructose will alleviate much of these “metabolic syndrome” symptoms. Is it more important for me to avoid carbs or sugars?

    I am in my early thirties, have high “bad” cholesterol, low “good” cholesterol, and “very high” triglycerides, mildly hypothyroid, and appx 20 lbs overweight..