Dr. David Ludwig on high-carb vs low-carb vs slow-carb diets

I came across this short talk Dr. David Ludwig gave on some of his research on the difference between high-carb, low-carb, and slow-carb diets.  The presentation is a great summary of the calories-in/calories-out way of thinking of dieting versus the alternative hypothesis, which is that carbs drive insulin, and insulin drives fat storage.  Dr. Ludwig discusses some of his own research on the many physiological changes that take place when substituting carbs that absorb more slowly for those that rapidly absorb. I learned a few things from this lecture, so I figured it was worthwhile to pass along.  It is very much worth the short time it takes to watch.  I’ve put up the show notes and my comments and summary below.

0:42 First law of thermodynamics and calories in vs calories out (CICO), i.e., the conventional understanding of obesity

2:09 The simple (conventional) solution to obesity is to eat less and move more.

3:07 If the conventional solution to obesity is correct, then the low-fat diet will be your best friend.

4:06 But fat calories decreased as the obesity epidemic exploded.

4:35 Womens Health Initiative (WHI), the largest low-fat diet study ever done, or ever likely to be done, was an absolute bust. The deck was stacked in favor of the low-fat diet in that those on the low-fat diet got a ton of intensive individual counseling and guidance during periodic meetings with nutritionists whereas the control subjects were given written materials to study.  Despite the extra attention given the subjects on the low-fat arm of the study, they didn’t do any better than those more or less left to themselves.

5:10 The Hawthorn Effect

5:35 Multiple meta-analyses show subjects on high-fat diets consistently lose weight better than those on low-fat diets. This raises the possibility that the mainstream’s “primary approach to nutrition, the low-fat diet, has caused major public health harm.”

6:28 NHANES shows that only one in six overweight people have ever lost more than 10 percent of their body weight and kept it off for over one year.

7:00 We have to ask, Why has the simple CICO system of weight loss been such an abject failure?

7:27  Answer: Body weight is controlled more by biology than will power over the long term.

8:35 Hunger is a primal biological signal that is very difficult to ignore.  If you are able to ignore it or suppress it, your body fights back in other ways.

8:57 Nice discussion of what happens during overfeeding studies.  Subjects gain weight, but lose interest in food and end up being as miserable as those on starvation diets.  When the study is over, their weight drops back down to what it was at the start.

9:42 Results from these low-calorie and force feeding studies imply a body-weight set point that we defend.  But if such a set point exists, why has it gone up year after year for the past 30-40 years?  In the US, we’re defending a body weight that is 35 pounds higher than in was in the 1970s.  Why?  What can we do about it?

10:42 Begins a nice discussion of the alternative theory of obesity.  If  you’re unsure what the alternative theory is, this is a short incisive discussion that takes just a couple of minutes.

12:10 From the perspective of the alternative theory, eat less, move more is simply a symptomatic treatment, doomed to failure in the long run.

12:30 What causes the fat gain? Insulin.  Insulin is the Miracle Grow for your fat cells, which is not the miracle you want happening in your body.

13:17 The glycemic index.  As most of you know, I’m not a big fan of the glycemic index for a lot of different reasons, but, as we shall see as Dr. Ludwig’s talk continues, the more slowly absorbing carbs act more like low-carb foods and don’t create nearly the metabolic havoc that easily digestible carbs do.

14:10 Begins description of study on obese adolescents given one of three different meals for breakfast. One meal is instant oatmeal made of whole grains prepared in Dr. Ludwig’s lab.  Steel cut oats made up the second meal.  And the third meal was a vegetable omelette.  The first two meals both contained the same amount of protein, fat and carbs and the same number of calories.  The only difference was the variation in the speed of absorption of the carbs.  The third meal had no almost no carbs, so it served as the control.

15:20 Insulin and glucose rises faster and higher after the instant oatmeal meal.  Blood sugar crashes after the instant oatmeal meal.  And the fatty acids (your real main fuel) are suppressed after the two oatmeal meals, but stay suppressed longer after the highly absorbable one, giving credence to the idea that the fat stays trapped in the fat cells.

16:33 Adrenaline (an emergency stress hormone) surged after the instant oatmeal meal.

17:10 After the breakfast meal, when all the subjects were given free access to food, those who had eaten the highly absorbable instant oatmeal ate 600kcal-700kcal more than the other subjects.

17:28 What happens in the brain when fatty acids and glucose fall while adrenaline rises?  Let’s look at another study in which subjects got one of two milkshakes, one of which was sweetened with quickly digested corn syrup while the other was made with slowly digested, uncooked corn starch.  Both shakes had the same number of calories, the same fat/protein content and the same sweetness.  From a taste standpoint, they were identical.

18:20 Saw the same surge of blood sugar, insulin, and adrenaline, followed by a crash in blood sugar as before.

18:38 Brain scans showed the same areas lighting up as do so with cocaine, heroin, alcohol, tobacco, etc. Which gives rise to the notion that certain foods may trigger a process akin to addiction.  Here is the part I found interesting and that I hadn’t really considered.  The lighting up of the brain didn’t come because of taste, because both milkshakes tasted the same.  The changes came via their biological effects.

19:32 “Palatability isn’t an inherent aspect of food.”  I had never really thought of this or about this, but it’s true.  After you’ve stuffed yourself with Thanksgiving dinner and are lying in a stupor, the stuffing that seemed so good when you ate it almost revolts you to even think about eating. Yet the stuffing is the same.  It’s your perception of it that has changed based on your own physiology. “Palatability is an internal psychological response; it’s not something internal to food.”

20:45 Interesting rodent study.  Two groups of rats went on two diets – one made of slowly digested carbs and one of quickly digested carbs –  for 16 weeks (about ten rat years).  The researchers fiddled with the caloric intake in an effort to keep the rats all weighing the same for the duration of the study. Interestingly, they had to restrict the caloric intake of the rats on the quickly digested carb diet in order to keep them at the same weight as their mates on the slowly digested carb diet.  The metabolic rate of the rats eating the quickly digested carbs had slowed to the point that their caloric intake had to be restricted to prevent their becoming obese.

21:55 At the end of the study, the rats in both groups weighed the same, but the rats on the quickly digested carb diet sported 70 percent more body fat than the others.  Remember, that’s on a lower number of calories, which can’t be explained by the CICO model of obesity.  I know these are rodents and not humans, but this should be a cautionary tale about what happens when you eat a lot of easily digestible carbs.

23:00 A human study showed similar effects.  Took 21 obese young adults and put them on a restricted diet till they lost 10-15 percent of their body weight, then put them on one of three diets:  a low-fat, low-kcal diet; a low-carb, high-fat diet; or a Mediterranean diet.

Before the first weight loss diet, they were burning 3200 kcal/day.  After they lost 10-15 percent of their body weight, when they went on the higher glycemic low-fat, low-kcal maintenance diet, their caloric intake had to be reduced by almost 400 kcal to maintain the lower weight. In contrast, when they maintained on the low-carb, high-fat diet, their calories had to be decreased a bit, but not nearly as much as those on the low-fat diet.  The Mediterranean diet was kind of in the middle.  It bears repeating: it took a reduction of 325 kcal below the caloric starting point on the low-carb, high-fat diet to maintain the lower weight.  A huge difference.

24:45 We’ve all heard countless people say that it doesn’t matter what diet you go on, as long as you cut calories, you’ll lose weight.  The composition of the diet doesn’t matter; you’ve just got to stick with it.

25:07 This notion comes from the POUNDS LOST study, which looked at 800 people (a lot for a weight loss study) studied for two years in two different academic centers.  The subjects went on one of four different diets of varying compositions.  Dietitians gave written instructions on how to carry out the diet and provided minimal counseling.  At the end, all groups lost about the same amount of weight, confirming the notion that it doesn’t really matter what kind of diet you go on.

26:23 The above is a false conclusion. The study failed to achieve anywhere near its targeted nutrient differences.

27:18 When you look at the actual bio-measurements, they all look the same, so it’s pretty clear that they were all on more or less the same diet, so you would expect the same outcome.

27:40 Compare with the Direct study done in a power plant in Israel.  Workers came to the plant, stayed all day, and the company provided lunch.  Researchers designed three lunches: low-carb, low-fat, and an in-between Mediterranean-style diet.  The workers ate whatever they wanted at home before they came to work and after.  The only meal that was controlled was lunch. The study lasted two years.

28:22 Results? Rapid, sustained weight loss in those following the low-carb diet.  Slower weight loss with the Mediterranean diet that ultimately caught up with the low-carb diet.  The low-fat diet didn’t come close to the success of the other two.  And remember, this was just by changing one meal per day.

29:05 The alternative theory says that consumption of easily digestible, highly processed carbs drives insulin up and sends the fat cells into a feeding frenzy.  The results are that not only do we become more hungry, but we are stimulating the addiction centers in the brain, making these highly processed foods even more desirable for us.  And as we’ve seen from the studies described above, this process drives food intake and lowers energy expenditure.

30:00 I’m not sure I’m buying the part about the 16 ounce steak.

30:15 Improving diet quality may be less arduous and more successful than calorie restriction over the long term.

I encourage you to watch the entire video, so you can get Dr. Ludwig’s arguments fully fleshed out and not just from my sketchy notes.  Use those to review.  If you want to read about these studies more in depth, take a look at Dr. Ludwig’s book Always Hungry? , which I reviewed here a little over a year ago.

As I said at the start, I pretty much agree with everything across the board with some minor exceptions. When you look at the study using the low-carb omelette as the control, you’ll see that subjects did better on that than on the slowly digested steel cut oats.  Why not just eat the omelette and be done with it?  If you just have to have oatmeal, go for the steel cut, of course, but I’d rather just opt for the omelette.

I found enlightening the notion that food palatability isn’t intrinsic to the food itself, but is more driven by the state of our brains and our level of satiation at any given time.  I should have figured this out for myself based on one ill-fated fishing trip I went on as a teenager.  A friend and I hiked up into the San Gabriel Mountains in Southern California to go fly fishing for trout.  We were planning on spending the night and eating what we caught.  Of course we caught nothing, but we ran into another fisherman who was pulling them in right and left.  He obviously knew what he was doing while we didn’t.

We struck up a conversation with him about his technique and hung around watching him for a while trying to learn.  He, too, was spending the night, so we all set up camp together.  He fried up a couple of the trout he caught and asked us what we had brought to eat.  We sheepishly told him we hadn’t brought anything, that we were going to eat what we caught.  He said, “Bad move, boys.”  He said he always brought something he didn’t like just in case he wasn’t successful.  Then he would at least have something to eat, but would still he motivated to fish hard.

He then tossed us a couple of cans of Spam and told us to have at it.  I’ve alway found Spam to be revolting, but I’ve got to tell you, that night I found it delicious beyond belief.  So Dr. Ludwig is correct that the palatability is definitely not intrinsic to the food.

If you would like to see a longer talk by Dr. Ludwig, he is going to be on Detroit Public Television on Monday, March 13.  The episode will be streamed live.  Here is the promo for it:

 

 

 

 

 

 

 

 

 

 

 

 

 

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71 thoughts on “Dr. David Ludwig on high-carb vs low-carb vs slow-carb diets

  1. I greatly appreciate your notes on this video as well as some others you have posted. I greatly prefer to read than watch and now I know the gist of this video which I probably would not have watched. I am familiar with your work and Ludwig’s, but always find it helpful to refresh my brain. THANKS!

  2. As always, thank you SO much for this! Both for myself and for my “tribe” with whom I will share it, this is great info, well explained!

    The “palatability” thing is still a problem for me because (my family including my nearly 50-yr-vegetarian older sister reports: even when I was a baby in a high chair), my “palate” semi-forcibly rejects vegetables. I (still) nearly (and sometimes actually) gag when trying veg! And that (apparently innate?) recoil reaction was the cause of many, many unhappy hours of “sit there till you finish your dinner” stuck at the table. (Never could get the damned dog to eat the stupid veg under the table!)

    Sometimes I think: well there ARE the ‘no-carb’ and ‘no-plant’ versions of low carb, but when you cut out wheat and other ‘seeds,’ it leaves a pretty spare diet! I’m 61 (and way overweight). I learned to eat green pepper (mainly pureed as a seasoning) at age 30; iceberg lettuce (a little) at age 45 (only with 1000-island, and not with other ‘salad’ participants); and weirdly, sauteed parsnips at 58.

    Any advice? (I’m hyped on the new book by Dr Jason Fung (a nephrologist, who has amazing success “curing” Type II diabetes and its companion illnesses) and dear-0ld Jimmie Moore — about to embark on weekly 2-day fasts, heading toward longer ones…

    • You are probably what is referred to as a Super Taster. I’m assuming you don’t mind the taste of meat. If not, eat that. People live to old ages eating basically nothing but meat.

  3. Hi Dr MIke – I’m not overweight, in fact I’m underweight, so a lot of this study kind of went over my head, though I know when my DH eats carbs, as in cake or crossants, he always put on weight and wonders why. I don’t wonder why ! The bit about palatability not being so important rang very true. Once I was so hungry I took some food out of my bin and it still tasted good ! Almost anything tastes good when you are really hungry. It’s the same with animals, they’ll eat quite dirty food when they’re really hungry !

  4. Hi Dr Eades,

    Would love your insight about my experimental observation. If you have not tested this before you might find it quite interesting.

    I have noticed that carbs would have a lot worse effect if eaten with saturated fat as compared to eaten on their own in terms of keeping insulin high. Even 30-40g of carbs (slow or whatever), if consumed with saturated fat (butter) can be problematic. Dietary fat causes insulin resistance in the liver temporarily which really screws up glucose disposal which means insulin would stay up for longer. However, if carbs eaten fat free they get cleared quickly (in no -diabetics) and insulin doesn’t stay up for as long as in the presence of fat. If you check your glucose levels after fat free carbs and carbs+fats there will be a considerable difference in glucose levels at 1hr 2hr and 3hr mark.

    I am not anti fat, however, I’m anti insulin. To keep insulin low it has be either fat on its own with some protein and maybe some greens or slow carbs with very little fat. Combine carbs and saturated fat and it becomes lethal. It is also worrisome that with growing popularity of the idea that saturated fat is not bad, many/most of people will add saturated fats without dropping carbs.

    • You ask a question that can’t be answered simply. You are correct in your observation, but it’s not necessarily a bad thing. I need to write an entire post about this phenomenon some time, but it’s called physiological insulin resistance.

    • Certainly the basis for “the potato hack.” Absolutely no fat allowed.

      Potatoes, sweet potatoes, no butter? Perish the thought. Sigh.

      • “but it’s called physiological insulin resistance”

        With all respect, Mike, I think what NY is referring to is an acute metabolic effect that is a bit double-edged sword. In other words, the BG spike blunting of piling butter and sour cream on your baked potato comes at the cost of the slower gastric emptying needing 3-4 times more total volume of insulin secretion and twice the time over normal levels.

        PIR is a chronic condition from VLC that seems to resolve in days with the introduction of carbs even up to only moderate levels. In my experience, about 60-80g per day (good sources), normal morning BG. Under 30, and for both wife and I, we can easily be at 120 in the morning.

        • That’s interesting. Are you sure it does not relate to still having a fatty liver? Dr. Fung (an advocate of intermittent fasting for type 2 diabetics) implies high morning glucose is a function of fatty liver, and reducing fatty liver (via IF) will correct this.

          For me, I can get high morning glucose levels (where “high” = > 100 mg/dL), even if I eat a very low carb set of meals and I’m in ketosis. I will also get high blood glucose with higher carb, so perhaps I have different issues than you do. Also, I have not had many days of “higher” carb in a row, as I’m attempting to be in ketosis for a while, so I can’t verify what would happen if I was eating higher carb. I do know the last time I went on vacation where I ate higher carb, I had blood sugar levels over 100 every morning for the entire vacation.

  5. I think a lot of sensible diet philosophy is common knowledge that was lost with the official pushing of carbs in the infamous Food Pyraid. When I was growing up, everyone knew that if you wanted to lose weight, the first thing you did was give up desserts and other starches. Everyone knew that when you ate a lot of rice at a Chinese restaurant, you felt stuffed but a half hour later you were ravenous. Everyone knew that if you were going to be on the go, or if you had an exam at school, you needed a “stick to your ribs” breakfast, meaning bacon and eggs or steel-cut oatmeal instead of cold cereal or toast and jam.

    Supper was meat, potatoes, vegetables, and maybe a piece of bread and butter. We drank whole milk; sodas were a rare treat. If we were hungry between meals, we were offered a piece of fruit, otherwise no snacks allowed, not that we didn’t sometimes sneak candy bars.

    Maybe people should ask their grandparents what they ate growing up and try to mimic that diet.

    • Since I’ve become a grandparent myself, I always agree that grandparents are the true fonts of wisdom. 🙂

    • Thanks Dr Eades. I am quite familiar with physiological IR and Peter at Hyperlipid has done a great series on it. However, presence of dietary fat impairs glucose disposal (at least in my experience) independent of whether one is physiologically insulin resistant (due to carb restriction) or not, suggesting carbs and fat, especially saturated, do not go well together and might lead to higher insulin levels overall.

      • Yes, Peter at Hyperlipid has written a great series on it. Different tissues become insulin resistant at different rates. I would much rather be insulin resistant at the level of the adipocytes, which I think is what happens with the combo of saturated fat and carbs, than remain insulin sensitive and have all the glucose and fat go into my fat cells.

  6. Hi Dr. Eades,

    I have a few comments after reading this rather quickly.

    First, in the entry for 17:28, you note that one of the milkshakes “was sweetened with fast-digesting corn syrup while the other was made with slowly-digesting uncooked corn starch”. Corn starch is not a sweetener, so what WAS that second milkshake sweetened with? (Also, from a broader perspective, does that mean corn starch is not such a bad thickener for low-carbers?)

    Second, you should probably edit the first “sentence” in the third paragraph from the end because it is not really a sentence as it is (or so I think after several readings).

    In general, this is certainly food for thought. I have been wondering about the glycemic-index approach vs. the low-carb approach to dieting and lifestyle. I also have thought about a Mediterranean diet that omits high-carb foods.

  7. I used low carb to lose and maintain weight for most of my 30s and 40s, it is definitely the only way i can lose weight, though now in my 50s I have to count calories too…so, yeah, I’m over 200 lbs now, at 5’7 with a truly large German female peasant frame. I’m type II diabetic as well, but my A1C is still 5.6. My comment was that I do tolerate beans, brown and wild rice and potatoes pretty well, at least as far as staying in ketosis goes. Also popcorn! It takes a lot of energy to always have the right food in front of you, and choose to eat that, and not something that is ok, but not the best…or what everyone else is eating! Who can keep up that struggle? Gotta have some good carbs in there!

  8. This kind of video with your commentary is outstanding and so helpful! Thank you so much!

    One question: Does your comment that you “aren’t buying the part about the 16 ounce steak” mean you think it’s okay/good to eat LOTS of meat and protein? I ask because so many low carb doctors and supporters now seem to be recommending that protein restriction is best (Rosedale, Phinney, Gurganous, etc.).

    By the way, I recently started your 6 Week Cure (since my clothes were getting a bit tight) and wondered if you still think it’s okay to flavor the protein shakes with Splenda sweetened syrups by Torini? If not, can you offer alternatives?

    Also is there a brand of protein powder you particularly like?

    Thank you so much for your wise, interesting, and articulate blogs.

    Carole

    • Thanks for the kind words. I’m not convinced that protein drives gluconeogenesis unless one is really short of sugar. On a low-carb diet, protein can drive gluconeogenesis and increase the liver’s output of sugar, but on a low-carb diet, you need a little extra glucose.

      I think the flavored shakes by Torini are still okay. I don’t like artificial sweeteners, but compared to sugar, they’re great. If they make the shakes more palatable, go for it.

      I don’t ever chose protein powders. MD chooses all of ours, so I go with the flow. She loves MRM All Natural Whey protein. That’s her favorite, so when I get protein powder, that’s what I get. A lot of people love Isopure Zero Carb, but she prefers MRM.

  9. Hi Dr Mike,

    I’m hoping you can say a little about the effects of insulin that might not be related to the amount of carbohydrates. (Maybe a reference to his 16 oz steak comment…)

    How does insulin react to the quantity of non-carbohydrate food one eats? If the meal is large enough, does that prompt a similar insulin supply to a higher carb intake?

    While no one probably needs to eat a 16 oz steak, it would be helpful to know the limits of moderation when enjoying that kind of a meal.

    • Didn’t realize my offhand commentary about the 16 oz steak was going to be such a topic of conversation. I don’t think protein drives glucose production unless glucose is needed. If you’ve got plenty of glucose circulating around, there is no need for protein to jump in and convert to glucose. However, if your glucose is limited, because, say, you’re on a low-carb diet, then a little protein to glucose conversion is a nice thing.

  10. Hi Dr. , I love the way you take criticism constructively! You got right in there and fixed that sentence .I’ve been on low carb for two-plus years.I also cut out all artificial sweeteners hoping to help with all over body pain and hunger. I lost 50 lbs then maintained for a long time. I’ve gained 15lbs and still eat the same except for a few things.The diet that has work for so long is not working as well anymore.I eat meat,fat,eggs,high fat dairy in moderation,nuts in moderation,but not peanuts low carb vegetables,and that’s all.I read about omega 3-6-9 after I had already started taking a supplement.I have since stopped taking it.I was wondering if to much omega 3 could stop my weight loss or maintaining my weight?I thought the oils/fat I use or eat could be better choices . I then cut out cashews since they are omega-3. I also started drinking one or two diet soda/with no carb each day in which I had stop drinking for over four years.My body pain came back ! I have stopped drinking them again because of the weight gain ,hunger ,and pain have cropped up.The last thing I’ve done differently is I started using half and half in my coffee which I had also learned to drink black over the last few years.I no longer do that either because of the weight gain I’m currently having ( but I sure do like it ). I’m a fifty four year old female.I’m a sugar addict from childhood but since I don’t eat it anymore I don’t even miss it. I did notice when I added artificial sweeteners that are in the soda to my diet I became hungry for the first time in two years especially at night.The reason low carb has worked for me this long is because I’m not hungry.I eat when I want to and as much as I want but never after 5pm.I have dieted since I was ten years old ,always starved ,and always failed.Any suggestions to get my weight going down again instead of up without being hungry ? Is there a secret boost to long time low carb dieting that you can share? Thank you ? Donna

  11. The doctor made mention of changed metabolisms. Count me in on that! I am age 70, 6’1″ now (and shrinking!), currently hovering at 230 pounds. I was a bean pole as a kid, 135# at almost 6’3″. When on the swim team, I was eating 5,000 kcals/day, I’m sure. I was 280 in 2009, got back to 210 in 2010, up and down since then. I lost the big weight with The Primal Blueprint and Protein Power as guidance. To lose weight I must obsessively measure, weigh, record everything, as accurately and honestly as possible.

    Here’s the metabolic thing: Depending on resource, I should have a BMR of somewhere aroud 1800-1900 kcals/day. Laying in bed, staring at the ceiling. Add movement, daily living stuff, theoretically then needing about 2200 kcals/day for maintenance. The reality is I can’t go over 1500 a day or I will gain weight. I have plenty of energy, warm hands and feet, and sleep well.

    This is not some margin of error, misreporting phenomena. We are talking 50%! A good friend of slightly smaller stature has to stick to 1200 kcals/day to lose any weight.

    I don’t recall you writing about the following, forgive me if you have. When I read of this study of Big Losers who kept the weight off last year, my jaw dropped. They, too, had to eat some 600-800 calories a day less than theoretical. And were always hungry. Just like me.

    https://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html

    This certainly blows CICO out of the water.

    Thoughts?

    Oh, yeah, count me as one who appreciates your written summaries very much. Faster, for sure. An outcome of being literate, I guess.

    • Have you tried eating more calories as very low-carb calories to see what happens? If so, what happens? Do you gain on 2200 kcal of meat, for example?

      • Thanks for taking the time to respond.

        It is true that for my first major weight loss, I was, for the most part no more than 50 grams/day carbs, and most of that was veggies or tag along with liver or yogurt types.

        I recall trying “zero carb” a time or two and I gained weight. Meat alone just wasn’t satisfying unless I ate too much. Having said that, that was heavy on pork, beef, and turkey breasts. Even finding lean cuts, too much fat.

        I have no issue with fats, love ’em, know they are essential. But I have to keep them minimized to keep the calorie count down so that I can remain under my apparent low set point.

  12. SPAM * SPAM * SPAM !!!

    Take a look at the label on a can of S P A M:
    Ingredients: Pork with Ham, Salt, Water, Modified Potato Starch, Sugar, Sodium Nitrite.
    Nutrition Facts: Serving Size: 2 oz (56g); Servings: 6
    Calories: 180 ; Total Fat: 16g (24.62); Saturated Fat: 6g (30); Cholesterol: 40mg (13.33); Sodium: 790mg (32.92); Total Carbohydrates: 1g (0.33); Dietary Fiber: 0g ; Sugars: 0g ; Protein: 7g ;

    There’s 2g of Fat for every gram of protein – about 60% Fat, 30% Protein and 10% Aluminum Can and Plastic. Except for the aluminum and plastic, it seems to be a good fat to protein balance; one our hunter ancestors would like. If only it was made of beef instead of porky ham.

    Some store brand versions, like Walmart, omit the potato starch.

    • I don’t have anything against Spam nutritionally. In fact, it’s perfect for a low-carb diet. I haven’t had it in decades, so I don’t know how I would take to it now, but as a kid, I found it almost uneatable. Until I had hiked into the mountains and had no food – then it was damn good.

  13. A web search using “David Ludwig Endocannabinoid System” yielded Seven results, none of wich connected Ludwig to endocannabinoid system research. A web search using “endocannabinoid system appetite” produced 39,900 results. For example, an article published in 2015 says, “The EC are biosynthesized from two distinct families of dietary PUFA, namely the n-6 and n-3. Based on their biochemistry, these PUFA are well known to exert considerable physiological and health-promoting actions. However, little is known about how these different families of PUFA compete as precursor ligands of cannabinoid receptors to stimulate appetite or perhaps down-regulate the ECS to amend food intake and prevent or control obesity.” http://themedicalbiochemistrypage.org/endocannabinoids.php

    Another article says, “The ECS adjusts behavior and metabolism to food availability. Its activity is advantageous when access to food is limited or cannot be predicted, but becomes harmful when food is abundant, favoring the development of obesity and metabolic disease.” http://www.cell.com/trends/endocrinology-metabolism/fulltext/S1043-2760(15)00140-X

    You’d think that a biological system that regulates both energy expenditure and appetite would garner more attention from experts studying obesity.

  14. Food palatability notion probably explains the “pork chop vs. cake” situation: after eating, say, 3 pork chops, you’ll get nauseous of mere thought of eating the 4th one, but a piece of cake always finds the room. Our hormones protect us from over-eating the food they “understand,” but provide no protection against artificial creation for which our body has no reference. Does this sound plausible?

    P.S. CICO adepts should be offered to fulfill their daily caloric needs by 8 cans of Coke. Since a calorie is a calorie, they can satisfy their energy needs on the cheap, with all the convenience of opening the can. Then let’s ask them again in a year how it works out…

  15. You are bang on! Low fat and calorie restricted screws body big time!
    Please bring down Jenny Craig!
    It is killing, deceiving, and manipulating the innocent people!
    I am a firm believer of high, good fat, 75% of vegetables and proper protein for best fuel burning and consumption in order to have the best effect for optimal health and weight loss!
    I am down myself now, 56lbs so far from mid September. .now at March 11th. I have a history of constant diets that were brutal of the constant deprivation of calories and food and awsy non-fa!!! Terrible!!!
    This is the first time in my life I can honestly say I have finally figured it out! I am 40 years old and have even worked on the weight loss industry! Weight watchers and Jenny Craig, should be shut down and shamed on to how many people have lost, gain, lost, gained over and over just to grab poles money and rob them of the truth to get healthy!
    I love that I have unleashed the proper lifestyle change and further losing weight to get to where I néd to be!
    Thanks to knowledge I can eat an avacado everyday!!!!

    • I’m assuming you’re on a low-carb diet, but whatever diet you’re on, congratulations! That kind of weight loss requires a good amount of diligence. Keep me posted on how you’re doing.

  16. A very good blog which gives food for thought (lo carb). It coincides with an experience I had yesterday, I am on vacation in Singapore. Afternoon tea was a delight and I ate my first piece of cake in 7 months, then another and another. There definitely is an addictive component that overcame reason, once piece I can justify but the rest by a person that has lost 27kg and reversed diabetes in 7 months is irrational.
    The other part is CICO. It makes sense, so are we measuring correctly? CO must include waste and waste is used as food and nutrients for plants and animals, so must have calories. Carbs appear to be fast acting products of photosynthesis, which is energy conversion. Energy foods are the first, processed in the duodenum and excess stored in liver and adipose fat for later use, it makes sense. Protein next in the Jejunum which can be slowly used for energy or mainly build muscles, but why store excess? Perhaps excess is passed to waste. I know my urine changes colour from vitamin excess. The same for fat, get the nutrients out and convert to energy if needed but otherwise send to waste. I know that peanut calorie input is countered by waste as I see them in my stools, ok it’s a digestive issue but still reflects CICO needing to account for waste. Initial perceptions and I must think about this more.

    • When Wilber Atwater did his calculations in the late 1800s to come up with the calorie as we know it today – called, appropriately enough, the Atwater System – he accounted for waste from feces, urine, gases and other secretions. So the stuff you notice has already been figured into the caloric equation.

      • Wow, that really does open up a can of worms looking at Wiki!

        ” As with the calculation of protein from total nitrogen, the Atwater system is convention and its limitations can be seen in its derivation.”

        Maybe, over a century later, it needs a rethink?

  17. I once read a suggestion that for an emergency food supply when backpacking take along some packaged dog or cat food. You’re not going to eat that unless you really need it!

  18. I have been LCHF for a long time but only recently noticed that I now have an aversion to HC foods. Those sweet things don’t taste so good anymore, so I am an example of what David Ludwig mentions. I have always liked orange marmalade and make my own with much reduced sugar content and half the ‘sugar’ being dextrose to keep fructose and sweetness low. When I bought marmalade at a free-trade fair I found it inedible even though I have only a teaspoon of it anyway.

  19. Dr. Eades

    I’m surprised a bit the palatability thing hadn’t occured to you earlier. It seems to me that the old saying about things being an “acquired taste” speaks directly at learned palatability. We eat foods; our brains make the connection between taste and effects-on-the-brain and on we go.

    This explains:

    – coffee tastes terrible to anyone who hasn’t had it before — and it usually takes at least few times for our brains to learn the connection (same is true for any/every caffeinated beverage)
    – alcohol — same thing — see the taste of your first beer for proof
    – and on and on

    It also explains why simply thinking about food can spawn a physiological reaction. And it speaks to how foods that always taste the same amd have lots of easily digestible calories (see: any and every junk food) are likely to become highly addictive addictive because the link between taste and nutrients. And that’s all the more true if the energy within the food spikes hormones (like insulin).

    It’s all learned behavior. Todd Becker has written some thoughtful stuff about this — and how to decondition responses to food palatability. This is one related post:

    http://gettingstronger.org/2011/09/does-tasty-food-make-us-fat/

    Speaking anecdotally, while I still love lots of junk food I no longer eat, I have much, much more control over reactions I have to being around that kind of food today — after years of not regularly indulging myself — than I did before. I figure that’s a result of deconditioning.

    Generally speaking, I figure we’re always training some behavior (I think I picked that idea up from Becker, too). If we are doing [something] we are training ourselves to do it over and over again. It’s looking at everything we do as “practice.” So if we are practicing eating the types of food that are going to make us fat, we’re going to reinforce the brain-food connection every time we indulge. Breaking that connection takes practice.

    Anyway, some additional “food for thought.”

  20. I am following your 6 Week Cure diet and having great success–Thank you! I have a question for Mary Dan if you would pass it along. In her blog from November 26, 2008, the recipe for Creamy Cauliflower Puree calls for ONE FULL ROUND of Boursin Cheese with Herbs and Garlic per 1 large head cauliflower. However, the recipe in the book specifies only ONE HALF Boursin round. Otherwise the recipes are identical. Which one is correct? (Frankly, I’d much rather add a whole Boursin round! LOL). Thanks again for your incredibly informative and helpful blogs.

    • Just checked with her, and she says, Do whatever you like. She, herself, uses a half round, but our daughter-in-law uses a full round. The difference doesn’t add a lot of carbs, but does add some extra calories. So, if you’re losing nicely on a full round, I would say, keep it there. If you’ve leveled off, maybe good to drop to a half. How’s that for decisiveness?

  21. I agree on some points but less on others. I gave up the macronutrients debate to focus on food. Real food vs fake food. I agree with Ian Spreadbury about carb acellularity that drives leptin and insulin resistance mediated by the microbiota. Furthermore, gluten, lectins and ATIs contribute to leaky gut and dysbiosis that trigger low level inflammation hence insulin resistance.
    Insulin resistance is more about inflammation than true natural carbs.

  22. I’m old fashioned, I prefer reading to watching videos.

    But since I’m currently reading/rereading David Ludwig’s twitter feed thanks for the heads up, I’ll find time to watch this one.

    He impresses me not just for the quality of his work, and that which he tweets (and his patient arguments on Medium) but because he works at Harvard and is NOT under Willett’s thumb, unlike some hu we could mention.

    • Now, now… Having been on the speaker side of the equation many times, I can tell you all control over the filming falls to someone else. You end up with what the AV teams wants you to end up with. Sometimes it’s a budget issue, some times it’s another issue. But you can’t blame the speaker. He/she just shows up and speaks.

  23. I hate to keep bothering you about the 6 Week Diet Cure that I’m doing, but I was wondering if I had to have 2-3 Shakes a day. I find them SO filling that I only want one a day. I’m never hungry in the morning, and so I don’t want to eat until about noon. I use a little less than two scoops of Jay Robb Whey protein powder as suggested for my weight, (which means each shake has 45 grams of protein) but the shakes are incredibly filling. I work out doing a Slow Burn Fitness routine and HIIT about 5 times a week. Can I safely have just the one shake plus the suggested dinner and still be within the guidelines for the amount of protein that’s needed? (I generally eat 6-8 ounces of protein at dinner depending upon the type of meat/fish/chicken.) I love how I feel and I’ve already lost 1 1/2 inches from my waist in 10 days. But I don’t want to do anything that is harmful. Thanks so much for your patience with my questions.

    • Given the amount of protein you’re eating, the one shake per day along with the meal should be fine. The 45 gm in the shake plus the 49 or so gm in your meat meal are providing plenty of protein.

  24. Dr. Eades, first time commenter… Abut a year ago you posted a blog entry in which you hypothesized that the real culprit behind obesity is not sugar and carbs, but the processed PUFA vegetable oils: soybean, safflower, sunflower, cottonseed, corn, etc. Do you have any new insight or updates on that concept? Of course we shouldn’t be eating tons of sugar either, since PaleoDudes certainly didn’t; they were lucky to find a behive or a crabapple tree. But if you’re correct that it’s the seed oils messing up out metabolisms, then the difference between low-carb or slow-carb may not be as important in context. Thank you for being a pioneer in the field.

    • I do think vegetable and seed oils high in omega-6 fats are problematic and help drive the issues caused by excess carb consumption. And I agree re the low-carb vs slow-carb. But a lot of years of experience taught me that in terms of rapid weight loss, low-carbs > slow-carbs.

  25. About the brain scans at 18:38: Dr. David Kessler saw a similar effect in his book “The End of Overeating.” Wheat and sugar fired up the dopamine receptors. Dr. William Davis of “Wheatbelly” basically declares that wheat is a mild addictive drug. I don’t know that I’d go as far as Dr. Davis, but I have observed this: suggest to a smoker that maybe he should cut down on the cigs, and he’ll bite your head off. Suggest to an obese person that maybe he should cut down on the donuts… and he’ll bite your head off, often with the same words and same tone of voice. Similar addiction behavior?

  26. The Calories in – Calories out dogma is flawed for one simple reason. The first law of thermodynamics should be applied as the 1st law of an open system, where there is also matter in – matter out. So the full equation in a simplistic way is:

    mass in = calories out + mass out