Detail from Pieter Bruegel's The Triumph of Death
Detail from Pieter Bruegel's The Triumph of Death

The Dark Ages were an inglorious period of human history bounded on the one side by the Classical Age and by the Renaissance on the other.   These grim times began when a classical empire was savaged by barbarians plunging the world into a long era of darkness ruled by ignorance, superstition and fear, and ended finally by the intellectual stirrings of the Italian Renaissance.
I believe that the latest dietary study published in the New England Journal of Medicine is an early indicator that our own era of dietary darkness may be coming to an end.
Loud have been the cries of all the low-carb bloggers, dieters, and practitioners about this paper, which purports to show that macronutrient consumption doesn’t really matter.  Low-carb, high-protein, low-fat, high-carb, it makes no difference, say the authors, it’s just the calories that count, not the composition of those calories.   As expected, all the major media picked up on the story.
Opined Jennifer Levitz of the Wall Street Journal:

You aren’t what you eat. You’re how much.
That’s the message from a two-year National Institutes of Health-funded study that assigned 811 overweight people to one of four reduced-calorie diets and found that all trimmed pounds just the same. It didn’t matter what foods participants ate, but rather how many calories they consumed.

Tara Parker-Pope of the New York Times writes:

For people who are trying to lose weight, it does not matter if they are counting carbohydrates, protein or fat. All that matters is that they are counting something.

The study has been written about and dissected by so many others that I don’t see any need to go into it in any detail myself.   Everyone with good sense who has read it understands what the deal is.  The researchers, old-school low-fatters one and all, constructed the study in such a way as to ensure the outcome they wanted, which was that all that really counted was the total caloric intake.  They did this by making sure that the diet with the lowest carb content – over 150 g per day – couldn’t possibly be called a low-carb diet by anyone who really understands what a low-carb diet is.   But the authors did call it a low-carb diet and the media perpetuated the myth.
There are a couple of ways this old fudgaroo can be brought off.
First, the way this New England Journal study did it.  If diets of similar but slightly different macronutrients are compared, the likely outcome is that calories, not macronutrient composition, is what correlates with weight loss.  In terms of carbohydrate, it’s only if intake drops significantly that a difference is seen, based on macronutrient composition.  None of the diets tested in this study qualified as a real low-carb diet.
There is a second way the effects of macronutrient composition can be minimized, leading the unwary or the unintelligent (or those who have an agenda) to misunderstand.  If you keep subjects on very-low-calorie diets, you find that the weight lost is virtually all a function of the caloric intake.  Why? Because if subjects don’t get enough calories to meet even the most basic caloric needs, all calories go to keep the body alive.  The hormonal influences of these calories don’t matter.  So, if you want to have weight loss be strictly a function of how many calories are consumed, put subjects in metabolic units to they can be observed closely, keep them on 500 calories per day of any mixture you want, and watch the weight come off about the same no matter what the macronutrient composition.    This is the trap that Anthony Colpo fell into when he decided that macronutrient composition didn’t matter and wrote a book listing a bunch of metabolic studies proving his point.   Virtually all of the studies fell into this extremely-low-calorie category, and would be expected to show weight loss strictly as a function of calories and not macronutrient composition.  But, as we all know, this idea doesn’t hold up in the real world of more normal calorie consumption.  (I suspect that Anthony has even figured this out by now since he’s pretty much vanished from the face of the earth.)
These researchers – Stark, Bray, et al – from the low-fat, it’s-only-calories-that-count school set up a low-carb straw man, then knocked it down with this study.  And a lot of people got the message.  In fact, while we were in Seattle over the past few days, I heard no fewer than three people mention that a new study had shown that only calories really counted.  So how can I write that this is the last gasp of the dark ages of nutrition?
Easy.    Think about where we’ve been and what has happened.
Petrarch (1304-1374), the Italian genius and man of letters, who started the process of dragging the world from the recesses of the Dark Ages wrote:

Each famous author of antiquity whom I recover places a new offence and another cause of dishonour to the charge of earlier generations, who, not satisfied with their own disgraceful barrenness, permitted the fruit of other minds, and the writings that their ancestors had produced by toil and application, to perish through insufferable neglect. Although they had nothing of their own to hand down to those who were to come after, they robbed posterity of its ancestral heritage.

Now, consider the history of the low-carb movement.    Gary Taubes laid it all out in Good Calories, Bad Calories.  Up until the late 1950s/early 1960s scientists the world over were homing in on the fact that excessive carbohydrate intake makes people fat.  There were international conferences, symposia and numerous papers published tying carbohydrate intake to fat accumulation.   The metabolic pathways involved were worked out in detail.   Physicians were prescribing reduced carb diet to their patients for weight loss.  It was the classical age of low-carb. Then the barbarians struck.
Ancel Keys published his Seven Countries study and began to demonize fat. The nutritional dark ages began.  For the past forty years we’ve languished in this wilderness of idiocy.  Just as there were a handful of great works of art produced during the Dark Ages, there have been a few prophets crying out during this time of low-fat, high-carb error, but the mainstream has ignored them or ridiculed them and forged ahead advocating whole grains and complex carbs while besmirching fat, especially saturated fat. During these times, obesity, diabetes, GERD and other disorders of excess carb intake have skyrocketed to epidemic proportions, a fact the main stream appears oblivious to. More carbs and less fat – that’s how you solve the problem, we’re told.  And the people get fatter and more diabetic. These mainstream pushers of carbs have forgotten the “writings that their ancestors had produced by toil and application” and have allowed it “to perish through insufferable neglect.”
“Although they had nothing of their own to hand down to posterity,” they instead filled the medical and scientific journals of their time with insipid studies designed to prove their own ill-derived hypotheses.  These are studies that will be laughed at in generations to come.
But it has all been changing.  Think about it.  When I first went out on the stump in 1989 promoting a low-carb diet, I was attacked almost everywhere I went.  Robert Atkins was, too, when he went out 15 years earlier.  We both described our clinical experiences with low-carb diets and were met with derision. “All anecdotal,” they said. “Where are the studies?  Show us the studies.”  We couldn’t really show them the studies because recent studies hadn’t been done. I countered by asking, “Where are the studies showing low-fat diets prevent anything?”  But that question was usually shrugged off with a condescending smirk.
Look at the progression over just the past five years.  Thanks to a ton of research comparing low-fat diets to low-carb diets, the mainstream thinking has first gone from the low-fat, high-carb diet is the best for weight loss, lipids, reducing cardiovascular risk, and good health in general to Okay, maybe the low-carb diet does bring about more weight loss, but at the price of clogging your arteries.   Then to Well, the low-carb diet may bring about quicker weight loss and at least an equal reduction in cardiac risk as low-fat diets do in the short term, but where are the studies showing safety over the long term?  (One could of course counter with Where are the studies showing the low-fat diet is safe over the long run?  And one often does.)  As the long term data has started to trickle in showing no problems with low-carb diets for the long haul, the mainstream has been left with pretty much no place to hide.  So, now, as a last ditch effort, they are resorting to the calorie defense.  It’s all calories.  It has nothing to do with macronutrient composition.
If you think about it, this is a pretty amazing admission for them.  Could you imagine any one of these clowns making such a statement during the height of the low-fat frenzy? They are basically saying, Low-fat, low-carb, high-protein, high-fat: it doesn’t really matter.  They all work. It’s simply a function of calories. This is a huge admission for them.  It’s the last step before actually admitting that the low-carb diet is superior across the board.
And this admission will come.  But probably not for a few more years because it won’t come from any of these guys.  This is as close as it gets.  But these are the guys who were training when Keys and his idiocy held sway. That’s what they learned and that’s what they built their careers on.  But they are old and ready to move on.  When they do, the younger people with a different outlook will come to the fore.
As the great physicist Max Planck said

A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it.

The old generation is waning and this study is one of its last gasps.   Granted, they had to fiddle with the experimental design yet again to get the results that they wanted, but this study puts low-carb on par with any other diet, including the low-fat diet beloved by them all.  No longer can they cast aspersions on the low-carb diet.
I think a nutritional renaissance is on the way.


  1. Dark ages were horrific times for humanity. Most of Europe’s beautiful women were burnt because they were considered witches! Great post!
    Have you seen this? It moved me a lot!
    Many of America’s most beautiful women were made obese by the nutritional dark ages. Hadn’t seen the film. Very nice. I’ll show it to my kids the next time they get annoyed with me.

  2. I have seen the best and worst of humanity already. I lived 90 miles away from Chernobil explosion when it happened. My town was ordered to evacuate all women and children within 48 hours. I have seen gronw men push pregnant women of the trains to save their lives. I was only 14 when it happened and could never forget it. I have also witnessed September 11 th and how united people were. I almost lost my siter that day. It was tragic, yet the whole country was one kind, gentle and humane family. It has been only 8 years and where are we now? United? Kind? Humane? To some point, but so much more work needed. And as far as many American women made obese by nutritional dark ages cant argue with you there, but so were American men! But I still wonder how come Russian people are not as fat as American. Russian food is all meat and potatoes, bread and butter, fries and lots of smoked meat all watered down by vodka. And Russians love to party too. I just celebrated my best friend’s 37 Bday. We, a group of 20 people had a two day party. Between 20 people there was so much food and vodka it was almost illegal. And yet I was the only fatso there. All my friends, icluding my gfriend are skinny and attractive. What happened to me?;jsessionid=aJAZ-xpqURO6?st.cmd=userMain&tkn=779

  3. I was writing a comment and it was swallowed up and disappeared! Oh well, I can rewrite it. I agree with you that many American women were made obese by dark nutritional ages but so were American men. But how can you explain Russian men and women who eat and drink so much it should be illegal! Russian cousine is mostly meat and potato, bread and butter, washed by a bottle of vodka. I just had my best friend’s 37 th Bday party. We, a party of 20 people ate and drank for two days! kid you not, I am afraid what will happen when he turns 40! And yet I am the only fatso amongst them . All of women, iincluding my gfriend are mad skinny! And my gfriend eats more than a baby elephant! Go figure!

  4. Dr E,
    How I hope you are right! But, pardon me for pointing this out, it was still a very long journey from Dante, through Brunelleschi, Regiomontanus, Copernicus, Michelangelo and Leonardo till Galileo (in science) and Monteverdi (in music), by which time we are firmly in the Baroque. Dante died in 1321, and both Galileo observed Jupiter’s moons and Monteverdi wrote his Vespers in 1610. Even Brunelleschi built his dome in 1446-1460. In other words, getting out the Dark Ages took an inordinate amount of time. The Dark Ages themselves went on and on, from the fall of the Roman Empire (c. 440 AD) till Dante )at least!). The Nutritional dark ages have so far gone on for, what, 30 years.
    Would Gary Taubes equate with Regiomontanus (the mathematical genius who corrected the ephemeris tables, thus making circumnavigation of the planet possible)? If so, and the analogy holds, we are only halfway there! Hope not!
    Michael Richards
    The nutritional dark ages are approaching 50 years. And I agree with you that people didn’t just wake up one day and the Dark Ages were over – it took a while. I figure it will take a while here, too. But I think we’re seeing the light at the end of the tunnel.

  5. Dr. Eades,
    PLEASE don’t ever stop writing 😉
    Vadim, thank you for sharing that wonderful video!

  6. Dr. Mike, thanks for yet another great post. I just hope you’re right. I’ve gotten so tired of trying to justify the way I eat when it’s those people who live on Lean Cuisine and Weight Watchers frozen meals who should be justifying THEIR way of eating. I don’t even bother trying to explain it to them anymore.
    A frend at work is on WW and has lost 11 pounds in about 4 weeks. That’s great. She says it’s the only plan that works for her, because she can eat anything she wants (as long as it’s in a package with the WW logo!). I don’t say anything, but just because you CAN do something doesn’t mean you SHOULD do it or that it’s GOOD for you. I also won’t say anything when she gets tired of the frozen dinners and gains back all the weight.
    No plan is easy. I think I’m starting to really internalize that. Any plan takes dedication and a little sacrifice.
    And, not to bring up that old subject again so soon, but it IS harder the Nth time you begin again. The first time I was on LC, I went into ketosis after about 3 days and my appetite dropped off completely. The pounds melted away. I dropped a size every month for four months, going from a very tight size 16 (probably more like a comfortable 18) to very slim size 10 (even the 8s were beginning to fit).
    I’ve been “clean” for about 3 weeks now (less than 20 ECC per day and no alcohol), and I still haven’t gotten to the point of my appetite lessening. It’s definitely a struggle.
    Hang in there.

  7. i am in total agreement with you on nutritional matters. in fact, it is not a matter of agreeing with you it is a simple matter of provable scientific fact that you are right. however, on historical matters you have also bought into the myth of the “dark ages”. The middle ages was a time of intense scientific and philosaphical innovation. Space and time does not allow me to cite examples or prove the point. i would like to simply indicate that the situation is not unlike that which obtains in nutritionsl circles. Namely that a lie has been perpetuated because many people and institutions who are supposed to be our guiding lights prefer to go along with the status quo. the situation is even more similar in that nowadays the historical establishment is finally accepting the contribution of the middle ages to the progress of mankind.
    Thanks for this blog. i look foreward to it and it makes my day a little better.

  8. We need someone to do that kind of big study using a truly low-carb diet (hint…hint).
    Just get me the funding (hint…hint).

  9. Speaking as a former medieval/early modern historian, I’ll just complain mildly that the Dark Ages get a truly bad rap (and witch-burnings were a product of the Reformation, well past the traditional “Dark Ages” cutoff), as there was plenty of art, intellectual activity, and political development going on (to say nothing of commerce).
    Anyway, given that the metaphor holds fast despite academic understanding to the contrary, I think it winds up being an appropriate descriptor. Anyway, I’m moving my household (slowly) over to the low-carb side. I’m already pretty much there, I just have to drag the rest of ’em with me!
    Good luck with the low-carb transition.

  10. Excellent, and I couldn’t agree more. It’s very interesting to be alive during a scientific revolution such as this, even more so because it’s one of the first (maybe the first?) major such revolution to occur during the information age. Previous revolutions have been limited by the flow of information, which was usually restricted to experts. Today information flow is nearly instantaneous, and available to the masses. Gary Taubes notes that “Good Calories, Bad Calories” would not have been possible without the Internet. And when else in history would “Fat Head” have been possible?
    I’m still amazed at the resistance of the mainstream in the face of the rapidly rising tide of information. It’s a great illustration of the strength of dogma, and further that the most dogmatic people are often those who are supposedly the most objective: scientists. Also a great example of why the government should stay out of science and healthcare (and probably just about everything else other than building roads and dropping bombs).

  11. I do believe you are right, Doc. Here’s an example.
    I’m getting married in July and just this AM I stumbled onto a link from a wedding site outlining a diet for brides to lose weight. Curious, I clicked on it, sure it would be the typical low fat dogma:
    But the message is more mixed. Avoid butter, creamy and oily sauces, yes, but also avoid desserts, sugary sodas, and the month before your wedding…. go on a “healthy” low carb diet! No clue as to what that means, but somewhat surprising.
    There is still a good deal of lowfat dogma there, particularly in month 3, but I was surprised that they advocate a low carb diet in month 1.
    Of course, I’m going to do a low carb diet all the months before and possibly even an all-meat diet for awhile. And I will lose more weight than all of them. 🙂
    My biggest fear is not the nutritional “authorities” but the global warming/animal rights activists. There has been a lot of hubbub about meat contributing to global warming in these circles. A decade ago I would have said a cap and trade scheme was ridiculous so I don’t think it’s beyond the realm of possibility that these folks try to ban meat.
    I am preparing a post on this topic soon. I’ll leave the link in the comments line when I’m done. These people are either hopelessly clueless or woefully corrupt. Do they think the soybeans grown in South America (a plant with a shallow root system that contributes to soil loss), shipped all the way to the US, processed in an extruder using hexane and petroleum, and then shipped once more across the country is more environmentally friendly than locally raised pastured meats contributing to soil fertility?
    Yep, we’ve really got an unholy alliance between the GWers and the animal rights folks. It can come to no good.

  12. Speaking on the evolutionary diet, how do you feel about the Zero Carbohydraters out here?? I would love to see a post on your view on this way of living. I think it is fascinating. Im personally begining to think there is a government conspiracy to make money by keeping the SAD diet the way it currently is, which empahsizes low fat and 60% carbs. The medical field is making a ton of money off cancer, diabetics, insulin this/that, metabolic this/that… the list of diseases goes on. They know the truth, and any good nutritional read will say the carbohydrates are NOT a requirement by humans. So, instead of save our money and lives and preaching a good diet, they preach a BAD diet and keep the death rate even with the amount of food they can get produced, because if everyone in the world gave up processed food and ate meat/eggs/fat/some veggies… then there would be no way to keep up with the supply & demand.
    have you checked out charles blog ?
    I think the zero carb diet is fine. In fact, I follow it myself from time to time.

  13. Well you may be more dead on than you think.
    Behold this article in today’s NY Times
    Med students actually questioning their teachers about things like cholesterol, and perhaps that maybe statins aren’t the best course of actions with all the side effects?!
    And then becoming aghast to discover their teacher has 10 paid contracts with companies that make Cholesterol lowering drugs.
    My god the times they are a changing.
    I read this article yesterday and was amazed myself. But this is what I mean about the old guys dying off and the new guys coming in.

  14. Kathy, I could almost have written your post! I’ve been trying to get my sister to commit to low carb too (I think she could *greatly* benefit from it if she did, not so much from weight loss, but because I believe dropping wheat and sugar would great decrease her mood swings). But she can only commit to it for a day or two before she veers off on cookies or Dunkin Donuts or pizza. But she told me this week that she has just signed up for Nutrisystem! Like your friend from work she is happy to just be *told* what to eat and to have pre-prepared meals she can deal with, as she says it is too much work and effort to have to keep cooking, and planning meals.
    And I also agree about it being harder the Nth time you go low carb. But I’m into my 9th week now of strict low carb, absolutely no grains, no sugars. I *am* down 15 pounds, but the weight has been inching off, not dropping off as it did my first time on LC when I think I lost 15 pounds in the first 2 weeks. And when you have as much to lose as I do you want to see those pounds dropping like flies! And while my appetite is not as strong, I still feel “deprived” if my intake is below about 2500 calories daily, and at 2000 or below I feel like I’m on starvation rations, LOL.
    It sure would be wonderful, though, to see the end of the Dark Ages, and some real consensus on low carb dieting. I think one of the things that makes it hard for many – who don’t have the support of the internet and the many wonderful blogs like this one – is the “you’re killing yourself” and the ridicule low carbers often have to face from the ignorant. *** “It’s not the things we don’t know that get us into trouble. It’s the things we know that just ain’t true.” ***
    My brother-in-law, in the medical field, “knows” that what you eat has absolutely nothing to do with how you feel or how you lose weight, and is totally opposed to my sister following a low carb diet, which also makes it hard for her. How I would love to see more and more of the nutritional Renaissance appearing as the scales drop from the eyes of noted researchers, and low carb comes into its own in the mainstream.

  15. I hope you are right that we are approaching the end of the low-fat high-carb insanity. You’re right, “It’s all calories” is an admission of defeat for the low-fat Vandals. (Although comparing the barbarians to the low-fat crowd is actually a calumny, as the real barbarians feasted on meat and cheese while eschewing grains as suitable for effete and decadent Romans.) I will have to remember to ask for the long-term studies showing the effects of low-fat, but advocates usually point to epidemiological studies that confound so many factors they prove almost nothing. I have also started using the line, similar to your analysis of the very low-calorie studies, “The only reason low-calorie diets work is that they reduce the total amount of carbs, if not the percentage.”
    I have begun questioning just about all the standard nutrition and weight loss party line. One that I am now wondering is what is the support for the truism that losing more than 2 pounds a week is unhealthy? And has the alleged slowed metabolism from restricting calories been tested on a low-carb diet, or only the SAD?
    You have promised an article on intermittent fasting. I am waiting eagerly for that one, and hope it will be soon.
    The slowing of metabolism with caloric restriction is called adaptive thermogenesis, and, as far as I know, has never been studied in subjects on low-carb diets. My guess is that the fall off in metabolic rate with a low-carb, higher-protein diet would be less than with the same number of low-fat, high-carb calories.

  16. Dr. Eades,
    I love your site!! The study reports, like you said, it is all about calories. Yet when I look at the data I see a problem. It was reported that the participants had lost 13 pounds on average at 6 months and maintained 9 pounds lost at 2 years. When you look at the Nutrient intake they all were eating fewer calories at 2 years than they were at 6 months. If it is about calories in and calories out, how did they gain an average 4 pounds while eating fewer calories? Am I reading the data incorrectly?
    No, you’re not reading the data incorrectly. The data obviously aren’t representative of what the subjects actually ate. Since these intakes were self reported, there was a lot of fudging going on. Had these subjects truly adhered to these caloric intakes, they would all have lost substantially more than they did. Until researchers figure out a better way to determine caloric consumption other than simply asking the subjects to report it, these kinds of studies will remain little better than worthless.

  17. I’m definitely hanging in there!
    I just got an email from my cousin in Phoenix; we’ve recently reconnected after not seeing or hearing from each other in about 40 years. She’s several years older than me (maybe around 57), but definitely in the same generation. She’s been a die-hard raw foods person (and no meat) for more than 30 years. She got involved with a company that sells Chinese Herbal Foods at that time and said she made enough money to retire after 1 1/2 years. She raves about it.
    She started out by telling me about an intense yoga class she took that made her vomit all night long (a good thing, in her view). She added that she’s “been working for the last two months on cleaning out fat and of course with cleaning out the fat comes the opportunity to clean out toxins from the tissues. Amazing!!!! I “cleaned house” internally for about 2 weeks beforehand.”
    She tells of all the energy she has and how healthy she is. I still don’t understand how she can be, when she’s spent the past 30 years of her life depriving her body of the protein it needs to function. What gives?
    But who knows how much energy she would have if she were on a decent diet? Plus, she’s got a financial incentive to keep her at least thinking and reporting how great she feels.

  18. Talk about emerging from the dark ages! I am a registered dietitian, attended school during the early part of this decade and boy did all of my teachers rail against the Atkins diet at the height of its popularity! “Its a low calorie diet in disguise” “You don’t eat any fruits or vegetables” “The body NEEDS carbohydrate to survive” “All of your protein is wasted to make glucose”, etc…Thankfully, I somehow managed to read Taubes’ book and, well, enlightenment. Then I discovered your wonderful blog. Its quite a challenge trying to convince my colleagues to at least listen to some of the ideas, but most of the fatter, older dietitians have no interest in even entertaining the notion that carbohydrate restriction works. Sigh, at least I know that there are doctors such as yourself fighting the old guard. Keep up the good work.
    Thank God there is at least one RD out there who understands nutrition. You’ve really got your work cut out for you in fighting the old guard in the RD biz. Keep it up!

  19. Dear Dr,
    Thanks for the post. Yes, looks like the mainstream is starting to turn and see reason. They can no longer fight this. The very reason they came around and accepted “only calories count” and the macro nutrient composition does not matter is just absurd. Then why do they say Carb is the energy and high protein is dangerous for kidneys?
    Interestingly I was reading Jimmy Moore’s post yesterday. This was on the Low carb wave sweeping through Sweden. I know that Sweden’s Federal agency approved Low Carb as a approved treatment for weight loss and diabetes. Now, Unilever is not able to advertise Margarine with heart friendly logo as it used to. Low carb blogs are seeing max traffic hits and books are being sought after.
    I wish that happens here in the US and everyone walking away with PP book and keep visiting this blog.
    Jimmy Moore’s Sweden article can be found here
    Thanks for your service.
    Believe it or not, but I, too, wish that everyone in the US would walk away with a PP book in hand. 🙂

  20. Dr. Eades,
    Off topic but wanted to get your thoughts on this. Mark Cuban is doing a little VC work and funding a “healthy pizza” resturant. After LMAO at the concept I checked out their nutritional information and found what I figured I’d find they linked to this study, noting that low carb was shown to reduce good gut bacteria to a level that they deemed too low. HAve you seen or commented on this study before?
    and the pizza shop’s info page which actually does have some valid nuggets in it.
    I haven’t commented on this subject before. The bacterial fauna changes with everything we eat. Gorillas consume enormous amounts of fiber, which is converted into butyrate and other short-chain fatty acids in their colons, and can be followed by the sounds of their constant belching and farting. These same effects are seen in those who eat diets filled with complex carbohydrates. Why? Because these bacteria give off a lot of gas. Humans have relatively short colons, more like those of a carnivore, which means that we’re not really designed to do a lot of fermenting in there. Butyric acid can be provided to the colon cells from the blood and doesn’t have to come from the interior of the colon, so I wouldn’t worry about it. No studies have shown that people who eat less fiber suffer more colon cancer, so I don’t think that complaint is valid. The writers of the info on the Naked Pizza site need to avail themselves of a little more info. Calcium isn’t absorbed in the colon, which makes that argument for eating their pizza pretty weak.

  21. I continue to be dismayed at how the mainstream media simply repeats the sound bites of researchers in these situations, rather than actually reading the study and asking skeptical questions. And people wonder why newspapers are in trouble. Most journalists fell asleep at the switch a long time ago. These days one has to visit web sites like this one to get a thorough analysis of news items (I also love

  22. I think we are coming out of the low fat dark ages because in the past month I’ve come accross two diabetics who have been told by their doctors to go low-carb, and that everything they’d been taught about low fat was wrong. It’s funny because the wife of one of these diabetics jokes about how she knows she needs to eat more meat because her thought processes become very slow and difficult. How sad her previous attempts at healthy living were the cause of her problems.
    But the GWers are just at the beginning of their crusades. My 6-year-old has asthma, and the new inhalers are worthless. We’ve had to go back to using a nebulizer. All outdoor activities that don’t have an electrical outlet nearby are now risky business.
    Is your 6-year old on a low-carb diet? I had a lot of success treating kids with asthma with low-carb diets, especially low-carb diets without dairy. Just a thought.

  23. well, if this post doesn’t wake up the thunder down under, I suppose nothing ever will!
    You should have seen it before my wife made me tone it down.

  24. Dear Dr Eades,
    I certainly agree with your central theme, but I’d like to digress a little.
    What Max Planck said was more succinct: „Die Wahrheit triumphiert nie, ihre Gegner sterben nur aus.“
    This translates pretty closely to, “Truth never triumphs, it’s opponents just die out.”
    Much more succinct. Thanks for the quote in the original.

  25. Yes, cracks are starting to show in the low fat, high carbohydrate paradigm.
    Fructose Metabolism More Complicated Than Was Thought
    “His study shows that the metabolism of fructose is more complex than the data had indicated. “Our gene-expression analysis showed that both insulin-responsive and insulin-repressive genes are induced during this process. Our bodies can do this, but it’s complicated, and we may pay a price for it,” he said.”
    Missing Link Between Fructose, Insulin Resistance Found
    “There has been a remarkable increase in consumption of high-fructose corn syrup,” said Gerald Shulman of Yale University School of Medicine. “Fructose is much more readily metabolized to fat in the liver than glucose is and in the process can lead to nonalcoholic fatty liver disease,” he continued. NAFLD in turn leads to hepatic insulin resistance and type II diabetes.
    I agree. Even though these are both rodent studies, they indicate a directional change.

  26. In my experience there DOES come a point where you gotta start counting calories to continue weight loss (all other things being equal like energy expenditure). Low-carb did 80% of my weight loss but there were hurdles I just couldnt jump without severly restricting calories for a time.
    Anyone who has dieted knows that sooner or later you reach a damn plateau, and the only way I could break mine was fasting for 1-2 days completely or Carb loading by stuffing my face with donuts, cakes, and pizza on 1 ‘binge’ day.
    What I have discovered is the laws that govern weight loss are not the same as those for weight gain. For some reason weight gain on low carb (>30g/day) is almost impossible even on extreme calorie counts.
    Love the Max Planck quote though and I think its spot on, and sadly the only way mainstream opinion on nutrition is going to change.

  27. Funny, I hadn’t noticed the names Stark and Bray, but now it makes perfect sense.
    Re: Noah’s comment: Thanks for posting that! A rash of fresh, curious people.
    Mr. Grassley is also in the news again:
    Sorry for the disjointed comment. I quit smoking and have to retrain my brain to think properly without nicotine.
    Seems that Grassley was inspired by the story in the Times yesterday about medical students getting bad treatment for questioning their profs on their (the profs) unrequited stance on statins.

  28. I am originally from India, so we never had dark ages ( except during the times when middle eastern muslims ruled large parts of the country, it was close to dark) the way you guys had them in Europe.
    Anyway, I had a question. When my husband does LC he drops the pounds quickly. But when I do it ( even the first time) not a pound moves. What gives? Am I one of those people who should stick to a diet that is has more carbs?
    Not necessarily. You may just have to give it a little time for a number of reasons.

  29. My husband mentioned these studies to me the other night, and I almost got into an argument with him out of pure frustration. He knows I follow low-carb and have done well on it, but his reaction was that this was somehow new information that would level the playing field across diets. I had to remind him that no, it’s not about the calories, because the human body doesn’t run on algebra. We function by chemistry, and in chemistry, the amount of the substances doesn’t always predict the size of the reaction.
    Calorie reduction doesn’t work for me. My body doesn’t seem to care how much fuel it gets, but it goes haywire if i give it fuel from the wrong sources. I might not live to see the day when the experts say “ok, we were wrong, grains are bad, fats are good”, but at least I can enjoy watching the reasons to demonize fats fall by the wayside, one by one.
    Your husband’s buying into this study is the very reason it was done. To divert the unwary.

  30. First, thank you, Martin Lopez and Andrew Ager, for sticking up for a great period in history, the Middle Ages. To take you to task a little, Dr. Eades, your characterization of the Middle Ages seems more rooted in a belief assimilated from popular culture about what that period was like than in actual in-depth historical study of it. Your view of the Middle Ages is to the actual period what low-fat dogma is to actual human biochemistry. We can be bona fide experts in one field and and quite unqualified to discuss another. The popular view of the “Dark” Ages is fueled in part by anti-Catholic bigotry, as well as a pervasive general ignorance in our culture about the past of any time and place. Many just accept what they hear, whether in nutrition or history. There is definitely a party line of propaganda about the past that is all most people know.
    That aside, I think part of what makes it so hard for low-carb to gain acceptance is not just the prejudice of those who define nutritional policy and slant their research based on flawed premises, but also the fact that people following the low-fat advice can have success with it. People do lose weight when they reduce fat, or start exercising more, or follow this, that, or the other diet plan, no matter what macronutrient ratio it recommends. Or they don’t. Or they do and they gain it back for whatever reason. Biochemical research may say one thing but anecdotal evidence says many others. It makes it hard for most people to know whom to believe, or to understand why whatever weight loss plan they followed did or did not work. The human body is way more complex than what the average “study shows” article in the local paper is going to convey, but most people will never do the homework it takes to resist the inundation of popular propaganda.

  31. Hey, I was just debunking that study for a friend yesterday and it looks like I did it the right way.
    Disregarding their claim of showing low-carb equivalence, I also pointed out that if calories were all that mattered, two years of carefully calculated diet (at a deficit of 750 calories), exercise, and bi-weekly Weight Watchers-style meetings should have produced a loss of 60 kg (if they had that to spare) in every subject. Period. You couldn’t have had better conditions for dieting success than being in this study.
    Instead, about 8 people out of 800 achieved a loss of 30 kg, while 7 people gained 15 kg. If the body is simply an open-loop furnace, there is no excuse for those results.

  32. To shutchings: I can verify, at least in my case, that low carb got rid of all my pollen allergies/occasional asthma problems, but my trial and error testing showed that it had to do with the elimination of wheat. I still eat a fair amount of dairy.

  33. I’m fascinated that you would quote writers for the WSJ and the NYT, two publications that are totally out of touch with hoi polloi. I suppose if you’re fixated on losing weight no matter what that this study is relevant. But virtually all readers of your blog are battling more than weight, to wit: heart disease, diabetes, cancer and other afflictions. Low carb has worked very well for me in the month or so that I’ve been on it, and as long as I don’t overeat I’m confident I’ll reap even more benefits. Studies are interesting, but all that really matters to me is the results I’m experiencing with the slow burn exercise program and the very-low-carb diet. Your site is truly a marvelously rewarding experience for me.
    I quoted those writers simply to show how the mainstream media picked up on this study. I’m glad you’re doing so well on the program.

  34. The version of the article I originally read had a quote from the researcher himself to the effect that there was only a 2% difference between the two diets, so it wasn’t really a reliable indicator of efficacy in terms of macronutrient composition. I can’t seem to find that version anywhere. Maybe it has been silenced forever.
    You read that in the editorial by Martijn Katan that also appeared in the same issue of the NEJM.

  35. As far as I’m concerned, the dark ages will be over when Nabisco, Kelloggs and Hershey’s are filling the shelves with truly low-carb food (not that sugar-free sugar alcohol stuff). The biggest inhibitor to a low-carb diet is finding food that fits the criteria. My boss and I both find it easier to eat low-carb by going out to eat than by going to the grocery store; just take the bread out, and you’re good to go!
    I’ve been educating my friends and family regarding their diets, and being a hypoglycemic all my life, I’ve had a lot of experience with different diets (trying to find the right combination to keep me from gaining weight and passing out). A few months ago, I created a calorie deficit and ate every two hours. I would eat chips, crackers, candy, but not many cheeses or meats. I still had issues with dizziness, and even with the caloric deficit and exercise, I was still not losing weight. I started to gain then, falling off the wagon because I didn’t see any results. I immediately lost 7lbs upon going on a less-than-20g-carb diet, and I no longer need to eat every two hours. I just wanted to thank you for the education, and let you know I’m sharing it with everyone I know. It’s the consumers that drive the market by creating a need, and I hope to get everybody to need low-carb!

  36. MR Eades wrote: Gorillas consume enormous amounts of fiber, which is converted into butyrate and other short-chain fatty acids in their colons, and can be followed by the sounds of their constant belching and farting. These same effects are seen in those who eat diets filled with complex carbohydrates. Why? Because these bacteria give off a lot of gas. Humans have relatively short colons, more like those of a carnivore, which means that we’re not really designed to do a lot of fermenting in there. Butyric acid can be provided to the colon cells from the blood and doesn’t have to come from the interior of the colon, so I wouldn’t worry about it. No studies have shown that people who eat less fiber suffer more colon cancer, so I don’t think that complaint is valid.
    According to research Peter was discussing over at Hyperlipid, fiber may actually increase cancer prevalence:
    Helicobacter lives on the hydrogen from flatus, so is present in far too high a number for health in our flatulent carb eater and chronically irritates the gastric lining. Insulin-like Growth Factor-1 (IGF-1) receptor is over-expressed and converts disorderly proliferation of gastric mucosa into gastric cancer.
    He had another interesting post suggesting that hydrogen gas might also be fueling massive overgrowth in acinobacter, making multiple sclerosis more likely:

  37. Here’s a new press release for a study that offers a nice counterpoint to the NEJM garbage.
    It won’t get nearly the air time (if it gets any at all) since it doesn’t contain prestige names like Harvard or NEJM, which always send the media into such feeding frenzies. The sad (or perhaps shocking) part of this is that the names Harvard, Mayo, NEJM, etc are tantamount to rock star or Hollywood star names that get quoted no matter what rubbish spews from their mouths. It’s not the content that matters, it’s the star power behind the news release that determines whether it’s “important” enough to be worthy of a headline in these Medical Inquirers.
    In my mind Harvard and NEJM are, more often than not, associated with junk science, egos and marketing, than anything that really matters to the world.
    I managed to not delete it this time. Thanks for resending.

  38. Thanks for this post, Dr. Eades. I was waiting for your response and you did not disappoint. Another argument being brought against the low carb diet is that a diet high in meat is bad for the planet and not sustainable for the masses – i.e. we should be eating less meat, not more. Your thoughts?
    My idea is, of course, that this idea of not eating meat so that we can have a sustainable planet is sheer lunacy.

  39. You wrote to Leslie:
    “Just get me the funding (hint…hint).”
    How much? I don’t have it, but I think collectively we could come up with it. Could you develop a plan and post a link to donate? We could get the word out on the low carb boards. Some of the creative and energetic people would undoubtedly take on the task of soliciting additional funding.
    I was being kind of tongue in cheek. It requires much more than funding to do a quality study. It requires a facility, a staff, a lab and countless other moving parts. It would probably cost in the neighborhood of half a million dollars to do a good study with plenty of subjects.

  40. Couple of points on the comments. One of the comments referred to the medical industry making money from sick people so that’s why they advocate sickening diets. True enough. The other point I would like to add and this is something that the owners of the planet probably get: There isn’t enough protein on the planet to support the human population in good health. Carbs are the reason we have this huge human population. It is politically risky to tell the masses that their relatively cheap carbs are leading to expensive and debilitating chronic disease in middle and old age. What would we give them instead? I don’t have anything against the Animal Rights religion. They are just irrelevant to the problem and shouldn’t get much airplay unless the masses just need the entertainment.
    Second point. You would think that the sole reason to choose a diet is to lose weight or more importantly fat. What about health? It seems to be well shown that the greatest loss in weight initially in reduced calorie diets comes from lost muscle mass not fat. So what’s healthy about that? But maybe people don’t motivate for anything but “what will make me look better?” i.e. weight loss.
    As a GLUCOSE INTOLERANT 65 year old after a near brush with diabetes I have plenty of motivation to understand what the best diet for me may be. My blood lipid profile is excellent, my triglycerides are low, my weight is perfect (low fat). Now if I could just get my fasting glucose down out of the borderline high range. I am trying the macro-nutrient cycling advice of Robert Fagin so I can eat zero carb most of the time. And, as always, can’t wait until Dr. Mike’s Blog hits my inbox.

  41. Dr. Eades, if you felt so inclined, I would appreciate a post on your experience treating asthma in children with low-carb eating, and the science behind why it improves the condition. My grandson, who is 4, was diagnosed with asthma last year, and is on a medication regimen to deal with it, all the while being fed ramen noodles, macaroni and cheese, lots of milk, bread, a sweet treat before bedtime, etc. His dad is diabetic (in his early 30’s) and eats low-carb, but that’s just a special diet for Daddy.
    Basically, asthma is an inflammatory disorder. Low-carb diets tend to decrease the inflammatory response, which is why they seem to work so well with asthma. Give it a try on your grandson to see what happens. It won’t hurt him, and it may help a whole lot.

  42. @shutchings
    This is just one person’s experience and therefore purely anecdotal evidence, but back in my starch-eating vegetarian days, a doctor told me I had asthma. He said it was a mild case, and didn’t require medication.
    I mentioned that to another doctor during a checkup a few years ago, so he listened to my breathing several times and said no, you don’t have asthma.
    But on those rare occasions when I break discipline and eat pizza with the crust, my breathing becomes labored for awhile and I wheeze a bit.
    (If I’m in Chicago, I have to order a stuffed pizza from Giordano’s. It’s worth a wheeze or two.)

  43. Yes, we will emerge from the Dark Ages of nutrition, and I don’t think we’ll have to wait for the old guard to die off. The production and distribution of information is being rapidly democratized, thanks to the Internet and computers.
    Dr. Mike, I know you share my fascination with economics, so if you haven’t already read it, I’d recommend picking up “The Long Tail,” by Chris Anderson. Great book about how the digital revolution is changing what people decide what to read, watch, listen to, etc.
    In the pre-digital world, the available supply of books, music and movies was limited by factors such as shelf space in the brick-and-mortar stores. News was limited by the size of newspapers and magazines and the length of network newscasts. So the gatekeepers controlled the supply. If bookstores didn’t think your book would sell, no one ever read it. If a record company didn’t produce your CD, no one heard your music. If the New York Times and Walter Cronkite didn’t think a story was newsworthy, it didn’t become news.
    That’s all changing. Amazon lists hundreds of thousands of books and movies. iTunes offers literally millions of songs. Bloggers draw thousands and in some cases millions of readers. They can create news, disseminate news, or — as Dan Rather found out — they can loudly and publicly bust the mainstream news media when they get their facts wrong. Anyone with a digital camcorder and some editing software can put a short film on YouTube.
    And it turns out consumers love the nearly limitless supply, and they’re wading into it far and deep to find alternatives to the mainstream. The result is that the wisdom of the experts is being replaced by the wisdom of crowds. (“The Wisdom of Crowds” is another excellent read, by the way.) People are discovering bands and writers and filmmakers that the supposed experts didn’t think would draw an audience. The gatekeepers are realizing that their gates no longer have fences attached.
    Gary Taubes pointed out that for decades, the conversation about nutrition was controlled by a handful of people who all bought into the low-fat theory. They may still be in charge of the big-name journals, but they are losing control of the conversation.
    Bad studies are ridiculed online. People go on low-carb diets and talk about their weight loss and improved lipids on FaceBook or their blogs. People read your blog, they listen to Jimmy Moore’s podcasts, and they buy copies of “Fat Head” — which I couldn’t have produced or gotten distributed a dozen years ago. (Production aside, I wouldn’t have been able to do the research sitting in my den, and I wouldn’t have been able to find you and start the email conversation that led to the on-camera interviews.)
    The Renaissance has already begun.
    (Anyone know how to say “Ornish is a fruitcake” in Italian?)

  44. What if humans evolve to handle large amounts of carbs before this dark age ends, then certain LC arguments won’t be as strong. The reason I ask this is because recently there has been a lot of talk about how the idea that human evolution stopped a long time ago is not only wrong, but the exact opposite of the truth. Scientists are starting to believe that evolution is currently taking place at an extremely accelerated pace(similar to older generations of doctors being set in their ways and the younger ones challenging the norm, this is what is happening with scientists and evolution). This makes sense since population has increased a huge amount and a larger population is the perfect environment for accelerated appearance of mutations.
    This idea also helps to answer vadim’s question. For instance Europeans eventually shifted to a more cattle herding culture and it made sense to be able to use milk for nutrition even after infancy. The enzyme to digest lactose then appeared in them and now roughly 80% of Europeans can digest lactose. On the opposite end of the spectrum Asian countries never had this major movement to herding and today most Asians cannot digest lactose, they never had the need to and never evolved to keeping that enzyme active. Maybe that is why Russians handle carbs better, or why some people do not respond to LC as well or as fast as others.
    While I am a follower of LC and actually have been almost ZC for almost a month, if carb adaptation happened through evolution I would not be saddened by the world being able to healthfully live and digest large amounts of carbs.
    I just think it’s an interesting thing to think about, even if it seems that my generation missed that evolutionary bus.
    A fast pace in evolutionary terms is still extremely slow in human-life terms. I don’t think people are evolving before our very eyes, and I don’t think there will be any degree of evolutionary change that will mean anything to those alive today. It may make a difference in those many generations down the road, however.

  45. LOL, I have to laugh at Tom Naughton’s comment. It’s a good thing I don’t travel to Chicago on business anymore. A pizza from Giordano’s would be hard to resist! In fact a couple years ago a friend who lives in Chicago actually mailed me a Giordano’s pizza as a special treat.
    But I’ve also had doctors suggest I was borderline asthmatic, and it’s amazing how much my breathing has improved since going low carb and eliminating grains (and sugar). The change is so great that I think even if faced with a Giordano’s pizza I would be happy to just scoop out the generous (and mostly low carb) filling and leave the crust behind. 🙂 Hey, tomorrow starts week 10 on this low carb way of life, and I’m down 16 pounds. Who needs pizza crust!

  46. Hrm…
    The Renaissance didn’t happen all at once. It started here and there in Italy, and moved outward, northward. It took steps back (ie Savonarola’s rule in Florence) and was clearly different in less Catholic places, like the Netherlands and modern day Belgium and Luxembourg. And really, while we think of 1450 AD as maybe the time when it all changed, the Iberrian Peninsula was still kind of dark until much later. And clearly, there is a flux between the humanistic ideals of a time like the Renaissance and the strong patriarchal hierarchy of say the Dark Ages, or the post Ren.
    I bring all this up, because we can look at the Pre-Ancel Keyes period as perhaps being similar to the Roman Empire period (where there were still massive pockets of barbarity). The post Ancel Keyes period can perhaps be looked at as the Dark Ages of Low Fat (with perhaps small pockets, like the big trading city/states of Italy that stayed brighter than the low wattage mass of Europe) with the original Dr. Atkins diet and the other pre-revolution low carb diets being like Venice or Padua. Atkins and you and the Dr. Mrs. are Dante and Petrarch. Taubes Big Fat Lie article in the NY Times magazine is Giotto.
    The point is, back in 2002-3, it was perhaps the dawn of the Renaissance in smaller pockets. Now, I think we are in the Florentine period, with universities on line, a more activist base, more versions of the reduce carbs, eat protein + fat diet. We should not expect universal change overnight. Or even in a couple years. Just as there were regional versions of the renaissance, so there will be changed interpretations. Just as there were Savonarolas, so there will be studies like this.
    Last thing: Have to second the nod to Giordano’s above, though without the crust, it is a substantial meal anyway (and easily accomplished, really.
    After all these hosannas about Giordano’s pizza, I may have to bolt from my diet long enough to try one next time I’m in Chicago.

  47. Regarding the “evolve to handle carbs better” speculation: it can’t happen. Even putting aside the time frames that would have to go by, if the negative effects on the gene host (“us”) doesn’t manifest ( and they don’t ) until AFTER the next generation of those genes has been produced , then there is no selective pressure for the “better” carb-handling genes to become common-place.
    Of course science could produce an “antidote”, or some sort of carb-neutralizer, but that is outside Natural Selection pressures.

  48. I hope you are right. It will be so much easier for us (as you’ve pointed out in previous posts) to stick to low carb if the general tenor of the media is not degrading.
    But the dying gasps are still out there, on none other than Lew Rockwells site. Today they put up this post by one Dr. McDougall, on the wonders of starch. It is a humorous read. I never heard of Dr. McDougall before, but I just have to wonder if he ever reads any medical literature, and how exactly he can get away with claiming 7 day diabetes cures on pure starch diets, as he does on his website:
    McDougal is a lipophobe of the deepest die.

  49. Dr. E:
    Thank you for this post. 10 minutes ago, a co-worker who knows I can’t eat sugar asked if I wanted a piece of cake. I responded “no thank you.” She continued, but it’s pineapple upside down cake. I told her she didn’t need to elaborate. I reminded myself that I have been migraine/headache free for 7 weeks since cutting all sugar and starch.
    I hope the dietary revolution will happen before I die and before this co-worker develops cancer or alzheimers to receive the true benefit of my revenge.

  50. Well, evolutionary adaptation to carbs probably has occurred to some extent in some populations. Just as some people of European descent handle lactose quite well, about 25% of the population does fine on a high carb diet.

  51. Further comment on evolving to handle carbs better
    I’ve thought about this myself, and it seems that the poor tolerance to carbs is passed on quite easily. Perhaps one who is very prone to diabetes and metabolic syndrome does not manifest those until AFTER the period of reproduction. A person might have a very poor tolerance, but still be able to make to the age of reproduction, have offspring and pass along their poor carb tolerance, and then not succumb to the trappings of a high carb lifestyle until in their 40s, 50s, or even 60s. And the cycle repeats itself. It seems that the only way to stop this would be that those with poor carb tolerance are naturally selected out of the population early, and I certainly can’t imagine our society allowing 10 years olds with type II diabetes to die.

  52. As an ex Chicagoan, I always preferred Eduardo’s deep dish pizza over Giordano’s. Nancy’s, Gino’s East, or Uno’s deep dish pizza. I actually have the recipe for Eduardo’s pizza from when it was published in the Chicago Sun Times newspaper in the 80’s. I make my own mean Eduardo’s deep dish pizza. Even have the deep dish pizza pans. Or I used to make them. Not exactly a low carb meal unfortunately. Two layers of bread dough in some of the recipes. Definitely not low carb.

  53. Thank you for the advice about putting my 6-year-old on low-carb. I’ve tried to have everyone in the house on at least a lower-carb diet, but maybe I’ll have to get strict. I would like to give her fish oil, but don’t know what would be a good amount, or the best way to give it to her. The pills I take would be too big for her to swallow and I don’t think I could get her to take it straight. Any suggestions?
    And thank you so much for all the time and effort you put into this blog. It helps keep me sane.
    You can puncture the fish oil or krill oil caps and squirt the contents into something that would hide the taste. Or you could get some Nordic Naturals DHA Juniors (we have them on our website) somewhere or some other fish oil for kids. You can find them at most health food stores or natural grocers.

  54. “The enzyme to digest lactose then appeared in them and now roughly 80% of Europeans can digest lactose.”
    The enzyme to digest lactose were in all of us since infancy, it just doesn’t “appear” all of the sudden. For Europeans who continued to drink milk after infancy their bodies simply continued to make the enzyme past infancy, not very complicated. I think…

  55. As Gary Taubes pointed out, much research on weight loss was done by German scientists. The anti-german backlash after WWII may be mostly to blame for our plunge into the nutritional dark ages. Researchers just started over, rather than examining the previous German research. Of course, they headed off in a new and dangerous direction and we are paying the price for their “experiement.” I am one of their victims with years of morbid obesity and type 2 diabetes.
    There are indications of change in the right direction. Some in the dietary establishment are begining to realize that at least some fats are good for you and low fat may not be right for everyone. Saturated fat phobia will be the last thing to die.

  56. I’m joining the chorus of folks who saw an improvement in their breathing upon adopting low-carb eating habits. I’ve been LC for two years, and in that time I’ve thrown away my steroid inhaler, and am down to using albuterol two or three times a week (compared to five or six times a DAY). I hope to someday be rid of the albuterol, too. I keep thinking I need to give up dairy, but…butter and cheese and cream, oh my!
    With regard to this “study,” I’m hoping Tom Naughton is right. Perhaps the current headlines will encourage more people to be skeptical of expert cabals who profess to be masters of (what they’d like to keep as) mysterious arts. Let’s expose the furtive practices of necromancers, macroeconomists and nutritionists to the light of day. 🙂

  57. Re: Kathy’s manic relative…
    Sounds like she’s suffering from a bit of the starvation neurosis. This happens to people vulnerable to anorexia nervosa, it’s what makes CRONers so religious-minded, and basically in certain vulnerable people an extreme deficit of caloric nutrition and insulin (as in the case of a raw food vegan) will result in a paradoxical amphetamine-like response of hyperactive energy, decreased interest in eating, and religious/moral preoccupation with the activity surrounding starvation.
    Ever see a raw fooder talk about how great they feel and how much energy they have in spite of looking emaciated and anoretic? Ever observe a CRONer testify to how powerful and energetic he feels in spite of being visibly unhealthy? Ever listen to a 14 year old anorexic talk about how not-sick she feels as she bounces off the wall and paces back and fourth? Starvation neurosis, all of it.
    Here’s a clue explaining what’s going on. Insulin (from calories) and IGF-1 (from protein) decrease the dopamine transporter in the brain, which results in a feeling of power, well being, preoccupation and obsessiveness, moral and religious thoughts, yer typical manic delusion stuff. The norepinephrine transporter is increased, which ameliorates nervousness and some types of anxiety. Lower glucose levels in the brain may also lead to a stronger stress-catecholamine response, changes in hypocretin, similar to being on stimulants. Nausea and vomiting from eating, food aversion, delusional thoughts (that one is strong and well on a hypocaloric anemic raw food diet), moral preoccupation with food and hyperactivity are symptoms of a stimulant-like response from food aversion.
    IN fact, amphetamines work by blocking the action of downstream proteins related to the dopamine transporter that insulin acts upon. It is noted insulin is necessary for amphetamine to produce a high, and that is because insulin is necessary for dopamine transporters to work at all (the dopamine transporter has an “efflux” function which allows dopamine to pour out in the synapse, and amphetamine capitalizes on this… if insulin is not present, the dopamine transporter cannot work, which blocks the amphetamine high).
    But, high insulin is very much a downer, for the same reason that low insulin can produce a stimulant high in certain vulnerable people with a tendency to higher dopamine production, more active D2 receptors (genetic trait) or reduced catabolism of catecholamines (e.g. low activity COMT variants) .
    When chronic, food restriction will also increase dopamine d2 receptor density, in addition to acutely producing a stimulant-like high from acute hypoinsulinemia and low IGF levels. When starvation is a bit longer term, not only are we dealing with the acute higher dopamine from acute lower insulin/lower blood sugar, but now we are dealing with a dopamien system that works a hell of a lot better.
    End result? A whole lot of people looking like they are refugees from auschwitz describing the power flowing through them as they run for miles, oblivious to the fact they are frail and physically pushed to the limit of life.
    This explains CRONers/orthorexia/anorexia nervosa.
    As for people who are raw food junkies with a hypomanic personality, reporting “a high from exercise that makes them vomit”… this is probably a less clinically severe of the same starvation-high phenomenon. Invariably any frutarian, raw food vegetarian is starving due to poor bioavailability of food and very low insulin/IGF secondary to protein and energy deprivation.
    Just thought I would throw this out there, as I imagine it presents a paradox to anyone who hasn’t done the research on this sort of hypomanic starvation neurosis… how do we reconcile the subjective well being of balanced dieters, with the subjective well being of mildly insane people who starve themselves /eat deprivational diets? The difference is that the deprivational dieters (low calorie, low/no protein) are wired on starvation, whereas dieters who eat enough protein and calories genuinely feel healthy and do not appear emaciated and frail.

  58. A bit of sad news has dropped into my mail box.
    Dr Phillip Poole-Wilson has died suddenly just before his 66th birthday. He was one of the leading lights in acute heart failure in the UK and the world. Was one of those rarest of beasts: a REFORMED statinator!
    Check out “Statins and Heart Failure: A Deadly Mix?”
    Pertinent quote:
    “Dr. Poole-Wilson, who presented the studies at a medical conference, is one of the few cardiologists who is willing to admit he was wrong, saying now that the results are in he would not put anyone with heart failure on them [i.e. statins — MR], not even if they had the earliest stage of heart failure, called class one heart failure, in which people don’t typically have any symptoms.”
    We need more of him! (Now, if only he’d had a heart scan and followed Dr Davis’s programme he would still be with us!)
    All the Best,
    Michael Richards
    Yes, I read about this today, too. Dr. Poole-Wilson was a sort of reformed statinator. Based on what I’ve read about him, he still thought the evidence “overwhelming” that statins were protective against cardiovascular disease. His own research, however, demonstrated to him that omega-3 fats were a better treatment for congestive heart failure than were statins. And he was mensch enough to admit it and to not weasel around trying to find an excuse. RIP.

  59. On a blog I was posting on today pertaining to an RDs position that carbohydrates are an important part of a healthy diet and that whole grains prevent diabetes etc. yada, yada, yada a poster who claimed to be a biology student agreed with the RD stating that it has been established in the text book. Molecular Biology of the Cell (5th edition) by Bruce Alberts, Alexander Johnson, Julian Lewis,Martin Raff, Keith Roberts and Peter Walter. Garland Science, 2008 that carbohydrates are an essential nutrient to human health. I am skeptical to put it mildly. Is anyone on this blog familiar with this textbook?
    I’m sure this biology student was confused over the difference between sugar in the blood and sugar in the mouth. Your body can make the former without having to rely on the latter. The book in question is a respected text, and I can’t imagine the authors making the statement attributed to them. If they did, however, they are wrong. And, as Samuel Johnson would say, there’s an end on’t.

  60. Some what on topic….My problem with these metabolic ward studies that Colpo seemed to feel proved that the composition of the diet didn’t matter is who the subjects were who participated in the study – usually young student volunteers. Just like you say that mice are not furry humans, well, I don’t think how a 20 year old who has never been over weight reacts to food has any relevancy to how MY body reacts to food. Those studies just show how a 20 year old normal weight person reacts to food – nothing more. Just like the mice studies show what happens in mice and that may not be relevant to humans at all.
    I’ve never been able to understand how the medical community cannot see people ARE different in how they bodies handle food. They totally get this for medication. Take 100 with the same medical condition and give them each the same medication. It is quite accepted that the medication will not work for each one of those people. The people who the medication doesn’t work for are usually not accused of lying and cheating like over weight folks are.
    You are on the money. This is one of the reasons I don’t like the idea of the glycemic index. The studies were all done on young, healthy subjects. Who knows what the glycemic index is for someone who is old, fat and diabetic. I doubt that it is the same.

  61. Yesterday while driving to work I heard a couple of disc jockeys refer to eggs and bacon as health food. “His wife has time to cook him all that healthy stuff for breakfast, like bacon and eggs.”
    !! 🙂 Maybe times are changing faster than we thought.

  62. They buried the lead in reporting this. The real lead should have been:
    ‘All variations of “heart healthy” diets fail.’
    ‘”Heart healthy,” low-calorie, low-saturated fat, high-fiber diets with 90 minutes of exercise a week and a minimum of 35% carbohydrates fail to produce significant weight loss.’
    Thanks again for your blog, Doc – long time reader, first time commenter.
    Yep, they could have reported it differently. And would have had it suited their purposes.

  63. Please don’t ever quit writing your blog! It keeps me going amidst all of the anti-low-carb propaganda out there. Some days it’s so discouraging.
    As you probably know, here in Canada, about 3 years ago, the government banned the word “carbohydrate” on all packaging – it’s illegal to say “low carb” or “less carbs” or whatever – so low-carb products are impossible to find. I mostly stick to fresh meats, dairy, and vegetables, anyway, but occasionally I’d like to have some low-carb spaghetti or something like that – but no, Dreamfields pasta is no longer available at my local grocer (or any grocer) – it’s banned.
    I have to say, watching what’s going on in the U.S. – I hope it doesn’t come to that for you – governments who prefer the role of babysitting their people, such as ours does (well, our previous one), and I fear, your new one – leads to things like low-carb bans. I hope it doesn’t get worse before it gets better – the dying gasp, so to speak.
    I fear we’re heading down the nanny state pathway ourselves. What the government gives, it controls. And the current government is wanting to give a lot.

  64. This might be seen in bad taste but in regards to the sudden death of Dr Phillip Poole-Wilson that Michael Richards mentions in a comment above, doesn’t it seem ironic that one of the so-called leading authorities in heart disease, is suspected of dying of heart disease? There all these glowing comments on about him on the page Michael Richards linked to, saying what a great cardiologist he was, what a loss to the cardiology research community. Wouldn’t the death of cardiologist by a heart attack cause anyone to think maybe that what they believed about heart disease is wrong? That causes me to not be so hopeful about us getting out of the dark ages any time soon.
    Continuing in possible bad taste – but when I look at various head shots of Dr Poole-Wilson around the net, I see a guy who is definitely carrying some extra weight and probably had a bit of a belly. To me, he looked like exactly the person who would be a possible risk for heart disease and likely because he followed the standard diet advice.

  65. Wow – 3 comments by me on one post!
    Re. the glycemic index and who the index was tested on – young normal weight volunteers. Yes, I had forgotten about that.
    I started down the path to low carb by first hearing about the glycemic index. Someone I know who gained weight as a sedentary middle aged adult had great success losing weight by just avoiding high glycemic carbs. And I saw alot of books and news stories about the index around the same time. So I tried it and it didn’t work for me. (What has worked is very low carb and high fat – 35 lbs gone so far).
    I have been over weight my whole life, even as a young child. Yet my family did not eat junk food (mother cooked home made real food every night) and rarely ate desserts. I was a child at the time when there was usually only one fat kid in a class – and that happened to be me!
    I remember seeing my peers as a teenager and young adult eat all kinds of things, in great quantities, that I could never eat because I would gain weight – but they wouldn’t. My husband is a perfect example of that. His parents had a small grocery store and he was allowed to eat whatever candy and junk food he wanted. And he was a very skinny person up until has late 40s. Even now, he can eat much more sweets and grains than I can and not gain weight.
    So there is something different about me than that normal weight young person. Yet most of the medical establishment (and the fitness and diet community) will deny this is the case and say I must be lying about what I eat and how much if what works for a thin young person doesn’t work for me!

  66. I too applaud the quote at the end! Thanks for a great blog post. ~j
    Glad you enjoyed it.

  67. Despite my gains since adopting a low-carb diet, my wife, a health professional, continues to doubt it. And yesterday she acquired a product called “3X Slimming Power,” which has been cited by the FDA as a dangerous, illegal compound that contains several chemicals not listed in the ingredients, and no maker’s or marketer’s name on the container. Maybe if you’ll comment on this insanity she’ll listen.
    So your wife objects to a diet of whole natural foods used by millions to successfully lose weight and improve health (and clinically tested with said tests published in numerous prestigious medical journals) because she has “doubts,” yet she is willing to throw back some sort of God awful concoction composed of mystery ingredients that has been cited as dangerous by the FDA? Is that what you’re trying to tell me? And you want me to intervene?

  68. As to the studies that “prove” whole grains prevent diabetes, the researchers simply compared the results of a diet full of white flour with a diet full of whole-grain products. Duh … the whole grain products, which cause a less dramatic rise in blood sugar, were somewhat less likely to lead to diabetes.
    That doesn’t mean whole grains prevent diabetes; it simply means they are less likely to cause diabetes. That’s a huge distinction.
    By their logic, I could drink a 12-ounce glass of wine one day, a 12-ounce glass of whiskey another day, note that my hangover was far less severe after the wine, then declare that wine prevents hangovers.
    Dr. Mike may have already conducted this experiment with Jameson’s, though …
    I have indeed. But I can’t remember the results. 🙂

  69. Its The Woo, thanks for chiming in on my wing nut relative. I’m just itching to see some pictures of her. She promised, so maybe. What you wrote explains the euphoria some of these people feel.
    And a big THANK YOU to Dr. Eades for writing this blog and responding to so many questions, both on and off topic!

  70. @Tom Naughton,
    I remember conducting a similar experiment at the age of 12 (i.e. about 1962) with my cousin Harold. We raided my grandmother Leah’s liquor cabinet and drank a whole bottle. Bliss! Then we were discovered by Leah, whose first words were: “My God! Not the 1933 Para!”
    We had lucked out with the most expensive port in her entire collection! Well, if it came from 1933, it had to be good. That’s how we figured it.
    Conclusion: Not much hangover, but we had trouble walking! My mother had to help me down the stairs.
    (I think the price quoted is undervaulued.)
    Michael Richards

  71. My takedown of this study was “If you eat a high carb diet it doesn’t much matter how much fat you eat”. Thanks for the longer version
    Talking of takedowns you all need to look at this
    that’s the quicksand on which the current dietary house of cards has been built.
    If it wasn’t you it was someone equally wise who pointed out the lack of long term low carb studies is because they would be disallowed by Eithics Committees. Yet the long term whole world “study” of low fat diets got through on THIS??? I suspect Keys will go down in history as having increased cardiovascular disease elsewhere to the US level.
    “A fast pace in evolutionary terms is still extremely slow in human-life terms. I don’t think people are evolving before our very eyes, and I don’t think there will be any degree of evolutionary change that will mean anything to those alive today. It may make a difference in those many generations down the road, however.”
    They’re working on it by causing the early demise of all carbohydrate intolerant individuals

  72. With regards to MCT oil, what is its effect on a person’s lipid profile? If the body uses it preferentially as a fuel source from its rapid conversion to ketones, then wouldn’t that decrease the need to utilize one’s own fat stores if MCT is supplied predominantly in the diet and as a result minimize weight loss?
    As long as a deficit is created, it shouldn’t matter what the source of the fat intake is. MCTs are taken up directly into the liver in basically the same way as carbs are. Longer-chain fats get taken up into the lymphatics and are dumped into the bloodstream through the thoracic duct. Both fats get into the blood, MCTs just get there sooner. If you provide all the body’s energy needs by dietary fat – irrespective of chain length – then the fat cells have no need to give up their fat stores. It’s much more a function of amount than type.

  73. @shutchings:
    For what it’s worth, my own mild asthma is due to sulfite sensitivity. As long as I stay away from foods and beverages that contain sulfites naturally, or are preserved with sulfites, my breathing is fine. Relatively easy to do on a low-carb, minimally processed, mostly organic diet. In my case, neither dairy nor wheat seem to initiate or exacerbate an attack. Balsamic vinegar does, in a big way.
    I wish you the best of luck in identifying the substances in your daughter’s environment that may trigger or aggravate her asthma. It’s a worthwhile endeavor.

  74. I had long suspected I had blood sugar problems. I had a definite sweet tooth. I had burning feet. I got hungry right away after eating, if I then had a dessert of any kind (whether it was artificially-sweetened iced tea, a piece of fruit, or a piece of pie), even if I had just eaten half a chicken.
    Well, about four to five years ago, I went to see a doctor whom I knew slightly socially. I took with me some printed materials, including one of your Protein Power books (Lifeplan, it may have been), and also some other stuff on low-carbing. He wasn’t willing to even look at any of it. Said he didn’t have time.
    Well, he wanted me to go on Slim-Fast! And even before the laboratory results were back, he wanted to write prescriptions for not only a blood pressure medication, but also metformin (which I’d asked for), and especially a statin (which I absolutely refused to even consider taking). He claimed that cholesterol control was especially important for diabetics.
    He also told me that I probably have irritable bowel syndrome, based on symptoms. He wasn’t enthusiastic about taking fish oil, because he was oh-so-concerned about calories.
    He was still stuck on stupid (that is, on the a-calorie-is-a-calorie nonsense). I was extremely dissatisfied with his nutritional ignorance, and later politely told him that I wanted to seek out someone else who was more nutritionally aware.
    Well… Sam, the man I live with, had bypass surgery in his mid-40s (he has never learned to cook for himself). At some point a couple of years ago, he developed chest pain and I took him to a local emergency room. Before going to the ER that night, he had e-mailed a few friends to let them know what was happening. (He eventually had two stents placed during that hospitalization.)
    The news got around to this doctor. He called me up one afternoon. After chatting about a few other things, the moron had the nerve to tell me that if I were to encourage Sam to avoid statin drugs, I would be helping to dig his grave. And, BTW, Sam had never been a patient of this moron’s at all.
    I told him I didn’t have time to argue with him and got off the phone hurriedly. Apparently the moron had no clue that he had just insulted me.
    I sent him an e-mail nastygram, which he then proceeded to broadcast to many of the local Libertarian Party folk, claiming that my reaction to him had just come out of the blue, and he had provided absolutely no provocation whatsoever. He just had no clue.
    At any rate, people like him are one reason why I am not enthusiastic about doctors… him, plus all the OTHER statin-pushers whose reports I have transcribed night after night after night for over 20 years.
    Honestly, Dr. Eades, I really hope the tide is turning, as you state. But honestly, my gut feeling is that Gary Taubes’s book is catching on more among ordinary people than it is among any kind of medical professionals.
    I am not questioning that most doctors are probably good and capable at what they have been trained to do… it’s just that I have a big disagreement with the rationale for a lot of what they’re doing.
    If I broke my leg, I’d have no qualms about showing up at the local urgent care or ER and having them set my leg, because I’d at least agree with what they were trying to do.
    It’s the other stuff they do that really puts me off and scares the hell out of me.
    I don’t think that the vast majority of doctors would be willing to follow the intellectual path which you and MD have traveled, which seems to have required you to change your minds about a lot of things.
    Sorry you’ve had such a bad experience with the medical profession. Looks like you are at least taking charge of your own health. If more people did this, there would be fewer statinators statinating.

  75. Dr. Eeades and Readers:
    I am a mexican citizen , and I have lived in United States as well, but when little i was raised following the “Mexican Diet” which mainly consists of Rice, Beans and the Evil “Tortilla”.
    I struggled all my childhoold and adolescence with a body I did’nt like but finally when i was around 19 yo my father took me to this bariatrist , who introduced me to this new world. I was one of his big success stories, I lost around 120 pounds in around 8 months i went from being size 46 to 34 and given I am 6′ 3″ and my bone structure is wide , my weist size and weight were alright. i was about 180 pounds or less sometimes.
    I sticked to the diet for about 6 years, it was very very very difficult for me to follow, because I had to be giving explanations to everybody here and there. It didn´t make sense for the waiter taking my order the fact that i was asking for a Diet Coke when i was about to eat a plate of delicious “carnitas” ; they would tell me, “yeah right a diet coke with all that fat, ok sir”. . But when I would come a couple of months later they had this “WTF” face after seeing how much weight i had lost. I remained like that for about 6 years and I was indeed very happy.
    The problem started when I ended my first, and of course derived from my success in losing weight, relationship. Since i had been a very rejected boy when younger, losing that person , took away all my self-esteem. After the break up I tried to stick to the diet , but finally gave in, because I moved to Mexico city, the capitol just of Mexico, but of Starches and Horrible Carbs on earth. I gave up and started eating, in the beginning i could still do some exercise so the weight gain didn’t happen very fast. But eventually I went from being a size 34 to Being a size 52, 2 years later.
    Depression and lack of love for myself are the circumstances that I let destroy my success at that moment. Until this point the story seems dissapointing I would say, but what comes next should encourage people a lot.
    When being size 52 and around 380 pounds, I could not breathe , obviously I couldn’t dance as I used to, and I hit horrible levels of sugar in my blood. I was around 190 , 210 in levels of glucose. Once a spider bit me and it took over a month for my finger to heal…
    At that moment i had given up all hope, even though I was a succesful case of weight loss once, my depression took all my knowledge away and to be honest with you i had no love for life anymore. Nothing would make my react until i watched this atkins success story in youtube , which unfortunately I can’t post the link of right now, which reminded me of all what a LC diet can help you out to achieve.
    At that moment I had moved to United States back, so starting the diet again was pretty easy. Believe it or not, chicken, meet , pork, beef , bacon are less expensive in US than in Mexico.
    So I started my process and little by little in less than 10 months i have lost around 120 pounds again!!! I am in size 38 right now, taking care of my flabiness is what has kinda gotten me stuck in the point where I am at right now, but I will not give up until i achieve a size 36 or even a 34.
    Some people I have met do the atkins diet, lose a lot of weight, then abandon their diet and finally end up gaining all the weight they had lost and even gaining more weight.
    If I did it, you can do it too
    I respectfully send you all my love Dr. Eades because of you earth is a better place to live.
    Thanks for the kind words. I’m happy to learn that you’ve recommitted and are doing so well. Keep it up and keep us posted.

  76. Doctor on Fox News (Dr. Rosenfeld) is as establishment as it gets. He (and the establishment) are retreating in saying that all diets are equal – retreating from their former matra that one diet is to rule them all (the low fat diet).
    But they still use scare tactics, as this Dr. did: “if you worry about your heart or have a high cholesterol level, you dont want a high fat diet”
    Dr. Rosenfeld is obviously a moron when it comes to nutritional matters. By the looks of him, he should spend a little more effort on his own diet rather than wading into waters he knows nothing about.

  77. Several people mentioned the global warming/animal rights alliance. I was curious about this and went searching a while back. Seems some studies have been done and it turns out that cattle put off less methane if they are not grain-finished. In short, if they only eat what they are adapted to eat. Go figure. On top of that, I have learned it is possible to raise cattle under at least light tree cover. It’s called “silvopasture.” So if we need to have more forests as a carbon sink, we can do that and still eat meat. Furthermore? If you don’t have to clear a forest to raise cattle, you still have to clear a forest to raise wheat or soy. I have mentioned this numerous times to vegetarians and vegans, and gotten deafening silence in return.
    I consider myself something of an environmentalist and believe it is possible human beings are contributing to global warming, mainly because we’ve pumped a lot of carbon into the atmosphere and thus into the carbon cycle that wasn’t there before we started burning fossil fuels. But that doesn’t mean I’ll sit idly by and let people make up convenient facts to suit an ideology rather than save a biosphere if the latter’s what they’re really after, as per their claims.
    As for the “nanny state” thing, part of the problem is there is just so MUCH information out there, and a person without the right background can’t possibly absorb it all. Much less someone working in the higher echelons of government who is constantly busy, busy, busy from dawn until well after dusk. Yet another reason the government should stay out of matters of science, I guess, except that the guys who represent “science” (and most of them are guys, so, not a bad choice of words) are not being forthcoming about actual scientific fact. And again, it takes a lot of time and effort to ferret out who’s been bribed, who’s lying, who’s got an agenda to make themselves or their clients more money. We can’t expect the government to sort all this out, but at the same time some of the folks in government genuinely trust scientists and genuinely believe we have a crisis. How do you convince them to back down and listen? First you’d have to get to them through their handlers. What a mess.
    And if the government did completely get out of science then we’d have to rely on private industry to deliver food and medical care and environmental protection and you know, that just doesn’t work very well. They had their chance to do it on their own and then we had to call the government in because the food was adulterated and the medical care was shoddy (at one point doctors didn’t even wash their hands between patients!) and species were disappearing left and right and rivers were catching fire. So… I dunno.
    You should check out The Anthropik Network, can’t recall the URL at the moment, they turn up on a Google search. Jason Godesky wrote out thirty theses about wild humanity vs. domestic/civilized humanity and one of his theses was that population is a function of food supply. And given the ecological costs of raising plant crops, I hope humanity never adapts to a high-carb diet. We’d destroy the biosphere for sure. Again, you don’t have to clear forest to eat critters–and the more forest you clear, the more you mess things up, with desertification and changes in atmospheric composition and so on.
    Great blog. I’m stealing your breakfast smoothie recipe. (For my own use, of course.)
    Enjoy the breakfast smoothie.

  78. I don’t blog about low carb issues, but I do publish a weekly status on my Facebook page about how many weeks I have been grain and sugar free, and how many pounds I am down since I reconnected with this journey at the beginning of 2009 (16 pounds so far). I’ve even been pretty public with the fact that my diet breakdown works out to about 25% protein, 5% carb, and 70% fat. But we will never be totally out of the Dark Ages until we can reach out to all corners of the land. I still get comments from friends like:
    *** “why all the high fat, cholesterol laden oil and meats? We eat more on the Zone plan of 30% protein, 40% complex carbs like vegetables, 30% fat like olive oil. Seems healthier and more helpful in weight loss.” ***
    Maybe for some, but 40% carbs, even from healthy veggies, would be too high for me (and most of the veggies I consume are fairly low calorie, I don’t think my stomach would be big enough to cope with 40% of my calories coming from them! I don’t see how I could do it without adding lots of starchy stuff and/or grains – *not* something I care to do). But it’s still perceived as “healthier”.
    But even sadder is this comment from another Facebook contact, which I suspect is a pretty common though process here in the US: *** “I’m on a “See Food & Eat It Diet” It’d be horrific to have to change now, so I’ll take my cholesterol pill every day” ***
    And these are people who are online and internet savvy. It will take even longer to reach out to folks who are not.

  79. We aren’t there yet, I’m afraid, but I’m doing my share to educate medical persons. I just got back from the doctor – a naturopath, by the by, so at least he’s not pushing manufactured drugs. He congratulated me on my excellent progress – my bg readings are no longer diabetic. I’ve lost 95 pounds. My cholesterol is 168. (That’s not TOO low, is it?) Triglycerides 77, HDL 66, LDL 87.
    After reading my nutritional log – you guessed it, low carb, high fat, heavy on the meat – his recommendation was that I work toward eating less meat and more beans and vegetables. Next time I will try to pin him down on exactly what this is meant to achieve, since he can’t be trying to lower my cholesterol.
    We do not, however, agree about normal bg values. He considers 2h pp values up to 130 to be healthy. (You probably have to take that as healthy if you are pushing a high-carb vegan diet.) Can you point me to some research I could share with him on the benefits of keeping bg lower?
    Thanks for an excellent blog.

  80. Wow, telling your spouse that you doubt the validity of low carb and then buying some mystery substance–talk about cognitive dissonance ! Too much trust, or is it hope?
    Obliquely, it reminds me of a customer who came by that I hadn’t seen in several years. It turned out she had retired and not sold her business to someone else. She came by to get sausage seasoning to make her own sausage, since she doesn’t trust what food companies put in commercial sausage product. No mystery substance for her!
    She said she had been going to a nutritionist to improve her health. I didn’t want to get into controversy, so I didn’t ask whether the advice was low carb or high. She tells me the nutritionist told her the most interesting thing: IF IT HAS A LABEL, IT’S NOT FOOD!
    That pretty much leaves water, meats, veggies, fruit, since grains and dairy are mostly processed, and the label has to tell you!

  81. Not relevant to this topic, but I wasn’t sure where else to ask the question. Did you do a post recently which mentioned how the treatment of breast cancer had a lot of false positives? I think it was something to do with how to read statistics. Or am I just imagining it?! Thanks.
    I usually remember most of my posts, but if I did one on breast cancer and false positives, I don’t remember it. Maybe you read it in one of the comments?

  82. BabyCenter, a nice website for moms of youngsters and mothers-to-be is sadly still in the dark ages. I look at their nutritional advice just for “fun” but it’s really frustrating the advice they give out. Check out this little quiz they sent to my email today.
    Plenty of low fat snacks will keep your hunger pangs away? Seriously? Good thing I listen to your advice and not theirs. I’d be 20 lbs up by now, instead of just 8 lbs. up, which I’m very pleased about 🙂 Very different from my other 2 pregnancies.
    Glad to hear you’re doing so well. Keep it up. And keep away from BabyCenter for your nutritional advice.

  83. I’m encouraged: I met an out-of-town friend at a local coffee house the other day. She returned my copy of Taubes’ Good Calories, Bad Calories. On the way out of the coffee house, with book in arm, a 30-something customer waiting in line to be served caught our attention and said, “that’s a really, really great book!”, to which we both agreed. Wish there had been an opportunity to chat find out more about his thoughts on the subject, but we had to go.
    I can’t tell you how many times I read that book in public places and no one ever commented or seemed to notice the book’s title or subject. So I find it heartening, maybe evidence it’s really “out in public” now, instead of destined to be a “cult classic”.

  84. Among my transcriptions lately have been quite a few reports for people about to undergo, or who have undergone, some form or another of gastric bypass. Seems to me that this kind of treatment is fraught with dangers, plus the person with a bypass is basically going to starve himself for the rest of his life after that operation. It’s my understanding that a person with a bypass can only eat about 3 oz. of food at a time, they must take huge amounts of supplements, and they are quite prone to abdominal pain after the procedure. Plus, apparently a lot of them keep on being carbohydrate addicts, and often they eventually gain back all the weight they originally lose. Do you have any more comments about this kind of procedure for weight loss? Just curious. Heck, I love to eat, and 3 oz. of food is such a small serving that I’d hardly remember having eaten it.
    Gastric bypass is far from a benign procedure, fraught with a lot of morbidity and a fair amount of mortality. And in most instances, it can be avoided if people just content themselves with a good quality, whole-foods, low-carb diet.

  85. To Andrea L, our doctors may be related. I had my lipids down to trigs 39 HDL 47 LDL 105 with which she was quite pleased. She told me she was “not supposed” to recommend other than the “Heart Healthy” diet but since low carbing was working so well to keep it up.
    When I went back with trigs 62 HDL 55 and LDL 94 she wanted to know how I’d achieved the reversal. When I told her by eating saturated fats she freaked out.
    I don’t like to hit 120 at 1 hour postprandial, those lipids will tell you why. Also that appears to be the level where my insulin resistance starts to increase, I begin to feel a distinct lack of energy which is noticeable at 150 and horrendous at 200: obviously as my meter tells me the glucose is in my bloodstream but the muscles stop uptaking it properly, and this effect lingers for a few hours after a postprandial spike before the GLUT-4 transporters wake up again.
    More to be found here
    including links to various papers

  86. Hmmm, that comment “If it has a label, it’s not food!” seems like a very good rule of thumb. I am puzzled and troubled by the number of labels I have read recently that are just plain WRONG! as in internally inconsistent, even allowing for rounding error. I picked up a bottle of pomegranate vinegar which claimed to have 2g carbohydrate and 2 calories. Doesn’t add up no matter how you pour it.

  87. My guess is some of the carbs in vinegar have been converted to acetic acid? The same way some of the carbs in yogurt is converted to lactic acid. How many calories does acetic acid have?
    I don’t think very many, but I haven’t checked.

  88. The whole gastric bypass thing baffles me. Why not just eat as if you had had the operation – wouldn’t the results be the same?
    Actually, that has possibilities: how about a study where one group has the bypass, and the other a placebo operation? Double blind, of course….I bet both groups would show similar rates of weight loss, but the control group would have fewer surgical complications.
    There actually has been such a study. And the finding was that subjects who ate the same as those who underwent the bypass had the same results as those who underwent the bypass.

  89. Regarding gastric bypass, Dr. Eades, tonight I transcribed a report for a woman who had gastric bypass and then about six more abdominal surgeries. At this point she no longer even has a stomach! Yikes.

  90. Sometimes the “a calorie is a calorie” thing is just the first half of a two-part argument. As in “A calorie is just a calorie, and each gram of fat has more than twice the calories of a gram of protein or carbohydrate, so avoiding fat will help keep your calories low.” Sigh.
    Anyway, I appreciate the post and your logic about why these studies are flawed.

  91. I would like to reply to the Russian native who commented on how Russians eat so much meat and potatoes, fried foods and vodka, and yet are not fat… My personal hypothesis to this is, if you put those same Russians in houses, apartments, and offices where it’s still kept at 70 to 72 degrees F or warmer all through the winter… and they never walk miles through the cold daily to get from place to place, but instead sit in a heated vehicle, whether car or bus or train… they too would become obese.
    The more cold a person is exposed to, the more calories he or she burns to exist and stay warm. That’s why comparisons used to be made between a pound of wool on the back being worth a pound of butter, or some such. And typically, people whose ancestors adapted to extreme cold (and ate a traditional diet high in calories and fat in order to deal effectively with that cold) are the ones who balloon into the most extreme cases of obesity when they are plunged into year-round tropical temperature control, especially when physical activities are reduced to American levels. The Inuit, the Quebecois, and many other people whose ancestors adapted very well to cold climate living, can be seen as disproportionately obese compared to other Americans, when they live the typical American life.
    That’s my suspicion as to why cold-climate people such as German and Russian Europeans, often bemoan “ballooning up” if they come to live in America for a long period of time, even if they don’t live on junk or fast food. There is simply too much heated indoor environments and too little provisions in cities for walking or bicycling. Many places, you must drive even if the place you want to get to is but a mile away, and many Americans are accustomed to thinking of a mile as a long distance to have to walk.

  92. By the way, all this does help explain how my mother got into such terrible health by her early 60’s (lifeong messages that carbs are good, fats are bad) but also why she is remarkably slim, strong, erect-standing, and how the heck she managed to clear her clogged arteries despite continuing to smoke, even with poorly managed diabetes and CHF. They wanted her on statins, Vioxx for her arthritis (luckily we researched that one after the cardiologist declared it safe, and politely refused), etc etc. Instead of accepting standard medical advice out-of-hand, she takes Bromelain and Co-Enzyme Q-10, and amazed cardiologists when she reduced her arterial plaque buildup from 50% to less than 20% in the space of months, despite smoking and still eating the occasional junky sweet roll, and practically living on cheap high-fat hamburger meat and fatty sausage. I still wish she would quit smoking and give up the sweets, but she’s doing amazingly better than docs would believe based on her dismissing their drugs and dietary advice, and taking “weird” supplements instead.

  93. Mike, if you wrote a book reflecting the way you write here on the blog, it would be huge!
    And you and maybe three or four others would read it. Or at least that’s how publishers see the situation. It’s difficult to sell a book about serious nutritional issues to a publisher because most publishers think general readers are stupid.

  94. Hi Dr. Eades,
    I am driving myself slightly bonkers. I am [b]sure[/b] that I read an analysis on this paper carefully breaking down the results of this trial, particularly their Figs 3 and 4, which I didn’t have time to read at the time and put aside and unfortunately forgot about. I just remembered it today, and thought it was on your blog. Am I mistaken?
    Also, didn’t you do an(other) analysis on the lipid results for a similar trial at one point? Similar story …
    Sorry to ask you to be my human Google 😉 . Thanks!

  95. I don’t know if you would consider this comment to be relative or not, but here goes. Poor people have always been fed the highest carb cheapest foods available. I’ve read that the people of Egypt along the Nile started the agriculture revolution by farming grain crops. In my opinion they weren’t growing the crops for the grain but for the straw to make brick to build with. The grain was a byproduct that was a cheap way to feed the slave labor. And since people tend to stick with the foods they grew up eating the slaves continued to eat grain (bread, gruel, and all variations) after they were freed.
    Even now it is cheaper to go to the store and buy a bag of flour to make bread than it is to buy hamburger. Cheap hot dogs cost less than the flour but nutrtionally you probably aren’t coming aut ahead by much.
    With the economy the way it is you are better off trying to tell people how to eat high protein on a budget than trying to tell them how bad the carbs are for them. As far as that goes, a more positive and less condeming approach is always best when trying to convince someone to do something they are unsure of. I have had to learn this the hard way since I tend to use a hammer to kill a fly!

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