Coffee and Cream, Ketosis and Autophagy

On Twitter, Jerry Teixeira (JT) declared his love of cream in coffee. It led to a long thread where the joys and benefits of creamy vs black coffee were argued.

An interesting side discussion formed over the issue of fasting, ketosis, and autophagy. I must admit that my understanding was always a big hazy about the relationship between the latter two, both of which can be results of fasting. Despite common factors involved in both processes, I didn’t think there was a causal link.

I guess there is a connection, after all (Camberos-Luna et al, The Ketone Body, β-Hydroxybutyrate Stimulates the Autophagic Flux and Prevents Neuronal Death Induced by Glucose Deprivation in Cortical Cultured Neurons.). Even so, that still leaves other benefits of fasting, such as downregulating mTOR (vitamin D3 and Autophagy).

* * *

Patrice Bäumel
My number one reason for drinking black coffee in the morning is to not interfere with IF, which cream does.

Rob W. James
The benefits of IF are overstated in my opinion. Most of the benefits come from calorie restriction, which a splash of milk isn’t going to make much difference too

Patrice Bäumel
The main benefit is clearing out damaged cells. It’s an anti-aging hack. You lose that benefit by breaking fast.

JT
Coffee is still a xenobiotic, you are breaking a fast by drinking coffee and you are breaking a fast by drinking 2 tbsp cream. Regardless, autophagy is stimulated via ketogenesis, neither coffee nor cream Inhibit ketogenesis.
https://www.ncbi.nlm.nih.gov/m/pubmed/26303508/

Tell
Autophagy doesn’t really hit significant levels until 48hrs though. So benefits are mininal if any during IF

Tell
This is not to say autphagy isn’t present until 48hrs, rather it hits full scale around 48hrs.
And if autophagy is why you “fast” an extended fast.. past a normal IF, is necessary to achieve what you’re after.

JT
Autophagy happens downstream via BHB regardless, when you are on a ketogenic diet you have these elevated BHB levels at that point for long periods, where fasting takes 48 hours to get you where a Keto diet keeps you

JT
So if you are IF and eating plenty of carbs I totally agree. It takes longer to get to the higher BHB levels because BHB and carbohydrate are inversely proportional

Tell 
This is such an important point I don’t see anyone talking about.
That’s why I was talking about fasting a few weeks ago.
No one is talking about needing to be in ketosis to be fasted. So most of these guys doing IF are basically just TRE.. Which is a good enough reason to IF

Tell 
The contents creators aren’t talking about this though and selling false promises of autophagy and fountain of youth.

Dave
I read an article about IF that showed signs of arteriole smoothing with a 16:8 diet. If this is true then autophagy at 48 hours isn’t necessary for sole benefit and daily fasting does have vasculature anti-aging properties.

JT
There are benefits for every hour you fast according to Salk institute researchers . What we will need to see is calorie matched studies between TRE/ IF and CR. But to say there is zero additional benefit if you are healthy is wrong. The amount of benefit is arguable

JT
Beta hydroxy butyrate is an HDAC inhibitor and downstream via that action increases autophagy. Cream doesn’t matter. The longer you fast for the higher the bhb. Or a ketogenic diet can increase the bhb. Ketogenic diet mimics fasting and vice Versa.

JT
They are not synonymous. Of course, however elevated BHB levels are a common thread and a little cream in your coffee is not going to matter at all in that regard.

JT
Myriads research over the last two years and mixing more underway showing the mechanisms by which you still see these benefits from BHB weather or not you fast. I am compiling all the links and will sends them over when done if you would like

Erik
Hell, coffee alone (even decaf) induces autophagy.
https://t.co/2KcTpGZur0?amp=1

JT
Yeah, I saw some research that it increases ketogenisis

What causes health?

What causes health? It’s such a simple question, but it’s complex. The causes are many and the direction of causality not always clear. There has been a particular challenge to dietary ideology that shifts our way of thinking. It has to do with energy and motivation.

The calorie-in/calorie-out (CICO) theory is obviously false (Caloric Confusion; & Fung, The Evidence for Caloric Restriction). Dr. Jason Fung calls it the CRaP theory (Caloric Reduction as Primary). Studies show there is a metabolic advantage to low-carb diets (Cara B. Ebbeling, Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial), especially ketogenic diets. It alters your entire metabolism and endocrine system. Remember that insulin is a hormone that has much to do with hunger signaling. Many other hormones are involved as well. This also alters how calories are processed and used in the body. More exercise won’t necessarily do any good as long nothing else is changed. The standard American diet is fattening and the standard American lifestyle makes it hard to lose that fat. Even starving yourself won’t help. The body seeks to limit energy use and maintain energy stores, especially when it is under stress (NYU Langone, Researchers Identify Mechanism that May Drive Obesity Epidemic). All that caloric restriction does is to slow down metabolism, the opposite of what happens on carbohydrate restriction.

We associate obesity with disease and rightly so, but that isn’t to say that obesity is the primary cause. It too is a symptom or, in some cases, even a protective measure (Coping Mechanisms of Health). The body isn’t stupid. Everything the body does serves a purpose, even if that purpose is making the best out of a bad situation. Consider depression. One theory proposes that when there is something wrong we seek seclusion in order to avoid further risks and stressors and to figure out the cause of distress — hence the isolation and rumination of depression. It’s similar to why we lay in bed when sick, to let the body heal. And it should be noted that depression is a symptom of numerous health conditions and often indicates inflammation in the brain (an immune response). Insulin resistance related to obesity also can involve inflammation. When the cause of the problem is permanent, the symptoms (depression, obesity, etc) become permanent. The symptoms then become problems in their own right.

This is personal for me. I spent decades in severe depression. And during that time my health was worsening, despite struggling to do what was right. I went to therapists and took antidepressants. I tried to improve my diet and exercised. But it always felt like I was fighting against myself. I was gaining weight over time and my food cravings were persistent. Something was missing. All that changed once I got into ketosis. It’s not merely that I lost weight. More amazingly, my depression and food addictions went away, along with my tendencies toward brooding and compulsive thought (The Agricultural Mind). Also, everything felt easier and more natural. I didn’t have to force myself to exercise for it now felt good to exercise. Physical activity then was an expression of my greater health, in the way a child runs around simply for the joy of it, for no other reason than he has the energy to do so. Something fundamentally changed within my body and mind. Everything felt easier.

This touches on a central theory argued by some low-carb advocates. It’s not how many calories come in versus how many go out, at least not in a simple sense. The question is what is causing calories to be consumed and burned. One thing about ketosis is that it forces the body to burn its own energy (i.e., body fat) while reducing hunger, but it does this without any need of willpower, restraint, or moral superiority. It happens naturally. The body simply starts producing more energy and, even if someone eats a high-calorie diet, the extra energy creates the conditions where, unless some other health condition interferes, increased physical activity naturally follows.

It’s not merely that being in ketosis leads to changed activity that burns more energy. Rather, the increased energy comes first. And that is because ketosis allows better access to all that energy your body already has stored up. Most people feel too tired and drained to exercise, too addicted to food that trying to control it further stresses them. That is the typical experience on a high-carb diet, mood and energy levels go up and down with the inevitable crashes becoming worse over time. But in ketosis, mood and energy is more balanced and constant. Simply put, one feels better. And when one feels better, one is more likely to do other activities that are healthy. Ketosis creates a leverage point where health improvements can be made with far less effort.

In the public mind, diet is associated with struggle and failure. But in its original meaning, the word ‘diet’ referred to lifestyle. Diet shouldn’t be something you do so much as something that changes your way of being in and relating to the world. If you find making health changes hard, it might be because you’re doing it wrong. Obesity and tiredness is not a moral failing or character flaw. You aren’t a sinner to be punished and reformed. Your body doesn’t need to be denied and controlled. There is a natural state of health that we can learn to listen to. When your body hungers and craves, it is trying to tell you something. Feed it with the nutrition it needs. Eat to satiety those foods that contribute to health. Lose excess weight first and only later worry about exercise. Once you begin to feel better, you might find your habits improving of their own accord.

This is a challenge not only to dietary belief systems but an even more radical challenge to society itself. Take prisons as an example. Instead of using prisons to store away the victims of poverty and inequality, we could eliminate the causes and consequences of poverty and inequality. We used to treat the mentally ill in hospitals, but now we put them into prisons. This is seen in concrete ways, such that prisoners have higher rates of lead toxicity. As a society, it would be cheaper, more humane, and less sociopathic to reduce the heavy metal poisoning. Similarly, studies have shown the prison population tends to be extremely malnourished. Prisons that improve the diet of prisoners result in a drastic reduction in aggressive, violent, anti-social, and other problematic behaviors. A similar observation has been made in studies with low-carb diets and children, as behavior improves. That indicates that, if we had increased public health, many and maybe most of these people wouldn’t have ended up in prison in the first place (Physical Health, Mental Health).

We’ve had a half century of unscientific dietary advice. Most Americans have been doing what they’ve been told. Saturated fat, red meat, and salt consumption went down over the past century. In place of those, fruits and vegetables, fish and lean chicken became a larger part of the diet. What has been the results? An ever worsening epidemic of obesity, diabetes, heart disease, autoimmune disorders, mood disorders, and on and on. In fact, these kinds of health problems were seen quite early on, following the fear toward meat that followed Upton Sinclair’s 1906 muckraking journalism on the meatpacking industry in The Jungle. Saturated fat intake had been decreasing and seed oil intake had been increasing in the early 1900s, in the decades leading up to the health epidemic that began most clearly around the 1940s and 1950s. The other thing that had increased over that time period were grains, sugar, and carbs in general. Then the victims who followed this bad advice were blamed by the experts for being gluttonous and slothful, as if diet were a Christian morality play. We collectively took the hard path. And the more we failed, the more the experts doubled down in demanding more of the same.

Do we want better lives for ourselves and others? Or do we simply want to scapegoat individuals for our collective failures? If you think we can’t afford to do the right thing, then we really won’t be able to afford the consequences of trying to avoid responsibility. The increasing costs of sickness, far from being limited to healthcare, will eventually bankrupt our society or else cause so much dysfunction that civil society will break down. Why choose such a dark path when an easier choice is before us? Why is the government and major health institutions still pushing a high-carb diet? We have scientifically proven the health benefits of low-carb diets. The simplest first act would be to change our dietary guidelines and all else would follow from that, from the food system to medical practice. What are we waiting for? We can make life hard, if we choose. But why not make it easy?

* * *

I’ve long wondered why we humans make life unnecessarily hard. We artificially construct struggle and suffering out of fear of what would happen if people were genuinely free from threat, punishment, and social control. We think humans are inherently bad and must be controlled. This seeps into every aspect of life, far from being limited to demented dietary ideology.

We are even willing to punish others at great costs to ourselves, even to the point of being highly destructive to all of society. We’d rather harm, imprison, kill, etc millions of innocents in order to ensure one guilty person gets what we think they deserve. And we constantly need an endless parade of scapegoats to quench our vengeful natures. Innocence becomes irrelevant, as it ultimately is about control and not justice.

All of it is driven by fear. The authoritarians, social dominators, and reactionaries — they prey upon our fear. And in fear, people do horrific things or else submit to others doing them. Most importantly, it shuts down our ability to imagine and envision. We go to great effort to make our lives difficult. Struggle leads to ever more struggle. Suffering cascades onto suffering. Worse upon worse, ad infinitum. As such, dietary ideology or whatever else pushed by the ruling elite isn’t about public good. It’s social control, pure and simple.

But let all of that go. Let the fear go. We know from science itself that it doesn’t have to be this hard. There are proven ways to do things that are far simpler and far easier and with far better results. We aren’t bad people who need to be punished into doing the right thing. Our bodies aren’t fallen forms that will lead us into sin. What if, instead, we looked to the better angels of our nature, to what is inherently good within us?

Here is some of what I’ve written before about the easy versus the hard, about freedom versus social control:
Public Health, Public Good
Freedom From Want, Freedom to Imagine
Rationalizing the Rat Race, Imagining the Rat Park
Costs Must Be Paid: Social Darwinism As Public Good
Denying the Agency of the Subordinate Class
Capitalism as Social Control
Substance Control is Social Control
Reckoning With Violence
Morality-Punishment Link
Unspoken Connection: Fundamentalism and Punishment
What If Our Economic System Conflicts With Our Human Nature?
An Invisible Debt Made Visible

About imagining alternatives, I’ve been reading Edward Bellamy’s Looking Backward. It’s a utopian novel, but in many ways it isn’t all that extreme. The future portrayed basically is a Nordic-style social democracy taken to the next level. That basic model of governance has already proven itself one of the best in the world, not only for public good but also wealth and innovation.

In reading about this fictionalized world, one thing stood out to me. The protagonist, Julian West, was put into trance to aid his sleep. He was in a sealed room underground and apparently the house burned down, leaving behind an empty lot. As a leap of imagination for both author and reader, this trance state put him into hibernation for more than a century. His underground bedchamber is discovered by the Leete family who, in the future world, lives on his old property although there house was built on a different location.

The father is Doctor Leete who takes particular interest in Julian. They have many conversations about the differences between the late 19th and early 21st centuries. Julian struggles to understand the enormous changes that have taken place. The world he fell asleep in is no longer recognizable by the world he woke up in. When he questions something that seems remarkable to him, Doctor Leete often responds that it’s more simple than it seems to Julian. The contrast shows how unnecessarily difficult, wasteful, and cruel was that earlier society.

The basic notion is that simple changes in social conditions can result in drastic changes in public good. The costs are miniscule in comparison to the gains. That is to say that this alternative future humanity chose the easy path, instead of continually enforcing costly punishment and social control. It’s quite amazing that the argument I make now was being made all the way back in 1888 when Bellamy began writing it. From the novel, one example of this other way of thinking is the description of the future education system in how it relates to health:

I shall not describe in detail what I saw in the schools that day. Having taken but slight interest in educational matters in my former life, I could offer few comparisons of interest. Next to the fact of the universality of the higher as well as the lower education, I was much struck with the prominence given to physical culture, and the fact that proficiency in athletic feats and games as well as in scholarship had a place in the rating of the youth.

“The faculty of education,” Dr. Leete explained, “is held to the same responsibility for the bodies as for the minds of its charges. The highest possible physical, as well as mental, development of everyone is the double object of a curriculum which lasts from the age of six to that of twenty- one.”

The magnificent health of the young people in the schools impressed me strongly. My previous observations, not only of the notable personal endowments of the family of my host, but of the people I had seen in my walks abroad, had already suggested the idea that there must have been something like a general improvement in the physical standard of the race since my day ; and now, as I compared these stalwart young men and fresh, vigorous maidens, with the young people I had seen in the schools of the nineteenth century, I was moved to impart my thought to Dr. Leete. He listened with great interest to what I said.

“Your testimony on this point,” he declared, “is invaluable. We believe that there has been such an improvement as you speak of, but of course it could only be a matter of theory with us. It is an incident of your unique position that you alone in the world of to-day can speak with authority on this point. Your opinion, when you state it publicly, will, I assure you, make a profound sensation. For the rest it would be strange, certainly, if the race did not show an improvement. In your day, riches debauched one class with idleness of mind and body, while poverty sapped the vitality of the masses by overwork, bad food, and pestilent homes. The labour required of children, and the burdens laid on women, enfeebled the very springs of life. Instead of the these maleficent circumstances, all now enjoy the most favourable conditions of physical life ; the young are care fully nurtured and studiously cared for ; the labour which is required.of all is limited to the period of greatest bodily vigour, and is never excessive ; care for one’s self and one’s family, anxiety as to livelihood, the strain of a ceaseless battle of life, all these influences, which once did so much to wreck the minds and bodies of men and women, are known no more. Certainly, an improvement of the species ought to follow such a change, In certain specific respects we know, indeed, that the improvement has taken place. Insanity, for instance, which in the nineteenth century was so terribly common a product of your insane mode of life, has almost dis appeared, with its alternative, suicide.”

* * *

Bonus Article:
Here’s What Weight-Loss Advice Looked Like Nearly 100 Years Ago
by Morgan Cutolo, Reader’s Digest

I’m throwing this in for a number of reasons. It is showing how low-carb views are basically the same as dietary advice from earlier last century. Heck, one can find advice like that going back to the 1800s and even 1700s. Low-carb diets were well known and mainstream until the changes at the AHA and FDA over the past 50 years or so.

The return of low-carb popularity is what inspires such articles from the corporate media. Reader’s Digest would’t likely have published something like that 10, 20, or 30 years ago. Attitudes are changing, even if institutions are resistant. Profits are also changing as low-carb products become big biz. Corporate media, if nothing else, will follow the profits.

Here is what really stood out to me. In the article, two major dietary experts are quoted: Dr. Jason Fung and Dr. Robert Lustig. Both of them are leading advocates of low-carb diets with Dr. Lustig being the most influential critic of sugar. But neither of them is presented as such. They are simply used as authorities on the topic, which they are. That means that low-carb has become so acceptable as, in some cases, to go without saying. They aren’t labeled as low-carb gurus, much less dismissed as food faddists. No qualifications or warnings are given about low-carb. The article simply quotes these experts about what the science shows.

This is a major advance in news reporting. It’s a positive sign of changes being embraced. Maybe we are finally turning off the hard path and trying out the easier path instead. Some early signs are indicating this. The growing incidence of diabetes might be finally leveling out and even reversing for the first time in generations.

Diabetic Confusion
Low-Carb Diets On The Rise
American Diabetes Association Changes Its Tune
Slow, Quiet, and Reluctant Changes to Official Dietary Guidelines
Official Guidelines For Low-Carb Diet
Obese Military?
Weight Watchers’ Paleo Diet

“Is keto safe for kids?”

“How come no one ever asks if sugary breakfast cereal, grape juice, and white bread w/ margarine is “safe for kids?” We have entered bizarro world when we’re asking if it’s safe for kids to not eat sugar.”
~ Amy Berger

How come no one ever asks if sugary breakfast cereal, grape juice, and white bread with margarine is “safe for kids?” We have entered bizarro world when we’re asking if it’s safe for kids to not eat sugar or carb-load like they’re about to run a marathon. As I explain here, there is nothing — no vitamin, mineral, or other essential nutrient — that you can get from high-carb foods that you cannot get from LOW-carb foods.

This reminds me of the case brought against Tim Noakes. He recommended a low-carb diet to a pregnant woman. Public officials considered it to be a crime against humanity that must be harshly punished. After the first attack on him failed, he was forced to endure a second trial. The government spent millions of dollars persecuting him and he not only proved his innocence but proved that the low-carb diet was scientifically valid. It was the greatest boost for the low-carb diet since Ancel Keys led his crusade against it.

Tweet that landed Noakes in hot water ‘scientifically correct’ – lawyer
by Alex Mitchley

Tim Noakes Found Not Guilty Of Misconduct Over Advising Mother To Get Her Baby Onto The Banting Diet
from Huffington Post

Professor Noakes Found Innocent (Again)!
from Nutrition Coalition

Lore of Nutrition
by Tim Noakes & Marika Sboros
pp. 32-34, Introduction by Marika Sboros
(see more at: The Creed of Ancel Keys)

This is the story of a remarkable scientific journey. Just as remarkable is the genesis of that journey: a single, innocuous tweet.

In February 2014 , a Twitter user asked a distinguished and world-renowned scientist a simple question: ‘Is LCHF eating ok for breastfeeding mums? Worried about all the dairy + cauliflower = wind for babies??’

Always willing to engage with an inquiring mind, Professor Tim Noakes tweeted back: ‘Baby doesn’t eat the dairy and cauliflower. Just very healthy high fat breast milk. Key is to ween [ si c ] baby onto LCHF.’

With those few words, Noakes set off a chain of events that would eventually see him charged with unprofessional conduct, caught up in a case that would drag on for more than three years and cost many millions of rands. More difficult, if not impossible, to quantify is the devastating emotional toll that the whole ordeal has taken on him and his family, as critics attacked his character and scientific reputation at every turn.

At the time, it was open season on Tim Noakes. Doctors, dietitians and assorted academics from South Africa’s top universities had been hard at work for years trying to discredit him. They did not like his scientific views on low-carbohydrate, high-fat foods, which he had been promoting since 2011 . His opinions contrasted sharply with conventional, orthodox dietary ‘wisdom’, and the tweet provided the perfect pretext to amp up their attacks and hopefully silence him once and for all.

Within 24 hours of his tweet, a dietitian had reported him to the Health Professions Council of South Africa for giving what she considered ‘incorrect’, ‘dangerous’ and ‘potentially life-threatening’ advice. To Noakes’s surprise, the HPCSA took her complaint seriously.

Noakes is one of the few scientists in the world with an A 1 rating from the South African National Research Foundation (NRF) for both sports science and nutrition. In his home country, he has no equal in terms of expertise in and research into LCHF. Few can match his large academic footprint – quantified by an H-index of over 70 . The H- or Hirsch index is a measure of the impact of a scientist’s work. Noakes’s impact is significant. He has published more than 500 scientific papers, many of them in peer-reviewed journals, and over 40 of which deal exclusively with nutrition. He has been cited more than 17 000 times in the scientific literature.

Yet, remarkably, the HPCSA chose to back the opinion of a dietitian in private practice over an internationally renowned nutrition research scientist. They charged him with ‘unprofessional conduct’ for providing ‘unconventional advice on breastfeeding babies on social networks’ and hauled him through the humiliating process of a disciplinary hearing.

The public quickly dubbed it ‘the Nutrition Trial of the 21 st Century’. I’ve called it Kafkaesque. The HPCSA insisted that it was a hearing, not a trial, but the statutory body’s own conduct belied the claim.

At the time of Noakes’s tweet, I wanted to give up journalism. After more than 30 years of researching and writing about medicine and nutrition science, I was frustrated and bored. People were growing fatter and sicker, and the medical and dietetic specialists I wrote about weren’t making much difference to patients’ lives. Neither was my reporting.

Then I started investigating and writing about the HPCSA’s case against Noakes. The more questions I asked, the more walls of silence came up around me, and from the most unexpected sources. There’s an old saying that silence isn’t empty, it is full of answers. I found that the silence was loudest from those with the most to hide. I could not have foreseen the labyrinthine extent of vested inter ests ranged against Noakes, or the role played by shadowy proxy organisations for multinational sugar and soft-drink companies in suppressing and discrediting nutrition evidence.

It took a US investigative journalist to join many of the dots I had identified. Russ Greene’s research led to the International Life Sciences Institute (ILSI), a Coca-Cola front organisation. In an explosive exposé in January 2017 , Greene showed how the ILSI has worked to support the nutrition status quo in South Africa, as well as the health professionals and food and drug industries that benefit from it. It has opened a branch in South Africa and has funded nutrition congresses throughout the country. It has also paid for dietitians and academics opposed to Noakes and LCHF to address conferences abroad . *

Of course, it might be coincidence that so many doctors, dietitians and academics with links to the ILSI became involved, directly and indirectly, in the HPCSA’s prosecution of Noakes. Then again, maybe not.

The HPCSA’s conduct throughout the hearing and since its conclusion has been revelatory. To a large extent, it confirms the premise of this book: that those in positions of power and influence in medicine and academia were using the case to pursue a vendetta against Noakes. The trial highlighted the inherent perils facing those brave enough to go against orthodoxy.

Tim Noakes: The Quiet Maverick
by Daryl Ilbury
pp. 166-172

Into this turgid culture of food and identity stepped Tim Noakes on 5 February 2014, when he replied to a question posted two days earlier on Twitter, addressed to him and Sally-Ann Creed, a nutritional therapist (and co-author with Noakes of The Real Meal Revolution ). It was from a breastfeeding mother, Pippa Leenstra: ‘Is LCHF eating ok for breastfeeding mums? Worried about all the dairy + cauliflower = wind for babies??’ Noakes’s reply was the following: ‘Baby doesn’t eat the dairy and cauliflower. Just very healthy high fat breast milk. Key is to ween [ sic ] baby onto LCHF.’

It’s neither an offensive tweet by any stretch of the imagination, nor does it fall foul of any media law – it’s not libellous and there’s no encouragement of harm to others. People could disagree with him and had a voice to do so; that’s the point of social media: it is a platform for public discussion. And people did disagree, quite vocally, and there were others who supported his advice, equally vocally. Importantly, the question demanded a public, not private, response, which the person asking the question was free to accept or reject. And, as a medical doctor, Noakes didn’t cross any ethical boundaries in replying on a public platform. He didn’t publish any confidential patient information or dispense a diagnosis for a specific patient without seeing that patient; he simply provided generalised nutritional advice based on scientific evidence. Breast milk is high in fat, and there is scientific evidence to support the benefits of an LCHF diet. There is also evidence to the contrary, but, as we’ve realised, that’s science for you. The secret in making sense of science is context, and this is where it clashes with social media.

The character limitation of Twitter is one of its selling points; it demands concise expression, a sub-editor’s dream. It also means that tweets can be short on context, unless accompanied by click-through links to supporting evidence. Therefore tweets can be open to interpretation. However, this misses the main point of the brevity of Twitter messages: they are designed to encourage debate. Whether Noakes should have said ‘Key is to wean a baby …’ as opposed to ‘Key is to wean baby …’ is a matter for retrospective semantic debate. The fact is he provided a broad opinion on a public platform as a scientist and researcher of human nutrition.

Importantly, in her original tweet, to which Noakes replied, Pippa Leenstra never referred to herself or her baby. She spoke of ‘breastfeeding mums’. She was doing the media equivalent of asking a question in a town hall where the discussion was around LCHF. At that moment, Leenstra was a media consumer of medical or health information.

Not everyone saw it that way. One of those was Claire Julsing-Strydom, who at that time was president of the Association for Dietetics in South Africa (ADSA), the professional organisation for the country’s registered dietitians. Julsing-Strydom’s reaction was to register a complaint with the Health Professions Council of South Africa. It was a decision that would effectively threaten to destroy Noakes’s career, and make Julsing-Strydom the focus of a social media witch-hunt.

According to its website, the HPCSA provides the public with the right to request an investigation of any registered health practitioner whom they believe has acted unethically or caused harm. The site includes a downloadable form and an email address for Legal Med, the department within the HPCSA that handles complaints. To make sure that no health professional is a victim of a truculent member of the public with a hefty doctor’s bill in one hand and an axe to grind in the other, there is a due process of investigation and assessment before any measure of disciplinary action is followed. Only the most serious cases demand a professional-conduct committee hearing, which is what Tim Noakes would be called before.

As I said at the beginning of this book, I am not going to go into the trial in detail; instead, I will focus on the following: the complaint, the charge that resulted, two key components in the case against Noakes, and the unexpected outcome of the hearing. The main focus will be on how this was all covered in the media.

By now you know that whereas content is king, context is King Kong, and in this case the context behind the complaint makes for interesting reading, for two reasons: firstly, it shows that Noakes’s tweet was judged in isolation, and, secondly, it suggests that the complaint may not have been thought through.

What most people may not know is that directly after Noakes’s reply on Twitter to Pippa Leenstra, someone else entered the discussion: Marlene Ellmer, a paediatric dietitian and someone well known to Julsing-Strydom. Ellmer tweeted the following: ‘Pippa, as a paeds dietician I strongly advise against LCHF for breastfeeding mothers.’ Leenstra replied by posing the following question to both Noakes and Ellmer: ‘Okay, but what I eat comes through into my milk. Is that not problematic for baby and their winds at newborn stage?’ Ellmer responded by tweeting another message with her email address, encouraging Leenstra to contact her directly. Noakes didn’t do this, which is important to note, as we shall soon see. Leenstra tweeted to Ellmer that she would contact her, and after the discussion played out further with various people providing input, Leenstra tweeted: ‘Thanks, but I will go with the dietician’s recommendation.’ This she did, rejecting Noakes’s LCHF suggestion.

Let’s summarise: at that point Leenstra had posted a question on a public forum, received different opinions, including from two health professionals – one of them a registered dietitian – and been provided with the contact details of one of those professionals with an invite to get hold of her. Leenstra was free to choose which one to follow up with, and she agreed, publicly, to contact the registered dietitian. Theoretically, things could have stopped there.

However, the day after Ellmer’s invite for Leenstra to contact her, Julsing-Strydom entered the discussion and reacted with a tweet directed to Noakes, written thus: ‘I AM HORRIFIED!! HOW CAN YOU GIVE ADVICE LIKE THIS??’ For those unfamiliar with the idiosyncrasies of social media, the use of uppercase letters is normally reserved to express a strong feeling of annoyance, displeasure or hostility. On its own, Julsing-Strydom’s use of uppercase in a tweet is perfectly acceptable; it shows how she must have felt reading Noakes’s tweet, and there are possible reasons for that. Firstly, she had a four-month-old daughter she was breastfeeding, so she had a personal as well as a professional interest in the topic under discussion. Secondly, as she would later testify, she had had a strongly worded engagement the previous month with Noakes over what she saw as his dispensing nutritional advice to breastfeeding mothers during a talk. It’s easy to imagine that for Julsing-Strydom the tweet was the last straw, and so she submitted her complaint, including screenshots of Noakes’s tweet, to Legal Med. The accompanying email read:

‘To whom it may concern. I would like to file a report against Prof Tim Noakes. He is giving incorrect medical [nutrition therapy] on Twitter that is not evidence based. I have attached the Tweet where Prof Noakes advises a breastfeeding mother to wean her baby on to a low carbohydrate high fat diet. I urge the HPCSA to please take urgent action against this type of misconduct as Prof Noakes is a celebrity in South Africa and the public does not have the knowledge to understand that the information he is advocating is not evidence based. It is specifically dangerous to give this advice for infants and can potentially be life-threatening. I await your response. Claire Julsing-Strydom.’

The wording is a little breathless, and the reason for that would emerge in the hearing.

The complaint contains many factors that Legal Med would have considered, but five pertain to focus points covered so far in this book: the limits to the public’s understanding of science, in this case that of human nutrition; the complexity and unreliability of academic research behind that science; the media profile of Tim Noakes, and the idea that he is a ‘celebrity’; that the complaint related to something said within a disrupted media environment; and the suggestion that nutritional advice is a clear-cut case of right or wrong.

What the legal department would have known when they received the complaint was that the complainant was another health professional; this wasn’t just someone with a beef about their proctologist having cold hands. This meant that the complainant would have understood the potential outcomes of submitting her complaint, especially one claiming that an act by a fellow health professional was ‘life-threatening’. The fact of the matter is that Legal Med saw sufficient seriousness in the complaint to investigate.

However, inconsistencies in Julsing-Strydom’s complaint soon came to light. She supposedly submitted it on behalf of ADSA, and yet didn’t make that clear in the complaint. When questioned in the HPCSA hearing that her complaint triggered, she replied that it was the first time she had registered a complaint, saying, ‘I was not aware that this email would actually be, you know, used at this level.’

Now, after 30 years of interviewing people for the media, if there’s something I’ve learnt it’s that the most honest comments are usually unconsidered – made as an aside, when thoughts are wandering, or if a little flustered. Perhaps, I thought, Julsing-Strydom hadn’t really thought through what was going to happen once she submitted the complaint.

Furthermore, a forensic analysis of Twitter timelines and the submission date and time of the complaint shows that Julsing-Strydom publicly expressed her horror on Twitter on 6 February 2014 at 07:48, and sent her email to Legal Med less than an hour later, at 08:47. It’s fair to say that Julsing-Strydom was upset when she wrote that email.

Based on the findings of a preliminary committee of inquiry, the legal department of the HPCSA sent a letter to Noakes on 28 January 2015, saying that he was to be summoned before the Professional Conduct Committee of the Medical and Dental Professions Board. The charge against him was attached to the letter, and it makes for puzzling reading: ‘That you are guilty of unprofessional conduct, or conduct which, when regard is had to your profession is unprofessional, in that during February 2014, you acted in a manner that is not in accordance with the norms and standards of your profession in that you provided unconventional advice on breastfeeding babies on social networks (tweet).’

It is so badly written that it would send any sub-editor reaching for a stiff shot of whisky, so it was invariably presented in the media thus: ‘charged with providing unconventional advice on social media to breastfeeding mothers’.

When I first read the charge, that part about ‘social networks’ intrigued me the most. Providing advice on a public social media platform is an ethical catch-22 for any clinician: if they provide generalised information, they can be accused of not taking into consideration the specifics of the patient; yet if they ask for specifics, they risk encouraging the sharing of confidential information on a public platform. There’s also the ethical conundrum that if they open a consultative dialogue with someone other than a patient, they can be charged with supersession, essentially ‘stealing’ a patient; and for the HPCSA, that is grounds for discipline. How is that for irony?

I sensed confusion in the poorly worded charge. On a hunch I contacted the HPCSA and asked for a copy of their guidelines for how registered health practitioners should engage with the public on social media – if the HPCSA were charging Noakes because of his use of social media, they’d obviously have the necessary guidelines in place. I received the following reply: ‘Kindly note that the HPCSA doesn’t have guidelines around how registered health practitioners should engage with the public on social media.’ The HPCSA was clearly in unfamiliar territory. I thought it didn’t bode well for a speedy, clear-cut course for the hearing; and I was right.

What started on 4 June 2015, and was supposed to be wrapped up in little over a week, would drag on for almost two years, and if its aim was to deliver a swift, unsparing and public reprimand of a dissident scientist, it failed.

Dietary Dogma: Tested and Failed

There were two recent studies that looked at diets. One compared the 2010 Dietary Guidelines against the typical American diet. The other compared multiple dietary interventions: Mediterranean diet, low-fat diet, and low-salt diet. This covers the main diets advocated most often by doctors, nutritionists, dieticians, and health officials. Yet neither study found a significant overall benefit to any of the recommended diets. That is shocking, when one considers how official experts and major institutions have pushed these diets for decades. The low-fat diet has been a favorite among dietary technocrats for about a half century (The Creed of Ancel Keys).

What these studies didn’t bother to consider is the benefits of traditional foods diet (Weston A. Price & Sally Fallon Morrell), paleo/hunter-gatherer diet, low-carb high-fat diet, ketogenic diet, carnivore diet, etc. Nor any of the related but less well known diets like ketotarian, pegan, etc. Nor related dietary strategies such as fasting, either intermittent or extended, along with calorie restriction. With a narrow focus, the comparisons were limited. Still, it is a powerful judgment that none of the diets that were tested stood out as being all that impressive. What is being brought under doubt represents the key message of authoritative opinion on diet and nutrition. These diets tested (official Dietary Recommendations, Mediterranean diet, low-fat diet, and low-salt diet) are among the best that the collective wisdom of mainstream thought has to offer.

Here is an intriguing point. The first study looked at the 2010 Dietary Guidelines as separate from weight loss, to determine what were the results of the diet itself (besides, even including weight loss, the low-fat diet is one of the worst, as studies show few people drop body fat when adhering to it — see meta-analysis by UK Public Health Collaboration, Eat Fat, Cut The Carbs and Avoid Snacking To Reverse Obesity and Type 2 Diabetes). This officially trumpeted dietary regime, a fad diet that hasn’t been around long by the way, had no noticeable affect on glucose homeostasis, fasting lipids, or type 2 diabetes. Let’s consider another study, as a comparison and to clarify a point (Parker N. Hyde et al, Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss). As with the above mentioned study, body weight was carefully maintained so as to control for that potentially confounding factor. What were the results?

“Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS [metabolic syndrome, including type 2 diabetes], especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate.”

Interestingly, these particular two studies demonstrate that obesity by itself is not necessarily the problem. Rather, it is a symptom of the problem. Obesity can even be an attempt by the body to compensate in preventing something even worse (Coping Mechanisms of Health). The fundamental problem is the metabolic syndrome itself and the insulin resistance behind it, and any diet that doesn’t directly deal with that will be ineffective. Only some variation of a low-carb diet can accomplish that end.

It’s time to rethink dietary recommendations and guidelines. There are signs this is already happening. The public is already turning toward low-carb diets (Low-Carb Diets On The Rise). And slowly but surely the official position is shifting in this direction (Obese Military?, Weight Watchers’ Paleo Diet, American Diabetes Association Changes Its Tune, Official Guidelines For Low-Carb Diet, & Slow, Quiet, and Reluctant Changes to Official Dietary Guidelines). The evidence keeps accumulating. These recent two studies add to the growing pile. It’s getting harder and harder to ignore the obvious.

* * *

A randomized controlled-feeding trial based on the Dietary Guidelines for Americans on cardiometabolic health indexes
by Sridevi Krishnan et al

To our knowledge, this is the first controlled-feeding trial to test the effect of a food-based dietary pattern following recommendations of the DGA [2010 Dietary Guidelines for Americans]. We measured cardiometabolic disease risk factors in an at-risk female cohort, while maintaining body weight, with the use of foods that are accessible and acceptable to the consumer. The higher quality of the DGA diet relative to the TAD [typical American diet] was confirmed by HEI scores of 98 and 62, respectively. We found that, in the absence of weight loss, consuming a diet based on recommendations of the DGA did not change glucose homeostasis or fasting lipids in our cohort. The 2015 DGA Advisory Committee report concluded that there was moderate evidence for reduction in type 2 diabetes risk associated with nutrient-dense diets (2); however, the results from our short-term intervention trial did not align with this evidence. By design, the intervention did not lead to significant weight loss, and because changes in body weight and body fat can play a role in the pathogenesis of type 2 diabetes (31), this may also explain why improvements in blood sugar control were not observed despite the improvement in diet quality.

Supplements and Diets for Heart Health Show Limited Proof of Benefit
by Anahad O’Connor

When Dr. Khan and his co-authors looked at various diets recommended for cardiovascular prevention, they found a similar lack of solid evidence.

That was certainly the case for low-fat diets, which health authorities have recommended for decades as a way to lower cholesterol and heart disease risk. Dr. Khan and his colleagues found that the most rigorous randomized trials provided no evidence that eating less fat, including saturated fat, had an impact on mortality or cardiovascular outcomes. Low-fat diets have largely fallen out of favor among health authorities in recent years, though the federal government’s dietary guidelines still encourage people to limit their intake of foods rich in saturated fat, such as butter, meat and cheese.

One diet that remains highly touted by health authorities is the Mediterranean diet, with its abundance of whole grains, beans, nuts, fruits and vegetables and olive oil. While clinical trials have found that it reduces cardiovascular risk, some of the major ones have been flawed, and experts who have scrutinized the evidence for the diet have urged caution.

One of the largest and most publicized Mediterranean diet trials, called Predimed and published in 2013, found that it reduced heart attacks and strokes. But last year it was retracted because of methodological problems. The Predimed authors published a new analysis of their data, claiming their conclusions had not changed. But other Mediterranean diet trials have been embroiled in similar controversies. After analyzing data from all the relevant trials, Dr. Khan and his colleagues found that “the totality of evidence did not favor the Mediterranean diet for cardiovascular outcomes.”

“It’s not favorable or harmful,” he added. “It’s just a neutral diet from a cardiovascular perspective.”

The one dietary intervention that seemed to have the most support from randomized trials was lowering salt intake, though the researchers graded the evidence only as having “moderate certainty.” And there was nuance. Low-salt diets reduced mortality from all causes only in people with normal blood pressure. Among people with hypertension, lowering salt intake reduced deaths from heart disease but not from other causes.

Dr. Topol said that in his own clinic he sees a wide range of responses to salt intake. Some people are very sensitive to salt: A small increase in salty foods can have a pronounced effect on their blood pressure. But others can eat salt-laden meals and their blood pressure will hardly budge.

Dr. Topol said he finds diet studies hard to interpret because they rarely take into account the unique way that different people can have markedly different responses to dietary changes, whether it is cutting back on salt or avoiding fat or carbohydrates.

“The problem we have here is that all these studies essentially treat all people as one,” he said. “I think that all these things are going to turn out to be quite heterogeneous. Maybe salt restriction really is beneficial for some, but we haven’t defined the people yet that would drive that.”

Low-Carb Diet Is Healthy Even Without Fat Loss

Studies have shown that a low-carb, high-fat diet improves health. But it wasn’t clear if this is caused directly by the diet or caused instead by the fat loss that is a common result of the diet. In a new 3-year study, researchers controlled for fat loss and many of the same health benefits were still seen.

The researchers did this by providing prepared meals. They had to make sure that the subjects were getting enough calories so as to lose no weight. This meant increasing fat intake, sometimes by extraordinary amounts. Despite this including an increased in saturated fat, there was no increase of saturated fat in the bloodstream. This is yet more evidence against the scapegoating of saturated fat. The diets also would have been high in cholesterol and, unsurprisingly, all the health markers for cholesterol were positive.

On the other hand, there are confounding factors. Subjects were given prepared meals. This would naturally decrease the consumption of processed foods. To really understand what was going on, we would have to look at the precise ingredients.  For example, did these prepared meals have less industrial vegetable oils that are known to cause all kinds of health problems, including affecting metabolic syndrome?

The fact that there was greater amount of saturated fat in the diet indicates that the kind of fat one eats does matter. So, simply replacing sources of PUFAs with healthy fats, including saturated fats, will lead to massive improvements, whether it is caused by what is being eliminated or by what is being added in. Still, from what we know about the harm caused by excess starches and sugar, it’s hard to conclude that this study merely showed the positive effects of changes in the amounts and kinds of fats.

Whatever the cause, it is well-established at this point that a low-carb, high-fat diet is healthy. This is true, whether or not there is fat loss. Yet considering fat loss is a definitely health benefit typical of this diet, it demonstrates how the advantages are multiple. If you need to lose weight, it’s the best diet around. But if you don’t need to lose weight, it’s still great. There is no way for you not to come out ahead.

* * *

Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss
by Parker N. Hyde et al

Low-carb diets could reduce diabetes, heart disease and stroke risk even if people DON’T lose weight by cutting down on bread, potatoes and pasta
by Sam Blanchard

Silence on the US Front–News Flash of US Research from the UK!
by Angela A. Stanton

Low-Carb Diet Could Reduce Risk of These Diseases
by Kashmira Gander

Low-carb diet may reduce diabetes risk independent of weight loss
by Misti Crane

“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.”

* * *

*”[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:

 

Does a Healthy LCHF Diet Protect Against Sunburns?

As I’ve written about lately, there is something unique about a low-carb, high-fat diet. People feel better and have more energy. Diverse symptoms disappear, including from serious conditions that for some people are reversed, from autoimmune disorders to mood disorders. That is particularly true in the context of exercise, calorie restriction, fasting, OMAD, ketosis, autophagy, etc and when combined with traditional foods, paleo, carnivore, etc. Many have experimented with this area of dietary changes and have observed major improvements, but it isn’t always clear exactly what is causing any given improvement.

We do understand certain things well. I’ve already discussed in detail ketosis and related factors. And there has been more info coming out about autophagy, an even more fascinating topic. There is the signaling in relation to mTOR, IGF1, and AMPK. And there are the hormones that deal with hunger, satiety, and fullness. Everything is context-dependent. For example, the carnitine in red meat can be turned into carcinogenic TMOA by the Prevotella gut bacteria, but that is a non-issue as long as you aren’t eating the grains that feed Prevotella in the first place. Or consider how vitamin C deficiency that leads to scurvy is rare on carnivore diets, even though vitamin C is found in such small amounts in animal foods, since on a low-carb diet the body needs less vitamin C. Issues with gut health, inflammation, and neurocognition are also more clear in explanation as they’ve received much scientific attention.

Other results are more anecdotal, though. This is largely because the research on low-carb, high-fat diets has been limited and in many cases, such as with zero-carb, scientific evidence is even more sparse. But what thousands of people have observed remains interesting, if yet not entirely explained. Many LCHF dieters have noted that their thoughts are less obsessive and compulsive, something I’ve argued has to do with eliminating addictive foods from the diet, especially added sugar and grains. An example of this is decrease of intrusive sexual thoughts reported by some (and less distraction in general), although at the same time some also state decrease in erectile dysfunction (the latter being unsurprising as the LCHF diet are causally linked to hormonal functioning and cardiovascular health). Sexuality definitely is changed in various ways, as demonstrated in how early puberty becomes common when populations switch to agriculture with high amounts of carbohydrates, in particular grains, and maybe dairy has something to do with it as well since dairy triggers growth hormone — maybe why agricultural societies were able to outbreed hunter-gatherers, overwhelming them with a continually growing supply of cheap labor and cheap lives to send off to war.

There are some confounding factors, of course. Along with more nutrient-dense foods with an emphasis on fat-soluble vitamins, people going on various kinds of low-carb diets also tend to increase cholesterol, saturated fat, and omega-3s while decreasing omega-6s. Cholesterol is one of the most important substances for brain health and it helps your body to process vitamin D from sunlight. Saturated fat is a complicated issue and no one fully knows the significance, beyond our knowing the fear-mongering about it appears to be no longer valid. As for omega-3s, they are essential to so much. The main problem is that omega-6s are at such a high level in the modern diet that they are inflammatory. In using healthier oils and fats, most low-carbers eliminate vegetable oils in junk food and in cooking with vegetable oils being the main source of omega-6s.

This could explain why some think sunburns are less common on a low-carb diet (read down through the Twitter comments). It may or may not have anything specifically to do with carbohydrates themselves and, instead, be more about the general eating pattern common among low-carb dieters. This might have to do with oxidation and free-radicals in relation to omega-6s. Or it could have something to do with fat-soluble vitamins or dietary cholesterol that is typically greater in low-carb, high-fat diets. There are similar patterns in multiple areas of dietary changes and health, and they indicate something that can’t be explained by mainstream health ideology. Consider how Americans have experienced worsening health as they have followed expert opinion in eating more vegetables, fruits, whole grains, and vegetable oils while decreasing red meat and saturated fat. Americans have been following expert advice from mainstream institutions and from their doctors. The same kind of thing has happened with people protecting themselves against sun damage. Americans have increased their use of sunscreen while spending less time in the sun, as they were told to do. What has been the results? The skin cancer rate is going up and those avoiding the sun are less healthy. Is it a mere coincidence that the intake of omega-6s was also increasing during the same period? Maybe not.

When the actual causes are determined, we can isolate them and re-create the appropriate conditions or mimic them. This is biohacking — Siim Land is great in explaining how to get particular results based on the scientific evidence. If omega-6s or whatever is the problem behind sunburns, then it’s far from being knowledge of value limited to the low-carb community. Omega-6s haven’t been as clearly on the radar of many other diets, but health issues with omega-6s are already well known in the scientific literature. So, the advantages in this case might be attained without restricting carbs, although we don’t know that as of yet, assuming the anecdotal observations are proven valid. The interaction between omega-6s and carbohydrates might be a total package, in terms of pushing the body more fully into an inflammatory state where sunlight sensitivity becomes an issue. All we can do at the moment is offer hypotheses to be tested in personal experience and hopefully soon in scientific studies.

There are other arguments for why a specifically low-carb diet could offer sunburn protection, as explored by Keir Watson in Animal Products That Protect You From UV Damage. This is particularly true when we are talking about a paleo or similar diet with plenty of fatty animal foods. Along with omega-3s, saturated fat might play a role: “A higher saturation index should be protective against free-radical damage, suggesting that more saturated fat in the diet might be good, but the evidence I found was not very strong.” More research will need to be done on that possibility. Even if saturated fats simply replace omega-6s, they will be beneficial in this area of health. Another thing to consider is creatine, plentifully found in meat and fish, that “has marked protective effects against oxidative stress and UV-induced damage in the skin, including protecting mitochondrial DNA.” The last thing brought up by Watson are antioxidants, although typically associated with plants, are also found in animal products: “Lutein and zeaxanthin (from egg yolk),” “Astaxanthin found in wild salmon, krill, lobster and crab,” “retinol (vitamin A from animal source, e.g. liver),” and vitamin D from “oily fish – salmon, mackerel, herrings and sardines – the very same fish that give you the protective omega-3 fats!”

The body is a complex system. Change even a single factor and it can have cascading effects. But change multiple factors and the entire functioning can shift into a different state, altering numerous areas of health. Many of the results will be unpredictable based on present science because most research up to this point has had a narrow focus in the population being studied, almost entirely those on the Standard American diet and variations of it. What is true for most people following the past half century of health advice won’t always apply to those following entirely different diets and lifestyles. It’s not that LCHF is going to heal all that ails you, but we find ourselves at a rather fascinating point in the views on diet, lifestyle, and health. We are coming to realize how profoundly affected is the body and mind by even some minor changes. We have more hypotheses at present than knowledge, and that isn’t a new situation. So much of what we thought we knew in the past, the basis of mainstream ideology of health experts, were largely untested hypotheses when first advocated and much of it remains unproven.

Now it’s time to get serious about exploring these other glimpses of entirely different possibilities of understanding. That is the point of hypotheses that often begin as observations and anecdotal evidence.

* * *

Effect of Dietary Lipid on UV Light Carcinogenesis in the Hairless Mouse
by Vivienne E. Reeve, Melissa Matheson, Gavin E. Greenoak, Paul J. Canfield, Christa Boehm‐Wilcox, and Clifford H. Gallagher

Isocaloric feeding of diets varying in lipid content to albino hairless mice has shown that their susceptibility to skin tumorigenesis induced by simulated solar UV light was not affected by the level of polyunsaturated fat, 5% or 20%. However a qualitative effect of dietary lipid was demonstrated. Mice fed 20% saturated fat were almost completely protected from UV tumorigenesis when compared with mice fed 20% polyunsaturated fat. Multiple latent tumours were detected in the saturated fat‐fed mice by subsequent dietary replenishment, suggesting that a requirement for dietary unsaturated fat exists for the promotion stage of UV‐induced skin carcinogenesis.

Effects of high-fat diets rich in either omega-3 or omega-6 fatty acids on UVB-induced skin carcinogenesis in SKH-1 mice
by You-Rong Lou et al

Is Sunscreen the New Margarine?
by Rowan Jacobsen

Don’t Drink (oil) and Fry (in the sun) – the link between polyunsaturated vegetable oil and skin cancer
by George Henderson

N=Many on Omega-6 and Sunburn: Can Sunburn be Reduced?
by Tucker Goodrich

Don’t Blame it on the Sun!
by Dawn Waldron

Why I Don’t Use (Or Need) Sunscreen
by Tom Naughton

American Diabetes Association Changes Its Tune

Over the past decade, ever more mainstream health organizations and government agencies have been slowly reversing their official positions on the dietary intake of carbohydrates, sugar, fat, cholesterol, and salt. This was seen in how the American Heart Association, without acknowledgment, backed off its once strong position about fats that it defended since I think 1961, with the federal government adopting the same position as official policy in 1980. Here we are in 2019, more than a half century later.

Now we see the American Diabetes Association finally coming around as well. And its been a long time coming. When my grandmother was in an assisted living home, the doctors and nurses at the time were following the official ADA position of what were called “consistent carbs”. Basically, this meant diabetics were given a high-carb diet and that was considered perfectly fine, as long as it was consistent so as to manage diabetes with consistent high levels of insulin use. It was freaking insanity in defying common sense.

While my grandmother was still living with my parents, my mother kept her blood sugar under control through diet, until she went to this healthcare facility. After that, her blood sugar was all over the place. The nurses had no comprehension that not all carbohydrates are equal since the glycemic index might be equivalent between a cookie and a carrot, irrespective of glycemic load and ignoring that maybe diabetics should simply be cutting out carbs in general. Instead, they argued that old people should be allowed to enjoy carbs, even if it meant that these nurses were slowly killing their patients and profiting the insulin companies at the same time. My mother was not happy about this callous attitude by these medical ‘professionals’.

Yet here we are. The ADA now says low-carb, high-fat (LCHF) diets aren’t a fad and aren’t dangerous. They go so far as to say they are beneficial for type 2 diabetes. Those not completely ignorant have been saying this for generations. And the research has been accumulating for just as long. The shift in official recommendations that happened in the decades following the 1960s never made sense even according to the research at the time. Many academics and researchers pointed out the lack of evidence in blaming saturated fat and cholesterol. But they were ignored and dismissed, then later attacked, discredited, and silenced by influential and, in some cases, downright charismatic figures (e.g., Ancel Keys) in powerful organizations that became aligned with leading politicians and bureaucrats in key positions. Many careers were destroyed and debate was shut down.

Now those victims of dietary authoritarianism are vindicated, not that this helps all the average folk harmed. There was many decades of bad dietary advice was force onto the American public. This determined official policies and practices of government healthcare programs, school lunch programs, and healthcare providers. Because of the central position of the United States as a geopolitical power during the Cold War, countries all over the world adopted this unhealthy dietary ideology as part of their own official policies.

This also influenced the food system with the government subsidizing high yields of corn and grains to meet the recommendations of these nutritional guidelines. Big ag and big food changed their business models accordingly and put out products that were high in carbs and sugar while low in saturated fat, replacing the latter with unhealthy hydrogenated oils. At least hundreds of millions, if not billions of people, worldwide over multiple generations have suffered a horrible diet, increased sickness, bad medical care, and premature mortality as a result.

Without admitting they were wrong all this time, without apologizing for all the harm they caused, these leading experts and officials are changing their opinion. Better late than never. Mark this date for it is a historic moment.

* * *

Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report
by Alison B. Evert et al, American Diabetes Association
(also see here)

EATING PATTERNS: Consensus recommendations

  • A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes.
  • Until the evidence surrounding comparative benefits of different eating patterns in specific individuals strengthens, health care providers should focus on the key
    factors that are common among the patterns:
    ○ Emphasize nonstarchy vegetables.
    ○ Minimize added sugars and refined grains.
    ○ Choose whole foods over highly processed foods to the extent possible.
  • Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.
  • For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low- or very lowcarbohydrate eating plans is a viable approach

New Consensus Report Recommends Individualized Eating Plan to Meet Each Person’s Goals, Life Circumstances and Health Status
news release from American Diabetes Association

“‘What can I eat?’ is the number one question asked by people with diabetes and prediabetes when diagnosed. This new Consensus Report reflects the ADA’s continued commitment to evidence-based guidelines that are achievable and meet people where they are and recommends an individualized nutrition plan for every person with diabetes or prediabetes,” said the ADA’s Chief Scientific, Medical and Mission Officer William T. Cefalu, MD. “The importance of this consensus also lies in the fact it was authored by a group of experts who are extremely knowledgeable about numerous eating patterns, including vegan, vegetarian and low carb.”

Nina Teicholz:

Just out: @AmDiabetesAssn guidelines–most comprehensive review to date of Dietary Patterns + diabetes prevention/treatment. What’s new: low-carb recommendations are prominent. (Says low-carb “are among the most studied eating patterns for T2 diabetes.”) […]

This is the key advancement of new @AmDiabetesAssn guidelines. Low carb is no longer “dangerous”‘or “fad”‘but a “viable”‘diet supported by “substantial”‘research and considered best for a number of T2 diabetes outcomes.

Dr. John Owens:

This is an historic day! My case managers and dietitian have been supporting my low-carb recommendations for years, going against ADA guidelines. Now they don’t have to!

Dr. Eric Sodicoff:

Still….They seem a little backward here. Bust out the low carb diet when meds not working?? Really? IMHO-Carb restriction is JOB #1 in diabetes management for use early and always. It is NOT second to medication my treatment protocol.

Starofthesea:

If you go back to the beginning, like back in the 1930’s, the doctors were telling diabetics to stop eating carbohydrates. Then somebody fabricated the cholesterol theory of heart disease and invented a drug called statins. Then suddenly carbs were okay for diabetics.

Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report — American Diabetes Association
from r/ketoscience

lutzlover:

“Eating patterns that replace certain carbohydrate foods with those higher in total fat, however, have demonstrated greater improvements in glycemia and certain CVD risk factors (serum HDL cholesterol [HDL-C] and triglycerides) compared with lower fat diets.”

Yay! Ack that higher fat isn’t deadly.

“The body makes enough cholesterol for physiological and structural functions such that people do not need to obtain cholesterol through foods. Although the DGA concluded that available evidence does not support the recommendation to limit dietary cholesterol for the general population, exact recommendations for dietary cholesterol for other populations, such as people with diabetes, are not as clear (8). Whereas cholesterol intake has correlated with serum cholesterol levels, it has not correlated well with CVD events (65,66). More research is needed regarding the relationship among dietary cholesterol, blood cholesterol, and CVD events in people with diabetes.

Or, in layman’s language: While the data doesn’t support vilifying cholesterol as causing heart attacks, we’re going to keep on searching in hopes we find the answer we want.

dem0n0cracy:

Are protein needs different for people with diabetes and kidney disease?

“Historically, low-protein eating plans were advised to reduce albuminuria and progression of chronic kidney disease in people with DKD, typically with improvements in albuminuria but no clear effect on estimated glomerular filtration rate. In addition, there is some indication that a low-protein eating plan may lead to malnutrition in individuals with DKD (317–321). The average daily level of protein intake for people with diabetes without kidney disease is typically 1–1.5 g/kg body weight/day or 15–20% of total calories (45,146). Evidence does not suggest that people with DKD need to restrict protein intake to less than the average protein intake.

dem0n0cracy:

“The amount of carbohydrate intake required for optimal health in humans is unknown. Although the recommended dietary allowance for carbohydrate for adults without diabetes (19 years and older) is 130 g/day and is determined in part by the brain’s requirement for glucose, this energy requirement can be fulfilled by the body’s metabolic processes, which include glycogenolysis, gluconeogenesis (via metabolism of the glycerol component of fat or gluconeogenic amino acids in protein), and/or ketogenesis in the setting of very low dietary carbohydrate intake (49).”

dem0n0cracy:

Low-carbohydrate (110–112) Emphasizes vegetables low in carbohydrate (such as salad greens, broccoli, cauliflower, cucumber, cabbage, and others); fat from animal foods, oils, butter, and avocado; and protein in the form of meat, poultry, fish, shellfish, eggs, cheese, nuts, and seeds. Some plans include fruit (e.g., berries) and a greater array of nonstarchy vegetables. Avoids starchy and sugary foods such as pasta, rice, potatoes, bread, and sweets. There is no consistent definition of “low” carbohydrate. In this review, a low-carbohydrate eating pattern is defined as reducing carbohydrates to 26–45% of total calories. c A1C reduction c Weight loss c Lowered blood pressure c Increased HDL-C and lowered triglycerides

Very low-carbohydrate (VLC) (110–112) Similar to low-carbohydrate pattern but further limits carbohydrate-containing foods, and meals typically derive more than half of calories from fat. Often has a goal of 20–50 g of nonfiber carbohydrate per day to induce nutritional ketosis. In this review a VLC eating pattern is defined as reducing carbohydrate to ,26% of total calories. c A1C reduction c Weight loss c Lowered blood pressure c Increased HDL-C and lowered triglycerides”

dem0n0cracy:

Low-Carbohydrate or Very Low Carbohydrate Eating Patterns

“Low-carbohydrate eating patterns, especially very low-carbohydrate (VLC) eating patterns, have been shown to reduce A1C and the need for antihyperglycemic medications. These eating patterns are among the most studied eating patterns for type 2 diabetes. One metaanalysis of RCTs that compared lowcarbohydrate eating patterns (defined as #45% of calories from carbohydrate) to high-carbohydrate eating patterns (defined as .45% of calories from carbohydrate) found that A1C benefits were more pronounced in the VLC interventions (where ,26% of calories came from carbohydrate) at 3 and 6 months but not at 12 and 24 months (110).

“Another meta-analysis of RCTs compared a low-carbohydrate eating pattern (defined as ,40% of calories from carbohydrate) to a low-fat eating pattern (defined as ,30% of calories from fat). In trials up to 6 months long, the low-carbohydrate eating pattern improved A1C more, and in trials of varying lengths, lowered triglycerides, raised HDL-C, lowered blood pressure, and resulted in greater reductions in diabetes medication (111). Finally, in another meta-analysis comparing lowcarbohydrate to high-carbohydrate eating patterns, the larger the carbohydrate restriction, the greater the reduction in A1C, though A1C was similar at durations of 1 year and longer for both eating patterns (112). Table 4 provides a quick reference conversion of percentage of calories from carbohydrate to grams of carbohydrate based on number of calories consumed per day.

“Because of theoretical concerns regarding use of VLC eating plans in people with chronic kidney disease, disordered eating patterns, and women who are pregnant, further research is needed before recommendations can be made for these subgroups. Adopting a VLC eating plan can cause diuresis and swiftly reduce blood glucose; therefore, consultation with a knowledgeable practitioner at the onset is necessary to prevent dehydration and reduce insulin and hypoglycemic medications to prevent hypoglycemia.

“No randomized trials were found in people with type 2 diabetes that varied the saturated fat content of the low- or very low-carbohydrate eating patterns to examine effects on glycemia, CVD risk factors, or clinical events. Most of the trials using a carbohydrate-restricted eating pattern did not restrict saturated fat; from the current evidence, this eating pattern does not appear to increase overall cardiovascular risk, but longterm studies with clinical event outcomes are needed (113–117).”

dem0n0cracy:

What is the evidence to support specific eating patterns in the management of type 1 diabetes?

“For adults with type 1 diabetes, no trials met the inclusion criteria for this Consensus Report related to Mediterraneanstyle, vegetarian or vegan, low-fat, low-carbohydrate, DASH, paleo, Ornish, or Pritikin eating patterns. We found limited evidence about the safety and/or effects of fasting on type 1 diabetes (129). A few studies have examined the impact of a VLC eating pattern for adults with type 1 diabetes. One randomized crossover trial with 10 participants examined a VLC eating pattern aiming for 47 g carbohydrate per day without a focus on calorie restriction compared with a higher carbohydrate eating pattern aiming for 225 g carbohydrate per day for 1 week each. Participants following the VLC eating pattern had less glycemic variability, spent more time in euglycemia and less time in hypoglycemia, and required less insulin (130). A single-arm 48-person trial of a VLC eating pattern aimed at a goal of 75 g of carbohydrate or less per day found that weight, A1C, and triglycerides were reduced and HDL-C increased after 3 months, and after 4 years A1C was still lower and HDL-C was still higher than at baseline (131). This evidence suggests that a VLC eating pattern may have potential benefits for adults with type 1 diabetes, but clinical trials of sufficient size and duration are needed to confirm prior findings.”

Obese Military?

I came across some articles on obesity and the military (see below). Metabolic syndrome, obesity being one part of it, is on the rise in the military and in the population in general, along with much else such as autoimmune and mood disorders.

Weight issues are not an issue of mere exercise, as I discovered in aging. The weight began accruing in my thirties and continued into my forties. I’ve always been active and so, in response, I became even more active. I had long done aerobic exercise multiple times a week, often long jogs and sometimes carrying extra weight. Weightlifting was added to my regimen these past few years. Still, the body fat wouldn’t budge. Besides, the worst rates of obesity are found among the young and so aging is not the issue, as further demonstrated by age-related diseases (e.g., what was once called adult onset diabetes) hitting hard at younger and younger ages.

Why is that? Some of it is basic biological changes in aging, of course — still, that couldn’t explain it all since it is happening in all age groups. I had improved my diet over time, but admittedly I was still eating a fair amount of carbs and sugar, even if no where near the amount the average American gets. In the wider population, the consumption of carbohydrates and added sugars has drastically increased over time, specifically as dietary percentage of red meat and saturated fat has gone down while dietary percentage of vegetables and vegetable oils has been on the rise. There are other complex factors that could be mentioned, but I’ll keep it simple.

The point is that the American population, in and outside of the military, are in compliance with official dietary recommendations. The military is even able to enforce a high-carb, low-fat diet on military personnel since they have few other choices when food is prepared for them, and it is specifically during deployment that military personnel have the worst diet-related health decline. There is no greater opportunity than the military for gathering highly-controlled dietary data, as the only other segment with more controlled diets are those locked away in institutions. Also, the military enforces a rigid exercise program, and those who join are those who self-selected for this lifestyle and then had to meet high standards to be accepted. Yet military personnel apparently are getting fatter and fatter.

The amount of carbohydrates we’re talking about here is not insignificant. The USDA recommends 50-60% of the diet to consist of carbohydrates with an emphasis on grains, most of those simple starchy carbs. Even adding some fiber back into processed foods doesn’t really make them any healthier. Grains alone brings up a whole mess of other issues besides gluten (e.g., grains block absorption of certain key nutrients) — it’s long been known that the best way of fattening animals is with grains.

To put in context how distorted is our diet, a recent study compared a high-carb and a low-carb diet where the latter consisted of 40% carbs. If that is what goes for low-carb these days, no wonder we are such a sickly population. Most traditional societies rarely get such high levels of carbs and what they do get usually comes from sources that are fibrous and nutrient-dense. Look at hunter-gatherers — 40% carbs would be at the extreme high end with many groups only getting 22% carbs. As a concrete example, compared to potato chips or a baked potato, chewing on a fibrous wild tuber is a laborious process because of how tough it is, only gaining slightly more calories than you’d be expending for all the effort.

For further perspective, a study published this month implemented a ketogenic diet (Richard A. LaFountain et al, Extended Ketogenic Diet and Physical Training Intervention in Military Personnel). That by itself isn’t noteworthy, as ketosis has been scientifically studied for about a century. What is significant is that it was the first time that such a diet done was done with military personnel. If you’re familiar with this area of research, the results were predictable which is to say they were typical. Military personnel aren’t essentially any different than other demographics. We all evolved from the same ancestors with the same metabolic system.

The results were positive as expected. Health improved in all ways measured. Body fat, in particular, was lost — relevant because the subjects were overweight. Benefits were seen in other aspects of what is called metabolic syndrome, such as better insulin sensitivity. All of this was accomplished while physical fitness was maintained, an important factor for the military. Going by what we know, if anything, physical fitness would improve over time; but that would require a longer term study to determine.

Ketosis is how I and millions of others have lost weight, even among those who don’t know what ketosis is. Anyone who has ever restricted their diet in any way, including fasting, likely has experienced extended periods of ketosis with no conscious intention being required — ketosis simply happens when carbs and sugar are restricted, and even commercial diets like Weight Watchers are quite restrictive along these lines. Other ketogenic gains often are experienced in relation to hunger, cravings, mood, energy, stamina, alertness, and focus. The point here, though, was weight loss and once again it was a glorious success.

That such studies are finally being done involving the military indicates that, after a century of research, government officials are maybe finally coming around to taking ketosis seriously. It’s understandable why drug companies and doctors have been resistant, since there is no profit in a healthy sustainable diet, but profit isn’t a concern for the military or shouldn’t be, although military contractors who provide the food might disagree (high-carb food is cheaper to provide because of high-yield crops subsidized for a half century by the government). If the USDA won’t change its guidelines, maybe the military should develop its own. A military filled with those of less than optimal health is a national security threat.

As for the rest of us, maybe it’s time we look to the studies and make informed decisions for ourselves. Not many doctors know about this kind of research. And if anything, doctors have a misinformed fear about ketosis because of confusion with diabetic ketoacidosis. Doctors aren’t exactly the most knowledgeable group when it comes to nutrition, as many have noted. And the government is too tied up with agricultural and food corporations. Any positive changes will have to come from the bottom up. These changes are already happening in a growing movement in support of alternative diets such as ketogenic low-carb, which is maybe what brought it to the attention of some military officials.

Government will eventually come around out of necessity. A global superpower can’t maintain itself in the long run with a malnourished and obese population. The healthcare costs and lost sick days alone could cripple society — even now most of the healthcare costs go to a few preventable diseases like diabetes. I’m willing to bet that when the next world war is fought the soldiers will be eating low-carb, high-fat rations made with nutrient-dense ingredients. Not doing so would risk having an inferior military. For-profit ideology only goes so far when the stakes are high.

* * *

Is U.S. Nutrition Policy Making the Military (and Recruits) too Fat to Fight?
from Nutrition Coalition

This year, for the first time since 2005, the Army fell short of its recruitment goal, according to the recent report, “Unhealthy and Unprepared,” by The Council for a Strong America, a group of retired generals and admirals. Obesity was largely to blame. Some 71% of young people between the ages of 17 and 24 fail to qualify for military service, says the report. These alarming numbers raise the disturbing question of whether the U.S. will be able to continue the luxury of maintaining an all-volunteer army in the future.

Another recent study, this one by the Rand Corporation found that some two-thirds of the nation’s active military personnel are overweight or obese. Topping the scale is the Army, with 69.4% of its personnel overweight or obese. But even the trimmest military branch – the Marine Corps – isn’t much better, at 60.9%. These numbers may be misleading, since “obesity” is defined by BMI (body mass index), which does not distinguish between whether extra pounds come fat or muscle—the latter being more likely to be the case in the military. Still, rates of 60-69% are disturbingly high. Since these folks are following the military’s exercise program, we certainly can’t blame them for shirking on physical activity.

It seems, in fact, that the U.S. military diet actually worsens health, according to an Army publication six years ago. Chanel S. Weaver of the U.S. Army Public Health Command wrote, “Even those Soldiers who are actually fit enough to deploy can face challenges in maintaining a healthy weight while serving in the deployed environment.”

In the article, Dr. Theresa Jackson, a public health scientist at the U.S. Army Public Health Command, states, “Literature suggests that fitness decreases and fat mass increases during deployments.” This is an astonishing fact: fitness declines in the military, despite mandated regular exercise.

This paradox could be explained by the growing understanding that exercise plays a relatively minor role in weight loss. “You can’t exercise your way out of a bad diet,” is the new common catchphrase among experts. Instead, the principal factor driving obesity, as the data increasingly show, is poor nutrition.

A look at the Army’s nutrition guidelines shows that they emphasize low-fat, high-carbohydrate foods. The Army recommends eating “…high protein, low-fat items such as: fish, beans, whole wheat pasta, egg whites, skim or 1 percent milk, and low-fat yogurt” while avoiding “items such as: fried items, high fat meats, egg yolks, and whole milk.” This guidance comes from the U.S. Dietary Guidelines for Americans (DGA), a policy that has been co-issued by USDA and US-HHS since 1980. The military essentially downloads these guidelines and serves food in mess halls to reflect DGA recommendations.

Ironically, this reliance on the U.S. Guidelines could well be the very reason for the military’s obesity problems. This diet tells the entire U.S. population to eat 50-60% of their calories as carbohydrates, principally grains, and just as a high-grain diet fattens cattle, a large body of government-funded science shows that a high-carbohydrate diet, for most people, is inimical to sustainable weight loss.

The argument that Americans don’t follow the guidelines is not supported by the best available government data on this subject—which demonstrates widespread adherence to the Dietary Guidelines.

New military study: “Remarkable” results among soldiers on a ketogenic diet
by Anne Mullens and Bret Scher

Those on the ketogenic diet lost an average of 17 pounds (7.5 kg), 5 percent of their overall body fat, 44 percent of their visceral fat, and had their insulin sensitivity improve by 48 per cent. There was no change in the participants on the mixed diet. Training results in physical strength, agility, and endurance in both groups were similar.

The researchers noted:

The most striking result was consistent loss of body mass, fat mass, visceral fat, and enhanced insulin sensitivity in virtually all the ketogenic diet subjects despite no limitations on caloric intake. Physical performance was maintained…. These results are highly relevant considering the obesity problem affecting all branches of the military.

[…] Although neither group counted calories, the ketogenic diet group naturally reduced their caloric intake while eating to satiety.

The most noteworthy response was a spontaneous reduction in energy intake, resulting in a uniformly greater weight loss for all ketogenic diet participants.

The military should lead the U.S. fight against obesity
by Steve Barrons

That advice, driven by the government’s Dietary Guidelines for Americans, has largely stuck to the familiar low-fat, high-carbohydrate diet that calls on us to cut meat, butter and cheese. Yet in recent years, the science has evolved, and it has become increasingly clear to people like me that fats aren’t the enemy. Indeed, as I ate more fat and reduced my intake of sugars and other carbohydrates like grains, I lost weight and became healthier.

Experiences like mine are now backed by a fast-growing body of science, showing carbohydrate restriction to be effective for fighting obesity and diabetes while improving most heart-disease risk factors.

For many, it’s hard to get past the basic assumption that the fat on your plate becomes the fat in your body. But the truth is that it’s excessive carbohydrates that turn into body fat — completely contrary to what Americans have long been told.

So why hasn’t the government’s dietary advice caught up to the science? According to a rigorous investigation in The BMJ on the dietary guidelines, the experts appointed to review the scientific evidence relied on weak scientific standards in their report and failed to review the most recent science on a number of topics, including optimal intakes for carbohydrates, saturated fat and salt. Most critically, the report relied heavily on observational studies in which researchers follow test groups over long periods of time. But even the best epidemiological studies, according to the BMJ, “suffer from a fundamental limitation. At best they can show only association, not causation. Epidemiological data can be used to suggest hypotheses but not to prove them.” This is science 101.

The U.S. military serves more than 150 million meals per year to its personnel, and when those meals are based on a government-advised, high-carbohydrate diet, our troops have a harder time staying trim and healthy. The Army’s own website warns people to stay away from high-fat meats, egg yolks and whole milk and advises “eating less fatty food for better overall health,” while encouraging a diet that includes pasta and bread. Making matters worse, service members usually have fewer options for avoiding these nutritional mistakes, especially on deployments when they often can’t cook their own meals.

Pentagon eyes controversial diet in bid to build more lethal warriors
by Ben Wolfgang

Ditching carbs may be the key to military success in America’s future wars.

Top Pentagon officials say research has shown that human bodies in ketosis — the goal of the popular and controversial ketogenic diet — can stay underwater for longer periods, making the fat- and protein-heavy eating plan a potential benefit to military divers. It is one example of a rapidly growing trend as military researchers zero in on how nutrition and certain drugs can enhance how fighting men and women perform in battle. […]

But industries that specialize in the link between diet and performance are eager to engage in complex conversations about using cutting-edge science to optimize the human body while preserving basic elements of choice and individuality. The example of how ketosis — a biological process in which the body burns fat for fuel — could produce more capable military divers is one of the clearest examples of the 21st-century debate that now confronts the Pentagon.

“One of the effects of truly being in ketosis is that it changes the way your body handles oxygen deprivation, so you can actually stay underwater at [deeper] depths for longer periods of time and not go into oxygen seizures,” Lisa Sanders, director of science and technology at U.S. Special Operations Command, said at a high-level defense industry conference in Tampa late last month.

“That kind of technology is available today,” she said. “We can tell whether you are or are not in ketosis. We have really good indications of how to put you in ketosis. And we know statistically what that does to your ability to sustain oxygen.

“The problem,” she said, “is I don’t have the authority to tell people — swimmers, submariners, etc. — that they’re going to get themselves in ketosis so they can stay in the water longer. That’s an authority question, not a technology question.”

Defense Department to ban beer and pizza? Mandatory keto diet may enhance military performance
by Kristine Froeba

The controversial ketogenic or “keto” diet may be the future of the military, some defense officials say.

Service members, and Navy SEALS especially, may have to forgo beer and burritos for skinny cocktails and avocado salad (forget the tortilla chips) if a proposal from Special Operations Command gains momentum.

While a nutritionally enhanced future could eventually be put into effect for all branches, the SEALS and other underwater dive-mission specialists might be the first groups targeted for the change in nutritional guidelines. […]

Discussion of new dietary guidelines for service members comes at a time of growing concern about obesity in the military and its potential threat to readiness. […]

For the diet to be implemented laterally across the military, produce choices and meat quality at military dining facilities across the world would have to change significantly, not to mention the high-carb and sugar content of MRE’s. The popular pepperoni pizza MRE would be a thing of the past. Although one benefit of formulating a new high-fat ration is that it would be lighter weight to carry.

“You can carry even more calories because fats weigh less, which is an advantage,” said Kinesiologist Jeff Volek, a professor at Ohio State University’s Department of Human Sciences and author of the study.

* * *

Low-Carb Diets On The Rise

I’ve been paying close attention to diet this past year. It’s something I’ve had some focus on for decades now, but new info has recently changed the public debate going on. For example, a few years back, the research data from Ancel Keys was reanalyzed and an entirely different conclusion was found to be more plausible — instead of blaming saturated fat, the stronger correlation was to sugar. So much of what mainstream dietitians and nutritionists asserted as fact was based on Keys’ work, but it has since come under a dark cloud of doubt. Simply put, it was horrible science and even worse public health policy.

My own recent interest, though, was piqued in watching the documentary The Magic Pill. It came out in 2017 and several other great documentaries have come out in the last few years, with Nina Teicholz’s documentary in the works. In playing around with diet in the broad sense, I didn’t find much that helped, beyond limiting added sugar and throwing in a few healthy traditional foods (e.g., cultured dairy). It’s not that I ever was much interested in formal diets — some combination of laziness, apathy, and being too independent-minded, hence figuring something out for myself or else failing on my own terms, no doubt plenty of failure was involved and long periods of depressive despair and frustration. I’ve always been more about experimenting and finding what works or doesn’t work for me, if for no other reason than being stubborn in going my own way.

The problem was that nothing fundamentally had worked for my depression that plagued me my whole life nor for the weight gain that hit me as I approached my 40s. It is damn hard struggling to be healthy while depressed, but I did try such things as exercising regularly for it had some immediate palpable effect. Still, it was strange to exercise and yet not lose weight, even if aerobics did lift my mood ever so slightly. I was literally running to stay in place.

That is where The Magic Pill came in. I randomly came across it and watched it out of passing curiosity. Something about the case made was compelling to me, a blend of science and personal experience that rang true to my decades of reading and experimentation. It brought many pieces together: the whole foods emphasis on quality, the vegetarian emphasis on plant foods, the traditional food emphasis on nutrient-density, the low-carb emphasis on avoiding grains, legumes and sugar, the ketogenic emphasis on shifting metabolism, mood and much else, the alternative health emphasis on eliminating processed foods and additives, and the holistic/functional medicine emphasis on seeing the body as a system and part of larger systems.

So, what miraculous diet brings all of this diversity of views together under the umbrella of a coherent understanding? It’s the paleo diet, although some prefer to call it a lifestyle or a philosophy as it isn’t a singular dietary regimen or protocol. It’s about learning how to be healthy by following the examples of traditional societies in combination with the best science available, not only research in diet and nutrition as narrow fields but also research from dentistry, anthropology, archaeology, etc — any and all info that helps us understand the evolution of human health, specifically in explaining what has gone so terribly wrong in industrialized societies with the diseases of civilization. Diet is important, but only one part. Through an alliance with functional medicine, there is a greater focus on what makes for a healthy lifestyle: exercise, stress reduction, toxicity elimination, forest bathing, sun exposure, learning new things, etc… and don’t forget about play, something lost to so many modern adults.

Despite that greater focus of concern, it is the dietary angle that draws people in. Simply put, a lot of people feel better on the paleo diet, often in healing numerous conditions or at least reversing some of the worst symptoms, from conditions like obesity and diabetes to autism and depression to Alzheimer’s and multiple sclerosis, and much else. The paleo diet, as with traditional foods (both inspired by the work of Weston A. Price), is a good introduction to an alternative way of thinking not only about diet but health in general. It seems to be a gateway diet for many who go on to try related diets: primal (paleo plus dairy), Whole30, ketogenic, ketotarian, pegan, pescatarian, carnivore, etc. Primal, as one common example, demonstrates how paleolists have a tendency of drifting toward the similar traditional foods. Paleo is more of a framework than anything else, to the extent that it requires or promotes a paradigm change in one’s attitude.

The greater issue at hand is a potential paradigm change of society. That is the battle going on right now, those promoting that shift and those defending the status quo. Most figures and institutions of authority attack diets like paleo and keto because they are threatening. And the reason they are threatening is because of their growing popularity which in turn comes from their being highly effective for their intended purposes, while also being followed and sometimes promoted by many famous people, from media figures to politicians, including plenty of athletes (according to various sources, and in no particular order):

Bill Clinton, Madonna, Drew Carey, Renee Zellweger, Katie Couric, Al Roker, Halle Berry, Kim Kardashian, Kourtney Kardashian, Vinny Guadagnino, Jordan Peterson, Vanessa Hudgens, Megan Fox, Adriana Lima, Jessica Biel, Blake Lively, Channing Tatum, Eva La Rue, Phil Mickelson, Aisha Tyler, Matthew McConaughey, Edgar Ramirez, Jeb Bush, Kanye West, Christina Aguilera, Jack Osbourne, Kelly Osbourne, Sharon Osbourne, Miley Cyrus, Ursula Grobler, Becca Borawski, Aaron Rodgers, Andrew Flintoff, Jenna Jameson, Savannah Guthrie, Chris Scott, Tamra Judge, Grant Hill, Uma Thurman, Kobe Bryant, Gwyneth Paltrow, LeBron James, Alicia Vikander, Tim McGraw, Kristin Cavallari, Tom Jones, Grant Hill, Mick Jagger, Melissa McCarthy, Jennifer Lopez, Robin Wright, Cindy Crawford, Jennifer Aniston, Guy Sebastian, Elle Macpherson, Courteney Cox, Catherine Zeta Jones, Geri Halliwell, Ben Affleck, Joe Rogan, Brendan Schaub, Shane Watson, Tim Ferris, Jessica Simpson, Rosie O’Donnell, Lindsey Vonn, Alyssa Milano, Kendra Wilkinson, Christina Aguilera, Britney Spears, Joe Manganiello, Tom Kerridge, Jessica Alba, Mariah Carey, Tobey McGuire, Jennifer Hudson, Shania Twain, etc.

These low-carb diets work. People feel better, lose weight, go off their meds, have a lot of energy, and on and on. It’s a paradigm change with a real kick and so the change is largely coming from below, from probably hundreds of thousands of individuals experimenting similar to what I’ve done, including individual doctors who decide to buck the system and sometimes are punished for it (a few key examples are: John Yudkin, Tim Noakes, and Gary Fettke). And every individual this works for ends up being an inspiration to numerous others, even if only to the people they personally know such as family members, friends, neighbors, and coworkers. Other people see it works and so they try it themselves. This is how it went from a minor diet to its present growing momentum and did so in a fairly short period of time.

As I was saying at the beginning of this piece, I’ve been observing this shift. And I’ve come to realize it might be a seismic change going on. Every now and then, I see hints of the impact in the world around me. These alternative views are taking hold and won’t remain alternative for long. They are forcing their way into mainstream awareness, often for practical reasons such as bakeries taking a hit in sales (Amy-Clare Martin, Bakers notice decline in dough – as more Brits ditch bread for low-carb diets). Unsurprisingly, there is backlash.

There is the corporate media, of course, with their typical attack pieces on “fad diets”, ignoring the fact that the keto diet has been medically researched since the early 1900s, the low-carb diet having been the first popular diet starting back in the 1800s, the traditional foods diet based on hundreds of thousands of years of shared human experience, and the paleo diet as the diet hominids have thrived on for millions of years. The corporate media prefers to ignore what is threatening, until the point it no longer can be ignored, and so we are in that second phase right now, maybe a bit beyond since the mainstream authorities have already adopted some of the alternative views without acknowledging it (e.g., AHA quietly lowering its recommendations of carb intake after pushing a high-carb diet for a half century, as if hoping no one would notice this implicit admission to having been wrong, and wrong in a way that harmed so many; also see here and here). Local media is sometimes more open to new views, though.

The whole EAT-Lancet issue demonstrates the sense of conflict in the air. The authors of the report frame the situation as a crisis for all of humanity and the earth. And they use that as a cudgel to bash the new low-carb challengers, to nip them in the bud, even to the extreme of pushing for international regulations that would force conformity with the high-carb approach of conventional diets that have risen to prominence these past decades — mainstream versions of: vegetarianism, veganism, and Mediterranean (the modern Mediterranean diet as studied after World War II, not the traditional one with high levels of animal foods that existed for millennia before 20th century industrialization of the food system, no noodles or tomatoes prior to modern colonial trade, and surprisingly not much if any olive oil since according to ancient texts it was mainly used for lamp fuel, with animal fat being preferred for cooking). We’ve seen this push with such things as “Veganuary”.

It has become an overtly ideological fight, but maybe it always was. The politicization of diet goes back to the early formalized food laws that became widespread in the Axial Age and regained centrality in the Middle Ages, which for Europeans meant a revival of ancient Greek thought, specifically that of Galen. And it is utterly fascinating that pre-scientific Galenic dietary philosophy has since taken on scientific garb and gets peddled to this day, as a main current in conventional dietary thought (see Food and Faith in Christian Culture ed. by Ken Albala and Trudy Eden with an excerpt to be read here; I made this connection in realizing that Stephen Le, a biological anthropologist, was without awareness parroting Galenic thought in his book 100 Million Years of Food).

But the top-down approach to pushing dietary regimens hasn’t been all that successful in more recent years, maybe because of growing cynicism about past failures. Even with it being heavily promoted by well-funded organizations and government agencies, the high-carb plant-based diets are beginning to find it hard to maintain their footing in the tides of change. According to various data, it’s easy to get people to try veganism for a short period, but few maintain it (only 20% who try veganism continue on the diet long-term). Vegetarianism is less restrictive, of course, but consistent adherence is still rare. The vast majority who start veganism or vegetarianism either occasionally eat meat or fish or else eventually give up on the diet (less than 3.2% of Americans are vegan or vegetarian and few of them consistently adhering to the diet). There is big money, including corporate money, behind the campaigns promoting it (most processed foods, including junk food, are technically vegan and big food has come to realize this is an effective way of marketing unhealthy food as healthy). Still, it doesn’t seem to be catching on with the general public, not that I doubt there will be those who continue their games of propaganda, persuasion, and perception management.

People have gotten the message that a plant-based diet is good. That part of the official messaging machine has been successful. Indeed, for decades, most Americans have been increasing their intake of fruits and vegetables and that might or might not be a good thing (the science is contested), but as far as that goes the paleo diet and many related diets also tend to recommend high levels of fruits and vegetables. The main advantage the low-carb diets have is that it’s easier to give up bread than to give up all animal foods (including eggs and dairy), though vegetarianism is a decent compromise since it allows some animal foods and that increases availability of the key fat-soluble vitamins. It’s not that low-carb, keto, or paleo vegetarianism is hard to do — so it isn’t an either/or scenario, but many pushing a so-called “plant-based” diet for some reason want to portray it in such dualistic terms, maybe as a way of falsely portraying low-carb as an anti-plant caricature in order to make it seem ridiculous and extremist.

Despite the ideological reaction, there is the growing realization that maybe there is some profit to be had in this emerging trend, as most businesses ultimately don’t care about dietary ideology and will go where the wind blows. New products cater to these alternative diets (paleo creamer, keto supplements, etc) or else old products are repackaged (“Keto Friendly!”). This is why it gets called a “fad diet”. But if being heavily marketed makes a diet a fad, then the same label applies to conventional diets (e.g., low-fat) as well that are more heavily marketed than any alternative diet. I’ve also begun seeing paleo and keto magazines, guides, and recipe booklets in grocery stores. Even when dismissed by experts such as in rankings of recommended diets, these “fad diets” nonetheless get mentioned, albeit usually tossed to the bottom of the list. As all this demonstrates, we are long past the silent treatment.

Furthermore, it goes beyond the products specifically marketed as paleo or keto or whatever. Demand has been increasing for organ meats, coconut products (from coconut milk to coconut oil), cauliflower, etc; consumption of eggs is likewise on the rise — all favorites on the paleo diet, in particular, but also favorites for similar diets. Prices have been going up on these items and, because demand sometimes exceeds supply, they can go out of stock at stores. Why are they so sought after? Organ meats are nutrient-dense, coconut milk is a good replacement for dairy and coconut oil for unhealthy vegetable/seed oils, and cauliflower can be used as a replacement for rice, mashed potatoes, tater tots and pizza crust (“The weird thing about cauliflower, though, is that while it has allies, it doesn’t really have adversaries.” ~Rachel Sugar); as for eggs, their popularity needs no explanation now that the cholesterol and saturated fat myths are evaporating.

Even Oprah Winfrey, though financially invested in the conventional Weight Watchers diet (in owning 8% of the company) and a self-declared lover of bread (actual quote: “I love bread!”), has put out a line of products that includes a low-carb pizza with cauliflower crust. This is interesting since, as low-carb diets have gained popularity, the stock of Weight Watchers has plunged 60% and Oprah lost at least 58 million dollars in one night and a loss of 500 million over all, putting Oprah’s star power to a serious test — maybe Oprah decided it is wise to not put all her eggs in one basket, in case Weight Watchers totally tanks. The company is finding it difficult to gain and retain subscribers. Those profiting from established dietary ideology are feeling the pinch.

It’s amusing how Weight Watchers CEO Cindy Grossman responded to the low-carb threat: “We have a keto surge,” she said. “It’s a meme, it’s not like a company, it’s people have keto donuts, and everybody on the diet side look for the quick fix. We’ve been through this before, and we know that we are the program that works.” And that, “We’ve lived through this [competition from fad diets] for 57 years and we’re not going to play a game and we never have.” Good luck with that! Maybe in reassuring stockholders, she also stated that, “We’re going to be science informed and we’re sustainable for the long term.” That is great. Everyone should be science informed. The problem for those trying to hold onto old views is that the science has changed and so has the public’s knowledge of that science.

Most people these days aren’t looking for complicated diets with eating plans and paid services, much less pre-prepared meals to be bought. A subscription model is becoming less appealing, as so much info and other resources are now available online. Besides, the DYI approach (Do It Yourself) is preferred these days. Diets like paleo and keto are simple and straightforward, and they can be easily modified for individual needs or affordability. But even for those looking for a ready-made system like Weight Watchers, there are other options out there that are looking attractive: “Wall Street is clearly nervous, too. JPMorgan analyst Christina Brathwaite downgraded the [Weight Watchers] stock to “underperform” last week and slashed her price target. One of the reasons? She was worried about competition from rival weight-loss service Diet Doctor, which is a proponent of keto.”

In whatever form, like it or not, low-carb diets are on the rise. Even among vegans and vegetarianism, the low-carb approach will probably become more common. Maybe that is why we’ve suddenly seen new low-carb, plant-based diets like Dena Harris’ paleo vegetarianism (2015), Will Coles’s ketotarianism (2018), and Mark Hyman’s peganism (2018). Do a web search about any of this and you’ll find numerous vegans and vegetarians asking about, discussing, or else praising low-carb diets. The same is true in how one sees broad interest in thousands of websites, blogs, and articles. Hundreds upon hundreds of organizations, discussion forums, Reddit groups, Facebook groups, Twitter alliances, etc have sprouted up like mushrooms. More and more are jumping on the low-carb bandwagon, as apparently that is what a large and growing part of the public is demanding. Whether or not it ever was a fad, it is now a movement and it isn’t slowing down.

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New Survey Shows Changes in American Diet Trends
from Nutrition Coalition

Many Americans appear to be ditching low-fat diets for higher-fat foods in hopes of improving heart health and losing weight — according to a recent survey by the International Food Information Council (IFIC) Foundation on more than 1,000 Americans, ages 18 to 80.

Roughly 36 percent of respondents reported following a specific diet, according to the survey. Of those on a diet, nearly 25 percent chose plans with more fat or protein. Some seven percent followed a paleo diet, six percent low-carb, five percent Whole30, four percent high-protein, and three percent ketogenic.

Ten percent of respondents reported following a regime of intermittent fasting, or cycling between periods of fasting and eating, during a defined period of time.

The report did not include data on the other 64 percent of survey respondents who elected not to share specific dietary preferences.

Overall, the survey suggests that Americans are increasingly trading carbohydrates for fats. Twenty-five percent of survey respondents blamed carbohydrates for their growing waistlines — up from 20 percent last year, while 33 percent blamed sugar. These numbers are both at “the highest since 2011,” according to the report. Only 16 percent blamed fats for weight gain, and just three percent fingered protein.

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Why are these changes happening now? Here is one answer. The wisdom of crowds.