What is Moderate-Carb in a High-Carb Society?

“If we were eating what the government actually funded in agricultural supports, we’d be having a giant corn fritter, deep fried in soybean oil. And it’s like, that’s not exactly what we should be eating.”
~ Mark Hyman

A couple years back (2018), researchers did an analysis of long-term data on intake of carbohydrates, plant foods, and animal foods: Sara B Seidelmann, et al, Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis). The data, however, turns out to be more complicated than how it was reported in the mainstream news and in other ways over-simplified.

This was an epidemiological study of 15,000 people done with notoriously unreliable self-reports called Food Frequency Questionnaires based on the subjects’ memory of years of eating habits. The basic conclusion was that a diet moderate in carbs is the healthiest. That reminds me of the “controlled carbs” that used to be advocated to ‘manage’ diabetes that, in fact, worsened diabetes over time (American Diabetes Association Changes Its TuneAmerican Diabetes Association Changes Its Tune) — what was being managed was slow decline leading to early death. Why is it the ruling elite and its defenders, whether talking about diet or politics, always trying to portray extreme positions as ‘moderate’?

Let’s dig into the study. Although the subjects were seen six times over a 25 year period, the questionnaire was given only twice with the first visit in the late 1980s and with the third visit in the mid 1990s — two brief and inaccurate snapshots with the apparent assumption that dietary habits didn’t change from the mid 1990s to 2017. As was asked of the subjects, do you recall your exact dietary breakdown for the the past year? In my personal observations, many people can’t recall what they ate last week or sometimes even what they had the day before — the human memory is short and faulty (the reason nutritionists will have patients keep daily food diaries).

There was definitely something off about the data. When the claimed total caloric intake is added up it would’ve meant starvation rations for many of the subjects, which is to say they were severely underestimating parts of their diet, most likely the parts of their diet that are the unhealthiest (snacks, fast food, etc). Shockingly, they didn’t even assess or rather didn’t include carbohydrate intake for all those periods for they later on extrapolated from the earlier data with no explanation for this apparent data manipulation.

To further problemitize the results, those who developed metabolic health conditions (diabetes, stroke, heart disease) in the duration, likely caused by carbohydrate consumption, were excluded from the study, as were those who died — it was expected and one might surmise it was intentionally designed to find no link between dietary carbs and health outcomes. That is to say the study was next to worthless (John Ioannidis, The Challenge of Reforming Nutritional Epidemiologic Research). Over 80% of the hypotheses of nutritional epidemiology are later proved wrong in clinical trials (S. Stanley Young & Alan Karr, Deming, data and observational studies).

Besides, the researchers defined low-carb as anything below 40% and very high-carb as anything above 70%, though the study itself was mainly looking at percentages in between these. This study wasn’t about the keto diet (5% carbs of total energy intake, typically 20-50 grams per day) or even generally low-carb diets (below 25%) and moderate-carb diets (25-33% or maybe slightly higher). Instead, the researchers compared diets that were varying degrees of high-carb (37-61%, about 144 grams and higher). It’s true that one might argue that, compared to the general population, a ‘moderate’-carb diet could be anything below the average high-carb levels of the standard American diet (50-60%), the high levels the researchers considered ‘moderate’ as in being ‘normal’. But with this logic, the higher the average carb intake goes the higher ‘moderate’ also becomes, a not very meaningful definition for health purposes.

Based on bad data and confounded factors for this high-carb population, the researchers speculated that diets below 37% carbs would show even worse health outcomes, but they didn’t actually have any data about low-carb diets. To put this in perspective, traditional hunter-gatherer diets tend to be closer to the ketogenic level of carb intake with, on average, 22% of dietary energy at the lower range and 40% at the highest extreme, and that is particularly ketogenic with a feast-and-fast pattern. Some hunter-gatherers, from Inuit to Masai, go long periods with few if any carbs, well within ketosis, and they don’t show signs of artherosclerosis, diabetes, etc. For hunter gatherers, the full breakdown includes 45-65% of energy from animal foods with 19-35% protein and 28-58% fat. So, on average, hunter-gatherers were getting more calories from fat than from carbs. Both the low end and high end of the typical range of fat intake is higher than the low end and high end of the typical range of carb intake.

The study simply looked at correlations without controlling for confounders: “The low carb group at the beginning had more smokers (33% vs 22%), more former smokers (35% vs 29%), more diabetics (415 vs 316), twice the native Americans, fewer habitual exercisers (474 vs 614) ” (Richard Morris, Facebook). And alcohol intake, one of the single most important factors for health and lifespan, was not adjusted for at all. Taken together, that is what is referred to as the unhealthy user bias, whereas the mid-range group in this study were affected by the healthy user bias. Was this a study of diet or a study of lifestyle and demographic populations?

On top of that, neither was data collected on specific eating patterns in terms of portion sizes, caloric intake, regularity of meals, and fasting. Also, the details of types of foods eaten weren’t entirely determined either, such as whole vs processed, organic vs non-organic, pasture-raised vs factory-farmed — and junk foods like pizza and energy bars weren’t included at all in the questionnaire; while whole categories of foods were conflated  with meat being lumped together with cakes and baked goods, as separate from fruits and vegetables. A grass-finished steak or wild-caught salmon with greens from your garden was treated as nutritionally the same as a fast food hamburger and fries.

Some other things should be clarified. This study wasn’t original research but was data mining older data sets from the research of others. Also, keep in mind that it was published in the Lancet Public Health, not in the Lancet journal itself. The authors and funders paid $5,000 for it to be published there and it was never peer-reviewed. Another point is that the authors of the paper speak of ‘substitutions’: “…mortality increased when carbohydrates were exchanged for animal-derived fat or protein and mortality decreased when the substitutions were plant-based.” This is simply false. No subjects in this study replaced any foods for another. This an imagined scenario, a hypothesis that wasn’t tested. By the way, don’t these scientists know that carbohydrates come from plants? I thought that was basic scientific knowledge.

To posit that too few carbs is dangerous, the authors suggest that, “Long-term effects of a low carbohydrate diet with typically low plant and increased animal protein and fat consumption have been hypothesised to stimulate inflammatory pathways, biological ageing, and oxidative stress.” This is outright bizarre. We don’t need to speculate. In much research, it already has been shown that sugar, a carbohydrate, is inflammatory. What happens when sugar and other carbs are reduced far enough? The result is ketosis. And what is the affect of ketosis? It is an anti-inflammatory state, not to mention promoting healing through increased autophagy. How do these scientists not know basic science in the field they are supposedly experts in? Or were they purposefully cherrypicking what fit their preconceived conclusion?

Here is the funny part. Robb Wolf points out (see video below) that in the same issue of the same journal on the same publishing date, there was a second article that gives a very different perspective (Andrew Mente & Salim Yusuf, Evolving evidence about diet and health). The other study concluded a low-carb diet based on meat and animal fats particularly lowered lifespan which probably simply demonstrated the unhealthy user effect (these people were heavier, smoked more, etc), but this other article looked at other data and came to very different conclusions,

“More recently, studies using standardised questionnaires, careful documentation of outcomes with common definitions, and contemporary statistical approaches to minimise confounding have generated a substantial body of evidence that challenges the conventional thinking that fats are harmful. Also, some populations (such as the US population) changed their diets from one relatively high in fats to one with increased carbohydrate intake. This change paralleled the increased incidence of obesity and diabetes. So the focus of nutrition research has recently shifted to the potential harms of carbohydrates. Indeed, higher carbohydrate intake can have more adverse effects on key atherogenic lipoproteins (eg, increase the apolipoprotein B-to-apolipoprotein A1 ratio) than can any natural fats. Additionally, in short-term trials, extreme carbohydrate restriction led to greater short-term weight loss and lower glucose concentrations compared with diets with higher amounts of carbohydrate. Robust data from observational studies support a harmful effect of refined, high glycaemic load carbohydrates on mortality.”

Then, in direct response to the other study, the authors warned that, “The Findings of the meta-analysis should be interpreted with caution, given that so-called group thinking can lead to biases in what is published from observational studies, and the use of analytical approaches to produce findings that fit in with current thinking.” So which Lancet article should we believe? Why did the media obsess over the one while ignoring the other?

And what about the peer-reviewed PURE study that was published the previous year (2018) in the Lancet journal itself? The PURE study was much larger and better designed. Although also observational and correlative, it was the best study of its kind ever done. The researchers found that carbohydrates were linked to a shorter lifespan and saturated fat to a longer lifespan, and yet it didn’t the same kind of mainstream media attention. I wonder why.

The study can tell us nothing about low-carb diets, even if low-carb diets had been included in the study. Yet the mainstream media and health experts heralded it as proof that a low-carb diet was dangerous and a moderate-carb diet was the best. Is this willful ignorance or intentional deception? The flaws in the study were so obvious, but it confirmed the biases of conventional dietary dogma and so was promoted without question.

On the positive side, the more often this kind of bullshit gets put before the public and torn apart as deceptive rhetoric the more aware the public becomes about what is actually being debated. But sadly, this will give nutrition studies an even worse reputation than it already has. And it could discredit science in the eyes of many and could bleed over into a general mistrust of scientific experts, authority figures, and public intellectuals (e.g., helping to promote a cynical attitude of climate change denialism). This is why it’s so important that we get the science right and not use pseudo-science as an ideological platform.

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Will a Low-Carb Diet Shorten Your Life?
by Chris Kresser

I hope you’ll recognize many of the shortcomings of the study, because you’ve seen them before:

• Using observational data to draw conclusions about causality
• Relying on inaccurate food frequency questionnaires (FFQs)
• Failing to adjust for confounding factors
• Focusing exclusively on diet quantity and ignoring quality
• Meta-analyzing data from multiple sources

Unfortunately, this study has already been widely misinterpreted by the mainstream media, and that will continue because:

1. Most media outlets don’t have science journalists on staff anymore
2. Even so-called “science journalists” today seem to lack basic scientific literacy

In light of the Aug 16th, 2018 Lancet study on carbohydrate intake and mortality, where do you see the food and diet industry heading? (Quora)
Answered by Chris Notal

A study where the conclusion was decided before the data.

They mentioned multiple problems in their analysis, but then ignored this in their introduction and conclusion.

The different cohorts: the cohort with the lowest consumption of carbs also had more smokers, more fat people, more males, they exercised less, and were more likely to be diabetic; each of these categories independently of each other more likely to result in an earlier death. Also, recognize that for the past several decades we have been told that if you want to be healthy, you eat high carb and low fat. So even if that was false, you have people with generally healthier habits period who will live longer than those who do their own thing and rebel against healthy eating knowledge of the time. For example, suppose low carb was actually found to be healthier than high carb: it wouldn’t be sufficient to offset the healthy living habits of those who had been consuming high carb.
Also, look at the age groups. The starting ages were 46–64. And it covered the next 30 years. Which meant they were studying how many people live into their 90’s. Who’s more likely to live into their 90’s, a smoker or non-smoker? Someone who is overweight or not? Males or females? Those who exercise or those who don’t? The problem is that each variable they used in the study along with high carb, on their own supports living longer than the opposite.

Carbs, Good for You? Fat Chance!
By Nina Teicholz

A widely reported study last month purported to show that carbohydrates are essential to longevity and that low-carb diets are “linked to early death,” as a USA Today headline put it. The study, published in the Lancet Public Health journal, is the nutrition elite’s response to the challenge coming from a fast-growing body of evidence demonstrating the health benefits of low-carb eating…

The Lancet authors, in recommending a “moderate” diet of 50% to 60% carbohydrates, essentially endorse the government’s nutrition guidelines. Because this diet has been promoted by the U.S. government for nearly 40 years, it has been tested rigorously in NIH-funded clinical trials involving more than 50,000 people. The results of those trials show clearly that a diet of “moderate” carbohydrate consumption neither fights disease nor reduces mortality.

Deflating Another Dietary Dogma
By Dan Murphy

Just the linking of “carbohydrate intake” and “mortality” tells you all you need to know about the authors’ conclusions, and Teicholz pulls no punches in challenging their findings, calling them “the nutrition elite’s response to the challenge coming from a fast-growing body of evidence demonstrating the health benefits of low-carb eating.”

By way of background, Teicholz noted that for decades USDA’s Dietary Guidelines for Americans have directed people to increase their consumption of carbohydrates and avoid eating fats. “Despite following this advice for nearly four decades, Americans are sicker and fatter than ever,” she wrote. “Such a record of failure should have discredited the nutrition establishment.”

Amen, sister.

Teicholz went on to explain that even though the study’s authors relied on data from the Atherosclerosis Risk in Communities (ARIC) project, which since 1987 has observed 15,000 middle-aged people in four U.S. communities, their apparently “robust dataset” is something of an illusion.

Why? Because the ARIC relied on suspect food questionnaires. Specifically, the ARIC researches used a form listing only 66 food items. That might seem like a lot, but such questionnaires typically include as many as 200 items to ensure that respondents’ recalls are accurate.

“Popular foods such as pizza and energy bars were left out [of the ARIC form],” Teicholz wrote, “with undercounting of calories the inevitable result. ARIC calculated that participants ate only 1,500 calories a day — starvation rations for most.”

Low carbs and mortality
by John Schoonbee

An article on carbohydrate intake and mortality appeared in The Lancet Public Health last week. It is titled “Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis”. In the summary of the article, the word “association” occurs 6 times. The words “cause”, “causes” or “causal” are not used at all (except as part of “all-cause mortality”).

Yet the headlines in various news outlets are as follows:

BBC : “Low-carb diets could shorten life, study suggests”

The Guardian : “Both low- and high-carb diets can raise risk of early death, study finds”

New Scientist : “Eating a low-carb diet may shorten your life – unless you go vegan too”

All 3 imply active causality. Time Magazine is more circumspect and perhaps implies more of the association noted in the article : “Eating This Many Carbs Is Linked to a Longer Life”. These headline grabbing tactics are part of what makes nutritional science so frustratingly hard. A headline could perhaps have read : “An association with mortality has been found with extreme intakes of carbohydrates but no causality has been shown”

To better understand what an association in this context means, it is perhaps good to use 2 examples. One a bit silly, but proves the point, the other more nuanced, and in fact a very good illustration of the difference between causality and association.

Hospitals cause people to die. Imagine someone saying being in hospital shortens your life span, or increases your mortality. Imagine telling a child going for a tonsillectomy this! Of course people who are admitted to hospital have a higher mortality risk than those (well people) not admitted because they are generally sicker. This is an association, but it’s not causal. Being in a hospital does not cause death, but is associated with increased death (of course doctor-caused iatrogenic deaths and multidrug resistant hospital bugs alters this conversation).

A closer example which more parallels the the Lancet Public Health article, is when considering mortality among young smokers, men particularly. Young men who smoke have a higher mortality risk, mostly related to accidental death. Does this mean smoking causes increased deaths in young men? Clearly the answer is NO. But smoking is certainly associated with an increased death rate in young men. Why? Because these young men who smoke have far higher risk taking profiles and personalities, leading to more risk taking behavior including higher risk driving styles. Using a product that has severe health warnings and awful pictures, with impunity, clearly indicates a certain attitude towards risk. They are dying more because of their risk taking behavior which is associated with a likelihood of smoking. But it’s not the smoking of cigarettes that is killing them when they are young. (When they are older, the cancer and heart disease is of course caused by the cigarette smoking, but at an earlier age, that is not the case.)

The guidelines for “healthy” eating since the late 1970’s (which were not evidence based) have stipulated a certain proportion carbohydrate intake. Guidelines have typically also biased plants as being healthier than animal sources of protein and fat. In this context then, “healthy eating” is understood to be consuming 50-55% of carbohydrates, and having less animal products, and more plants, as general rules. It means those who then choose to ignore these guidelines – hence eat far higher amounts of animal fat and protein – would conceivably be those that are snubbing generally accepted “good health” advice (whether evidence based or not) and who probably do not care as much about their health. Their lifestyles would not unreasonably therefore be expected to be unhealthier in general.

The Lancet Public Health article shows that in the quintile of their study participants having the least amount of carbohydrate intake, they significantly

• are more likely to be male
• smoke more
• exercise less
• have higher bmi’s and
• are more likely to be diabetic.

“Those eating the least carbohydrates smoked more, exercised less, were more overweight, and were more likely to be diabetic”

This seems to confirm an unhealthy user bias. Interestingly the authors also note that “the animal-based low carbohydrate dietary score was associated with lower average intake of both fruit and vegetables“. Ignoring conventional wisdom around the health of fruit and vegetables reaffirms the data and conclusion that the low carb intake group lack a certain healthy mindset.

Low, moderate or high carbohydrate?
by Zoe Harcombe

In 1977 the Senator McGovern committee issued some dietary goals for Americans (Ref 1). The first goal was “Increase carbohydrate consumption to account for 55 to 60 percent of the energy (caloric) intake.” This recommendation did not come from any evidence related to carbohydrate. It was the inevitable consequence of setting a dietary fat guideline of 30% with protein being fairly constant at 15%.

Call me suspicious, but when a paper published 40 years later, in August 2018, concluded that the optimal intake of carbohydrate is 50-55%, I smelled a rat. The study, published in The Lancet Public Health (Ref 2), also directly contradicted the PURE study, which was published in The Lancet, in August 2017 (Ref 3). No wonder people are confused. […]

I wondered what kind of person would be consuming a low carbohydrate diet in the late 1980s/early 1990s (when the 2 questionnaires in a 25 year study were done). The characteristics table in the paper tells us exactly what kind of person was in the lowest carbohydrate group. They were far more likely to be: male; diabetic; and current smokers; and far less likely to be in the highest exercise category. The ARIC study would adjust for these characteristics, but, as I often say, you can’t adjust for a whole type of person.

The groups have been subjectively chosen – not even the carb ranges are even. Most covered a 10% range (e.g. 40-50%), but the range chosen for the ‘optimal’ group (50-55%) was just 5% wide. This placed as many as 6,097 people in one group and as few as 315 in another.

This is the single biggest issue behind the headlines.

The subjective group divisions introduced what I call “the small comparator group issue.” This came up in the recent whole grains review (Ref 6). I’ll repeat the explanation here, and build on it, as it’s crucial to understanding this paper.

If 20 children go skiing – 2 of them with autism – and 2 children die in an avalanche – 1 with autism and 1 without – the death rate for the non-autistic children is 1 in 18 (5.5%) and the death rate for the autistic children is 1 in 2 (50%). Can you see how bad (or good?) you can make things look with a small comparator group?

From subjective grouping to life expectancy headlines

For the media headlines “Low carb diets could shorten life, study suggests” (Ref 5), the researchers applied a statistical technique (called Kaplan-Meier estimates) to the ARIC data. This is entirely a statistical exercise – we don’t know when people will die. We just know how many have died so far.

This exercise resulted in the claim “we estimated that a 50-year-old participant with intake of less than 30% of energy from carbohydrate would have a projected life expectancy of 29·1 years, compared with 33·1 years for a participant who consumed 50–55% of energy from carbohydrate…  Similarly, we estimated that a 50-year-old participant with high carbohydrate intake (>65% of energy from carbohydrate) would have a projected life expectancy of 32·0 years, compared with 33·1 years for a participant who consumed 50–55% of energy from carbohydrate.”

Do you see how both of these claims have used the small comparator group extremes (<30% and >65%) to make the reference group look better?

Back to the children skiing… If we were to use the data we have so far (50% of autistic children died and 5.5% of non-autistic children died) and to extrapolate this out to predict survival, life expectancy for the autistic children would look catastrophic. This is exactly what has happened with the small groups – <30% carb and >65% carb – in this study.

The data have been manipulated.

When Bad Science Can Harm You
by Angela Stanton

“Statistical Analysis

We did a time varying sensitivity analysis: between baseline ARIC Visit 1 and Visit 3, carbohydrate intake was calculated on the basis of responses from the baseline FFQ. From Visit 3 onwards, the cumulative average of carbohydrate intake was calculated on the basis of the mean of baseline and Visit 3 FFQ responses…”

WOW, hold on now. They collected carbohydrate information from the first and third visit and then they estimated the rest based on these two visits? Do they mean by this that

1. The data for years 2,4,5, and 6 didn’t match what they wanted to see?
2. The data for years 2,4,5, and 6 didn’t exist?

What kind of a trick might this hide? Not the kind of statistics I would like to consider as VALID STATISTICAL ANALYSIS.

“…WWhen Bad Science Can Harm You
Angela A Stanton, Ph.D. Angela A Stanton, to reduce potential confounding from changes in diet that could arise from the diagnosis of these diseases… The expected residual years of survival were estimated…”

Oh wow! So those who ate a lot of carbohydrates and developed diabetes, stroke, heart disease during the study were excluded? This does not reduce confounding changes but actually increases them. That is because the very thing they are studying is how carbohydrates influence health and longevity, that is no diabetes, no strokes, and no heart disease. By excluding those that actually ended up with them completely changes the outcome to the points the authors are trying to make rather than reflect the reality.

Also, if they presume a change in diet for these participants, why not for the rest? Do you detect any problems here? I do! […]

There are 3 types of studies on nutrition:

1. Bad
2. Good
3. Meaningless–meaning it repeats something that was already repeated hundreds of times

This study falls into Bad and Meaningless nutrition studies. It is actually not really science–these researchers simply cracked the same database that others already have and manipulated the data to fit their hypothesis.

I have commented all through the quotes from the study of what was shocking to read and see. What is even more amazing is the last 2 sentences, a quote, in the press release by Jennifer Cockerell, Press Association Health Correspondent:

Dr Ian Johnson, emeritus fellow at the Quadram Institute Bioscience in Norwich, said: ‘The national dietary guidelines for the UK, which are based on the findings of the Scientific Advisory Committee on Nutrition, recommend that carbohydrates should account for 50% of total dietary energy intake. In fact, this figure is close to the average carbohydrate consumption by the UK population observed in dietary surveys. It is gratifying to see from the new study that this level of carbohydrate intake seems to be optimal for longevity.‘”

It is not gratifying but horrible to see that the UK, one of the most diseased countries on the planet today, plagued by type 2 diabetes, obesity, and heart disease, should consider its current general carbohydrate consumption levels to be ideal and finds support in this study for what they are currently doing.

I suppose that if type 2 diabetes, obesity, and other metabolic diseases is what the country wants (and why wouldn’t it want that? Guess who profits from sick people?), then indeed, a 50% carbohydrate diet is ideal.

Latest Low-Carb Study: All Politics, No ScienceLatest Low-Carb Study: All Politics, No Science
by Georgia Ede

Where’s the Evidence?

Ludicrous Methods. The most important thing to understand is that this study was an “epidemiological” study, which should not be confused with a scientific experiment. This type of study does not test diets on people; instead, it generates guesses (hypotheses) about nutrition based on surveys called Food Frequency Questionnaires (FFQs). Below is an excerpt from the FFQ that was modified for use in this study. How well do you think you could answer questions like these?

Source: Provided by Lancet Public Health

How is anyone supposed to recall what was eaten as many as 12 months prior? Most people can’t remember what they ate three days ago. Note that “I don’t know” or “I can’t remember” or “I gave up dairy in August” are not options; you are forced to enter a specific value. Some questions even require that you do math to convert the number of servings of fruit you consumed seasonally into an annual average—absurd. These inaccurate guesses become the “data” that form the foundation of the entire study. Foods are not weighed, measured, or recorded in any way.

The entire FFQ used contained only 66 questions, yet the typical modern diet contains thousands of individual ingredients. It would be nearly impossible to design a questionnaire capable of capturing that kind of complexity, and even more difficult to mathematically analyze the risks and benefits of each ingredient in any meaningful way. This methodology has been deemed fatally flawed by a number of respected scientists, including Stanford Professor John Ioannidis in this 2018 critique published by JAMA.

Missing Data. Between 1987 and 2017, researchers met with subjects enrolled in the study a total of six times, yet the FFQ was administered only twice: at the first visit in the late 1980s and at the third visit in the mid-1990s. Yes, you read that correctly. Did the researchers assume that everyone in the study continued eating exactly the same way from the mid-1990s to 2017? Popular new products and trends surely affected how some of them ate (Splenda, kale chips, or cupcakes, anyone?) and drank (think Frappucinos, juice boxes, and smoothies). Why was no effort made to evaluate intake during the final 20-plus years of the study? Even if the FFQ method were a reliable means of gathering data, the suggestion that what individuals reported eating in the mid-1990s would be directly responsible for their deaths more than two decades later is hard to swallow.

There are other serious flaws to cover below, but the two already listed above are reasons enough to discredit this study. People can debate how to interpret the data until the low-carb cows come home, but I would argue that there is no real data in this study to begin with. The two sets of “data” are literally guesses about certain aspects of people’s diets gathered on only two occasions. Do these researchers expect us to believe they accurately represent participants’ eating patterns over the course of 30 years? This is such a preposterous proposition that one could argue not only that the data are inaccurate, but that they are likely wildly so.

Learn why we think you should QUESTION the results of the recent Lancet study which suggests that a low carb diet is bad for your health.
by Tony Hampton

1) Just last year, the Lancet published a more reliable study with over 120,000 participates entitled Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. This study involved participates actually visiting a doctors office where various biomarkers were tracked. Here is the link to this study: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/abstract In this study, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. This is consistent with Dr. Hope and my recommendation to consume a lower carb high-fat diet.

2) Unlike the PURE study, the new Lancet study containing only 15,428 participates entitled Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis used food frequency questionnaires (FFQ) containing 66 questions asking participates what they ate previously. This is not as reliable as a randomized control trial where participants are divided by category into separate groups to compare interventions and are fed specific diets. Using FFQ is simply not reliable. Can you remember what you ate last week or over the last year? FFQ also are unreliable because participates tend to downplay their bad eating habits and describe what they think the researchers want to hear. FFQ are simply inherently inaccurate compared to randomized control trails and allow participates to self-declare themselves as eating low carb in this study.

3) Of the groups participating in the new Lancet study, the lower carb group’s participates were the least healthy of the study participates with higher rates of smokers (over 70% smoked or previously smoked), diabetics, overweight, and those who exercised less. This was not true of the other group’s participates.

4) The so-called low carb group at less than 40% carbs is not really a low carb diet. The participates in this group consuming 35-40% carbs are consuming nearly 200 carbs per day. Many of our patients on a low carb diet are consuming less than 50 carbs per day. So are the participates in this study really on a low carb diet? We would suggest they are not.

5) Declaration of interests: When Dr. Hope and I learned to review research studies, the first question we were taught to ask was: who funded the study. If you click on the study link above and go to the bottom of the study, you will see under the declaration of interest section that there were some personal fees from two pharmaceuticals (Novartis and Zogenix). Pharmaceuticals provide needed resources to fund much-needed research. The big message here, however, is full disclosure. Just as I discussed at the beginning of this post, Dr. Hope and I are somewhat biased towards a low carb high-fat diet. We felt you needed to be aware of this as you read this post. You also need to know who funded the Lancet study we are discussing. You decide how to use that information.

6) The Lancet study is an observational study. Observational studies only show an association, not causation. Association is weak science and should always be questioned.

7) The moderate carb diet in this study was associated with the lowest mortality. In this study, participates ate a diet with 50-55% carbs. This mirrors the current USDA diet which has been recommended over the last 40 plus years. During this timeline, Americans followed the USDA recommendations and reduced saturated fat while increasing carbs in their diets. This led to the onset of the obesity epidemic. Let us not go back to recommendations which have not worked.

8) Media sensationalism and bias. I know it’s frustrating to keep hearing mixed messages and dramatic headlines but this is how the media gets your attention, so don’t be convinced by headlines. If you are still reading at this point in the post, you won’t be sidetracked by dramatic press releases.

STUDY: Do Low Carb Diets Increase Mortality?
by Siim Land

Here’s my debunking:

• The “low carb group” wasn’t actually low carb and had a carb intake of 37% of total calories…It’s much rather moderate carb
• “Low carb participants” were more sedentary, current smokers, diabetics, and didn’t exercise
• The study was conducted over the course of 25 years with follow-ups every few years
• No real indication of what the people actually ate in what amounts and at what macronutrient ratios
• The same applies to the increased mortality rates in high carb intake – no indication of food quality of carb content
• Correlation does not equal causation
• Animal proteins and fats contributed more to mortality than plant-based foods, which again doesn’t take into account food quality and quantities
• It’s true that too much of anything is bad and you don’t want to eat too many carbs, too much fat, too much meat, or too much protein…

Is Keto Bad For You? Addressing Keto ClickBait
by Chelsea Malone

Where Did the Study Go Wrong?

1. This was not a controlled study. Other factors that influence lifespan like physical activity, stress levels, and smoking habits were recorded, but not adjusted for. The “low-carb” group also consisted of the highest amount of smokers and the lowest amount of total physical activity conducted.
2. The data collection process left plenty of room for errors. In order to collect the data on total carbohydrate consumption, participants were given a questionnaire (FFQ) where they indicated how often they ate specific foods on a list over the past several years. Most individuals would not be able to accurately recall total food consumption over such a long period of time and were likely filled with errors.
3. Consuming under 44% of total daily calories from carbohydrates was considered low carb. To put this into perspective, if the average person consumes 2,000 calories a day, that is 220 grams of carbohydrates. This is nowhere near low-carb or keto territory.
4. This study is purely correlational, and correlation does not equal causation. Think of it like this: If a new study was published showing individuals who wear purple socks were more likely to get into a car crash than individuals wearing red socks, would you assume that purple socks cause car accidents? You probably wouldn’t and the same principle applies to this study.

#Fakenews Headlines – Low Carb Diets aren’t Dangerous!
by Belinda Fettke

Not only was the data cherry-picked from a Food Frequency Questionnaire that lumped ‘meat in with the cakes and baked goods’ category while dairy, fruit, and vegetables were all kept as separate entities (implying that meat is a discretionary and unhealthy food??), they also excluded anyone who became metabolically unwell over the 25 year period since the study began (but not from baseline). […]

Dr Aseem Malhotra took it to another level in his interview on BBC World News.

Here are a couple of Key Points he outlined on Facebook:

1. Reviewing ALL the up to date evidence the suggestion that low carb diets shorten lifespan from this fatally flawed association study is COMPLETELY AND TOTALLY FALSE. To say that they do is a MISCARRIAGE OF SCIENCE!

2. The most effective approach for managing type 2 diabetes is cutting sugar and starch. A systematic review of randomised trials … reveals its best for blood glucose and cardiovascular risk factors in short AND long term. […]

The take-away message is please don’t believe everything that is written about the latest study to come out of Harvard T.H Chan School of Public Health. The authors/funders of this paper; Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis paid $5,000 to be published in the Lancet Public Health (not to be confused with the official parent publication – The Lancet). While it went past an editorial committee it has not yet been peer reviewed.

Low-carb or high carb diet: What I want you to know about the ‘healthiest diet’, as an NHS Doctor
by Dr Aseem Malhotra

1418: Jimmy Moore Rant On Anti-Keto Lancet Study
from The Livin’ La Vida Low-Carb Show

American Heart Association’s “Fat and Cholesterol Counter” (1991)

• 1963 – “Every woman knows that carbohydrates are fattening, this is a piece of common knowledge, which few nutritionists would dispute.”
• 1994 – “… obesity may be regarded as a carbohydrate-deficiency syndrome and that an increase in dietary carbohydrate content at the expense of fat is the appropriate dietary part of a therapeutical strategy.”*

My mother was about to throw out an old booklet from the American Heart Association (AHA), “Fat and Cholesterol Counter”, one of several publications they put out around that time. It was published in 1991, the year I started high school. Unsurprisingly, it blames everything on sodium, calories, cholesterol, and, of course, saturated fat.

Even hydrogenated fat gets blamed on saturated fat, since the hydrogenation process turns some small portion of it saturated, which ignores the heavy damage and inflammatory response caused by the oxidization process (both in the industrial processing and in cooking). Not to mention those hydrogenated fats as industrial seed oils are filled with omega-6 fatty acids, the main reason they are so inflammatory. Saturated fat, on the other hand, is not inflammatory at all. This obsession with saturated fat is so strange. It never made any sense from a scientific perspective. When the obesity epidemic began and all that went with it, the consumption of saturated fat by Americans had been steadily dropping for decades, ever since the invention of industrial seed oils in the late 1800s and the fear about meat caused by Upton Sinclair’s muckraking journalism, The Jungle, about the meatpacking industry.

The amount of saturated fat and red meat has declined over the past century, to be replaced with those industrial seed oils and lean white meat, along with fruits and vegetables — all of which have been increasing.** Chicken, in particular, replaced beef and what stands out about chicken is that, like those industrial seed oils, it is high in the inflammatory omega-6 fatty acids. How could saturated fat be causing the greater rates of heart disease and such when people were eating less of it. This scapegoating wasn’t only unscientific but blatantly irrational. All of this info was known way back when Ancel Keys went on his anti-fat crusade (The Creed of Ancel Keys). It wasn’t a secret. And it required cherrypicked data and convoluted rationalizations to explain away.

Worse than removing saturated fat when it’s not a health risk is the fact that it is actually an essential nutrient for health: “How much total saturated do we need? During the 1970s, researchers from Canada found that animals fed rapeseed oil and canola oil developed heart lesions. This problem was corrected when they added saturated fat to the animals diets. On the basis of this and other research, they ultimately determined that the diet should contain at least 25 percent of fat as saturated fat. Among the food fats that they tested, the one found to have the best proportion of saturated fat was lard, the very fat we are told to avoid under all circumstances!” (Millie Barnes, The Importance of Saturated Fats for Biological Functions).

It is specifically lard that has been most removed from the diet, and this is significant as lard was a central to the American diet until this past century: “Pre-1936 shortening is comprised mainly of lard while afterward, partially hydrogenated oils came to be the major ingredient” (Nina Teicholz, The Big Fat Surprise, p. 95); “Americans in the nineteenth century ate four to five times more butter than we do today, and at least six times more lard” (p. 126). And what about the Mediterranean people who supposedly are so healthy because of their love of olive oil? “Indeed, in historical accounts going back to antiquity, the fat more commonly used in cooking in the Mediterranean, among peasants and the elite alike, was lard.” (p. 217).

Jason Prall notes that long-lived populations ate “lots of meat” and specifically, “They all ate pig. I think pork was the was the only common animal that we saw in the places that we went” (Longevity Diet & Lifestyle Caught On Camera w/ Jason Prall). The infamous long-lived Okinawans also partake in everything from pigs, such that their entire culture and religion was centered around pigs (Blue Zones Dietary Myth). Lard, in case you didn’t know, comes from pigs. Pork and lard is found in so many diets for the simple reason pigs can live in diverse environments, from mountainous forests to tangled swamps to open fields, and they are a food source available year round.

Another thing that has gone hand in hand with loss of healthy, nutrient-dense saturated fat in the American diet is a loss of nutrition in general. It’s not only that plant foods have less minerals and vitamins because of depleted soil and because they are picked when not ripe in order to ship them long distances. The same is true of animal foods, since the animals are being fed the same crappy plant foods as us humans. But at the very least, even factory-farmed animals have far more bioavailable nutrient-density than plant foods from industrial agriculture. If we ate more fatty meat, saturated fat or otherwise, we’d be getting far more fat-soluble vitamins. But when looking at all animal foods, in particular from pasture-raised and wild-caught sources, there is no mineral or vitamin that can’t be obtained at required levels. The same can’t be said for plant foods on a vegan diet.

Back in 1991, the AHA was recommending the inclusion of lots of bread, rolls, crackers, and pasta (“made with low-fat milk and fats or oils low in saturated fatty acids” and “without eggs”); rice, beans, and peas; sugary fruits and starchy vegetables (including juices) — and deserts were fine as well. At most, eat 3 or 4 eggs a week and, as expected, optimally avoid the egg yolks where all the nutrition is located (not only fat-soluble vitamins, but also choline and cholesterol and much else; by the way, your brain health is dependent on high levels of dietary cholesterol, such that statins in blocking cholesterol cause neurocognitive decline). As long as there were little if any saturated fat and fat in general was limited, buckets of starchy carbs and sugar was considered by the AHA to be part of a healthy and balanced diet. That is sad.

This interested me because of the year. This was as I was entering young adulthood and so I was becoming more aware of the larger world. I remember the heavy-handed propaganda preaching that fiber is good and fat is evil, as if the war on obesity was a holy crusade that demanded black-and-white thinking, all subtleties and complexities must be denied in adherence to the moralistic dogma against the sins of gluttony and sloth — it was literally a evangelistic medical gospel (see Belinda Fettke’s research on the Seventh Day Adventists: Thou Shalt not discuss Nutrition ‘Science’ without understanding its driving force). In our declining public health, we were a fallen people who required a dietary clergy for our salvation. Millennia of traditional dietary wisdom and knowledge was thrown out the window as if it was worthless or maybe even dangerous.

I do remember my mother buying high-fiber cereals and “whole wheat” commercial breads (not actually whole wheat as it is simply denatured refined flour with fiber added back in). And along with this, skim or 1% fat dairy foods, especially milk, was included with every major meal and often snacks. I had sugary and starchy cereal with skim milk (and/or milk with sugary Instant Breakfast) every morning and a glass of skim milk for every dinner, maybe sometimes milk for lunch. Cheese was a regular part of the diet as well, such as with pizza eaten multiple times week or any meal with pasta, and heck cheese was a great snack all by itself, but also good combined with crackers and one could pretend to be healthy if one used Triscuits. Those were the days when I might devour a whole block of cheese, probably low-fat, in a single sitting — I was probably craving fat-soluble vitamins. Still, most of my diet was most starches and sugar, as that was my addiction. The fiber was an afterthought to market junk food as health food.

It now makes sense. When I was a kid in the 1980s, my mother says the doctor understood that whole fat milk was important for growing bodies. So that is what he recommended. But I guess the anti-fat agenda had fully taken over by the 1990s. The AHA booklet from 1991 was by then recommending “skim or 1% milk and low-fat cheeses” for all ages, including babies and children, pregnant and lactating women. Talk about a recipe for health disaster. No wonder metabolic syndrome exploded and neurocognitive health fell like a train going over a collapsed bridge. It was so predictable, as the failure of this diet was understood by many going back to earlier in the century (e.g., Weston A. Price; see my post Health From Generation To Generation).

The health recommendations did get worse over time, but to be fair it started much earlier. They had been discouraging breastfeeding for a while. Traditionally, babies were breastfed for the first couple of years or so. By the time modern America came around, experts were suggesting a short period of breast milk or even entirely using scientifically-designed formulas. My mother only breastfed me for 5-6 months and then put me on cows milk — of course, pasteurized and homogenized milk from grain-fed and factory-farmed cows. When the dairy caused diarrhea, the doctor suggested soy milk. After a while, my mother put me on dairy again, but diarrhea persisted and so for preschool she put me back on soy milk again. I was drinking soy milk off and on for many years during the most important stage of development. Holy fuck! That had to have done serious damage to my developing body, in particular my brain. Then I went from that to skim milk during another important time of development, as I hit puberty and went through growth spurts.

Early on in elementary school, I had delayed reading and a diagnosis of learning disability, seemingly along with something along the lines of either Asperger’s or specific language impairment, although undiagnosed. I definitely had social and behavioral issues, in that I didn’t understand people well when I was younger. Then entering adulthood, I was diagnosed with depression and something like a “thought disorder” or something (I forget the exact diagnosis I got while in a psychiatric ward after a suicide attempt). No doubt the latter was already present in my early neurocogntive problems, as I obviously was severely depressed at least as early as 7th grade. A malnourished diet of lots of carbs and little fat was the most probable cause for all of these problems.

Thanks, American Heart Association! Thanks for doing so much harm my health and making my life miserable for decades, not to mention nearly killing me through depression so severe I attempted suicide, and then decades of depressive struggle that followed. That isn’t even to mention the sugar and carb addiction that plagued me for so long. Now multiply my experience by that of at least hundreds of millions of other Americans, and even greater number of people from elsewhere as their governments followed the example of the United States, across the past few generations. Great job, AHA. And much appreciation for the helping hand of the USDA and various medical institutions in enforcing this anti-scientific dogma.

Let me be clear about one thing. I don’t blame my mother, as she was doing the best she could with the advice given to her by doctors and corporate media, along with the propaganda literature from respected sources such as the AHA. Nor do I blame any other average Americans as individuals, although I won’t hold back on placing the blame squarely on the shoulders of demagogues like Ancel Keys. As Gary Taubes and Nina Teicholz have made so clear, this was an agenda of power, not science. With the help of government and media, the actual scientific debate was silenced and disappeared from public view (Eliminating Dietary Dissent). The consensus in favor of a high-carb, low-fat diet didn’t emerge through rational discourse and evidence-based medicine —  it was artificially constructed and enforced.

Have we learned our lesson? Apparently not. We still see this tactic of technocratic authoritarianism, such as with corporate-funded push behind EAT-Lancet (Dietary Dictocrats of EAT-Lancet). Why do we tolerate this agenda-driven exploitation of public trust and harm to public health?

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 * First quote: Passmore, R., and Y. E. Swindelis. 1963. “Observations on the Respiratory Quotients and Weight Gain of Man After Eating Large Quantities of Carbohydrates.” British Journal of Nutrition. 17. 331-39.
Second quote: Astrup, A., B. Baemann, N. . Christenson, and S. Toubre. 1994. “Failure to Increase Lipid Oxidtion in Response to Increasing Dietary Fat Content in Formerly Obese Women.” American Journal of Physiology. April, 266 (4, pt. 1) E592-99.
Both quotes are from a talk given by Peter Ballerstedt, “AHS17 What if It’s ALL Been a Big Fat Lie?,” available on the Ancestry Foundation Youtube page.

(It appears that evidence-based factual reality literally changes over time. I assume this relativity of ideological realism has something to do with quantum physics. It’s the only possible explanation. I’m feeling a bit snarky, in case you didn’t notice.)

** Americans, in the prior centuries, ate few plant foods at all because they were so difficult and time-consuming to grow. There was no way to control for pests and wild animals that often would devour and destroy a garden or a crop. It was too much investment for too little reward, not to mention extremely unreliable as a food source and so risky to survival for those with a subsistence lifestyle. Until modern farming methods, especially with 20th century industrialization of agriculture, most Americans primarily ate animal foods with tons of fat, mostly butter, cream and lard, along with a wide variety of wild-caught animal foods.

This is discussed by Nina Teicholz in The Big Fat Surprise: “Early-American settlers were “indifferent” farmers, according to many accounts. They were fairly lazy in their efforts at both animal husbandry and agriculture, with “the grain fields, the meadows, the forests, the cattle, etc, treated with equal carelessness,” as one eighteenth-century Swedish visitor described. And there was little point in farming since meat was so readily available.” (see more in my post Malnourished Americans). That puts the conventional dietary debate in an entirely different context. Teicholz adroitly dismantles the claim that fatty animal foods have increased in the American diet.

Teicholz goes on to state that, “So it seems fair to say that at the height of the meat-and-butter-gorging eighteenth and nineteenth centuries, heart disease did not rage as it did by the 1930s. Ironically—or perhaps tellingly—the heart disease “epidemic” began after a period of exceptionally reduced meat eating.” It was the discovery of seed oils that originally were an industrial byproduct, combined with Upton Sinclair’s muckraking journalism about the meatpacking industry (The Jungle), that caused meat and animal fats to quickly fall out as the foundation of the American diet. Saturated fat, in particular, had been in decline for decades prior to the epidemics of obesity, diabetes, and heart disease. Ancel Keys knew this data, which is why he had to throw out some of his data to make it fit his preconceived conclusions in promoting his preferred dietary ideology.

If we were honestly wanting to find the real culprit to blame, we would look to the dramatic rise of vegetable oils, white flour, and sugar in the 20th century diet. It began much earlier with the grain surpluses and cheap wheat, especially in England during the 1800s, but in the United States it became most noticeable in the first half century following that period. The agenda of Keys and the AHA simply made a bad situation worse, albeit much much worse.

Blood Sugar Test: Ezekiel Bread vs White Bread

As with all sugars, all starches, including all grain products, will spike your blood sugar level. It doesn’t matter if bread is white, whole grain, sprouted, etc. Bread is bread, unless it’s keto bread made out of almond flour, coconut flour, or some other low-carb ingredient.

Ezekiel bread, for example, might be healthier in other ways such as nutrient profile, although the nutrient-density is rather meager compared to many other plant foods and animal foods. For certain, it is not healthy if you’re diabetic, pre-diabetic, or insulin resistant (the majority of Americans fall into one of these categories).

I used to eat Ezekiel bread thinking it was healthier. And this was during the time I was gaining weight and probably developing pre-diabetes or at least worsening insulin resistance. Claims of lower glycemic index is mostly bunk, as the following video shows — and the same would apply to glycemic load as well. The net carbs, excluding fiber, are identical in Ezekiel bread and white bread.

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More glycemic index tests comparing foods from Dennis Pollock at his Youtube channel, Beat Diabetes!

“Simply, we were dumb.”

Dr. Richard David Feinman*: “Whatever else we know or don’t know about Paleo, we know that our ancestors did not get three squares a day, and evolution must have invested far more in ketogenic metabolism than was reflected in our research interests.

“Simply, we were dumb. We’re trying to fix that now.”

Dr. Robert Lustig**: “The thing is I’m a practicing physician and a scientist and for every one patient I took care of and got better ten more would show up in my door. There was no way I was ever going to fix this.

“And the thing that really really bothered me was I learned virtually everything I know about nutrition in college because I majored in nutrition and food science at MIT. And then I went to medical school and they beat it out of me and told me that everything I’d learned was the irrelevant, it had no place in patient care, it wasn’t necessary, and that really all I had to do was focus on calories. I figured these are the clinicians. I’m gonna be closer. I better listen to them and so I practiced that way for like 20 years.

“And then I started doing research because my patients weren’t getting better and I started doing research to try to figure out what’s going on and it like all came rushing back to me, kind of like post-traumatic stress disorder. It’s like, oh my, I knew this stuff back in 1975. So I got pissed off. So I think part of the passion actually is sort of the the being dumbfounded and the anger of what I see going on in medicine today. So I’m glad it translates in a positive way and that people appreciate the passion but I’m just like really ticked off.”

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*”[Dr.] Richard David Feinman is Professor of Cell Biology (Biochemistry) at the State University of New York (SUNY) Downstate Medical Center  in Brooklyn, New York. Dr. Feinman’s original area of research was in protein chemistry and enzyme mechanism, particularly in blood coagulation and related processes.

“Dr. Feinman has worked in several scientific areas including animal behavior and he has had a previous life in the visual arts. His friends consider him a Renaissance Man but he has made peace with the term dilettante.

“His current interest is in nutrition and metabolism, specifically in the area of diet composition and energy balance. Work in this area is stimulated by, and continues to influence, his teaching in the Medical School where he has been a pioneer in incorporating nutrition into the biochemistry curriculum. Dr. Feinman is the founder and former co-Editor-In-Chief (2004-2009) of the journal, Nutrition&Metabolism. Dr. Feinman received his BA from the University of Rochester and he holds a PhD in chemistry from the University of Oregon.” (from bio on his blog)

Dr. Feinman is quoted by Kathryn Goulding in a Paleo Magazine interview for an article on his book Nutrition in Crisis (June/July 20019).

**Dr. Robert Lustig is a Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco. He specializes in neuroendocrinology and childhood obesity. He is a leading expert on the obesity, diabetes, and metabolic syndrome epidemics.

His career has included working as a physician, involvement in research (authored 125 peer-reviewed articles and 73 reviews), public speaking (videos of his talks have received millions of views), and authoring books (Fat Chance, Hacking the American Mind, Sugar Has 56 Names, and Obesity Before Birth; also the introduction to John Yudkin’s classic Pure, White and Deadly). He has also been a co-founder, president, director, chairman, member, and consultant of numerous public and private medical, health and dietary task forces, committees, board of directors, institutes, and other organizations.

His focus has been primarily on sugar, not carbohydrates in general. Dr. Feinman has been critical of him on this account. But it appears that he is moving toward the low-carb diet, along with a convergence of his views with those of Gary Taubes. See the discussion on the Ketogenic Forums: Has Lustig moved toward us?

Dr. Lustig is quoted from the below video:

 

Carcinogenic Grains

In understanding human health, we have to look at all factors as a package deal. Our gut-brain is a system, as is our entire mind-body. Our relationships, lifestyle, the environment around us — all of it is inseparable. This is true even if we limit ourselves to diet alone. It’s not simply calories in/calories out, macronutrient ratios, or anything else along these lines. It is the specific foods eaten in combination with which other foods and in the context of stress, toxins, epigenetic inheritance, gut health, and so much else that determine what effects manifest in the individual.

There are numerous examples of this. But I’ll stick to a simple one, which involves several factors and the relationship between them. First, red meat is associated with cancer and heart disease. Yet causation is hard to prove, as red meat consumption is associated with many other foods in the standard American diet, such as added sugars and vegetable oils in processed foods. The association might be based on confounding factors that are culture-specific, which can explain why we find societies with heavy meat consumption and little cancer.

So, what else might be involved? We have to consider what red meat is being eaten with, at least in the standard American diet that is used as a control in most research. There is, of course, the added sugars and vegetable oils — they are seriously bad for health and may explain much of the confusion. Saturated fat intake has been dropping since the early 1900s and, in its place, there has been a steady rise in the use of vegetable oils; we now know that highly heated and hydrogenated vegetable oils do severe damage. Also, some of the original research that blamed saturated fat, when re-analyzed, found that sugar was the stronger correlation to heart disease.

Saturated fat, as with cholesterol, had been wrongly accused. This misunderstanding has, over multiple generations at this point, led to the early death of at least hundreds of millions of people worldwide, as dozens of the wealthiest and most powerful countries enforced this in their official dietary recommendations which transformed the world’s food system. Similar to eggs, red meat became the fall guy.

Such things as heart disease are related to obesity, and conventional wisdom tells us that fat makes us fat. Is that true? Not exactly or directly. I was amused to discover that a scientific report commissioned by the British government in 1846 (Experimental Researches on the Food of Animals, and the Fattening of Cattle: With Remarks on the Food of Man. Based Upon Experiments Undertaken by Order of the British Government by Robert Dundas Thomson) concluded that “The present experiments seem to demonstrate that the fat of animals cannot be produced from the oil of the food” — fat doesn’t make people fat, and that low-carb meat-eating populations tend to be slim has been observed for centuries.

So, in most cases, what does cause fat accumulation? It is only fat combined with plenty of carbs and sugar that is guaranteed to make us fat, that is to say fat in the presence of glucose in that the two compete as a fuel source.

Think about what an American meal with red meat looks like. A plate might have a steak with some rolls or slices of bread, combined with a potato and maybe some starchy ‘vegetables’ like corn, peas, or lima beans. Or there will be a hamburger with a bun, a side of fries, and a large sugary drink (‘diet’ drinks are no better, as we now know artificial sweeteners fool the body and so are just as likely to make you fat and diabetic). What is the common factor, red meat combined with wheat or some other grain, as part of a diet drenched in carbs and sugar (and all of it cooked or slathered in vegetable oils).

Most Americans have a far greater total intake of carbs, sugar, and vegetable oils than red meat and saturated fat. The preferred meat of Americans these days is chicken with fish also being popular. Why does red meat and saturated fat continue to be blamed for the worsening rates of heart disease and metabolic disease? It’s simply not rational, based on the established facts in the field of diet and nutrition. That isn’t to claim that too much red meat couldn’t be problematic. It depends on the total diet. Also, Americans have the habit of grilling their red meat and grilling increases carcinogens, which could be avoided by not charring one’s meat, but that equally applies to not burning (or frying) anything one eats, including white meat and plant foods. In terms of this one factor, you’d be better off eating beef roasted with vegetables than to go with a plant-based meal that included foods like french fries, fried okra, grilled vegetable shish kabobs, etc.

Considering all of that, what exactly is the cause of cancer that keeps showing up in epidemiological studies? Sarah Ballantyne has some good answers to that (see quoted passage below). It’s not so much about red meat itself as it is about what red meat is eaten with. The crux of the matter is that Americans eat more starchy carbs, mostly refined flour, than they do vegetables. What Ballantyne explains is that two of the potential causes of cancer associated with red meat only occur in a diet deficient in vegetables and abundant in grains. It is the total diet as seen in the American population that is the cause of high rates of cancer.

As a heavy meat diet without grains is not problematic, a heavy carb diet without grains is also not necessarily problematic. Some of the healthiest populations eat lots of carbs like sweet potatoes, but you won’t find any healthy population that eats as many grains as do Americans. There are many issues with grains considered in isolation (read the work of David Perlmutter or any number of writers on the paleo diet), but grains combined with certain other foods in particular can contribute to health concerns.

Then again, some of this is about proportion. For most of the time of agriculture, humans ate small amounts of grains as an occasional food. Grains tended to be stored for hard times or for trade or else turned into alcohol to be mixed with water from unclean sources. The shift to large amounts of grains made into refined flour is an evolutionarily unique dilemma our bodies aren’t designed to handle. The first accounts of white bread are found in texts from slightly over two millennia ago and most Westerners couldn’t afford white bread until the past few centuries when industrialized milling began. Before that, people tended to eat foods that were available and didn’t mix them as much (e.g., eat fruits and vegetables in season). Hamburgers were invented only about a century ago. The constant combining of red meat and grains is not something we are adapted for. That harm to our health results maybe shouldn’t surprise us.

Red meat can be a net loss to health or a net gain. It depends not on the red meat, but what is and isn’t eaten with it. Other factors matter as well. Health can’t be limited to a list of dos and don’ts, even if such lists have their place in the context of more detailed knowledge and understanding. The simplest solution is to eat as most humans ate for hundreds of thousands of years, and more than anything else that means avoiding grains. Even without red meat, many people have difficulties with grains.

Let’s return to the context of evolution. Hominids have been eating fatty red meat for millions of years (early humans having prized red meat from blubbery megafauna until their mass extinction), and yet meat-eating hunter-gatherers rarely get cancer, heart disease, or any of the other modern ailments. How long ago was it when the first humans ate grains? About 12 thousand years ago. Most humans on the planet never touched a grain until the past few millennia. And fewer still included grains with almost every snack and meal until the past few generations. So, what is this insanity of government dietary recommendations putting grains as the base of the food pyramid? Those grains are feeding the cancerous microbes, and doing much else that is harmful.

In conclusion, is red meat bad for human health? It depends. Red meat that is charred or heavily processed combined with wheat and other carbs, lots of sugar and vegetable oils, and few nutritious vegetables, well, that would be a shitty diet that will inevitably lead to horrible health consequences. Then again, the exact same diet minus the red meat would still be a recipe for disease and early death. Yet under other conditions, red meat can be part of a healthy diet. Even a ton of pasture-raised red meat (with plenty of nutrient-dense organ meats) combined with an equal amount of organic vegetables (grown on healthy soil, bought locally, and eaten in season), in exclusion of grains especially refined flour and with limited intake of all the other crap, that would be one of the healthiest diets you could eat.

On the other hand, if you are addicted to grains as many are and can’t imagine a world without them, you would be wise to avoid red meat entirely. Assuming you have any concerns about cancer, you should choose one or the other but not both. I would note, though, that there are many other reasons to avoid grains while there are no other known reasons to avoid red meat, at least for serious health concerns, although some people exclude red meat for other reasons such as digestion issues. The point is that whether or not you eat red meat is a personal choice (based on taste, ethics, etc), not so much a health choice, as long as we separate out grains. That is all we can say for certain based on present scientific knowledge.

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We’ve known about this for years now. Isn’t it interesting that no major health organization, scientific institution, corporate news outlet, or government agency has ever warned the public about the risk factors of carcinogenic grains? Instead, we get major propaganda campaigns to eat more grains because that is where the profit is for big ag, big food, and big oil (that makes farm chemicals and transports the products of big ag and big food). How convenient! It’s nice to know that corporate profit is more important than public health.

But keep listening to those who tell you that cows are destroying the world, even though there are fewer cows in North America than there once were buffalo. Yeah, monocultural GMO crops immersed in deadly chemicals that destroy soil and deplete nutrients are going to save us, not traditional grazing land that existed for hundreds of millions of years. So, sure, we could go on producing massive yields of grains in a utopian fantasy beloved by technocrats and plutocrats that further disconnects us from the natural world and our evolutionary origins, an industrial food system dependent on turning the whole world into endless monocrops denatured of all other life, making entire regions into ecological deserts that push us further into mass extinction. Or we could return to traditional ways of farming and living with a more traditional diet largely of animal foods (meat, fish, eggs, dairy, etc) balanced with an equal amount of vegetables, the original hunter-gatherer diet.

Our personal health is important. And it is intimately tied to the health of the earth. Civilization as we know it was built on grains. That wasn’t necessarily a problem when grains were a small part of the diet and populations were small. But is it still a sustainable socioeconomic system as part of a healthy ecological system? No, it isn’t. So why do we continue to do more of the same that caused our problems in the hope that it will solve our problems? As we think about how different parts of our diet work together to create conditions of disease or health, we need to begin thinking this way about our entire world.

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Paleo Principles
by Sarah Ballantyne

While this often gets framed as an argument for going vegetarian or vegan. It’s actually a reflection of the importance of eating plenty of plant foods along with meat. When we take a closer look at these studies, we see something extraordinarily interesting: the link between meat and cancer tends to disappear once the studies adjust for vegetable intake. Even more exciting, when we examine the mechanistic links between meat and cancer, it turns out that many of the harmful (yes, legitimately harmful!) compounds of meat are counteracted by protective compounds in plant foods.

One major mechanism linking meat to cancer involves heme, the iron-containing compound that gives red meat its color (in contrast to the nonheme iron found in plant foods). Where heme becomes a problem is in the gut: the cells lining the digestive tract (enterocytes) metabolize it into cytotoxic compounds (meaning toxic to living cells), which can then damage the gut barrier (specifically the colonic mucosa; see page 67), cause cell proliferation, and increase fecal water toxicity—all of which raise cancer risk. Yikes! In fact, part of the reason red meat is linked with cancer far more often than with white meat could be due to their differences in heme content; white meat (poultry and fish) contains much, much less.

Here’s where vegetables come to the rescue! Chlorophyll, the pigment in plants that makes them green, has a molecular structure that’s very similar to heme. As a result, chlorophyll can block the metabolism of heme in the intestinal tract and prevent those toxic metabolites from forming. Instead of turning into harmful by-products, heme ends up being metabolized into inert compounds that are no longer toxic or damaging to the colon. Animal studies have demonstrated this effect in action: one study on rats showed that supplementing a heme-rich diet with chlorophyll (in the form of spinach) completely suppressed the pro-cancer effects of heme. All the more reason to eat a salad with your steak.

Another mechanism involves L-carnitine, an amino acid that’s particularly abundant in red meat (another candidate for why red meat seems to disproportionately increase cancer risk compared to other meats). When we consume L-carnitine, our intestinal bacteria metabolize it into a compound called trimethylamine (TMA). From there, the TMA enters the bloodstream and gets oxydized by the liver into yet another compound, trimethylamine-N-oxide (TMAO). This is the one we need to pay attention to!

TMAO has been strongly linked to cancer and heart disease, possibly due to promoting inflammation and altering cholesterol transport. Having high levels of it in the bloodstream could be a major risk factor for some chronic diseases. So is this the nail in the coffin for meat eaters?

Not so fast! An important study on this topic published in 2013 in Nature Medicine sheds light on what’s really going on. This paper had quite a few components, but one of the most interesting has to do with gut bacteria. Basically, it turns out that the bacteria group Prevotella is a key mediator between L-carnitine consumption and having high TMAO levels in our blood. In this study, the researchers found that participants with gut microbiomes dominated by Prevotella produced the most TMA (and therefore TMAO, after it reached the liver) from the L-carnitine they ate. Those with microbiomes high in Bacteroides rather than Prevotella saw dramatically less conversion to TMA and TMAO.

Guess what Prevotella loves to snack on? Grains! It just so happens that people with high Prevotella levels, tend to be those who eat grain-based diets (especially whole grain), since this bacterial group specializes in fermenting the type of polysaccharides abundant in grain products. (For instance, we see extremely high levels of Prevotella in populations in rural Africa that rely on cereals like millet and sorghum.) At the same time, Prevotella doesn’t seem to be associated with a high intake of non-grain plant sources, such as fruit and vegetables.

So is it really the red meat that’s a problem . . . or is it the meat in the context of a grain-rich diet? Based on the evidence we have so far, it seems that grains (and the bacteria that love to eat them) are a mandatory part of the L-carnitine-to-TMAO pathway. Ditch the grains, embrace veggies, and our gut will become a more hospitable place for red meat!

* * *

Georgia Ede has a detailed article about the claim of meat causing cancer. In it, she provides several useful summaries of and quotes from the scientific literature.

WHO Says Meat Causes Cancer?

In November 2013, 23 cancer experts from eight countries gathered in Norway to examine the science related to colon cancer and red/processed meat. They concluded:

“…the interactions between meat, gut and health outcomes such as CRC [colorectal cancer] are very complex and are not clearly pointing in one direction….Epidemiological and mechanistic data on associations between red and processed meat intake and CRC are inconsistent and underlying mechanisms are unclear…Better biomarkers of meat intake and of cancer occurrence and updated food composition databases are required for future studies.” ¹⁾ To read the full report: http://www.ncbi.nlm.nih.gov/pubmed/24769880 [open access]

Translation: we don’t know if meat causes colorectal cancer. Now THAT is a responsible, honest, scientific conclusion.

How the WHO?

How could the WHO have come to such a different conclusion than this recent international gathering of cancer scientists? As you will see for yourself in my analysis below, the WHO made the following irresponsible decisions:

1. The WHO cherry-picked studies that supported its anti-meat conclusions, ignoring those that showed either no connection between meat and cancer or even a protective effect of meat on colon cancer risk. These neutral and protective studies were specifically mentioned within the studies cited by the WHO (which makes one wonder whether the WHO committee members actually read the studies referenced in its own report).
2. The WHO relied heavily on dozens of “epidemiological” studies (which by their very nature are incapable of demonstrating a cause and effect relationship between meat and cancer) to support its claim that meat causes cancer.
3. The WHO cited a mere SIX experimental studies suggesting a possible link between meat and colorectal cancer, four of which were conducted by the same research group.
4. THREE of the six experimental studies were conducted solely on RATS. Rats are not humans and may not be physiologically adapted to high-meat diets. All rats were injected with powerful carcinogenic chemicals prior to being fed meat. Yes, you read that correctly.
5. Only THREE of the six experimental studies were human studies. All were conducted with a very small number of subjects and were seriously flawed in more than one important way. Examples of flaws include using unreliable or outdated biomarkers and/or failing to include proper controls.
6. Some of the theories put forth by the WHO about how red/processed meat might cause cancer are controversial or have already been disproved. These theories were discredited within the texts of the very same studies cited to support the WHO’s anti-meat conclusions, again suggesting that the WHO committee members either didn’t read these studies or deliberately omitted information that didn’t support the WHO’s anti-meat position.

Does it matter whether the WHO gets it right or wrong about meat and cancer? YES.

“Strong media coverage and ambiguous research results could stimulate consumers to adapt a ‘safety first’ strategy that could result in abolishment of red meat from the diet completely. However, there are reasons to keep red meat in the diet. Red meat (beef in particular) is a nutrient dense food and typically has a better ratio of N6:N3-polyunsaturated fatty acids and significantly more vitamin A, B6 and B12, zinc and iron than white meat(compared values from the Dutch Food Composition Database 2013, raw meat). Iron deficiencies are still common in parts of the populations in both developing and industrialized countries, particularly pre-school children and women of childbearing age (WHO)… Red meat also contains high levels of carnitine, coenzyme Q10, and creatine, which are bioactive compounds that may have positive effects on health.” ²⁾

The bottom line is that there is no good evidence that unprocessed red meat increases our risk for cancer. Fresh red meat is a highly nutritious food which has formed the foundation of human diets for nearly two million years. Red meat is a concentrated source of easily digestible, highly bioavailable protein, essential vitamins and minerals. These nutrients are more difficult to obtain from plant sources.

It makes no sense to blame an ancient, natural, whole food for the skyrocketing rates of cancer in modern times. I’m not interested in defending the reputation of processed meat (or processed foods of any kind, for that matter), but even the science behind processed meat and cancer is unconvincing, as I think you’ll agree. […]

Regardless, even if you believe in the (non-existent) power of epidemiological studies to provide meaningful information about nutrition, more than half of the 29 epidemiological studies did NOT support the WHO’s stance on unprocessed red meat and colorectal cancer.

It is irresponsible and misleading to include this random collection of positive and negative epidemiological studies as evidence against meat.

The following quote is taken from one of the experimental studies cited by the WHO. The authors of the study begin their paper with this striking statement:

“In puzzling contrast with epidemiological studies, experimental studies do not support the hypothesis that red meat increases colorectal cancer risk. Among the 12 rodent studies reported in the literature, none demonstrated a specific promotional effect of red meat.” ³⁾

[Oddly enough, none of these twelve “red meat is fine” studies, which the authors went on to list and describe within the text of the introduction to this article, were included in the WHO report].

I cannot emphasize enough how common it is to see statements like this in scientific papers about red meat. Over and over again, researchers see that epidemiology suggests a theoretical connection between some food and some health problem, so they conduct experiments to test the theory and find no connection. This is why our nutrition headlines are constantly changing. One day eggs are bad for you, the next day they’re fine. Epidemiologists are forever sending well-intentioned scientists on time-consuming, expensive wild goose chases, trying to prove that meat is dangerous, when all other sources–from anthropology to physiology to biochemistry to common sense—tell us that meat is nutritious and safe.

* * *

Below good discussion between Dr. Steven Gundry and Dr. Paul Saladino. It’s an uncommon dialogue. Even though Gundry is known for warning against the harmful substances in plant foods, he has shifted toward a plant-based diet in also warning against too much animal foods or at least too much protein, another issue about IGF1 not relevant to this post. As for Saladino, he is a carnivore and so takes Gundry’s argument against plants to a whole other level. Saladino sees no problem with meat, of course. And his view contradicts what Gundry writes about in his most recent book, The Longevity Paradox.

Anyway, they got onto the topic of TMAO. Saladino points out that fish has more fully formed TMAO than red meat produces in combination with grain-loving Prevotella. Even vegetables produce TMAO. So, why is beef being scapegoated? It’s pure ignorant idiocy. To further this point, Saladino explained that he has tested the microbiome of patients of his on the carnivore diet and it comes up low on the Prevotella bacteria. He doesn’t think TMAO is the danger people claim it is. But even if it were, the single safest diet might be the carnivore diet.

Gundry didn’t even disagree. He pointed out that he did testing on patients of his who are long-term vegans and now in their 70s. They had extremely high levels of TMAO. He sent their lab results to the Cleveland Clinic for an opinion. The experts there refused to believe that it was possible and so dismissed the evidence. That is the power of dietary ideology when it forms a self-enclosed reality tunnel. Red meat is bad and vegetables are good. The story changes over time. It’s the saturated fat. No, it’s the TMAO. Then it will be something else. Always looking for a rationalization to uphold the preferred dogma.

* * *

7/25/19 – Additional thoughts: There is always new research coming out. And as is typical, it is often contradictory. It is hard to know what is being studied exactly.The most basic understanding in mainstream nutrition right now seems to be that red meat is associated with TMAO by way of carnitine and Prevotella (Studies reveal role of red meat in gut bacteria, heart disease development). But there are many assumptions being made. This research tends to be epidemiological/observational and so most factors aren’t being controlled.

Worse still, they aren’t comparing the equivalent extremes, such as veganism vs carnivory but veganism and vegetarianism vs omnivory. That is to leave out the even greater complicating factor that, as the data shows, a significant number of vegans and vegetarians occasionally eat animal foods. There really aren’t that many long-term vegans and vegetarians to study because 80% of people who start the diet quit it, and of that 20% few are consistent.

As for omnivores, they are a diverse group that could include hundreds of dietary variations. One variety of omnivory is the paleo diet, slightly restricted omnivory in that grains are excluded, often along with legumes, white potatoes, dairy, added sugar, etc. The paleo diet was studied and showed higher levels of TMAO and, rather than cancer, the focus was on cardiovascular disease (Heart disease biomarker linked to paleo diet).

So, that must mean the paleo diet is bad, right? When people think of the paleo diet, they think of a caveman lugging a big hunk of meat. But the reality is that the standard paleo diet, although including red meat, emphasizes fish and heaping platefuls of vegetables. Why is red meat getting blamed? In a bizarre twist, the lead researcher of the paleo study, Dr. Angela Genoni, thought the problem was the lack of grains. But it precisely grains that the TMAO-producing Prevotella gut bacteria love so much. How could reducing grains increase TMAO? No explanation was offered. Before we praise grains, why not look at the sub-population of vegans, vegetarians, fruitivores, etc who also avoid grains?

There is a more rational and probable factor. It turns out that fish and vegetables raise TMAO levels higher than red meat (Eat your vegetables (and fish): Another reason why they may promote heart health). This solves the mystery of why some Dr. Gundry’s vegan patients had high TMAO levels. Yet, in another bizarre leap of logic, the same TMAO that is used to castigate red meat suddenly is portrayed as healthy in reducing cardiovascular risk when it comes from sources other than red meat. It is the presence of red meat that somehow magically transforms TMAO into an evil substance that will kill you. Or maybe, just maybe it has nothing directly to do with TMAO alone.

After a long and detailed analysis of the evidence, Dr. Georgia Ede concluded that, “As far as I can tell, the authors’ theory that red meat provides carnitine for bacteria to transform into TMA which our liver then converts to TMAO, which causes our macrophages to fill up with cholesterol, block our arteries, and cause heart attacks is just that–a theory–full of sound and fury, signifying nothing” (Does Carnitine from Red Meat Cause Heart Disease?).

 

Obesity Mindset

There is a piece from The Atlantic about weight loss, The Weight I Carry. It’s written from a personal perspective. The author, Tommy Tomlinson, has been overweight his entire life. He describes what this has been like, specifically the struggle and failure in finding anything that worked. One has to give him credit for trying a wide range of diets.

It was sad to read for a number of reasons. But a point of interest was a comment he made about carbs: “I remember the first time carbohydrates were bad for you, back in the 1970s. The lunch counter at Woolworth’s in my hometown of Brunswick, Georgia, sold a diet plate of a hamburger patty on a lettuce leaf with a side of cottage cheese. My mom and I stared at the picture on the menu like it was a platypus at the zoo. We pretended to care about carbs for a while. Mama even bought a little carbohydrate guide she kept in her pocketbook. It said biscuits and cornbread were bad for us. It didn’t stay in her pocketbook long.”

That is what I’ve read about. Into the 1970s, it was still well known that carbs were the main problem for many health problems, specifically weight gain. This was part of mainstream medical knowledge going back to the 1800s. It was an insight that once was considered common sense, back when most people lived on and around farms. Everyone used to know that how cattle were fattened for the slaughter was with a high-carb diet and so the way to lose weight was to decrease carbs. There was nothing controversial about this old piece of wisdom, that is until the government decreed the opposite to be true in their 1980s dietary recommendations.

The sad part is how, even as this guy knew of this wisdom, the context of understanding its significance was lost. He lacks an explanatory framework that can sift through all the bullshit. He writes that, “I’ve done low-fat and low-carb and low-calorie, high-protein and high-fruit and high-fiber. I’ve tried the Mediterranean and taken my talents to South Beach. I’ve shunned processed foods and guzzled enough SlimFast to drown a rhino. I’ve eaten SnackWell’s cookies (low-fat, tons of sugar) and chugged Tab (no sugar, tons of chemicals, faint whiff of kerosene). I’ve been told, at different times, that eggs, bacon, toast, cereal, and milk are all bad for you. I’ve also been told that each one of those things is an essential part of a healthy diet. My brain is fogged enough at breakfast. Don’t fuck with me like this.”

His frustration is palpable and reasonable. But I notice all that gets left out from his complaints. A low-carb diet by itself very well might feel impossible. If you aren’t replacing carbs with healthy fats and nutrient-dense whole foods, you will be trying to swim upstream. Carbs is used by the body as a fuel. Take it away and you better give the body a different fuel. And after a lifetime of nutrient deficiency as is common in modern industrialization, you’d be wise to rebuilding your nutritional foundations.

That is the failure of the deprivation model of diets. They eliminate without offering any good advice about what to add back in. The advantage of traditional foods and paleo is that they are less diets in this sense. They are simply seeking scientific knowledge based on how humans live in traditional communities in the world today and how humans have lived going back to the ancient world and beyond. The point is finding what naturally works for the human body, not forcing restrictions based on ideological demands. If a diet feels like a constant struggle, then you are doing something wrong. For most of human existence, the vast majority of individuals maintained a healthy body weight with no effort whatsoever. The epidemic of obesity is extremely and bizarrely abnormal. Obesity indicates something is seriously out of balance, specifically with insulin sensitivity and the related hormonal hunger signals. Deprivation simply antagonizes this state of disease.

We already know that the ketogenic diet is the most effective diet for weight loss. Not only in the losing part but also in maintaining one’s optimal weight. No other diet decreases hunger and eliminates cravings to the same extent. More generally, a recent study showed that a low-carb diet beat a low-fat diet in burning fat, even when protein and calories were exactly the same in both groups. This possibly indicates that, as some have speculated, a diet low enough in carbs may increase metabolism in burning more calories than one is consuming. Then when you reach your preferred weight, you can add back in some calories to attain an equilibrium. This is apparently the one thing the author didn’t try. He did try the South Beach diet, but it is only moderately low-carb and unfortunately is also low-fat, a bad combination — this diet, for example, recommends low-fat milk which is not only eliminating the needed fats but also the fat-soluble vitamins, especially in the form of dairy from cows that are pastured/grass-fed.

The author is trapped in the dominant paradigm. He doesn’t need to “Eat less and exercise.” And he recognizes this is bad advice, even as he can’t see an alternative. But he should look a bit further outside the mainstream. On a ketogenic diet, many people can lose weight while eating high levels of calories and not exercising. It’s more of a matter of what you eat than how much, although in some cases where there are serious health problems as is typical with lifelong obesity more emphasis might need to be given to exercise and such. But the point is to find foods that are satisfying without overeating, which generally means healthy fats. Your body gets hungry for a reason and, if you don’t feed it what it needs, it will remain hungry. Calorie counting and portion control won’t likely help anyone with long term weight issues. It will just make them frustrated and hangry, and for good reason. But when the old patterns repeatedly fail, it is best to try something new. Sadly, the author’s conclusion is to more fully commit to the old way of thinking. His chances of success are next to zero, as long as he continues on this path.

It’s an obesity mindset. The individual blames himself, rather than blaming the bad advice. He just needs more self-control and less gluttony. This time, he tells himself, it will work. I doubt it. I hope he doesn’t spend the rest of his life on this endless treadmill of self-defeat and self-blame. Life doesn’t need to be so difficult. Rather than losing weight, he should focus on what it takes to be and feel healthy. But it is hard to convince someone of that when their entire identity has become entangled with obesity itself, with their appearance as judged by the same society that gave the bad advice.

* * *

The Weight I Carry
What it’s like to be too big in America
by Tommy Tomlinson

I remember the first time carbohydrates were bad for you, back in the 1970s. The lunch counter at Woolworth’s in my hometown of Brunswick, Georgia, sold a diet plate of a hamburger patty on a lettuce leaf with a side of cottage cheese. My mom and I stared at the picture on the menu like it was a platypus at the zoo. We pretended to care about carbs for a while. Mama even bought a little carbohydrate guide she kept in her pocketbook. It said biscuits and cornbread were bad for us. It didn’t stay in her pocketbook long.

I’ve done low-fat and low-carb and low-calorie, high-protein and high-fruit and high-fiber. I’ve tried the Mediterranean and taken my talents to South Beach. I’ve shunned processed foods and guzzled enough SlimFast to drown a rhino. I’ve eaten SnackWell’s cookies (low-fat, tons of sugar) and chugged Tab (no sugar, tons of chemicals, faint whiff of kerosene). I’ve been told, at different times, that eggs, bacon, toast, cereal, and milk are all bad for you. I’ve also been told that each one of those things is an essential part of a healthy diet. My brain is fogged enough at breakfast. Don’t fuck with me like this.

Here are the two things I have come to believe about diets:

1. Almost any diet works in the short term.
2. Almost no diets work in the long term.

The most depressing five-word Google search I can think of—and I can think of a lot of depressing five-word Google searches—is gained all the weight back. Losing weight is not the hard part. The hard part is living with your diet for years, maybe the rest of your life.

When we go on a diet—especially a crash diet—our own bodies turn against us. Nutritional studies have shown that hunger-suppressing hormones in our bodies dwindle when we lose weight. Other hormones—the ones that warn us we need to eat—tend to rise. Our bodies beg us to gorge at the first sign of deprivation. This makes sense when you think about the history of humankind. There were no Neanderthal foodies. They ate to survive. They went hungry for long stretches. Their bodies sent up alarms telling them they’d better find something to eat. Our DNA still harbors a fear that we’ll starve. But now most of us have access to food that is more abundant, cheaper, and more addictive than at any other time in human history. Our bodies haven’t caught up to the modern world. Our cells think we’re storing up fat for a hard winter when actually it’s just happy hour at Chili’s.

Even worse, when people succeed at losing a lot of weight, their bodies slam on the brakes of their metabolism. […] Other studies had already shown that the body’s metabolism slows down as people lose weight, which means they have to eat fewer and fewer calories to keep losing. But this study showed that, for the contestants who lost weight quickly, their metabolism kept slowing even when they started gaining weight again. Basically, however fat they had been, that’s what their bodies wanted them to be. […]

“Eat less and exercise.”

That’s what some of you are saying right now. That’s what some of you have said the whole time you’ve been reading. That’s what some of you say—maybe not out loud, but you say it—every time you see a fat person downing fried eggs in a diner, or overstuffing a bathing suit on the beach, or staring out from one of those good-lord-what-happened-to-her? stories in the gossip magazines.

“Eat less and exercise.”

What I want you to understand, more than anything else, is that telling a fat person “Eat less and exercise” is like telling a boxer “Don’t get hit.”

You act as if there’s not an opponent.

Losing weight is a fucking rock fight. The enemies come from all sides: The deluge of marketing telling us to eat worse and eat more. The culture that has turned food into one of the last acceptable vices. Our families and friends, who want us to share in their pleasure. Our own body chemistry, dragging us back to the table out of fear that we’ll starve.

On top of all that, some of us fight holes in our souls that a boxcar of donuts couldn’t fill.

My compulsion to eat comes from all those places. I’m almost never hungry in the physical sense. But I’m always craving an emotional high, the kind that comes from making love, or being in the crowd for great live music, or watching the sun come up over the ocean. And I’m always wanting something to counter the low, when I’m anxious about work or arguing with family or depressed for reasons I can’t understand.

There are radical options for people like me. There are boot camps where I could spend thousands of dollars to have trainers whip me into shape. There are crash diets and medications with dangerous side effects. And, of course, there is weight-loss surgery. Several people I know have done it. Some say it saved them. Others had life-threatening complications. A few are just as miserable as they were before. I don’t judge any people who try to find their own way. I speak only for myself here: For me, surgery feels like giving up. I know that the first step of 12-step programs is admitting that you’re powerless over your addiction. But I don’t feel powerless yet.

My plan is to lose weight in a simple, steady, sustainable way. I’ll count how many calories I eat and how many I burn. If I end up on the right side of the line at the end of the day, that’s a win. I’ll be like an air mattress with a slow leak, fooling my body into thinking I’m not on a diet at all. And one day, a few years down the road, I’ll wake up and look in the mirror and think: I got there.

A Food Revolution Worthy of the Name!

“Our success with carbohydrates, however, has had a serious downside: a worldwide plague of obesity, diabetes and other diet-related diseases.”
~Gerald C. Nelson

The conventional view on diet promoted by establishment figures and institutions is based on the idea that all calories are equal. In dieting and fat loss, this has meant promoting a philosophy of calorie-in/calorie-out which translates as calorie counting and calorie restriction. Recent research has brought serious doubt to this largely untested hypothesis that has for so long guided public health recommendations.

There is also a larger background to this issue. The government has spent immense money promoting and subsidizing the high-carb diet. For example, they’ve put decades of funding into research for growing higher yield staples of wheat, corn, and rice. But they have never done anything comparable for healthy foods that are nutrient-dense and low-carb. This promotion of high yield crops with industrialized farming has denatured the soil and the food grown on it. This is problematic since these high-carb staples are low in nutrient-density even when grown on healthy soil.

This mentality of obsessing over food as calories is severely dysfunctional. It ignores the human reality of how our bodies function. And it ignores widespread human experience. Calorie-restricted diets are well known to have one of the lowest rates of compliance and success. It doesn’t matter how many or how few calories one tries to eat, as long as the food one is eating is of such low quality. Your hunger and cravings will drive you in your body’s seeking nutrition.

As I’ve eaten more nutrient-dense foods as part of a diet that is ketogenic and paleo, my hunger decreased and my cravings disappeared. I certainly don’t consume more calories than before and possibly far less, not that I’m counting. I no longer overeat and I find fasting easy. Maybe too many people eat so much making them fat because the food system produces mostly empty calories and processed carbs. It’s what’s available and cheapest, and the food industry is brilliant in making their products as addictive as possible. The average person in our society is endlessly hungry while their body is not getting what it needs. It’s a vicious cycle of decline.

I remember how I was for most of my life until quite recently, with decades as a sugar addict and a junk food junky. I was always hungry and always snacking. Carbs and sugar would keep my blood sugar and serotonin levels on a constant roller coaster ride of highs and lows, and it wrecked my physical and mental health in the process. It wasn’t a happy state. And anyone having told me in my deepest and darkest depressive funk that I should count and restrict my calories would not have been helpful. What I needed was more of the right kinds of calories, those filled with healthy fats and fat-soluble vitamins along with so much else. My body was starving from malnourishment even when I was overeating and, despite regular exercise, eventually gaining weight.

We don’t need to grow more food to feed the world but to grow better food to nourish everyone at least to a basic level, considering how many diseases even in rich countries are caused by nutrient deficiencies (e.g., Dr. Terry Wahls reversed multiple sclerosis symptoms in her self, in patients, and in clinical subjects through increasing nutrient-density). The same amount of food produced, if nutrient-dense, could feed many more people. We already have enough food and will continue to have enough food for the foreseeable future. That of equal and fair distribution of food is a separate issue. The problem isn’t producing a greater quantity for what we desperately need is greater quality. But that is difficult because our industrial farming has harmed the health of the soil and denatured our food supply.

The U.S. gov pays some farmers to not grow anything because the market is flooded with too much food. At the same time, U.S. gov pays other farmers to grow more crops like corn, something I know from living in Iowa, the corn capital of the world. Subsidizing the production of processed carbs and high fructose syrup is sickening and killing us, ignoring the problems with ethanol. Just as important, it also wastes limited resources that could be used in better ways.

We have become disconnected in so many ways. Scientific research and government policies disconnected from human health. An entire civilization disconnected from the earth we depend upon. And the modern mind disconnected from our own bodies, to the point of being alienated from what should be the most natural thing in the world, that of eating. When we are driven by cravings, our bodies are seeking something essential and needed. There is a good reason we’re attracted to things that taste sweet, salty, and fatty/oily. In natural whole foods, these flavors indicate something is nutrient-dense. But we fool the body by eating nutrient-deficient processed foods grown on poor soil. And then we create dietary ideologies that tell us this is normal.

What if we could feed more people with less land? And what if we could do so in a way that brought optimal and sustainable health to individuals, society, and the earth? Now that would be a food revolution worthy of the name!

* * *

The global food problem isn’t what you think
by Gerald C. Nelson 

Here’s what we found:

Under even the worst conditions, there will be enough food, if we define “enough” as meaning sufficient calories, on average, for everyone — with 2,000 calories per day as the standard requirement. . . [T]he post-World War II Green Revolution efforts to boost the productivity of staples such as wheat and rice have been so successful that we are now awash in carbohydrates. And because so much has already been invested in improving the productivity of these crops, solid yield gains will likely continue for the next few decades. The productivity enhancements have also made them more affordable relative to other foods that provide more of the other needed nutrients.

Our success with carbohydrates, however, has had a serious downside: a worldwide plague of obesity, diabetes and other diet-related diseases. The World Health Organization reports that in 2014, there were 462 million underweight adults worldwide but more than 600 million who were obese — nearly two-thirds of them in developing countries. And childhood obesity is rising much faster in poorer countries than in richer ones.

Meanwhile, micronutrient shortages such as Vitamin A deficiency are already causing blindness in somewhere between 250,000 and 500,000 children a year and killing half of them within 12 months of them losing their sight. Dietary shortages of iron, zinc, iodine and folate all have devastating health effects.

These statistics point to the need for more emphasis on nutrients other than carbohydrates in our diets. And in this area, our findings are not reassuring.