All posts by fshagan

Paleo Diet for Diabetics

New Study of Paleo Diets for Diabetics

What is a “Paleo Diet”?

The “paleolithic” or “caveman” diet is a variation of a low carb diet wrapped in a philosophical framework that asserts evolution has dictated that humans should eat a certain way. Adherents typically stress naturally raised, organic food sources with an emphasis on avoiding cereal grains, sugar and other refined products. In addition, paleo adherents tend to stress exercise as part of the life sytle. The weight loss and other macro health benefits coincide with a standard low carb diet (although, they will claim other, non-documented health benefits from avoiding pesticides, hormones and other chemicals found in non-organic food products).

I am not a paleo diet adherent, favoring a standard low carb way of eating. But I’m sympathetic to my cousins in the movement.

UCSF Study

With a hat tip to Dr. Steve Parker, originator of the Low Carb Mediterranean Diet (reviewed here), the University of California at San Francisco is studying the effects of a paleo diet regimen for diabetics:

The initial research findings are striking. Without losing weight, participants in a preliminary study improved blood sugar control, blood pressure control and blood vessel elasticity. They lowered levels of blood fats such as cholesterol. And most amazingly, participants achieved these results in less than three weeks — simply by switching to a Paleolithic diet.

These effects are commonly reported among all variations of the low carb diet, with the paleo version being just the latest. I’m sure Dr. Parker is seeing the same kind of results in his patients that adopt the Low Carb Mediterranean Diet, as other doctors have found with any low carb diet regimen. The plan I follow, Protein Power by Drs Mary Dan and Michael Eades, has many followers with the same results.

Links to the press release for the study are at Dr. Parker’s blog.

A Rose by Any Other Name

Red Chateau Rose by Kikuo Teranishi, <a href="">Creative Commons</a>Gary Taubes has noted that all diets succeed, inasmuch as they do, through carbohydrate restriction. Even reduced calorie diets, the most difficult of all diets to maintain, reduce carbohydrate intake along with other macro-nutrients. You can easily draw the conclusion that the lower average weight loss of low fat and other calorie restricted diets when compared to any of the low carb diets is due to the greater carbohydrate intake they allow; however, nearly any diet plan will restrict carbohydrates below the level of the Standard American Diet (SAD).

The paleo diet is simply another variation of the same low carb diet that has been around for decades, with a new emphasis on providing a philosophical framework for rationalizing the diet to self and others. The arguments in the paleo community center around the same issues as the low carb diet community at large. What are the biological effects of eating grains, starches and refined sugar products? How does the reduction of carbs affect hormones, lipid levels, and blood sugar?

The Advantages of Paleo

I don’t want to be dismissive of the paleo movement. It appeals to many people because of the wider range of beneficial influence, extending beyond just diet to other lifestyle topics as well, including the amount and type of exercise needed, the necessity for adequate sleep, and the well documented benefits of having an active and vibrant support community. People who have hesitated to adopt a standard low carb diet may feel more comfortable with its emphasis on the total lifestyle and modern, updated philosophical framework. I say, go for it.

Why This Study?

Because the benefits of carbohydrate restriction are well known and well studied for diabetics, it may have been easier to get funding for the “new” paleo diet. I am only speculating on this point, but it seems a reasonable speculation to me.

More on Paleo Diets

Mark’s Daily Apple, by Mark Sisson

Modern Paleo: The Blog created by Diana Hsieh, Ph.D

Paleo Diabetic by Dr. Steve Parker



Update: The Truth about Beef

The Truth About Beef Revisited

Last year, my post The Truth about Beef examined the claim that grass fed/grass finished beef was superior to common grain fed beef because of higher Omega-3 to Omega-6 ratios. At the time, the most reliable information I could cite showed about a 10mg difference in the amount of Omega-3. This is a nutritionally insignificant amount, and should never be cited as a reason to say grass fed beef is healthier or better for you than common supermarket beef. Yet, bloggers continue to claim grass fed beef has “67% MORE Omega-3!”.

Pete B, the author of Grass Based Health, examines the issue in more detail. With links to research, he reveals more detail on the levels of both Omega-6 and Omega-3 found in grass fed and grain fed beef, with charts, graphs and enough details to provide a definitive resource. Pete has a background as a “forage extension specialist” for Oregon State University, and is an advocate for ” local, sustainable animal production systems,” meaning he’s a friend to small farmers. Facts are stubborn things, and the Omega-6 / Omega-3 ratios in beef are essentially meaningless. I like the way Pete sums up the post:

Examining the data in these papers demonstrates the fact that beef, no matter how it’s produced, is not a rich source of n-3 fatty acids. And beef, not matter how it’s produced, is not a rich source of n– 6 fatty acids, either.
I want to emphasize that I’m focusing solely on the nutritional aspect of the beef, not on the issues of confined animal feeding operations, grain production, animal health, etc. I’m aware of these matters and I am NOT minimizing them.

Why Eat Grass Fed Beef?

There may be many reasons you choose to buy grass fed beef. You may believe that animals pastured until they are butchered are treated more humanely, and it becomes a personal, ethical choice. You may be concerned about the presence of hormones in beef, and want to avoid them (although, cattle are given hormones while they are pasturing, so this is no guarantee). You may prefer the taste of grass fed beef, or want to support the local farmer. Those are all valid reasons. The Omega-6 / Omega-3 ratio in beef is not.

What’s the Harm?

Many paleo or low carb dieters start out very simple by just cutting carbohydrates to 30 to 50 grams per day. They lose weight, note improvements in some chronic complaints like GERD, start sleeping better, have lower blood pressure, etc. As they fine tune their diet, they start adding rules and restrictions: coconut oil is better than canola, grass fed is better than grain fed, almonds are better than peanuts. Then they go further, nuts should be eaten in their raw state rather than roasted, organ meats should be added to the diet, and you should wear funny bare foot shoes that look like those 1970’s toe-socks. They become “purists” about the diet.

When they recommend going low carb, they toss in all of their other restrictions. The person asking them about their diet realizes, right about at the point that talk turns to “your leaky gut and legumes” that this diet is way too complicated, and way too expensive. And, just a bit nutty sounding.

But it is none of those things. You can vastly improve your health by reducing carbs and eating more animal protein and vegetables from the local supermarket.  The switch isn’t expensive … our food bill went down when we went low carb … and it isn’t hard to do. Going organic, eating grass fed beef, and snacking on heart, liver and brains can come later if you like. But those things aren’t sacraments, and they aren’t essential.



Diet, Gene Expression and Diseases

How Diet Affects Gene Expression

A new study from the Norwegian University of Science and Technology – Trondheim has mapped the way that diet affects gene expression. Gene expression is the “process where information from a gene’s DNA sequence is translated into a substance, like a protein, that is used in a cell’s structure or function.”

The study found that different types of foods cause different reactions in the cells themselves. Some of these reactions are considered good, and some are destructive, leading to increases in inflammation. As Dr. Steve Parker has noted, inflammation is thought to have a role in developing atherosclerosis (the cause of heart attacks and strokes), type 2 diabetes, and some cancers.

Bad News for Calories In/Calories Out

The idea that a “calorie is a calorie” and that the secret to losing weight and a healthy lifestyle is “eat less, move

How Calories Are Measured
A "bomb calorimeter" is used to determine the calories in food

more” assumes that all food is equal. The solution for a calorie counter is to simply induce a “calorie deficit” by burning more energy than you eat. When you have a calorie deficit of 3,500, you lose a pound of fat. This approach does work for some people, most notably young, healthy males, but rarely works as well for those in middle age. And women have an especially hard time losing weight this way.

As I noted in Eating Fat Does Not Make You Fat, it does matter what foods you eat. In that article we show that in every single test of a low carb vs. low fat diet, the low carb group has no calorie restriction. Yet they lose more weight, faster, than any other diet. The low fat diet proponents claim the low carb diet folks are “cheating” by spontaneously eating fewer calories.

This new study should put the final nail in the coffin for “calories in / calories out” mantra from a health perspective. It does matter what you eat, even more than how much you eat.

How The Study Was Conducted

The main study included 28 slightly overweight men and women who ate two different powdered diets. This type of controlled study on actual people, rather than a meta-analysis of statistics from other studies, shows actual cause-and-effect of the different diets for this group of men and women. A “cleansing period” of a week allowed the participants to eat normally between the diets. The researchers had the participants drink the liquid diet six times a day, with each participant’s caloric intake calculated to maintain their current weight.

The first powdered diet provided 65 percent of the calories from carbohydrates, 15 percent from protein and 20 percent from fat. For a 2,000 calorie diet, that’s 1,300 calories from 325 grams of carbohydrates, 300 calories from 75 grams of protein, and 400 calories from 44 grams of fat. That is very close to the USDA recommendations for a “well balanced diet”.

The second powdered diet  provided calories close to one-third carbohydrates, protein and fat. For our 2,000 calorie diet, that would translate into 667 calories for each macro-nutrient, with 167 grams each of carbohydrates and protein, and 74 grams of fat.

Blood tests were conducted before and after each diet period. All of the measurements of changes in gene expression were done so that each individual’s difference in gene expression was compared with that person alone. The results were then compiled.

Johnson says the studies resulted in two important findings. One is the positive effect of many meals throughout the day, and the details about the quality and composition of components in an optimal diet, including omega-3 and omega-6 fatty acids. The second is that a carbohydrate-rich diet, regardless of whether or not a person overeats, has consequences for genes that affect the lifestyle diseases, she says.

It’s important to remember that this is not a weight loss study, as the liquid diets were carefully measured to keep the participants at a steady weight. This prevents the temporary “bad effects” of weight loss from showing in the blood samples (those effects are explained clearly by Dr. Davis in his post about the alarm some dieters have after losing weight and seeing blood test results).

What the Study Found

For many health issues, there isn’t a single controlling gene. The researchers had to compare multiple genes to see how they reacted to the different diets. The article quotes professor of biology Berit Johansen:

“We are talking about collecting a huge amount of information,” says Johansen.

“And it’s not like there is a gene for inflammation, for example. So what we look for is whether there are any groups of genes that work overtime. In this study we saw that an entire group of genes that are involved in the development of inflammatory reactions in the body work overtime as a group.”

The lower carbohydrate diet not only reduced inflammation, but reduced activity of the genes associated with type 2 diabetes, cardiovascular disease, Alzheimer’s disease and some forms of cancer.

“It was interesting to see the reduction in genetic activity, but we were really happy to see which genes were involved. One set of genes is linked to cardiovascular disease. They were down-regulated in response to a balanced diet, as opposed to a carbohydrate-rich diet,” she says. Another gene that was significantly differently expressed by the diets that were tested was one that is commonly called “the youth gene” in the international research literature.

“We haven’t actually stumbled on the fountain of youth here,” Johansen laughs, “but we should take these results seriously. The important thing for us is, little by little, we are uncovering the mechanisms of disease progression for many of our major lifestyle-related disorders.”

Problems with the Article

The article shows that the idea of “calories in / calories out” is at best a simpleton’s approach to healthy eating, as it ignores the micro-nutrient composition of the foods we eat. It also provides direct evidence that the low fat diet is dangerous even though it is often prescribed as a way to reduce cardiovascular heart disease and presented as the “healthy alternative” to the standard American diet. But the good professor veers off the rails with some unsubstantiated advice:

The professor warns against being caught up in the fat trap. It’s simply not good to cut out carbs completely, she says. “The fat/protein trap is just as bad as the carbohydrate trap. It’s about the right balance, as always.”

She says we must also make sure to eat carbohydrates, proteins and fats in five to six smaller meals, not just for the main meal, at dinner.

“Eating several small and medium-sized meals throughout the day is important. Don’t skip breakfast and don’t skip dinner. One-third of every meal should be carbohydrates, one-third protein and one-third fat. That’s the recipe for keeping inflammatory and other disease-enhancing genes in check,” Johansen explains.

The problem with this portion of the article is that there is no evidence presented for her claim that a “balanced” intake of the three macro-nutrients is better than a lower carb variant. The study tested only a high carb / low fat diet against a lower carb diet. In order to make the claim above she would have to actually test the hypothesis that getting one-third is better than getting one-fifth of your calories from carbohydrates, as a typical 100 gram per day “maintenance level” low carb diet would provide. While there’s always the possibility that the professor has done such as study, and her statement is based on that prior study, I suspect she is “thinking linearly”. She really has no way to conclude that one-third carbohydrates is better than one-fifth carbohydrates until she tests it.

The study does provide direct evidence that the diet advice given to the American people by the USDA, that 65 percent of their calories should come from carbohydrates, is actually dangerous. Rather than reducing the risk for cardiovascular disease, type 2 diabetes, Alzheimer’s disease and some forms of cancer, the high carbohydrate diet “turns on” the genes associated with those chronic health problems.

The article also does not provide a citation for the idea that eating six times daily is better than three or four times (more frequent meals are usually recommended in higher carb diets to try and control the wild blood sugar spikes that occur). Many paleo / primal dieters find that eating “when hungry” leads them to fewer meals, often only two, in a typical day.

It Could Work

Even with my reservations, having someone adopt a true “balanced diet”, with one-third of their calories from carbohydrates, protein and fat, would undoubtedly lead to better health than the Standard American Diet. If the goal is to lose weight, reducing carbohydrates further, to 20 percent of total caloric intake, will usually result in slow, steady weight loss. To lose weight at the rate of 1 to 2 pounds per week, a true low carbohydrate diet, below 50 grams of carbs per day, will result in the best results for most people.


Frankenfoods: What has man wrought?

Plant Breeding and Genetic Modification

After reading Dr. Davis’ Wheat Belly, I decided to take another look at how man modifies his food. While there’s a lot of concern about genetic modification of foods, with some standards attached, traditional plant breeding has only a few steps between creation and marketing of the modified food.

Genetic modification (GM) is the process of inserting genes or portions of genes into a plant to introduce a specific trait, such as resistance to a herbicide. Most of the soybeans, corn, and cotton grown in the US are GM crops. In most cases, they have been modified to be resistant to a specific herbicide, Monsanto’s Round Up, or to be resistant to pesticides.

There is a patina of acceptability touted by the proponents of GM foods as the FDA Center for Food Safety and Applied Nutrition “evaluates” them. But the review process is less stringent than a driver’s license test: the food producer submits “summaries of food safety data” that are based “in part on the basis of comparability to conventionally-produced foods.” There are no specific tests done by FDA to determine safety.

Plant breeding, on the other hand, is a time-honored method of cross-breeding plants to obtain certain traits. Prior to the 1940’s, most cross-bred plants were within the same family, such as a mildew resistant pea being cross-bred with a high yield pea to produce a high yielding, mildew resistant pea. This type of cross breeding can occur in nature, but is a slow process, depending on the vagaries of wind, rain and animal movement to introduce new varieties.

There is a dark side to “traditional” plant breeding. Different techniques are used that would not be found in nature. In some cases the food scientist uses a chemical to produce mutations in a plant, and uses the resultant mutation to cross breed with a “normal” plant. The Wikipedia overview highlights the possible danger:

With classical breeding techniques, the breeder does not know exactly what genes have been introduced to the new cultivars. Some scientists therefore argue that plants produced by classical breeding methods should undergo the same safety testing regime as genetically modified plants.

The Poisonous Potato

There have been spectacular failures with traditional plant breeding, including poison potatoes:

. . . for example the poison solanine was unintentionally increased to unacceptable levels in certain varieties of potato through plant breeding. New potato varieties are often screened for solanine levels before reaching the marketplace.

As that quote indicates, there is no requirement to ensure the cross-bred plant is suitable for human consumption. The determination is made based on a plant biologist’s interpretation of how close to the original plant is to the cross-bred plant. In the case of the potato, the food company will look for the presence of a specific, known poison. But there are no long-term trials and no testing on human subjects. The impact on human health is not considered by a physician. We simply don’t know if the new, cross-bred plant carries a toxin that will be found only after the unwitting “test subjects” — the general population — start to have health problems.

Modern Wheat

As Dr. Davis has documented with more authoritative sources, modern wheat is a result of aggressive plant breeding, as Wikipedia notes:

The novel technological development of the Green Revolution was the production of novel wheat cultivars. Agronomists bred cultivars of maize, wheat, and rice that are generally referred to as HYVs or “high-yielding varieties”. HYVs have higher nitrogen-absorbing potential than other varieties. Since cereals that absorbed extra nitrogen would typically lodge, or fall over before harvest, semi-dwarfing genes were bred into their genomes. A Japanese dwarf wheat cultivar (Norin 10 wheat), which was sent to Washington, D.C. by Cecil Salmon, was instrumental in developing Green Revolution wheat cultivars.

No long term testing using human volunteers was implemented. The foods were introduced on the basis that a plant biologist deemed them similar to existing foods. There has been a long term test, of course. On all of us. The fact that we didn’t volunteer doesn’t seem to bother the plant biologists or food companies.

Wheat Belly shows us the result of just one of these “frankenfoods”, the modern dwarf wheat mutant that we have all been eating since the mid-1970s. Because wheat is so ubiquitous in our foods, its effects may have bubbled up to the surface faster than less-commonly used foods such as soybean, cotton and the high-yielding rice (although, there is plenty of evidence of issues with soy for certain people).

Note: I have used Wikipedia articles rather than the scientific journal articles to enable sharing of the resources by the general public, as the journal articles are long, hard to read, and some require payment to access. For those so inclined, Dr. Davis has 16 pages of footnotes to journal articles and studies in his book Wheat Belly.

Wheat Belly Book Review

Wheat Belly

About the Author

Dr. William Davis is a practicing cardiologist in Milwaukee, WI with over 25 years of experience treating patients. Dr. Davis has impressive credentials: he is a graduate of St. Louis University School of Medicine and the Ohio State University Hospitals, with additional training in advanced cardiac catheterization techniques and coronary angioplasty at the Case-Western Reserve University system in Cleveland. But along the way, Dr. Davis discovered that his heart patients had a host of other problems, including obesity, gout, GERD, IBS, celiac disease, unexplained rashes and other mystifying symptoms.

There is no one as certain of the truth as a scientist cloistered in academia, performing tests on cells in a petri dish, or a researcher running computer programs to find patterns in data. While doctors share the same training in the scientific method they also live in the real world, and they often see their patients reacting very differently than popular studies and national dietary standards describe.

Dr. Davis’ Journey

Like many other medical doctors, Dr. Davis found that low carb diets were most effective in lowering his patient’s weight and improving lipid panel results. But he is aware of the exceptions, where a person’s genetic makeup can require a different approach. It is this relentless pursuit of truth and frank discussion of exceptions that makes his Track Your Plaque / Heart Scan Blog so valuable.

Dr. Davis noted his patients had dramatic improvements in other health issues after restricting carbohydrates. After thousands of years of eating carbohydrates, why would the last 50 years see such a dramatic increase in GERD, pre-diabetes, type 2 diabetes, obesity and celiac disease? Not satisfied with simply knowing the facts, Dr. Davis sought the cause of the rapid increase.

Wheat Belly

His new book, Wheat Belly provides his answer: wheat. Yes, that golden grain, enshrined in our mythology and patriotic songs, is killing us. But humans have eaten wheat for thousands of years.

So why has this seemingly benign plant that sustained generations of humans suddenly turned on us? For one thing, it is not the same grain our forebears ground into their daily bread. Wheat naturally evolved to only a modest degree over the centuries, but it has changed dramatically in the past fifty years under the influence of agricultural scientists.

William Davis, MD, Wheat Belly, (New York: Rodale Inc., 2011), 13.

About Wheat Belly, the Book

Eminently readable, Wheat Belly is written in a conversational style, suitable for any audience. Extensive footnotes are gathered together in the References section at the end of the book, where they don’t interfere with the text. Sidebars include fascinating details; patient success stories, insights into heirloom wheat, etc.

The book is just under 300 pages, divided into three main sections:

  • Wheat, The Unhealthy Whole Grain
  • Wheat and its Head-to-Toe Destruction of Health
  • Say Goodbye to Wheat

The first section gives the history of wheat, from the heirloom wheat mentioned in the Bible (einkorn, gathered by semi-nomadic tribes such as the Natufians as far back as 8500 BCE) to the modern, genetically altered variety created by aggressive cross breeding in the past 50 years.

Differences between the wheat of the Natufians and what we call wheat in the twenty-first century would be evident to the naked eye. Original einkorn and emmer wheat were “hulled” forms, in which the seeds clung tightly to the stem. Modern wheats are “naked” forms, in which the seeds depart from the stem more readily, a characteristic that makes threshing (separating the edible grain from the inedible chaff) easier and more efficient, determined by mutations at the Q and Tg (tenacious glume) genes . . . But other differences are even more obvious.

William Davis, MD, Wheat Belly, (New York: Rodale Inc., 2011), 21.
Note: the ellipsis indicates I removed a reference to a study mentioned previously in the text.

The differences in modern and ancient wheat is more than “skin deep”. On the glycemic index, whole wheat bread exceeds table sugar, scoring 72 versus sugar’s 59 on the scale. Because the carbohydrates in modern wheat are so easily digestible, eating whole grain results in the same blood sugar impact as an equivalent amount of highly processed flour. White bread, with less of the whole wheat grain, comes in at 70. A Snickers candy bar comes in lower, with a glycemic index of 41.

Interestingly, Dr. Davis’ self-experiment with baking bread showed his own blood sugar rise from 84 mg/dl to 110 mg/dl with 4 ounces of bread made with einkorn wheat. He also baked bread with modern wheat, keeping all other ingredients the same, and consumed the same four ounces. His blood sugar shot up from 84 mg/dl to 167 mg/dl.

Dr. Davis provides more detail on the genetic differences that carry unknown effects including the increase in chromosomes from 14 to 42.

Wheat and Modern Health

After establishing why modern wheat is different, Dr. Davis lists the health impact this new, genetically modified food product has introduced. First among impacts is the addictive property of modern wheat, and how it stimulates hunger. Then an extensive treatment of each health condition:

  • Obesity
  • Celiac Disease
  • Diabetes and Insulin Resistance
  • Acid Reflux and Stomach pH
  • Cataracts, Wrinkles, and the aging process
  • Heart Disease
  • Wheat’s effect on the brain
  • Acne, rashes and other skin problems
Note: I have reworded the actual chapter titles to reflect the contents.

Each chapter in this section includes footnotes to studies, as well as examples from Dr. Davis’ practice. Each topic is fully developed, and written in an easy-to-read style without excessive medical terminology (Dr. Davis explains the medical terms he does use).

Practical Application of Wheat Elimination

In the third section, Dr. Davis deconstructs the modern “eat healthy whole grains” advice. If you eliminate all wheat, do you end up with vitamin and mineral deficiency? Not if you follow his basic (and very easy) guidelines. Dr. Davis comments on the true effect of eliminating wheat:

Let me describe a typical person with wheat deficiency: slender, flat tummy, low triglycerides, high HDL (“good”) cholesterol, normal blood sugar, normal blood pressure, high energy, good sleep, normal bowel function.

William Davis, MD, Wheat Belly, (New York: Rodale Inc., 2011), 188.

The book devotes 37 pages to Dr. Davis’ simple method for eliminating wheat and replacing it with unlimited vegetables, raw nuts, grass fed beef, chicken and fish, and other whole, nutritious foods. He departs from the usual low carb / paleo prescription to warn about eating too much processed meat, with its chemical soup of seasoning, nitrates and other potentially harmful chemicals. And, a special note is made regarding the proliferation of “gluten free” products that substitute fructose and “chemical soup” in place of wheat that may still pose health risks. Instead, Dr. Davis provides a variety of great wheat free recipes to provide an insight into managing a diet without wheat, introducing wonderful variety and enjoying the journey.

My Conclusions

I am by nature a skeptical person, but my personal experience with low carb dieting led me to believe, long before I discovered Dr. Davis’ blog, that I may have a “hidden” wheat allergy. After suffering from painful GERD for over a decade, I noted a rapid decrease in symptoms when I started a low carb diet. My GERD does not return when I have the occasional indulgence of ice cream while on a cruise, but comes back with a vengeance when I consume wheat products. My personal experience is not scientific proof, of course, any more than the sidebar stories of dramatic cures are scientific proof in Wheat Belly.

I suspect I will still eat bacon and other processed meats, and I don’t share the enthusiasm for grass fed organic beef and free range chickens and eggs. But those quibbles aside, Dr. Davis’ clinical experience, supported by his scientific research as revealed in 16 pages of references, make a powerful argument that I find hard to refute.

It is easy to do your own experiment; there are no adverse health effects to eliminating wheat and eating according to Dr. Davis’ easy prescription. Two weeks is usually sufficient to notice differences in some conditions. I can heartily recommend Wheat Belly as a practical guide to seeing if you also have a “hidden” wheat allergy.


Other Reviews:
Book Review: Wheat Belly, by Tom Naughton at Fathead.
Review: Wheat Belly by Dr.William Davis, by Dana Carpender at Hold the Toast.
Wheat Belly Book Review, by Joe Lindley at Stop Craving Sugar.

Dr. Davis’ Blogs:
Track Your Plaque / Heart Scan Blog
Wheat Belly Blog

Disclaimer: Dr. Davis provided a complimentary review copy of the book, but did not attach any editorial restrictions to the review.

Low Carb Poses No Arterial Health Risks

Will a Low-carb, High-fat Diet Clog Your Arteries?

The evidence against dietary fat has always been flimsy, and based mainly on studies more suited to developing a hypothesis than coming to a conclusion. Now evidence is mounting that much of what we have heard is wrong. A report in the Johns Hopkins University Gazette states:

Overweight and obese people looking to drop some pounds and considering one of the popular low-carbohydrate diets, along with moderate exercise, need not worry that the higher proportion of fat in such a program compared to a low-fat, high-carb diet may harm their arteries, suggests a pair of new studies by heart and vascular researchers at Johns Hopkins.

“Overweight and obese people appear to really have options when choosing a weight-loss program, including a low-carb diet, and even if it means eating more fat,” said the studies’ lead investigator, exercise physiologist Kerry Stewart.

Johns Hopkins and Low Carb Diets

Johns Hopkins has been at the forefront of research into various low carb diets, and has been successful in treating various conditions with a low carb, high fat ketogenic diet. They have found them safe in their studies of children with seizure disorder.

Low Carb Age first reported on the new study in our June report on the growing mass media acceptance of low carb diets.

The researchers stress that the direct comparison of a low carb and low fat diet in this study included moderate exercise for both groups. Like many modern press accounts conceding that a low carb diet works, the authors stress the efficiency of the low carb diet in losing weight without killing you. Unspoken, but implied, is the suggestion that once you lose the weight you can return to a higher carb diet.

Why Not Abandon Low Carb After Reaching your Weight Goal?

Abandoning the low carb way of eating after reaching your weight goal is a prescription for disaster, causing the familiar American model of yo-yo dieting. A much better approach is to view a low carb, high fat diet as being a permanent change in lifestyle.

That’s already the case for Hollywood stars like Courtney Thorne-Smith and country singers like Dolly Parton. The significance of Courtney and Dolly is that they represent the top two groups of people who biologically have the hardest time losing and then maintaining weight: pre- and post-menopausal women.

Eventually, mass media will recognize the long term benefits of reducing carbs, eating mainly foods you prepare yourself, and avoiding highly process, artificially sweetened frankenfoods.

Fat Doesn’t Make You Fat

Eating Fat Does Not Make You Fat

Contrary to popular opinion, eating a diet rich in dietary fats does not make you fat. The prejudice against saturated dietary fat, as found in meat, diary, and some plant sources such as coconut, is based on extrapolations and incorrect conclusions.

It’s Not About Calories

One reason the “fat makes you fat” mantra has been repeated so often is that of the three macro-nutrients, fat contains the most calories per gram. Fat contains 9 calories per gram, while the other two, carbohydrates and protein, each contain about 4 calories per gram. Therefore, eat more grams of protein and carbs, and less of fat, and you reduce your caloric intake, and will lose weight.

Real life interferes with this fantasy. People don’t eat grams, they eat food. Arguments about whether a “calorie is a calorie” no matter its source don’t hold up to common sense. Instinctively we know that eating 125 teaspoons of table sugar is not as healthy as eating the 2500 calories in a well designed diet plan. And its more than just the nutritional value of foods; even if Big Food decides to infuse table sugar with vitamins, we know eating nothing but sugar isn’t good for us.

One of the “criticisms” of a low carb diet is that people spontaneously reduce the amount of calories they consume when they replace carbohydrates with fat and protein. This is seen as somehow cheating. Think about it, on every other diet the studies have to closely monitor the caloric intake of foods. But those same studies don’t put any calorie restrictions on the low carb diet group. They count only carbs. The low carb diet group in study after study loses more weight, faster, than any other diet group. The low fat advocates protest that the low carb diet group spontaneously eats less calories, and have therefore cheated.

Presumably, they want you to feel hunger, and be tempted to cheat on your diet, so that they can continue feeling superior to the weak willed fat people who simply can’t “move more and eat less.” What kind of diet is easier to adopt? One in which you are hungry, or one where you spontaneously reduce food intake?

There are numerous internet debates on whether a low carb diet has some magic “metabolic advantage”, or if the low carb diet is simply more satisfying, so people naturally eat less. A new study suggests that a high fat diet may actually cause the body to burn fat faster, as explained below.

Fat is Energy Dense

At 9 calories per gram, fat has more than twice the energy density of protein or carbohydrate. Rather than being a reason to reduce fat in the diet, this fact may be a clue to what studies have shown: a higher fat diet satisfies hunger faster than a high carbohydrate diet.

In the wild, given plenty of their natural food, all mammals assume a strikingly familiar profile. All well nourished wild cats appear about the same to other cats in their age group. Coyotes, feasting on rodents and other small animals, all look about the same. They don’t suffer from the obesity of their domestic canine cousins, who are fed unnatural diets by humans, or their brothers and sisters held in captivity. They have adapted to their natural diet, and even if they overeat on occasion, such as after a big kill, they don’t seem to gain weight.

Fat’s energy density may be the reason it is more satisfying, curbing hunger sooner than other foods. Mankind’s long evolutionary history of eating fat-rich food may have adapted us to be satisfied with a smaller amount of fat-rich food.

But hold on … science may have given us an answer as to why low carb diets are often said to have a “metabolic advantage”.

The Most Recent Study

The most recent study I have found is one in which six men, between the ages of 18 and 40, were tested to see how a low fat and a high fat diet affected lipolysis of their abdominal fat tissue. Lipolysis is the breakdown and use of fat as energy by the body. For overweight people, getting the body to “burn fat” is the usual goal.

There’s a reason studies like this one segment the subjects so specifically. Men with still-high levels of testosterone like this group may react differently than men over 50, who may have lower levels. Testosterone aids in lipolysis, which is one reason all those young guys at the gym seem to have such rapid progress. And its one reason that women in general and men over 50 have a harder time losing weight.

Only Six Particpants?

At first glance, having only six participants in a study may make it seem insignificant. But this study is different from the cohort studies that track a large population over a period of time and draw correlations from the data. Many of the dietary studies we see are prospective or cohort studies, or even meta-analysis of multiple cohort studies. The purpose of a cohort study is to identify trends, and develop a hypothesis that can be tested in a specific study like this one. So, in this case, having six participants in a direct study is actually more indicative of what really happens to individuals than a cohort study with hundreds or thousands of participants. In this type of study, unlike in the cohort study, specific measurements are taken at specific times of known people.

What Was Measured?

The study, Increased adipose tissue lipolysis after a 2-week high-fat diet in sedentary overweight/obese men, set out to determine if a high-fat diet affected the rate of “fat burning” in the six men. How do you measure the amount of body fat that has been burned? The most accurate way is to measure one of the by-products of lipolysis, glycerol, in the small amount of fluid that surrounds each cell (called the “interstitial fluid”). The more glycerol present, the more fat tissue has been broken down and used by the body as fuel.

The men adopted a high fat diet for two weeks, and had the interstitial glycerol measured. Then they ate their normal diets for 10 days. After this “washout period”, they ate a “well-balanced” diet with the same number of calories. A “well balanced diet” is usually code for a diet such as the USDA recommends, with high carbohydrate levels. After two weeks, the interstitial glycerol was measured.

Note that this method corrects for differences in calorie intake. Both diets were composed of the same number of calories, or were “isocaloric” in dietary study parlance.

Average interstitial glycerol concentrations (index of lipolysis) as determined using microdialysis were higher after the high-fat diet (210.8 ± 27.9 μmol/L) than after a well-balanced diet (175.6 ± 23.3 μmol/L; P = .026).

Not only did eating fat NOT make the men fatter, it actually increased the rate of fat burning by 20%.

Is This The Answer?

Hold on, grasshopper. This study does show that the fat cells release more fat on a “high fat” (and therefore lower carbohydrate) diet. But that’s all it measured. Is it possible that a high fat diet could lead to more storage of fat elsewhere? They don’t know:

These results demonstrate that healthy nonlean men who diet on the high-fat plan have a higher lipolytic rate in subcutaneous abdominal adipose tissue than when they diet on a well-balanced diet plan. This higher rate of lipolysis may result in a higher rate of fat mass loss on the high-fat diet; however, it remains to be determined if this higher lipolytic rate in men on the high-fat diet results in a more rapid net loss of triglyceride from the abdominal adipose depots, or if the higher lipolytic rate is counteracted by an increased rate of lipid storage.

I suspect that last sentence is being used to request more funds for another study!

Salt is the New Scapegoat

Will Salt Kill You?

The newest dire warnings about a common food … table salt … are growing, and about to result in legislation. Busy bodies everywhere are clucking that “something has to be done!”


Adopting a villain is reassuring, as it absolves us of personal responsibility. It explains away some inconvenient facts that might not fit in with our preconceptions. In the seminal story that gave us the term “scapegoat”, the accumulated sins of the people are transferred to the goat, and the goat is sent to the wilderness, presumably to die for the community’s sins. This solves a big problem; the tabernacle that holds the sins transferred by weekly sacrifices is only so big. So you have to get them out of there somehow. It works great, unless you’re the goat. Vaya con Dios, goat.

What is Salt’s Role as a Scapegoat?

The list of errors in public health policy is long and dominated by scapegoats. Dietary cholesterol has no bearing on serum cholesterol levels, despite the scapegoating of eggs. Fat in the diet does not lead to extra fat in the body, yet the scapegoating of red meat and other dietary fat continues. Salt has joined the list because what we are doing isn’t solving our problems. Load up that scapegoat with heart disease, hypertension, and premature death and send it into the wilderness!

Why is Milk White When Cows Eat Green Grass?

Sometimes a childish question is too easily dismissed. Of course everyone knows that eating something green doesn’t make milk, urine or feces green. We know this because the body breaks down the food, and digests it, and we console ourselves that this process is too complex to explain to our children. The truth is, few of us really understand it, and we know that eating green grass does not lead to green milk because … milk is always white.

But often the science, as reported in the media, is something akin to the conclusion a child would come to without noticing that the milk is white. The cow eats green grass. What color is the milk? It must be green. Grass and milk have a close correlation … in one end, out the other. Without grass, there is no milk.

Salt is often associated with hypertension, and hypertension with heart disease and kidney failure. Ergo, salt causes heart disease and kidney failure, leading to early death. The milk is green.

Does Salt Consumption Lead to Early Death?

A meta-analysis of studies on salt consumption and hypertension, covering 6,489 participants with both high and normal blood pressure, with and without heart disease showed no benefit from salt reduction. None.

Despite collating more event data than previous systematic reviews of randomised controlled trials (665 deaths in some 6,250 participants), there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or cardiovascular morbidity in normotensive or hypertensive populations.

Are They Trying to Kill Us?

The problem with scapegoats is that they take our attention away from the real problem. And sometimes, the goat is dangerous. The study found that there was a slight, and probably statistically insignificant increase in deaths when salt was reduced in patients with heart failure. Get that? Not only did reducing salt intake NOT increase the life of those with heart failure, but it increased it slightly. In the study’s words:

Further RCT evidence is needed to confirm whether restriction of sodium is harmful for people with heart failure.

Reducing salt can lower blood pressure a bit. That is because salt helps retain water, and the excess water in the bloodstream increases blood pressure. Reducing salt can decrease blood pressure a bit, but usually doctors prescribe a diuretic like hydrochlorothiazide (HCZT) as a first step in blood pressure management. It really reduces the excess water in your bloodstream, as long as you take the drug.

One of the criticisms of low carb diets is that much of the initial weight loss is water, and thought to be temporary. Dieters starting out on a low carb diet are warned about this effect:

If you are currently under a doctor’s care for these disorders or taking medications to control them – especially if you are a diabetic on insulin or oral medications to control blood sugar or on diuretics to control blood pressure – you must consult with your physician before beginning this plan! This nutritional strategy is potent and will rapidly cause changes in blood pressure and blood sugar that will make your current doses of medication far too high.
– Drs. Mary Dan and Michael Eades in Protein Power Lifeplan

The criticism that water loss is temporary isn’t valid; a low carb diet is not a temporary diet to lose weight, but a new way of eating that resolves many health issues. As long as you don’t overdose on carbs, you don’t retain the water, and your HCZT stays in the bottle.

Expect to Hear More

Judging from past media scapegoats, expect the drumbeat of uninformed, erroneous news stories to continue scapegoating salt. As we don’t know the effects of a society-wide reduction in salt consumption as proposed by New York City, it will be decades before a rise in deaths attributable to lower salt consumption. Just remember that cows eat green grass, yet their milk is white. Correlation is not cause, and more study should be done before legislation bans salt shakers from our tables.

Low Carb and Paleo Links Page Added

Low Carb and Paleo Links

I added a page of my favorite low carb and paleo links. These sites are also included in my MegaSearch low carb and paleo website search engine.

I Have Rules

For low carb and paleo links to be included on my personal list, they must be active sites (with posts in at least the last six months) and NOT anonymous. There are some prominent sites that, for one reason or another, do not list their author’s name and background. Perhaps they are afraid of recriminations from the low fat advocates, or they are prison inmates compiling a list of meat eaters to victimize when they get out. We simply don’t know, and so I don’t include them.


Low carb and paleo links are separated into six different categories:

  • Medical Sites
  • Researchers
  • Researchers – Other Fields
  • Advocates
  • Personal Sites
  • Recipe Sites

Medical sites on the low carb and paleo links list are those sites with contributions from medical doctors. These authors have actual patient – centered experience in a clinical setting. In other words, if they haven’t said “turn your head and cough” in a professional setting, they aren’t included (what someone does for fun in the privacy of their own home does not matter in this case).

Researchers on the low carb and paleo links list are those sites that generally provide scientific information about the low carb and paleo way of eating, and are authored by people with a degree in a human health related field (physiology, biology, nutrition, etc.)

Researchers from Other Fields sites on the low carb and paleo links list are sites providing scientific information, and are authored by people with degrees not related to human health.

Advocates on the low carb and paleo links list are those sites run by enthusiasts who have contributed through the years to the understanding of issues surrounding human nutrition. This category includes the more commercialized personal sites that have large readership.

Personal Sites appearing on the low carb and paleo links list are often the most enjoyable. These sites are from a wide variety of contributors, some with advanced degrees, giving their personal story, recipes and advice. Others are the inspiring stories of personal triumph.

Recipe Sites … a low carb and paleo links list would not be complete without a section devoted to the low carb or paleo recipe. These sites are primarily about recipes, although many of them also have the personal touch of a personal site.

These categories are not really listed in order of importance. They are categorized to separate out the wheat from the chaff. Taking medical advice from someone who has never said “turn your head and cough” is probably not wise. And I wouldn’t necessarily trust my doctor for a great recipe (although Dr. Mary Dan Eades would definitely be an exception!) There is some cross over and duplication.

Hey, I’m in the Wrong Category!

Let me know if your site is listed in the low carb and paleo links list, and you think you are in the wrong category.

I Want to be Included!

I welcome additions to the low carb and paleo sites list. There is no requirement to include a link back to my site, although I would apprecaite it. To be included, your site has to be primarily about low carb or paleo, and be active; I intend prune links that are not active every few months, unless they have a lot of important content on the site already. Just let me know in the comments, or by email, and I’ll consider you for inclusion.

Low Carb Daily to Close

Low Carb Daily, my daily low carb news aggregator, has suffered from an import script that is not well supported by the author. To be fair, he produced a great import program, and distributed it free of charge. But for the last three months, I have been unable to either edit or add new feeds due to a frustrating display problem in the admin panel.

I had established a “Single Site VPS” using a “Site Virtual Server” for Low Carb Daily, and it worked very well. It was fast, well behaved and stable. Its a great option for a busy site that you want to run on its own virtual server.

But the combination of admin panel problems and my current unemployment status argue against continuing Low Carb Daily past the domain name renewal in early August. Any low carb advocate who would like the domain name please email me.

The site has been moved back to my shared server, and all the prior posts removed. It will continue to populate the current subscribed feeds until I close it down. Closing will be no later than July 21, 2011, and probably before then as I make room on my server for more customer sites (I don’t oversell the space).