A few days ago I received the following letter from a reader of the Protein Power LifePlan that I would like to share.
Dear Drs. Eades:
My wife and I are committed practitioners and advocates of your Protein Power LifePlan and have been since your initial publication in 1995. [Actually Protein Power was published in 1996, the Protein Power LifePlan in 2000] We believe that our health and appearance have been significantly improved since reversing our emphasis on carbohydrates and introducing a higher, appropriate amount of protein, good fat, while substantially lowering our overall carbohydrate intake. My overall muscle profile has radically improved, and although my wife has gained a fair amount of weight back, we believe this is simply the result of inadequate vigorous exercise at present.
We stumbled onto the attached article [a Xeroxed copy of the article was enclosed] that caused us a considerable amount of dismay and discussion. It seems, in a rough sense, diametrically to contradict the basic principles and biological/physiological rational outlined in your protein-based protocol.
Would you be kind enough to comment on the article and its claims in light of your current scientific and nutritional knowledge and understanding of the function and role of carbohydrates in the human diet? I am particularly struck by the article’s assertions in light of your comment on p. 9 of The Protein Power LifePlan: (“Carbohydrates, the third macronutrient, are totally unessential to human health.”)
Thank you kindly,
[Name withheld by me]
I’ve got to tell you, letters like this one drive me nuts.
Why?
Because it took MD and me about six solid months of writing (not to mention the 20 years apiece of medical practice and research so that we would know what to write) to complete the Protein Power LifePlan, a 400 plus page book that we consider our most comprehensive to date, and I can’t understand how someone who spends the time required to read such a book , then follows the recommendations and achieves success, can be caused a “considerable amount of dismay” by a pissy little article dashed off in a couple of hours by a free lance writer.
Maybe I’m being too sensitive, but let’s get real.
Before I get into the article (which I have reproduced below) I want to discuss exactly how the vast majority of magazine articles and other pieces of this nature come about. Editors decide what articles they want to go in which issue of whatever magazine, including online magazines. These editors then approach free lance writers and ask them to write the articles.
The editors don’t call the free lancers and say, “I want a full-blown investigative piece on the pros and cons of the low-carb diet,” because unless the free lancer is an investigative scientific journalist he or she won’t have the background to do the job. And those kinds of jobs cost the magazine a fair amount of money, well into the thousands. Typically, editors know exactly what they want and assign it.
For example, the theme of a particular issue of a magazine may be about entertaining with comfort foods, so the editor calls a free lancer and says, “We need a 2000 word article attacking low-carb diets.” The free lancer, who probably gets paid a few hundred dollars for such a piece calls a couple of “experts” and gets the needed info. Since the assignment was to attack low-carb diets any positive information is ignored and the negative information is written up.
This particular article was written by Abby Christopher, a free lance writer based in Portland, Oregon. If you google Ms. Christopher you will find that she writes frequently for Wired magazine, the trade journal more or less for computer and gaming geeks, which, of course, qualifies her to write knowledgeably about nutrition. She, being in Portland, picks up the phone and calls Diane Stadler, a “research assistant professor” at the University of Oregon. Ms. Stadler is so obscure that searching the university’s websites garners very little information about her. But Ms. Stadler, whom I suspect is a Registered Dietitian, is more than happy to provide Ms. Christopher with all sorts of negative information on low-carb diets.
To give her article a little bit more panache Ms. Christopher quotes none other than my good buddy Dean Ornish. And she does it in a carefully crafted way that would lead one to believe that Dr. Ornish was actually interviewed for this article, which I’m sure he wasn’t. She writes:
Diet guru [I love it] Dr. Dean Ornish also worries about the effect of such diets on the kidneys. “High total protein intake, particularly animal protein,” says Ornish, “may accelerate renal-function decline.”
He’s only said this about 50,000 times, so I’m sure she picked up the direct quote and dropped it in her piece.
This short article reminds me of a joke I once heard about a redneck that went to see Hamlet for the first time. When he came out of the theater someone asked him what he thought of the play. He replied” “Not much. It wasn’t nothing but a bunch of quotes all strung together.”
This article is nothing but a bunch of misleading myths about low-carb dieting all strung together. These myths have been refuted so many times in the medical literature that it defies belief that they’re still hanging on. But they are. It’s as if they’re impossible to kill. As a consequence I’ve named them the Vampire Myths.
Here is a listing of the Vampire Myths as I see them. (feel free to add to the tally)
Low-carb diets cause heart disease
Low-carb diets will destroy your kidneys
Low-carb diets cause osteoporosis
Low-carb diets decrease endurance
Low-carb diets make your thinking fuzzy
Low-carb diets cause cancer
Low-carb diets cause dangerous ketoacidosis
There are probably more, but these are the ones almost everyone is familiar with. These are all untrue. They are myths. In due course I will address all of these, but for now, let’s just hit a couple.
First, the idea that is made much of in this idiotic article concerns low-carb diets causing fuzzy thinking, so let’s take a little deeper look. Ms. Christoper writes:
…to achieve and maintain normal brain function, adults and children need 130 grams of carbohydrates a day. On the Atkins Diet or similar regimens, you’re allowed to eat about 20 grams of carbs daily at first; you can later nudge up the intake, but never to the minimum amount nutritionists recommend.
“Restricting carbs like that is going to have an effect on the brain,” Stadler warns.
She is absolutely correct. The brain does need about 130 grams of glucose per day. It actually needs more like 200 grams of glucose per day, but during fasting or a low-carbohydrate diet the body begins producing ketones, which replace at least 70 grams of the required glucose in the brain, dropping the overall requirement to about 130 grams per day. If a person only eats 20 grams of carbohydrate per day, the liver makes the other 110 grams. The liver is perfectly capable of churning out about 200 grams, or a cup, of sugar per day–even if you don’t eat anything–so the brain isn’t going to be deprived.
What sometimes does occur is what we call Ketone Brain. Let me explain. If you are on a high carbohydrate diet containing 200-400 grams of sugar (or sugar equivalents) per day, your brain has all the glucose it needs. (It actually has more than it needs; excess brain glucose is thought by many to be one of the driving forces behind Alzheimer’s and other dementias of aging. But that’s another story for another day.) If your brain is steaming along, fueled with all the glucose it needs, then you go on a low-carb diet and the glucose is cut off, the brain converts to using ketone bodies. But this conversion doesn’t happen in a split second. It takes a little bit for the conversion to take place. During this brief period you may feel a little fuzzy headed, but as soon as the conversion is complete, you actually think more clearly.
So, Ms. Christopher, along with a little help from Ms, Stadler, has taken a couple of strands of truth and spun them into a web of deceit and misinformation.
Let’s look at one more.
Diet guru Dr.Dean Ornish also worries about the effect of such diets on the kidneys. “High total protein intake, particularly animal protein,” says Ornish, “may accelerate renal-function decline.”
Does so-called diet guru Dean Ornish have anything to worry about with high-protein diets and the kidney? Hardly.
If you want to read about protein and the kidney, click here for a full-text article from the journal Nutrition & Metabolism.
My favorite article showing the absurdity of this claim comes from research performed in Israel almost 20 years ago by Dr. Marion Blum. There have been numerous studies since showing the same thing, but I like this one because of its simplicity and elegance.
Dr. Blum and her group recruited 30 vegetarian subjects of varying ages and sexes. These subjects had been vegetarians for over 13 years (so there were no recent coverts in the bunch) and had consumed low amounts of plant-based protein for a significant portion of their lives. Dr. Blum then found a group of 31 meat-eating subjects who were the same ages and sexes as the vegetarians, but who consumed large amounts of mainly animal protein. Dr. Blum tested the kidney function of both groups.
It is an unfortunate fact of life that as we age the function of our kidneys (and all our organs, for that matter) deteriorates. This deterioration can be measured and plotted on a graph showing decreased function as we get older.
Dr. Blum plotted the course of the age-related decline of kidney function in the vegetarians. She them plotted the same thing in the meat eaters and found that the two graphs were exactly the same. There was no difference in the age related kidney function of a long term vegetarian and a meat eater of the same age and sex. (Here is the link to the full text of the study)
I guess Dr. Ornish missed that study.
Here is the article that inspired this post. I have to give Ms. Christopher stylistic credit. She was able to fit a large number of Vampire Myths into a fairly small article. I hope they paid her well.
Oh, and by the way, the quote from page 9 of the Protein Power LifePlan that inspired the writer of the letter that kicked this post off is absolutely true:
Carbohydrates, the third macronutrient, are totally unessential to human health.
The article as published at www.edutopia.org.
Caveat Eater
Learning to love (again) the much-maligned carbohydrate.
By Abby Christopher
The craze for high-protein, low-carbohydrate diets is on the wane. One sure sign is that Atkins Nutritionals, the company that produces Atkins Diet-related products, declared bankruptcy this summer. Another is that the number of low-carb foods introduced this year was down compared to the past two years. But not everyone has given up the extreme approach to shedding pounds. So, if you’re on a high-protein, low-carb diet, watch out: You may be courting a nasty case of “Um … er … ah, what was I saying?” in front of an unforgiving classroom of students. According to nutritionists, diets too low in carbs can affect brain power, not to mention energy, bone mass, and kidney function.
On a low-carb diet, “you’ll have problems with word recall, and you’ll feel less sharp,” says Diane Stadler, research assistant professor in the Oregon Health and Science University’s Health Promotion and Sports Medicine Division.
Dietary reference tables published this year by the Institute of Medicine indicate that to achieve and maintain normal brain function, adults and children need 130 grams of carbohydrates a day. On the Atkins Diet or similar regimens, you’re allowed to eat about 20 grams of carbs daily at first; you can later nudge up the intake, but never to the minimum amount nutritionists recommend.
“Restricting carbs like that is going to have an effect on the brain,” Stadler warns. She adds that a high-protein/low-carb diet can also whittle away at your bone mass, regardless of your age or relative health. Diets high in meat raise the acid level of blood, increasing excretion of calcium and phosphorus from the bone, which leads to early loss of bone density and accelerating osteoporosis. High-protein diets that rely on meat also decrease levels of urinary citrate, which can cause kidney stones.
As distance runners know, carbs are fuel, so if your lifestyle includes intense cardio workouts or you plan to start an exercise program at the same time you begin a high-protein diet, you may lack the stamina for even thirty minutes on an elliptical machine.
“Even going up a flight of stairs, not just working out, you’re going to have some fatigue,” says Stadler. And though you may be okay during short workouts with weights, Stadler adds that the potassium concentration of a high-protein diet is more likely to cause muscle cramps.
Diet guru Dr.Dean Ornish also worries about the effect of such diets on the kidneys. “High total protein intake, particularly animal protein,” says Ornish, “may accelerate renal-function decline.”
More dangerous possible consequences exist, such as raised levels of bad cholesterol, as does a less dire but socially embarrassing side effect: bad breath. But losing focus while trying to hold students’ attention is a professional downside that even a rapid drop in weight can’t justify. Working to get yourself in better shape is a worthy goal, but when shape trumps sharpness, something’s got to give. So cook yourself a veggie stir fry on rice, whip up a plate of pasta primavera, or have a slice of whole-grain bread with your soup. Carbs are back. Your brain is hungry for them.
Photo by Ankhesenamun on Unsplash
I love your blog, it’s consistently informing and entertaining. Here are some more myths that I’ve heard:
Low-carb diets are impossible to stick to for any length of time.
Low-carb diets are “unbalanced”.
Low-carb diets promote weight loss only because food choices are so limited that people eat less.
Low-carb diets inhibit thyroid function.
Low-carb diets are wasteful of the earth’s resources.
I appreciate how frustrating it must be to have counter so much stupidity over and over again, but I applaud your willingness to take it on.
Thanks for your support. It’s a hard job, but someone’s got to do it.
Dr. Mike, it has been my experience that people don’t want believe statistics no matter how irrefutable they mey be. They would rather believe a story so obscure and hang their hat on that. An example, the statistics are overwhelming sbout lung cancer and cigarettes but they will believe an obsure story abou the 100 year old lady who smoked all her life and lived to be a ripe old age. People were meant to learn by stories and that is the way it will always be. By the way I have been a reader of you and you wife’s books since the first book “Protein Power” keep up the good work and fight.
Sir thanks your kind words re not posting.
ref The Vampire Myth folks.
Verily Sir if they have read and more importantly acted upon your fine work (albeit cheesy mugshot as per previous post) only then to ask ‘eejit’ questions then if it were i i would simply tell them that you were infact lying through your teeth when you wrote the PPL book.
Did you read David Myers wondrous Intuition its Powers and Perils ? there’s super section about people beleiving what they believe against all contrary evidence.
Pearls afore swine Sir as awful as that saying is; one has to face the sad fact that some people are as my Gran used to say ‘Daft as brushes’
Don’t sweat it as its wasted effort..sadly.
I would really like to have an email address for that ignorant journilist. I have lost 140 lbs on a 35 carb a day diet. I have learned to love eating this way. During this time I went from couch potatoe to working out 3 days a week at Curves, walking 4 miles every day, and line dancing 2 hours a week. Not to mention I passed 50 several years ago.No energy????? I can only be grateful the glut of low carb food has stopped as it was junk anyway. I love your blog. Keep up the good work. We who live and love low carb may always be a minority but we know what is right for our bodies. Those who do it correctly are usually much healthier than those who have been low calorie low fat for twenty years and are still gaining. Sorry this is so long but I really get wound up.
Adding to the list of myths…
Ketosis…
burns up muscles
gives you bad breath
compromises immune function
slows muscle recovery after workouts
Low-Carb Diets…
do bad things to your cholesterol
leave you mentally drained
eliminate fruit
affect your mood and make you cranky
are deficient in essential nutrients
are too low in fiber
cause kidney stones
cause liver disease
cause gout
cause joint pain
Any others?
PP cleared up my fuzzy thinking (and near-comatose state), which was CAUSED by eating too many carbs!
What I wonder is why so many magazine writers choose to write about “waning fads”. If nobody cared about the fad anymore, who do they expect would bother to read their articles or even buy the magazines? Are the article ideas put forward by the magazine’s grain and sugar advertisers?
Even magazines that do contain some LC articles always seem to make sure they run an ad or recipe for some sugar-laden crap on the same page.
Here’s another one:
On a low-carb diet the weight you lose is water.
Which is hilarious because I’ve lost 15.3% of my body fat since starting, from 37.8% to 22.5%. My goal is 19-20%, which I may or may not make.
The stamina thing I kind of agree with. While I usually have no trouble with 30 minutes of weight training and an hour of moderate intensity cardio, I absolutely can’t run more than a mile, and my performanace dropped during a 7.5 mile race one year. When I carbed up before the race, I shaved 15+ minutes off my time. And my running record after carbing up is 3.7 miles. I can WALK forever; I just can’t run when low-carbing.
So for normal activity, low carb isn’t a problem. But really intense exercise for an extended period is impossible.
I do not for a minute believe her when she says you won’t be able to do 30 minutes on the eliptical. As I said, most of my gym sessions involve an hour of cardio, and the eliptical is one of my favorite machines.
Just for reference, I shoot for about 60 net grams a day of carbs, though it creeps a bit higher some days. I’m officially on the maintenance phase of my plan, but am still watching my carb intake closely as I want to lose fat and gain muscle, increasing my health without losing any more weight.
Dear Dr. Mike,
My golf game sucks, I’m broke, and every single day I seem to get a day older. Do you think my problems could have anything to do with my low- carb diet? Please rush your answer because my brain feels really hungry right now and I’m beginning to think it needs a doughnut or maybe some popcorn.
When I play the game of “Go” I seem to do much better when on a low carb diet. Anyone ever take intelligence or reasoning/comprehension tests on and off the diet?
Ditto to what dierdra says about carbs and a comatose state.
I follow up on my customers needs with a lot of phone time, and it used to be that by the afternoon, if I was left on hold, I would fall asleep! I find that high protein, low carb leaves me much more coherent for much longer periods of time, and that my mind is a lot clearer and calmer.
“Mentally drained”… How funny! I’ve never felt better, in all respects.
Actually, I did try Mary Dan’s suggestion for “brain testing”. I played a classical piano piece that I know well (Beethoven Op. 57), and then did a Sudoku puzzle and recorded the time it took to finish the puzzle.
I then started learning an unknown piece (Mozart Fantasia K. 475). After about an hour of that, I did another Sudoku puzzle and shaved 20 minutes off the time it took to complete the puzzle.
While I am too embarrassed to report my actual times (I’m a beginner at Sudoku), suffice it to say that my brain is not the least bit foggy anymore. And the Mozart is coming along nicely!
“Low carb diets cause cancer” and “Low carb diets cause heart disease” are the most common myths that I hear.
Dr. Atkins died of a heart attack.
I know a guy whose uncle almost died from low carb.
Every doctor in low carb is being sued by someone who got sicker on low carb.
That “grease diet” can’t be healthy.
Oh yeah Karen it can’t be! You are so right, lol. Dr. Atkins died from complications from a slip and fall hitting his head.
I knwo a guys who’s uncle was abducted by space aliens.
So if they were getting sicker, were they sick to begin with.
How about all the people it has helped, Karen? Are you so blind you can not see them. Do you research before you run your mouth.
LOL
Brian, I believe you are attributing the wrong comment to me. The anti- Atkins comment was posted by David LaCivita, not by me.
Old thread, but I had to write.
What about the myth that long-term LC eating causes hypothyroidism and metabolic disorders? I keep reading that people (especially women) need 50 grams of carbs a day. Were that true, the Inuit and others who eat precious few carbs would have rampant depression and hypothyroidism.
Here’s a quote from Lyle McDonald in “The Ketogenic Diet.” Would love to hear your take on this.
“The body has two types of thyroid hormones (42). The primary active thyroid hormone is T3, called triiodothyronine. T3 is responsible most of the metabolic effects in the body. The other thyroid hormone is T4, called thyroxine. Thyroxine is approximately one-fifth as metabolically active as T3 and is considered to be a storage form of T3 in that it can be converted to T3 in the liver.
“T3 levels in the body are primarily related to the carbohydrate content of the diet (44-46) although calories also play a role (47-49). When calories are above 800 per day, the carbohydrate content of the diet is the critical factor in regulating T3 levels and a minimum of 50 grams per day of carbohydrate is necessary to prevent the drop in T3 (44,48,49). To the contrary, one study found that a 1500 calorie diet of 50% carbohydrate and 50% fat still caused a
drop in T3, suggesting that fat intake may also affect thyroid hormone metabolism (50).
“Below 800 calories per day, even if 100% of those calories come from carbohydrate, T3 levels drop (47). Within days of starting a ketogenic diet, T3 drops quickly. This is part of the adaptation to prevent protein losses and the addition of synthetic T3 increases nitrogen losses during a ketogenic diet (1). In fact the ability to rapidly decrease T3 levels may be one determinant of how much protein is spared while dieting (51).
“Hypothyroidism and euthyroid stress syndrome (ESS)
“There are two common syndromes associated with low levels of T3 which need to be differentiated from one another. Hypothyroidism is a disease characterized by higher than normal thyroid stimulating hormone (TSH) and lower levels of T3 and T4. The symptoms of this disease include fatigue and a low metabolic rate.
“The decrease in T3 due to hypothyroidism must be contrasted to the decrease seen during dieting or carbohydrate restriction. Low levels of T3 with normal levels of T4 and TSH (as seen in ketogenic dieting) is known clinically as euthyroid stress syndrome (ESS) and is not associated with the metabolic derangements seen in hypothyroidism (1). The drop in T3 does not appear to be linked to a drop in metabolic rate during a ketogenic diet(17,52).
“As with other hormones in the body (for example insulin), the decrease in circulating T3 levels may be compensated for by an increase in receptor activity and/or number (1). This has been shown to occur in mononuclear blood cells but has not been studied in human muscle or fat cells (53). So while T3 does go down on a ketogenic diet, this does not appear to be the reason for a decrease in metabolic rate.”
Hi Kathy–
MD and I have taken care of thousands of patients on low-carb diets and have gotten blood work on them all. Based on our large sample size, we haven’t really seen this effect. Of course, we didn’t have our patients on 800 calorie or lower diets, so maybe that’s a reason. I suspect that dietary protein enhances the conversion of T4 to T3, and since we always made sure our patients got plenty of good quality protein, perhaps that made the difference. Whenever I read something that sounds plausible, but goes against the evidence I’ve seem myself with my patients, I always go with the first hand experience.
Cheers–
MRE