What We Know About Fat

Do you think you know which of these is best for you?

 

What do we really know about fat?  About how fats react in the human body when they are eaten?  Government agencies make a lot of assumptions about fat, and they base that on the popular opinions of physicians and scientists who serve on their advisory committees.  Those recommendations are published, and then are used by many physicians, dieticians, nurses, and other health care professionals as a basis of what to recommend to patients.

But what if those experts got it wrong? When the latest data about fats is examined critically we find out that the recommendations made by those government agencies has no basis in the literature.  However, you will find those recommendations repeated as gospel in almost every website about what to eat and what is healthy for you, even the highly respected websites such as WebMD.com

In the March issue of Nutrition, a highly respected, peer-reviewed, academic publication,  Robert Hoenselaar outlines how the advisory committees not only got their advice wrong, but how they cherry-picked the data (Nutrition 28 (2012) 118-123, Saturated fat and cardiovascular disease: The discrepancy between the scientific literature and dietary advice).

Recommendations from the United States Department of Agriculture (USDA) and European Food Safety Authority (EFSA) regarding consumption of fat are similar

(a) Consume less than 10% of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids

(b) Keep the intake of saturated fatty acids as low as possible while consuming a nutritionally adequate diet

(c)  Saturated fat intake should be as low as possible

Saturated FatMonounsaturated FatPolyunsaturated fat
ButterCorn oilOlive oil
Chicken skinNuts, seedsPeanut oil/ peanut butter
Most meatsSoybean and soybean oilAvocado

 

In 2003, a meta-analysis of over 50 trials was published examining the relationship of dietary fat to serum cholesterol levels (Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serumlipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003;77:1146–55.).  The conclusion was that saturated fat increases the levels of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) but without changing the ratio of total to the HDL cholesterol.   They concluded that using cholesterol alone as a marker of risk was unreliable. This was because if you replace the saturated fat with carbohydrates or tropical oils if you examine the effects on HDL and apolipoprotein B. They concluded that “… we can never be sure what such fats and oils do to coronary artery disease risk.” To translate that from doctor-scientist language: we can improve some laboratory markers, but really not by any mechanism that makes a difference from what we know.

While a systematic review of randomized trials showed that when saturated fats are replaced by polyunsaturated fats there is a reduction in the laboratory marker for risk of heart disease, there was no association with mortality from heart disease.  To emphasize this: the laboratory values of the patients studied improved, but their mortality didn’t. The review also showed that monounsaturated fat intake significantly increased cardiac events, but no effect from the intake of saturated or polyunsaturated fat. Let me emphasize that: Monounsaturated fats, by at least one study, not only didn’t improve issues with the heart- the patients in that study did worse.

 

When examining other prospective studies about the risk of saturated fat and cardiovascular disease, there has been a consistent lack of an association between fat intake and heart disease, stroke, or total cardiac events.

Cohort studies show that by replacement of saturated fats with unsaturated fats, or carbohydrates – and examining the hazard ratios for heart attacks and deaths from heart disease were as follows: 0.87 for polyunsaturated fat, 1.19 for monounsaturated fat, and 1.07 for carbohydrates.  For those not familiar with statistics, these are essentially no difference, and if these small statistical numbers are accepted than polyunsaturated fat shows an alarming trend. So here is a study that indicates (with as much precision as most studies these days) that polyunsaturated fats are worse for you than saturated fats.

There is a difference between protection against what we define as risk of heart disease and death from heart disease.  Risk reduction means that we lower the laboratory values of factors we associate with risk – but the end point is death.  In a meta-analysis published in 2010 (Ramsden CE, Hibbeln JR, Majchrzak SF, Davis JM. N-6 fatty acid-specific and mixed polyunsaturated dietary interventions have different effects on CHD risk: a meta-analysis of randomised controlled trials. Br J Nutr 2010;104:1586–600.) examined seven different trials, they found that there was a risk reduction but no change in mortality.  Another study (Skeaff CM, Miller J. Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomized controlled trials. Ann Nutr Metab 2009;55:173–201.  ) had eight trials found “There is probably no direct relation between total fat intake and risk of CHD (heart disease).
The advise of the USDA is reflected in places like WebMD, recounted in public service commercials, and recited as gospel by health care workers everywhere.  Giving false impressions about what an appropriate diet is.

Many of us constantly look for the right things to eat, the right food to feed ourselves and our families.  For that information we choose what we consider informed sources about risk reduction. What we discover is that there is not a clear answer, at least not yet. The differences between these ingredients are not large enough in the studies performed for a reasonable person to make blanket statements.

The only statements about fat that can be made are that trans-fats are bad for a person.  Trans-fats are the fats found in stick margarine, most pastries, and fast foods – but rapidly being eliminated because of their clearly demonstrated bad effects.

Here is what we do know: eating too many calories, be it of fat, carbohydrates, protein, or alcohol will lead to excess weight, and excess weight is a contributor to heart disease, diabetes, and joint problems.

Eat healthy, fresh, delicious food — all in moderation.

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.

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Latest Comments

  1. David Brown says:

    Actually, there is some evidence that excessive omega-6 industrial seed oils consumption contributes to increased risk of obesity, diabetes, and non-communicable disease(1). The thing is, there are no trials in which omega-6s are deliberately restricted. There’s one trial in which omega-6s were inadvertently restricted and the result was a 70 % reduction in coronary heart disease morbidity and mortality(2).

    Circumstantially, increased obesity, diabetes, and non-communicable diseases follow in the wake of the introduction of omega-6 seed oils and food products containing them as an ingredient(3). And there’s some evidence that omega-6s tend to promote over eating(4).

    I can attest to the fact that excessive omega-6 consumption is unhealthy. I almost did myself in by consuming peanut butter sandwiches almost daily for many years(5). Were it not for Dr. Bill Lands I might not have realized my mistake(6).

    What’s truly amazing is that the tremendous increase in omega-6 consumption is considered a good thing by the highest nutritional authorities(7,8). One wonders if they will ever realize their mistake.

    References
    1. http://www.prweb.com/releases/david_brown/omega-6/prweb8933501.htm
    2. http://cordeliastorm.posterous.com/a-short-but-noteworthy-summary-of-the-article
    3. http://articles.orlandosentinel.com/2003-09-28/news/0309270148_1_overweight-or-obese-women-were-overweight-south-africa
    4. http://holisticandnutritionalhealing.com/2012/02/17/do-omega-6s-make-us-fat/
    5. http://theconsciouslife.com/omega-6-friend-or-foe.htm
    6. http://www.youtube.com/watch?v=dgU3cNppzO0
    7. http://circ.ahajournals.org/content/119/6/902.full
    8. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-full-story/

  2. thedoc says:

    Any fat in excess will lead to obesity. Once the fat is broken down, excess is simply used to store energy. We do often talk about the relationship between omega-6 fatty acids and omega-3 fatty acids, We are still early in our understanding of all these fatty acids, but clearly too much of the omega-6 fatty acids have been associated with increased chronic diseases. Still, without the eicosanoids in our body we would be reduced to a puddle of bacteria, yeast, and our version of pink slime. Inflammation is necessary and important to body functions, and to attempt to control them at a macro level has not proven beneficial. Instead, we are using the break down products as roles for specific targets in medicine.

  3. GDE says:

    First of all, I disagree that we don’t know what to eat. We can look at evolution and what our ancestors ate. We have seen certain diseases after we began using agriculture to get into grains and refine them 10,000 years ago, like heart disease and diabetes. Our bodies have not had time to adjust to a high carb diet that resulted. Insulin is the most important hormone in the body. When you constantly raise it too high, disease results. The polyunsaturated oils are rancid and have been shown to cause cancer. We know enough to know to eat whole foods, primarily meat, vegetables, some fruit, eggs, nuts, seeds, etc…, same kind of food our ancestors ate. We also know that most sugars create an insulin response that is too high and alcohol has sugar. Carbohydrates are broken down into sugar and that can be slowed down with fiber. But knowing how much a certain food raises blood sugar is crucial and we have the glycemic index, glycemic load, net carb counters, etc… to guide us. We know that grass-fed beef is best, along with organic foods and spring water. So, we actually know quite a bit about how to eat.

    Secondly, you claim eating too many calories will lead to excess weight. That’s not necessarily true. The body has amazing ways of balancing itself. You would have to eat to excess on a constant basis. But, the types of calories do indeed matter. You can eat much more fat calories than you can carbs and not gain weight. Exercise is a factor, because you can eat excess carbs and lose weight if you exercise enough. But without exercise, you will be able to eat more calories of fat, provided you don’t eat any, or eat few, carbs.

    I agree excess weight is a contributor to heart disease and diabetes and other diseases, but the cause of the weight gain (unless a genetic ailment that requires other involvement) should be remedied by eating a high saturated fat, low carbohydrate diet. Some people are so resistant to insulin, that they need a no-carb diet for a while in order to get back to normal. I am currently listening to the audio book by Gary Taubes “Good Calories, Bad Calories” and he did a brilliant job of citing all the studies that got us into this mess of thinking fat is bad, carbs are good, and high cholesterol makes a difference in heart disease. The evidence for the latter simply hasn’t ever been shown in any reliable study.

  4. The Doc says:

    Being a great believer in evidence based medicine, and not speculation based medicine I would have to ask – where is your proof? For example, your assertion that we didn’t eat grain until 10,000 years ago is just incorrect. Grain mills have been found that date to 30,000 years ago. The idea that our ancestors knew best first assumes we know what they ate? Since there was a wide diversity of foods that they ate, shows that we are more flexitarian eaters. You assume that the cavemen were healthy and somehow had an innate knowledge of how to eat, and that evolution takes place in long increments – all of which are rather difficult assumptions to prove. Don’t give me the dental records and forget to mention they had high concentrations of fluoride in their water ( a common paleo myth). Evolution can take place in a single change and a generation based on natural selection. We have seen, for example, a change in brains in the last 2000 years – larger than our bronze age ancestors.
    Alcohol does not have sugar, alcohol is a separate source of energy people can use, and alcohol has minimal to no effect on insulin (basic biochemistry).
    Insulin is the most important hormone- well, maybe it is, and maybe it isn’t, but again evidence not speculation and testing, not guessing with anecdotes.
    You are correct that the body can adapt, and calories are not the entire answer, but an approximation, and certain calories if processed quickly tend to lead to excess weight.
    Where you are incorrect is the assumption that all individuals are the same – we are not. Eskimos have a key enzymatic deficiency that leads them to grow fat and children develop dangerous levels of glucose if they fast too long, or have a highly carbohydrate based diet. They are different than the circumpolar friends, the Norwegians, who process dairy well. But an eskimo can eat a high fat diet, because of that deficiency.
    I am a fan of Gary Taube’s book, and recommend it also.
    While I am more in favor of the paleo-type diet than most, I would have to add- 1.3 billion people eat a carbohydrate based diet, either wheat or rice, and they do just fine. But I hate population studies, they are too often wrong, and it is a silly way to base all of what any eat. We don’t know what our own population eats, and cannot make statements about that, to talk about cavemen is just silly.
    Overall- most of your points are ok- just remember – evidence is not anecdote, correlation is not causation, and we will continue to search for what works for some. See our posts about how Evo lost weight on sausage and beer.

  5. The Doc says:

    Banting had a view that was over 100 years old- Kellog had a different view. You can lose weight by limiting what you like best – and convince yourself you like other things. But the undertaker, Banting- thought beer was bad- and yet, we have shown a person can have six beers a day and lose weight. Single anecdotes- well, yes they are

  6. GDE says:

    I thought I got the info about the 10,000 years from Gary Taubes’ book, but I could be wrong. But, that aside, grains and sugar raise insulin. Constant high insulin levels can cause diabetes and heart disease. So, whatever raises the insulin, we should not eat, or at least not eat a lot of.

    There is no way not to take into account what our ancestors ate, because our bodies have changed like .005% since they were here, that’s what I’ve read, anyway. We do know what they ate. We don’t know the entire history, but we have bones and artifacts that tell us a lot. I have read that cavemen were in fact healthy and that DNA has been done and their veins were clean. I don’t know, haven’t researched it yet. Yes, I do believe the cavemen knew what to eat, some innately perhaps, and some from trial and error. It could have been all from trial and error, but they evolved and were trim and ate no refined carbs and refined sugars. There have been studies to show that other cultures in our recent past did not have diabetes, heart disease and cancers before eating the western diet. Read Gary’s book where he cites those studies. I have also read that our brains evolved to be as smart as they are from a high fat diet and that our brains are 60% fat.

    I don’t think you understand evolution well, the changes are very small. The diet we started eating when we began eating refined grains, there wouldn’t be enough time to adapt to, thus we haven’t. Some alcohols have sugar, but nonetheless, it affects blood sugar levels. Studies have shown that alcohol interferes with all three sources of glucose and the hormones needed to maintain healthy blood glucose levels. You are way wrong on the biochemistry.

    To say we are not all the same misses the boat, in that, if we all kept insulin levels down from not eating sugars, grains (high glycemic foods) most everyone would avoid diabetes and heart disease. We didn’t see these things in our not so distant ancestors, nor even in other recent cultures. Granted, the reporting of such is limited, but even with that, there have been studies that show these are new illnesses and mostly from a western diet of high carbs. When coupled with the low fat recommendations handed down to us in the last few decades, it’s a recipe for disaster. I don’t know anything about the Eskimos, but I assume if they went on our diet, they’d get very ill.

    You say, “1.3 billion people eat a carbohydrate based diet, either wheat or rice, and they do just fine.” I disagree with this 100%. People do not do well on a carbohydrate-based diet. But that depends on what you are calling carbohydrate-based. We can do ok on some carbs, even some rice and wheat if we exercise and burn it off and also get some meat. For example, a japanese study demonstrated this. But, as Gary Taubes says, exercise just makes you hungry. A high carb diet will cause disease. There are many studies that show cause. To me, it sounds like you have not read the book by Gary Taubes “Good Calories, Bad Calories”, because if you had, you wouldn’t have grounds to say a few things you have said. Also, you like to throw the term anecdotal around a lot. I tend to think that you are hiding behind that a bit and not looking into the actual studies. Gary’s book is a tough read, as it takes one through the history of how we got to the dangerous low fat high carb diet we are told to eat, and it covers all the studies involved. It is quite spectacular.

  7. GDE says:

    I don’t believe that people can eat whatever carbs they want and be healthy. Banting’s goal was seemingly not to be healthy, but rather, to be thinner. I only pointed out the alcohol he drank because I guess you drink often by the look of your tweets. Nonetheless, cutting carbs will cause weight loss, although some have to cut all carbs to do it if they have gotten to a certain point.

    I found this info on alcohol that is interesting:

    Drinking hard (i.e., distilled) liquor by itself does not affect insulin secretion, but when hard liquor is consumed with food, it increases insulin resistance and insulin secretion. Hard liquor also contains quite a few calories per ounce. By contrast, an ounce of mixed drinks, wine or beer will have fewer calories from ethanol. However, mixed drinks, wine and beer all contain carbohydrates, and, if they are consumed in quantity, will result in insulin secretion and eventual weight gain.

    …a single glass of dry wine per day can improve insulin sensitivity….

    Alcohol stops gluconeogenesis…the process used by the liver to keep blood glucose levels within normal limits. ….

    http://lowcarb4u.blogspot.com/2008/11/alcohol-and-low-carb-lifestyle.html

  8. GDE says:

    Your friend doing the beer sausage diet (http://funanymore.com/2011/09/27/brewdiet-the-beginning) is not typical of someone who would just add beer to their diet. For one, it’s eating carbs with beer that puts on weight, although if you drink excessively over time, you can end up with insulin resistance from your body trying to metabolism all that poison. Also, your beer sausage guy is limiting himself to 1700 calories. So, I’m not too sure the point of this diet. If it’s for shock value, ok, but other than that, I see no point.

  9. The Doc says:

    Common belief, not supported by science- it isn’t 10,000 years, but paleo types have thrown that number around a lot.

  10. The Doc says:

    First, I don’t drink often – in fact I have probably had three beers this year, perhaps two hard drinks, and while I love the taste of some red wines, I find most are not that good and I refuse to drink a beverage or eat food that I find distasteful.
    Second, When people talk about insulin secretion they are making it up- because they are not measuring insulin levels. Most alcoholics that I have taken care of in my life are rather thin- be it alcoholic from beer, wine, scotch, etc. Love how people make up things about insulin levels without measuring insulin itself (a rather complicated lab value) – and most doctors don’t order insulin levels. So, people who talk about it might as well be talking religion and hearing voices.
    Third, The liver is used as a storage for glycogen and not to regulate blood glucose levels, except to replace it (for a limited and brief period of time).
    Alcohol is not an inhibitor of gluconeogenesis

  11. The Doc says:

    The diet was not excessive – nor did we promote that, and told it should be done with careful supervision, which it was. Drinking does not lead to insulin resistance- not sure where that came from – but again, plenty talk about insulin without measuring it – just guessing

  12. GDE says:

    Well, that’s not important, how many years we’ve had grains. It’s still a miniscule amount of time on the evolutionary scale. But, grains only became a problem when we refined it and ate more of it. Grains and sugar and some fruit and vegetables raise blood sugar. If people eat a lot high glycemic foods, they can sometimes get around weight gain by exercise. A majority either don’t exercise enough or are just insulin resistant. And, when I say they don’t exercise enough, I’m not implying laziness; it’s just that some are able to overcome the weight gain of a high carb diet through exercise and how much depends on the individual’s genetics. Me, I’d rather eat low carbs and exercise just enough to keep toned.

    It is refined grains and sugars that are mainly causing a high insulin response and in turn, diabetes and heart disease.

    And, doc, I’ll leave you with this… what is the ONE thing all centurians have in common? They all have relatively low blood sugar. No other commonalities have been discovered.

  13. GDE says:

    Well, you’re mostly right. But, you don’t want to drink with food, because the alcohol will be burned for energy first. Thus, it could cause weight gain.

    I found this info:

    In general, unsweetened wine (red or white) and hard alcohol like whiskey, vodka, etc., will not result in elevated glucose or require an insulin response. In fact, these drinks tend to result in a temporarily lower insulin response, since the liver stops its usual task of putting out glycogen (which triggers insulin release) to converting the alcohol – for a time, anyway.

    BEER, on the other hand, does contain varying amounts of carbohydrates, which will be converted to glucose and therefore require insulin. A bottle of regular beer has about 12 grams of carbs, with light beer having less.

  14. GDE says:

    Ok, I was just looking over your tweets and you make constant referrals to drinking, but I never know things for sure until I ask because people tweet all kinds of funny things.

    You say, “Most alcoholics that I have taken care of in my life are rather thin- be it alcoholic from beer, wine, scotch, etc”. I never said anything about alcoholics. You are throwing apples and oranges at me. Most alcoholics I have seen on tv hardly ever eat food.

  15. The Doc says:

    We have done the glucose challenge with beer – it does not change the glucose. Again, most people talk about this stuff, say what makes sense, but I am really more interested in what we really know from actual testing – not guessing.
    Alcohol doesn’t raise glucose. The liver doesn’t put out glycogen, it stores glycogen and ethanol acutely impairs hepatic glycogen repletion by inhibition at at least two distinct sites, namely (a) intestinal glucose absorption and (b) hepatic gluconeogenic flux.

  16. The Doc says:

    You are making some leaps with insulin and heart disease. Probably true – but they are leaps, and not something shown from a lab bench – and also they have been shown in some, but not all studies. I happen to like the glycemic index, a lot.
    In terms of exercise- it is a good thing- and one day I shall try it.
    Refined grains- well, that would be the noodles, dough, and etc used by the Chinese on the silk road, and everywhere in China- and they seem to have quite a collection of centurians. And, who tested blood glucose in centurians?

  17. GDE says:

    Below, you say, “Refined grains- well, that would be the noodles, dough, and etc used by the Chinese on the silk road, and everywhere in China- and they seem to have quite a collection of centurians. And, who tested blood glucose in centurians?”

    You need to do research. Any population that eats some refined products has offsets that allow them to not become obese, if they are in fact not. As I have said before, exercise can offset it. It still doesn’t mean you are healthy eating those carbs. For example, Jim Fixx.

    I’m not making leaps and bounds. Raising insulin too much too often by eating carbs that do that, will lead to heart disease and/or diabetes, and/or cancer, if the person lives long enough. It’s an individual thing, but stats and studies supporting this are out there.

    Low Grain and Carbohydrate Diets Treat Hypoglycemia, Heart Disease, Diabetes Cancer and Nearly ALL Chronic Illness says Dr. Joseph Brasco http://www.vitals.com/doctors/Dr_Joseph_Brasco

    I see this written by a few people on the net:

    There are three major centenarian studies going on around the world. What researchers are finding from these major centenarian studies is that there is hardly anything in common among these people. They have high cholesterol and low cholesterol, some exercise and some don’t, some smoke, some don’t. Some are nasty as can be, some nice and calm and some are ornery. But, they all have relatively low sugar for their age, and they all have low triglycerides for their age. And, they all have relatively low insulin.

    Also:

    Excerpt from “Primal Body, Primal Mind”
    by Nora T. Gedgaudas, CNS, CNT

    “If there is a known single marker for long life, as found in the centenarian and animal studies, it is low insulin levels.”
    –Ron Rosedale, M.D., 1998

    Research across the board has shown that long-lived individuals (animals and humans) share the following characteristics:

    Low fasting insulin levels
    Low fasting glucose
    Optimally low leptin
    Low triglycerides
    Low percentage of visceral body fat
    Lower body temperature

    One single longevity marker stands out among all long-lived animals and persons above the rest, however, and that’s low insulin levels.

    You may want to discount how the human diet has changed over the centuries from what it was when our ancestors were healthy and thin, but it doesn’t make any sense to do so. Our ancestors were in much better shape. What changed drastically? We added refined grains and sugars. Now we are fat and sick. I’m going to read the book “Primal Body, Primal Mind: Beyond the Paleo Diet for Total Health and a Longer Life” that I just found by surfing the net. It may not be a perfect book, but it looks good. Here is a good review on it by this very interesting person, Jodi Bassett http://amzn.to/Kq8I3r and here is her interesting Bio: http://ahummingbirdsguide.com/abouttheauthor.htm

  18. GDE says:

    I assume you did the testing of beer on an empty stomach? According to what I have read, it makes a difference.

  19. GDE says:

    I know that in your field of work, it is more dependent on the point of view that people just can’t control themselves, and energy in energy out. But, if you look at all the folks on Dr Oz, even, they look desperate and willing to do most anything to lose weight. But there’s no doubt people can keep thin by eating less, exercising more and/or having surgery. The stats tell us that most will fail at some point, though. Surgery, I assume has a better outcome because of such limited eating. I mean, if you’re limited at how much and how often you can raise your insulin way up, that can only help you. But, we all have heard about the nightmares lived by Carne Wilson, gaining the weight back after surgery.

    Our society has portrayed these desperate fat Dr. Oz cronies and others like them, as failures. If they aren’t couch potatoes, well they just must not be exercising enough. Some people do have a different outlook and just think of these poor folks as genetically predisposed to be fat or as having slow metabolism. Whatever the view, it seems most fat people have tried many diets. The problem doesn’t seem to lack of motivation, and if we simply blame genetics, that doesn’t help these people prevent disease and death. Granted, science is always working on the genetic aspect of it, but in the meantime, our nation is getting fatter.

    Much could be solved to end the out of control, energy in energy out, view if Dr Oz simply implemented a program like Gary Taubes and others recommend. I mean Mehmet has a huge platform and millions of willing participants. If he were to say, we’re going to do a low carb diet for some and a no carb diet for those who are more insulin resistant, and we’re going to stay on it for a few months, I think the results would be phenomenal.

    I personally tried the low carb thing a few months ago and dropped 15 lbs in 3 months. I kept it off for a few months, but lowered my carbs even more and have lost over 5 more lbs. What was even cooler was that the swelling in my ankles and feet went away in 2 weeks and hasn’t returned. I am not super fat, but my doctor calls me obese by the chart standards because I’m 169. Until I discovered the low carb thing, I was gaining weight steadily and extremely upset because I ate healthy, had even tried cutting calories, and didn’t know what to do. Even if a person doesn’t exercise, they shouldn’t become obese by eating a typical human diet. I found out it was type of calories I was eating, not the calories themselves. In fact, I’m eating many more calories than before, because when you do low carb, your fat intake goes up quite a bit.

    So, I’m going to keep doing this low carb diet. A few days ago I decided to throw 5 to 10 mins of exercise bike into it per day, choosing the fat burning mode on level 6 (it has 16 levels). I’m starting slow with that, as I’m not a huge fan of exercise. I do like bodybuilding, though, and hope to do it later. Gary taubes has a very good point, he says, “Lance Armstrong rides his bike six hours a day because he’s skinny. He’s not skinny because he rides his bike six hours a day.” And, that’s been my experience, the more weight I lose, the more I want to do physical things. (Please note, the context Gary meant this in was not that fat people can’t ride a bike and get thin, so please don’t take it that way).

  20. The Doc says:

    Jim Fix had hyperlipidemia and died as a result, like most of his family.
    Second- re: China- you are fitting your hypothesis to the data by making up stuff.
    Third: here is the real research:

    Here is a part of the abstract you might be interested in: In all subjects, an oral glucose tolerance test and euglycemic glucose clamp were performed. Centenarians have a lower fat-free mass (FFM) than aged subjects and adults, whereas fasting plasma glucose, triglycerides, free fatty acids, urea, and creatinine were not different in the groups studies. Centenarians had a 2-h plasma glucose concentration (6.0 +/- 0.2 mmol/l) that was lower than that in aged subjects (6.6 +/- 0.5 mmol/l, P < 0.05) but not different from adults [6.4 +/- 0.4 mmol/l, P = not significant (NS)]. During the clamp, plasma glucose and insulin concentrations were similar in the three groups. In these conditions, centenarians had a whole body glucose disposal (34.1 +/- 0.6 mumol.kg FFM-1.min 1) that was greater than that in aged subjects (23.3 +/- 0.5 mumol.kg FFM-1.min-1 P < 0.01) but not different from adults (34.6 +/- 0.5 mumol/kg x min, P = NS). In conclusion, our study demonstrates that centenarians compared with aged subjects had a preserved glucose tolerance and insulin action.
    So- it isn’t a longevity marker. The effects of insulin are important.
    Second- how do you know our ancestors were healthy and thin? Healthy? Average lifespan was???? We don’t do well with our own population studies in our time, and yet somehow we have divined that cavemen were thin, healthy, and had long life? First, you cannot tell how fat or thin they were (we have no photographs and few cave paintings). Second, you cannot tell how old they were when they died. Third, bones do not tell you if they had cardiac disease, pneumonia, parasites, flesh eating bacteria. Always amazes me when people think cavemen lived long – we just don’t know.

  21. The Doc says:

    Surgery is not dependent on people not controlling themselves – that is rather prejudice, and I think a lot of my patients would disagree with you. Surgery is more than limiting the amount of food- the band does not limit the amount of food. Wilson is another story- just had a band over her bypass done by my friend.

    People who eat low carb think it is a religion, and attempt to explain all obesity by it, and ignore the variables surrounding it. You can lose weight on low-carb as well as other “diets” but they all have a dismal long-term failure rate (well studied, see JAMA articles).

    It just isn’t that simple- but you have a few points- we are just scratching the surface.

  22. GDE says:

    Jim Fixx could have benefited from a low-carb diet for his hyperlipidemia, nonetheless. The study you list doesn’t prove anything. But, I believe being a centenarian is a combo of genetics and maintaining low blood sugar. I don’t know if there is data on this, but I assume so, since some in the medical field speak about it.
    We know our ancestors were healthy and thin from DNA testing and artifacts and bones, as I have already said. The things you say about not being able to tell when our ancestors died and such is wrong and unscientific. But, we don’t need to go back to caveman days to see the changes in obesity and disease. We added refined carbs and started teaching people that is the way to eat and as a result, we have more obesity and disease. It’s that simple.

    The one thing that bothers me is the notion we don’t know what to eat. I think we do. In my research, I just came across a youtube video: Metabolic Control of Food Intake covered by Dr. Gregory Ellis http://youtu.be/Jt7SsvCHf7g

    From it, I learned something about the low-carb diet. Dr. Ellis says you don’t have to do no carb or very low carb, that 60 to 80 grams of carbs is sufficient, and if you go lower, you can get fat eating too much protein and fat. Dr. Atkins had some on no carbs, and maybe that wasn’t a good idea. I know Atkins wanted fast results for some, but Dr Ellis’ take on it sounds healthier. So, I will up my carbs a bit, because I don’t think I have been getting quite enough lately.

  23. GDE says:

    Well, there are some people who admit to not being able to control their eating. In fact, Carne Wilson has spoken freely of this. So, I don’t see it as a prejudice.

    If your surgery doesn’t cause people to limit the amount of food they eat, then I guess I don’t know anything about lapbands. My apologies. I have a friend who had bypass surgery or whatever, and he is only able to eat small amounts of food every couple hours. They also recommended he remove his gall bladder to avoid troubles with the type of surgery he had.

    I want to rectify my statement above about some people who follow Dr. Oz could go on a no carb diet. After hearing what Dr. Gregory Ellis have to say about that, I think 60 grams of carbs a day would be sufficient for the very overweight, even if it takes longer to lose weight.

    You say, “People who eat low carb think it is a religion.” I got a chuckle out of that, since I was reading the health section of the Huffington Post today and read someone commenting that people treat their “low-fat, high-carb” and “vegetarian” diets like a religion. Some on both sides do, I’m sure. I don’t, because I change my mind when I see new evidence. I don’t always know what to believe, so it’s a matter of trial and error. I do know that I’ve lost over 20 lbs by doing a low-carb diet and made no other changes. So, I’m studying low-carb diets and have no interest going on a vegan, vegetarian, and/or high-carb diet.

    I believe I have said, or maybe inferred already that people can lose weight on any diet. if not, my apologies. However, keeping with off is a different story, like you say. I am interested in those who do low-carb as opposed to those who do high-carb low-fat, as to who is able to keep weight off long term. I am also interested in the amount of exercise needed to maintain each. So far, I’ve done virtually none. I believe those who do a low-carb diet for life will keep it off. I suppose it’s a matter of committment. I, like Gary Taubes, believe one day we will get back to the low-carb diets doctors put people on in the 1960s, before all this nonsense that fat causes heart disease came out.

    I don’t think maintaining a proper weight is a complex thing. But, we are fed a lot of wrong info about it, primarily, that low-fat high carb is healthy. It’s not. It’s the opposite. It’s getting so I hardly know anyone who is not on drugs for some ailment or another, and more and more of my friends and family have diabetes. Some people don’t care if they eat healthy. But, I think there are many more who do, just can’t get the right info, our government and many medical doctors are steering them in the wrong direction diet-wise, and offering drugs if they get ill.

  24. GDE says:

    One more thing I would like to add about this low-carb diet I have been on for a few months. When I first went on it back in January 2012, approximately, I did get some cravings. I ran for the nearest store and grabbed some reeces pieces. That happened once more, but I didn’t even want the whole bag, tasted way too sweet. I did tackle my friend’s red vines a couple times. After about two weeks, I wasn’t craving any sweets or junk-food anymore. I had occasional yearnings for something a bit sweet, so I made microwave cupcakes with stevia I heard about on Dr. Oz.

    Recently, in an attempt to incorporate a few carbs into my diet, I have eaten things like grapes and watermelon. I don’t eat a lot of them and I think I will be fine. I have read that one should try to avoid or severly limit grapes and bananas on low-carb diets. I did eat more of that sort of thing, along with raisins for the first three months. I found I was only maintaining the weight I lost. That is why I decided to cut more carbs. I also am putting a touch of exercise bike in. But now, I am going to find a happy medium with the carbs. I’ll eat some, but stay away from a lot of the higher ones until I lose the weight I want. Then, I’ll incorporate some back in, in higher amounts and see how it goes. The types of carbs I am referring to are fruits and vegetables, not grains or sugar, of course.

  25. GDE says:

    I forgot to say, with my new low-carb diet, I stay full for hours. Before, when I ate a lot of carbs, I used to get hungry way more often and eat much more. I haven’t made any attempt to change my caloric intake, but it seems like I am eating less calories. I eat a lot of fat. It keeps me full and I don’t crave foods. So far, I am liking it, as it seems like something I can do for life. Very recently, I have tried to eat less food, because I want to lose more weight. So far, I don’t feel deprived. The fat gives me a sense of well-being too, I have noticed.

  26. GDE says:

    Wow, this Dr Greg Ellis has some amazing info. I used to to do body-building back in the early 90s and did carb-loading. I wish I had this info back then. You can build muscle with fat, but you have to go through an adaption period. Over time, If you continue to eat carbs for building muscle, it won’t work nearly as well as fat and you’ll most likely GET fat: “Fuel for Muscle Contrations gone over by Dr. Gregory Ellis”: http://youtu.be/FpUu8Wdi3_U

    The most interesting point about this video is the adaptation period necessary to switch from high carb to low carb. He says this is why many failed on the Atkins diet. They needed time to adjust in order to start burning the fat, maybe 4 weeks or longer.

  27. GDE says:

    BUT, this Dr Greg Ellis isn’t perfect, because he thinks homeopathy works (http://youtu.be/yL8RrwRUdQE). From everything I have seen it is pseudoscience. It professes to make something powerful by diluting it down to virtually nothing and claiming the substance works on the energy field of our body. That defies logic and is unproven from everything I have read. I see it as nothing more than a placebo effect if anyone claims to have gotten a good outcome.

  28. The Doc says:

    DNA testing doesn’t tell us if you lived long, short, or died from pneumonia, heart disease, or TB. Bones won’t tell us that either. So, as a physician, with some training in forensic medicine, – well, cavemen just are not something we know.You love low- carb, but again- we don’t know as much about this as we should

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