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The Case Against Sugar And The Case For Low-Carb Diets by Dr. Michael Eades

Unless you’ve been living under a rock, you’re aware that science journalist Gary Taubes has a new book out: The Case Against Sugar.

I have not read the book myself, but have read a number of reviews of it. Including this one by Stephan Guyenet: Bad sugar or bad journalism? An expert review of “The Case Against Sugar”. Gary Taubes has penned a response to Stephan in a separate thread here: The Case against Sugar Isn’t So Easily Dismissed.

In his review, Stephan did have some elements of agreement and praise for Gary’s work. It’s by no means a slasher piece, at least not how I read it (three times). My purpose in this post is really not to either support or condemn low-carb diets, or sugar, for that matter. Rather, it’s to highlight differing perspectives and rather than me do it, I think Dr. Michael Eades does it best, via a lengthy email he sent me yesterday which I found fascinating and enlightening. He’s given me permission to post the email.

What kind of struck me when I read it is how much experience forms one’s views. You could call it “experience bias,” I suppose. One thing Mike and I always honesty emphasize with each other in our various correspondence (mostly focussed on current political events, not dietary intervention) is that bias is literally everywhere.

So here’s a rough template to illustrate this “experience bias,” for or against low-carb/sugar:

  1. Personal anecdote (for or against)
  2. Collectors, synthesizers, cherry-pickers of anecdotes, medical literature, books and articles (like a layman blogger—for or against)
  3. Professional researchers who review and contribute to the literature (like Stephan, Kevin Hall, etc.)
  4. Authors and journalists (like Gary, Alan Aragon, etc.)
  5. Actual clinicians (like Mike; Dean Ornish, Doug McDougall, etc.)

One could probably come up with more, but the point is to really dig in and understand how vastly different is the experience in each category, and as well, it goes both ways. In other words: everything works, and everything doesn’t work. It depends, and also, what works and what doesn’t work is experience that forms your “experience bias,” such that you may focus on what works (low-carb, calorie counting, plant based, etc.), or perhaps you’re a critic and your focus is on what doesn’t work (low-carb, calorie counting, plant based, etc.).

As for me, I’m part of both (1) and (2), above. low-carb both worked and then didn’t, for me. As a blogger at it a long time, I have thousands of anecdotes in comments as to how it works, and how it doesn’t work. I don’t particularly think about carbs, or even sugar. I just eschew crappy, empty calorie stuff, both at the supermarket and eating out. But I also focus on meal frequency, and portion size—without calorie counting. It maintains my weight in the 180s effortlessly, about 10-20 pounds from what would be considered lean, but I feel better than when in the 170s. In terms of carbs intake, I’d guesstimate it averages to about 150g per day. But some days are super low and some days, moderately high. I try to go at least 12 hours per day with zero caloric intake, so a 12-/12+ eating/not-eating window, and try to extend to one 24-30-hr stint per week. In terms of empty-calorie sugar, some weeks I’ll have a sugar-soda or two, or three, some weeks none. In terms of empty-calorie fat, I use good fats, and I take it very easy on added fats. I tend toward leaner cuts and I trim the fat. So that’s me. My experience.

Here’s the experience from Dr. Mike Eades, who’s parts of (1), (2), (3), (4), and (5).

~~~

One of my favorite quotes is from Bertrand Russell.

“The stupid are cocksure while the intelligent are full of doubt.”

I like it because we all are like atomic particles: we change states constantly. In some aspects of our lives and on some subjects we are intelligent while in others we are stupid. And, consequently, we are either cocksure or full of doubt, depending upon our state.

The older I get, the more I understand how potent the confirmation bias is. And how it is almost impossible to overcome. I’m suffused with it, as are you, and Taubes and Guyenet and just about anyone else either of us can point to. As a result, I never know—for absolute certain—whether I am on the right side of any argument or not. Whether I’m cocksure or full of doubt.

When I was in my middle thirties, I started gaining weight like crazy. Before I knew it, I was 35-40 pounds overweight. Like most doctors, I didn’t know shit about nutrition, so I went on the current fad diet at the time, which was in a book by a physician named Stuart Berger (who later died young and morbidly obese). It was low-fat, and I did okay, but hated it. I lost a bit, then regained. I then went on Pritikin, which I really hated. I think I tried one other diet, also low-fat (those were the only ones in vogue at that time), and it didn’t do me a lot of good. Optifast, a hospital-based fasting program was all the rage then, and I discovered there was a similar program (Medifast) set up to be administered through physicians’ offices, so I sent off for the info with the idea of using it as a means to increase revenue in our clinic. When I got the instructional materials, I read it through them and realized that it sounded suspiciously like a shake version of Atkins, whose book I had read years before and discounted, because the medical profession had badmouthed it. (At that time, I was as mainstream as mainstream can be.) The packet contained a few scientific papers, so I read them. The data they presented seemed convincing, so I decided to do the program myself before putting patients on it. I lost effortlessly, wasn’t particularly hungry, and had no decrease in energy levels as I had experienced with the low-fat, low-cal diets I had tried. Which was interesting, because the shakes themselves were low-fat and low-calorie. So the difference had to have been the carb restriction.

The problem I saw with the program was that the shakes worked great to effect weight loss, but when all the excess fat was lost, the company promoting the program had a low-fat, high-carb diet for maintenance. That seemed strange to me because all the papers that came in the physician starter kit argued for the effectiveness of the program as being a consequence of the carb restriction. If the papers were correct, I couldn’t figure out why the Medifast people thought adding a ton of carbs in for maintenance would do anything but bring about weight gain. So, I redid the maintenance program and designed it low-carb.

My patients, many of whom were overweight, had observed my weight loss and asked me about it. I decided that I would start running my own version of the fasting program and maintenance diet in the clinic. It became a hugely successful operation. I finally decided that if the fasting program worked so well, why wouldn’t a low-carb food program work just as well. So, I tried it. But since that diet contained a lot more fat, especially saturated fat (which was verboten in those days), I was worried about using it on anyone of heart attack age. MD sent me a patient from her clinic and I had a few others that disabused me of that notion.

After my experience with these early patients, I overcame my fear of saturated fat and for the rest of the time I was in practice, I used low-carb diets that I fiddled with and refined to treat an enormous number of patients. Most of those patients had tremendous success with it. MD and I hired on to be one center of a major drug study for the drug that ultimately became Xenical. It was a maintenance study, so we had to recruit patients and put them on a standardized, 6-month lead in weight loss diet which was the state-of-the-art low-fat, high-carb diet, designed by the drug company, to get them to lose enough to be accepted into the maintenance part of the program, during which they were to get the drug. All they had to lose over the six months was four percent of their body weight to qualify for maintenance. A 200 pound woman would have to lose eight pounds over six months to qualify. And I can’t tell you how many of them didn’t qualify. We got paid a fortune to do this study, but the payment schedule was skewed toward the end because the drug company (Hoffman LaRoche) obviously wanted patients to get to the maintenance phase to test their drug, so we did everything in our power short of horse whipping the patients to get them to stay on the program and lose.

One of the problems was that the drug-study patients came and waited in the same waiting room as our regular patients, all of whom were on low-carb diets. They would talk among themselves, and when the low-fat, high-carb, drug-study patients heard how much the low-carb patients were losing (sometimes almost as much in a week as the drug study patients were losing over months), the former became discouraged and wanted to be regular clinic patients instead of drug-study patients. It was a major pain in the ass. But it was extremely informative to me, because I saw first hand the difference in outcome of patients who had extensive nutritional counseling, dietary guidance, a dietitian on call, and weekly office visits (the drug study patients) versus our regular clinic patients on low-carb diets who had a short session on what to eat and came into the clinic once every couple of weeks to weigh in. There was no comparison. The low-carb diet vastly outperformed the low-fat diet, hands down. Better weight loss, better lab values, better sense of well being. Virtually any parameter you want to measure, the low-carbers did better. (The FDA requires study centers to keep all the data for something like 12 years, and I still have it all. I keep thinking someday that I can use it as the low-fat arm of a study or something. It is extensive.)

The point of this long story is that I have many years of experience dealing with low-carb diets, so I have a difficult time believing it when people tell me that low-carb diets are just the same as any other diet. My years of experience, both personally and professionally, tell me otherwise, irrespective of the findings of a few episodes of n=1 bro science here and there. My confirmation bias is damn near set in stone.

So, with that intro, telling you upfront where my bias is and why, let me get to the Guyenet article. Which I almost hesitate to do since I don’t think it really matters much. A year or so ago, I read a paragraph in Scott Adams’s book that changed my mind about engaging in these kinds of things. I think it pretty much sums up the way things are:

“If your view of the world is that people use reason for their important decisions, you are setting yourself up for a life of frustration and confusion. You’ll find yourself continually debating people and never winning except in your own mind. Few things are as destructive and limiting as a worldview that assumes people are mostly rational.”

So, with that said, here I go:

I’m sure you’re aware of the big brouhaha that took place at AHS11 when Taubes questioned Guyenet during the Q&A after Stephan’s talk. It was kind of chicken shit in that it wasn’t just a Q&A where Gary got in line to ask questions like everyone else. Gary was speaking right after Guyenet (and Gary was the big star of the show) and he took the opportunity as he approached the podium to zing Stephan.

Later that night, Gary, Rob Lustig, and I (maybe you were there by then) were in the lobby of the hotel having a drink when Guyenet walked up. The first words out of Gary’s mouth were, “Stephan, I’m sorry I was such an asshole today.” Stephan blew it off as if there was nothing to it, and we all sat there chewing the fat.

After the conference, the internet went wild with the spat (if that’s what you want to call it) with all these people posting their iPhone versions of it and many of them, maybe most, taking Guyenet’s side. I think it was only then that Stephan thought he had been ill used.

Whatever it was, Guyenet seems to have had it in for Gary since. And it’s a shame since they were friends before. I actually met Stephan though Gary. I happened to be in Seattle, and Gary invited me to a dinner he threw there for Philippe Hujoel who had invited him to speak at the University of Washington. Gary also invited Stephan and a couple of other people I can’t remember. Now it’s blown up and Stephan has aligned himself with that troll Evie along with James Krieger, Alan Aragon and all the other Taubes haters. So, it doesn’t surprise me that he wrote the review he did.

In my view, he took a lot of disingenuous shots at the book. I’m assuming you’ve never read the book, but I have. A couple of times, in fact. Once in manuscript and again in galleys. It’s like all of Gary’s books. Informative, well-written, and fun to read. Even if you don’t agree with all of it. But I don’t see how you can take a hostile reviewer’s side without reading the book in question to see if the reviewer is on the mark or not.

Gary was straight up at the outset of the book in saying that he was making the case against sugar. It’s even stated in the title: The Case Against Sugar. Not that he was being even handed. Not that he was being unbiased. But that he was gunning for sugar, much like a prosecutor in a trial. He made the point that Big Sugar has a promotional arm that spends hundreds of millions of dollars to make its case—he is simply making the case for the other side. And he basically ends the book by saying he hasn’t made the definitive case—all he has to go on are observational studies and poorly done, short RCTs. To really determine if sugar is causative would require years of randomized controlled trials, which would be prohibitively expensive, and impossible to monitor. The short term trials have been kind of bad for sugar, but that’s all they are: short term trials. Gary admits as much. Guyenet seems to be trying to make it out that Gary is definitively saying all the evidence is in and sugar is bad, when that’s really not the case. He’s simply presenting the anti-sugar case.

(If you read anything that Big Sugar has put out in the last few years, they are making their case – such as it is – by saying that sugar is simply calories, nothing more, nothing less. It’s a calorie just like an apple or a potato or a strip of bacon. In their view, a 2,000 kcal diet of meat, squash, and blueberries would be equivalent to a 2,000 kcal diet of pure cane sugar.)

Gary starts by presenting a history of sugar and the sugar industry. He discusses how the Dept of Agriculture was founded in large part to promote large ag industries, one of which was sugar beets. He also points out how in the early days there was a revolving door between the Dept of Agriculture and Big Sugar, just like there is now between the FDA and Big Pharma. And he describes many of the techniques Big Sugar used to increase the use of its product.

Recent internal documents from Big Sugar have come to light and were just published in the JAMA Internal Medicine (attached) showing that the sugar industry did indeed influence and promote the idea that saturated fat was bad in an effort to deflect attention from themselves. They spent a ton of money underwriting Frederick Stare, Hegsted, Keys and others to push the notion that saturated fat was the devil and deflect the attention from sugar. (The lead author on this study was one of Gary’s research assistants, whom he paid to travel to Boston to gather the documents. After leaving Gary’s employ, she wrote the paper and went through the peer-review process to get it published.)

I’m not going to go down Guyenet’s list one by one, though I could, but there are a couple of areas I will mention in which I think he is stretching it more than a little to make his point.

One is in saying that restricting calories will reduce insulin levels. Well, yes, sort of. But not by any stretch of the imagination to the extent reducing carbs will. A metabolic ward study published in 1996 shows pretty clearly this isn’t the case. Subjects in both arms went on 1,000 Kcal diets (low-calorie diets by anyone’s estimation) for 6 weeks. One arm went on low-carb, the other on 45 percent carb (which compared to the ~55% carb in the typical American diet isn’t that high-carb). Those on the calorie-restricted low-carb diet reduced insulin levels by about 50 percent, whereas the ones on the 45% carb diet slightly reduced insulin, but not to a statistically significant extent. (see attached)

As to the mentions of Kevin Hall, suffice it to say that that whole situation is mired in controversy, which won’t be resolved for a long time. Even I wrote on it. There is gotcha history there, and Gary probably shouldn’t have hired Hall in the first place. We can discuss the whole affair over a brew sometime.

On the findings of metabolic ward studies, I had that go round with Colpo here and here.

And pointing the finger at the addictive qualities of sugar (should they exist – and Gary admits the jury is out on this) is not confirming the food reward theory. There is a real but subtle difference.

One of the questions Gary proposes is this: Is there an amount of sugar the consumption of which becomes deleterious for health? He reports on a number of researchers throughout the world who have asked this same question. If you look at sugar consumption per capita, people seem to be okay as long as the per capita consumption doesn’t exceed a certain level. I don’t have the book in front of me now, but, as I recall, these levels are in the 50-70 lbs/person/year, which is a helluva lot of sugar (I doubt that I consume five pounds per year, if that). When the people in a country start to exceed those levels of intake, though, diabetes starts to appear and increase at rapid rates. Gary didn’t make this up—he’s simply reporting the findings of other people.

One of the effects of the confirmation bias is that so many issues are never solved until the evidence on one side is so overwhelming that it has to be believed. It takes a long time for the evidence to stack up to that extent, though, so it takes forever for people to finally come together.

It can happen individually, as in the case of Tim Noakes, who is an internationally renowned sports doc. He wrote the early books on running and endurance exercise. Was a big believer in carb loading and wrote about it extensively. Until he developed diabetes. Then he tried low-carb, and changed his life.

It takes a lot longer for the profession in general, but it is coming around.

Anyway, many of Stephan’s criticisms would be on point if Gary hadn’t already admitted to them in the book, so they’re not really valid criticisms. It’s not like Gary is trying to pull the wool over anyone’s eyes.

~~~

In conclusion, it’s my view that the overall view of low-carbohydrate dieting is evolving, becoming more nuanced, actually. Perhaps kinder, gentler stances all around. I may be wrong and this may be wishful thinking. I do believe that people are gradually coming around—from all dietary perspectives—to view obesity and chronic disease as a multi-factoral problem. So, someone like me—biased towards modern industrial-engineered foodstuffs, ease and cost of acquisition—in being conciliatory toward LC, might say well, LC is generally the outer isle and that’s where most of the good food is. So, the chances are that a person doing LC will eat healthier, more nutritionally-dense food.

A calorie-counter, being conciliatory, might say that LC diets show promise because they can be generally more nutritionally dense (especially if weighted toward proteins and not fats), this curbs appetite, so people eat less.

The plant-based or vegetarian might say sure, you can absolutely do it LC style.

The paleo might say sure, LC is one of the many available styles of paleo.

And so on.

…Finally, I would ask that comments be value-add and respectful to my friend Mike, who graciously gave me permission to publicly post his private email because I thought it was an awful waste only for me, whether one agrees with its content or not. So, please be mensch.

Update: Mike has put this up in a post of his own, now, including an addendum.

Richard Nikoley

I'm Richard Nikoley. Free The Animal began in 2003 and as of 2021, contains 5,000 posts. I blog what I wish...from health, diet, and food to travel and lifestyle; to politics, social antagonism, expat-living location and time independent—while you sleep—income. I celebrate the audacity and hubris to live by your own exclusive authority and take your own chances. Read More

51 Comments

  1. […] Update: The Case Against Sugar And The Case For Low-Carb Diets by Dr. Michael Eades […]

  2. Hap on January 31, 2017 at 13:46

    Experience bias…..really? they used to call it…..live and learn. WTF

    BTW I started reading Stephan’s commentary on his blog page…..did not have time to get through it but what I did read was good stuff. Gary Taubes is now making a very nice living (thank you) slamming sugar unapologetic-ally (really in my spell check). I am conflicted because he is a science reporter (maybe) but not a scientist, so he gets to editorialize with all the bias until the cows come home . He should just say that he hates sugar and Big Sugar and Big Pepsi and all the evils of corporate America and whatever else he has on his mind and get it the fuck over with. Oh yea…and for good measure put Big Tobacco in there with Big Sugar.. How much more eeeeevilll can you get? Well…it does sell books. Sorry I did not think of it…Damn.

    • Richard Nikoley on January 31, 2017 at 14:25

      Well, people don’t write books on tobacco or make distinctions—such as the difference between home or organically grown without additives—and those things called cigarettes—because the “science is settled.”

  3. ramon on January 31, 2017 at 13:48

    Thank you and Dr Eades very much.

  4. Tom on January 31, 2017 at 14:25

    What a wonderful, thoughtful, and even-handed email. And in its way, a portrait of a wonderful friendship.

    Kudos, Richard.

    • Richard Nikoley on January 31, 2017 at 14:46

      Mike ought never waste that much on me, again.

      I called him on it. 🙂

  5. Mrs. Coffee on January 31, 2017 at 14:26

    Thanks for sharing this post. Dr. Eades is always good for thoughtful analysis and I’m glad he let you post the email. So many different schools of thought jockeying for position. Paleo, Low Carb, Fasting, Vegan, Pegan, Flexitarian, etc. I’ve spent the better part of my life trying to find just the right way to eat for health/weight loss/medical conditions. Ended up usually so confused I didn’t know which end is up (as I expect many people can relate).

    I’ve watched my husband run a 50 miler (and come in 3rd after a couple 20 year olds) while fat adapted where he couldn’t get past 30 miles previously without bonking on higher carbs. I watched my grandfather get rid of a 50 year tremor in his hand from trying Atkins only to watch it come right back when he started sneaking Oreos. Personally, an Atkins style with liberal protein made me feel crippled since I have AKU (it’s PKU’s arthritic cousin) which means I don’t process tyrosine/phenylalanine correctly.

    All this long winded yap to say that after near 45 years I’ve realized we’re all different and different things work for different people but excessive sugar doesn’t seem to be a plan that works for anyone. I won’t give up trying to find what works for me. I’m dealing with an ulcer at present and Perlmutter’s latest “Whole Life Plan” (75% plate veggies, 3-4oz of meat, some added fat) is keeping my stomach calm, my protein manageable, and my pants looser. When you have to avoid dairy, sugar, chocolate, alcohol, citrus, potatoes, peppers, etc. to keep yourself out of pain you find yourself on a pretty restrictive diet without trying.

    As far as his comments about low calorie affecting insulin levels, all I know is that when I (stupidly) ate 600 calories a day including two pieces of fruit I managed to stay in ketosis. Never achieved it on Atkins not even a little bit.

    • Richard Nikoley on January 31, 2017 at 14:39

      “I have AKU (it’s PKU’s arthritic cousin) which means I don’t process tyrosine/phenylalanine correctly.”

      https://freetheanimal.com/2014/12/acknowledge-ketogenic-recommend.html

      “Let me give you an aside.

      “Ever heard of PKU: Phenylketonuria? Well, when I was a kid, the only thing I knew about it was that Protein Kills U. See, I had a cousin not far from my age with that PAH gene mutation. His mom was so very diligent about his diet, 50 years ago. It was, essentially, a vegan diet that saved his life and brain (oh, NO!). Here’s what I recall growing up: Matt could never eat what we were all eating at any common family affair. I recall salads with tomato and cucumber, green beans, and fruits, mostly. When he was a teenager, he was over the hump and was able to eat normally. He’s still alive, 50-something by now. Has kids and grandkids.

      “Fucking YEA science!”

    • Richard Nikoley on January 31, 2017 at 14:56

      “As far as his comments about low calorie affecting insulin levels, all I know is that when I (stupidly) ate 600 calories a day including two pieces of fruit I managed to stay in ketosis. Never achieved it on Atkins not even a little bit.”

      That’s because ketosis is an extremely valuable survival/starvation metabolic pathway, primarily. But, it is clearly an acute pathway, never intended to be a chronic one. There are acute-chronic therapies that have hand’s down, therapeutic results, such as in epilepsy and other neuro disorders. But as an everyday lifestyle by mimic, where you get fat so high, and protein and carbs so low…?

      You can be in solid ketosis eating 1,500 kcal per day of sugar only. I think everyone ought to at least understand that. We had people—even keto dieters usually—try the potato only deal for a while. Thing about it is, hard for most people to eat more than 1,300 – 1,500 kcal per day, so I got comments like “finally I am in deep ketosis.” Potatoes only.

      Everyone needs to understand this.

    • Mrs. Coffee on January 31, 2017 at 15:06

      That’s fantastic that he got past it. AKU doesn’t really hit you other than the black urine until you get closer to 40. Now, I’ve got arthritis and blue ear cartilage, c’est la vie. The doctor I spoke with about it at the NIH absolutely did NOT recommend veganism since there’s plenty of tyrosine in plants/beans so I can’t really avoid it anyway. Even talked to Caldwell Esselstyn (he called me personally) and as out and proud plant based as he is, he said vegan eating wouldn’t do a thing for my issue.

      The drug Nitisinone is in clinical trials overseas….bit leery of taking an herbicide and as with many drugs the side effects sound worse than the arthritis. There has been one case of someone being accidentally cured via liver transplant for another ailment.

      Oh well, it’s a weird deal.

    • Mrs. Coffee on January 31, 2017 at 15:10

      Oh, and I did find that after eating way too little for way to long, potatoes were fantastic for bringing my temperature back up with zero blood sugar swing issues. Sadly they are ripping my ulcer a new one right now for some reason…even plain/boiled.

    • Hap on January 31, 2017 at 16:45

      Molecular biology…..is a funny thing. All I can say is that there are a large number of folks who benefit long term from a LCHF kind of diet. Whether or not you can be in ketosis eating potatos….well if Richard says so I am no position to dispute it.

      There is a new article out today in Circulation concluding that “skipping breakfast” causes HTN, stroke, CVD, ED, and financial decline(kidding). If you actually read it there are some very interesting results right up front about intermittent fasting and meta analysis of studies showing improvements in just about every standard marker including decreased insulin, blood, glucoses, lipds (except increased HDL) and on and on.

      Skipping breakfast on the other hand is “epidemiologically” associated with tobacco use, alcohol abuse, obesity, and shitty diets….for which I cannot find that they controlled…but maybe they did somewhere….it’s freakin 27 pages.

      I think some combination of lowering carbohydrates to reasonable levels, moderate protein, and some good fat, along with intermittent fasting…..is a legit lifestyle. Forcing chronic ketosis is probably excessive unless you need a severe intervention , which when goals reached, should be modified while watching closely. You need to lose “50”…do ketosis cuz it will probably work but so might something else. Be prepared to put on the brakes some..

  6. Ron Culbertson on January 31, 2017 at 15:08

    Love the quote, “The stupid are cock sure while the intelligent are full of doubt.”. I used to be full of doubt, but now am stupid. After having FH and cholesterol of 400, incurring four heart attacks, two open heart surgeries, a stent, angina, dietary interventions and pharmacological interventions, none of which stemmed my declining health situation, I came to the conclusion that CVD was really a form of diabetes – Gary’s book, Why We Get Fat, helped me along that road. About two years ago, I ran into some research by Dr. Joseph Kraft. That confirmed it for me and since then, going very low carb has improved my health immensely. The angina, which I had to deal with every day for thirteen years has diminished to the point l’ve been able to exercise again, and now can cycle 25 to 30 miles every other day. Started lifting weights too, and can now do four sets of ten chin ups or more, the hard way. N=1 and call me stupid, but you won’t change my mind. When Guyenete goes through what I’ve been through, he might get stupid from another point of view. I’ll add a favorite quote of mine, ” You never know when the lunatic fringe will become the cutting edge.”

  7. thhq on January 31, 2017 at 19:37

    I don’t have enough energy to be argumentative, so I’ll just make a couple comments.

    Being active covers a whole host of dietary sins. 10,000 Steps is probably the easiest way to start.

    http://dailyburn.com/life/fitness/10000-steps-a-day-health-benefits/

    None of the dietary gurus, other than Cordain, puts a major emphasis on this. But calories-out has a lot to do with forcing metabolism to increase. And when you need 500 more calories a day one macronutrient is often as good as another.

    Dr. Eades made a comparison a decade ago between Ancel Keys and Jack Lalanne, both of whom lived very long and healthy lives eating lots of carbs. Both of them were also very active until late in life. If eating a lot of carbs is not optimal, their activity offset any macronutrient advantage IMO.

    It’s a lot easier to go on a diet than ride a bike 20 miles a day each and every day. That’s the problem. All the theories and diet plans in the world do not result in the same HEALTH benefits of going for long walks.

    Finally, before his sugar diatribes, Dr. Yudkin wrote a book on low carb dieting in the late 1950’s. This Slimming Business is well argued, well illustrated and concise. The principle behind it is carb counting, with emphasis on reducing high glycemics. None of what came after in low carb dieting – from Atkins to Taubes – can hold a candle to it.

    • Richard Nikoley on January 31, 2017 at 20:04

      Dude,

      I’ve seen you perturbed many times over Mike’s comparison of Keys and LaLane.

      Thank you, sir, for keeping it the value-ad context I requested. So mensch.

    • thhq on January 31, 2017 at 20:17

      Yeah I didn’t want to go there. Eades fired me up to read both Keys and Yudkin. That was a good thing.

    • Tom on January 31, 2017 at 21:49

      I thought Eades made the point that Lalanne did not advise many carbs. And that’s what the Lalanne video seems to show (aside from suggesting a glass of orange juice and a slice of toast with breakfast, it’s all meat, fat & veggies.)

      By the way, Lalanne’s son Jon Allen went to the same school as I did, and in fact he rode the same school bus route home, so we dropped him off at the Lalanne house in the Hollywood hills every afternoon. Lalanne’s kid was famous at my school for eating all the crap food he could get his hands on when he was away from home, because what his parents fed him was so scrupulously healthy.

    • Richard Nikoley on January 31, 2017 at 21:58

      Haha. So common. The best parents fall prey. Don’t teach, enforce.

    • Hap on February 1, 2017 at 12:26

      Jim FIxx was active…….look what it got him. Just sayin….. Nothing against action.

  8. Hap on February 1, 2017 at 11:28

    Sassysquatch….this is for you…and me. Not Eades or Taubes….but the Great Fung! And he even shows love for Denise Minger….as has Richard.

    As usual, Devil is in the details.

    • sassysquatch on February 2, 2017 at 03:21

      Yes, I like Fung’s research about fasting. But I believe that Fung slants towards
      a low carb diet bias (correct me if I’m wrong). I certainly don’t plan on going
      on the Rice diet, but just more proof that sugar may not be the Devil it is
      purported to be. Ray Peat – where are you when needed??

  9. Mark j on January 31, 2017 at 20:50

    Awesome. Love intellectual honesty and hate it’s opposite. That he can honestly both identify and publicize his biases is fantastic.

    Great post and than you to Dr. Eades.

    • Richard Nikoley on January 31, 2017 at 21:00

      I agree. It’s so fantastic.

    • Mark J on February 1, 2017 at 08:55

      It’s inspiring me to re think my own biases and at least be able to more clearly identify them.

  10. Hap on January 31, 2017 at 21:17

    So are we now back to Sears and “The Zone”?

    • Richard Nikoley on January 31, 2017 at 21:25

      Reasonable connection, but not sure why someone would buy the book and follow the protocols (I read it by the pool in’94).

      OTOH, coming full circle has a value unto itself. Read Atkins’ original book, for example.

    • Hap on February 1, 2017 at 09:42

      ” Read Atkins’ original ”
      Ithink that’s a plan. I might go back to Sears as well.

  11. Hap on February 1, 2017 at 13:35

    Here is the Fung /Minger analysis of Pritikin

    • thhq on February 2, 2017 at 03:54

      I’ve enjoyed reading this nugget for a while now.

      From Jim Fixx to Adele Davis to Pritikin and Atkins, health gurus have a tendency to die at relatively young ages. Fixation on the “one good thing” doesn’t look like the best plan to live long and prosper. As Guyenet notes in his critique of Taubes it’s a multifactorial problem.

    • thhq on February 2, 2017 at 03:41

      What makes me skittish about Pritikin is his suicide at 69. I’m just as skittish about Atkins and his heart problems, and the shading of evidence surrounding his death (which looked like heart failure edema to me). I don’t see these issues with either Keys and Lalanne, so have spent a lot more time focusing on what they did right rather that on what the others did wrong.

      And I credit Eades for bringing them to my attention.

    • sassysquatch on February 2, 2017 at 05:57

      Don’t overlook McDougall – 70 years old, slim, trim and healthy. Or Esselstyn
      and T. Colin Campbell (China study) both 82 + years old, slim, trim,
      active and healthy. All WFPB, low protein, low oils, high carb.

    • Mark J on February 2, 2017 at 08:27

      also don’t overlook Clarence Bass (moderate diet, whole foods, lowish fat, moderate protein and animal sources) and Art DeVaney.

      I’d take those two well before Campbell or the others. Of course, I doubt the others are doing any serious strength training, unlike Bass and DeVaney.

    • thhq on February 2, 2017 at 09:37

      And then there’s Jean Nidetch, founder of Weight Watchers, who lived to 91. Calorie counting didn’t shorten her life.

  12. Jim on February 1, 2017 at 06:50

    I found your site and Mark’s Daily Apple back in 2009 and lost 50 lbs doing LC paleo. The only reason I stopped was because I got into powerlifting and my body started screaming at me for carbs. I still recommend low carbs to any non-lifter that asks me though. That shit works.

  13. Tim Steele on February 1, 2017 at 09:38

    I’m in the “anything is better than SAD” camp. LC works great for weight loss when learning to avoid SAD staples of sugar, oil, and wheat concoctions. I’ve been following these discussions on LC eating since 2010. Sadly, I just do not see LC helping that many people long-term. Just read the online forum journals on any LC blog/website. You’ll see journals that were started in 2007 or even earlier, that always start out with high hopes and great weight loss. Many “before and after” shots that look amazing… But then the people fall off the wagon and regain, leading to several years of frustration and major weight regain following a weekend of off-plan eating.

    I was reading a random journal on a certain LC forum, here are some excerpts from one man’s journal. The internet is full of journals exactly like this, but most people are interested in Week 1 results, not Week 260. There are few people that actually “make it” and reverse obesity and achieve long-term weight maintenance in a healthy range. It may be possible to get this with LC, but usually it involves exploring other eating options when LC quits working and involves adding back nasty carbs like the original Atkins recommended:

    5/2007 – “I’m 27 years old and weighed 340 lbs when I started the Protein Power plan. My sister-in-law is a nurse and had suggested the plan to me and my wife when we were asking her about some health advice. She had a copy of Protein Power that she let us borrow and suggested we give it a 90 day trial to see if we could keep it up. We’ve since bought a copy of Protein Power Life Plan and are working our way through it.

    The first week or so was great, whenever I checked the scale I found I was losing weight. I dropped a quick 6 lbs and had visions that the rest of it would melt off just as easily. In retrospect, it was probably all water weight. I wasn’t feeling too good at first and realized I wasn’t getting enough potassium which was solved with a daily multivitamin. The difference in how I felt was amazing, such a simple thing that potassium.”

    5/2008 – “While the scale is offtrack this week, I’ve been noticing other differences.
    Some days I have to tighten the belt in a notch. Other days are fine on the regular notch. Once I sink back down towards my low from the post-low bounce, the new notch will probably be around to stay.
    The other day I did end up buying some clothes (don’t think I’ve talked about this yet). I’ve worn 3XL in shirt size for a while. I will admit that I usually wear my clothes kind of baggy so I’ve probably worn it longer than I needed to. Anway, my goal was to find some 2XL shirts either as motivation (something I’ll wear when I get there…) or to get some shirts that fit better (something I’ll wear now).”

    9/2009 – “Even with the weight I’ve lost, I don’t actually feel any different. I can see a difference when looking at old pictures or old clothes that don’t fit anymore, but my self-image is identical. According to BMI I’ve gone from morbidly obese to merely obese. So instead of really really overweight, I’m just really overweight. *shrug*”

    11/2011 – “Still moving in the right direction. My goal is to take November (historically bad weight loss month) lose more than I’ve been averaging lately. I’m not saying I won’t cheat a little around Thanksgiving but if I do I’ll do it in a gluten-free way. Yes, Wheat Belly really did shift my attitude that much.”

    1/2013 – “I think it helps that I’m not just viewing it as a diet but rather the cliched “lifestyle change”. Besides being happy with what I’m eating I really bought into the science behind why this is a healthier way to eat. If weight loss were my only goes I would have bailed during the 22 month plateau. What’s funny is that one of the things I was most worried about for the longest time was maintenance. With some of the stalls I’ve had it was effectively maintenance and I stuck to it so maintenance doesn’t concern me anymore.

    At this point I don’t honestly expect to ever hit my goal weight. I’m making a big push right now to hit 240 for milestone reasons but beyond that I expect I’ll cruise along with a rare new low here and there. When I no longer have an attainable goal in sight I expect it’ll be more of a struggle and I fully intend to lean on the folks here to help ”

    4/2016 – “Weight: The slide cointued. This morning it was at 325. The only positive is that when I started lowcarb in 2007 it was 340.

    Health: As I put the weight back on I got achille tendinitis due to having a short achilles. This has really slowed me down.

    It’s been a struggle. It’s hard to keep my willpower up when I’m not seeing progress which turns self-defeating pretty quickly. And while struggling I tend to stress eat which is also a losing situation.”

    • Tim Steele on February 1, 2017 at 10:00

      Here’s a journal that spans a full 6 years…read the first and last pages. Then look at other long-running journals and compare the beginning stages to many years later. LC leads to a lifetime of struggle and obsession for many people. Fueled by promised that if they “LC harder” they will finally be successful.

      Pg 1, Jan 2011 – excerpt: “…I mostly eat meat, vegetables and fruits with a tad dairy, dark chocolate and minimal alcohol. I have now begun to include small portions of potatoes, yams and rice in my regular eating but only a few times a week. ”

      pg 154, Jan 2017 – excerpt: “… I’ll do my best with lowering carbs and more activity.”

      And in these 7 years, a net gain of 12 pounds.

    • Hap on February 1, 2017 at 09:49

      that’s frankly depressing……..
      Well…..we work on healthy eating assiduously. However, there are temptations. My wife recently bought a bag of Oreos. Not for her…for me. At first I wondered what beef she might have with me. I opened the bag and ate one. Haven’t had another for a month. Now those Oreos have “aged” appropriately to that soft and stale version that can’t be resisted.

      Life is about avoiding The Sirens. I know of no Panacea.

    • sassysquatch on February 1, 2017 at 10:15

      I agree Tim. Most of us have been the low carb route at one time or another.
      The initial weight loss was great. But the health benefits (long term) are questionable
      at best. Give me carbs, starch and fiber (WFPB) and I’m a lighter, happier and healthier
      camper.

      Can Dr Eades or Mr Taubes explain why the ‘Kempner Rice Diet’ works so well for
      weight loss and disease reversal? The diet consists of white rice, fruit, fruit juices
      and table sugar…….talk about high carb!!!!!!!

    • thhq1 on February 1, 2017 at 12:26

      I’m into week 520 Tim. I’ve regained 10 lbs of the original 50 pound loss, and it’s been intentional to get lost muscle mass back.

      At the outset, I used carb restriction AND calorie restriction. But after the first 25 lbs was gone I added carbs back and kept losing at 2 lbs a week as I ramped up walking and biking to get weight burn. My waistline dropped 6″, but so did my chest, and my arms and shoulders got gaunt. Somewhere along the line I ruptured tendons in my rotator cuff. My shoulder strength was probably the cause – I couldn’t swing an axe like I did when I was heavy. For the last 3 years it’s been strength training without the rigid adherence to maintaining 50 lbs weight loss. My waistline hasn’t increased.

      What I see among dieters is a lack of long-term intent. You have to keep doing it every day for the weight stay off. People don’t seem to care enough develop healthy habits.

  14. Hap on February 1, 2017 at 11:22

    I would be truly surprised if I lost weight or changed my biomarkers for the better by drinking fruit juice, eating rice, and gulping table sugar. However, if you ever run into a diet that prescribes donuts, pizza, and oreos, lattes…….by all means pass it along. I do not eat at any fast food chain operation so I could be a good control for such a diet.

    • Tim Steele on February 1, 2017 at 11:32

      Of the choices, pizza could be do-able, ie. http://nypost.com/2016/01/27/how-i-lost-nearly-100-pounds-eating-pizza/

      And, even on the Potato Hack, pizza is a possibility! https://potatohack.com/2016/09/06/potato-pizza/

    • thhq1 on February 1, 2017 at 12:32

      I had a slice of thick crust pepperoni today for lunch. And a glass of Tamarack Firehouse Red.

      Gary Taubes doesn’t seem to understand that the obesity problem is in the portion size and what you do with it afterwards. Going outside this afternoon, getting on the bike and riding 10 miles.

    • ramon on February 1, 2017 at 17:23

      I am so going to make the potato flat bread.

  15. Hap on February 1, 2017 at 11:57

    Tim…..regarding the Pizza.

    From the article
    “I’d eat 10 or 12 [Oreos],” recalls Cozzolino, who later moved to the East Village’s Ribalta pizzeria, where he’s now the executive chef. “One time I even ate the whole box. It was like a drug for me.”

    YOu see…I told you..it’s the fucking Oreos.!!!! And they are right here in my house….right now.

  16. Hap on February 1, 2017 at 11:59

    BTW…whatever happened to Ornish and Pritikin?

    • thhq1 on February 1, 2017 at 12:40

      Pritikin and Atkins both expired at about the same age of 70. That’s convincing evidence to me that they were both wrong. Keys and Lalanne both lived to about 100, which is convincing evidence to me that they were doing things better than Pritikin and Atkins.

      And my dad lived to 88 eating cookies, white bread sandwiches, Applebees, collecting rocks and traveling as much as he could. That’s the baseline I’m trying to improve on. Pritikin and Atkins would be regressive.

  17. Hap on February 1, 2017 at 12:43

    Look …in this age of glucometers everywhere and easy testing to see what happens to your blood sugar after eating whatever, it’s pretty hard to claim that sugar does not cause sugar spikes or that rice or potatoes don’t either. I’ve done it after potatoes hot and cold. There seems to be a difference, at least for me. Anyway, if you are inclined to the issue of glucotoxicity , then this has to be a wakeup call. How does the glucose spike resolve?…..well….Insulin, for the most part.

    Maybe under certain circumstances you could lose weight while eating whatever the hell you want, perhaps as long as it isn’t much. You might be able to get away with sugar spikes but I doubt it is the healthiest thing. You might never get or make worse your diabetes…but don’t bet on it.

  18. kris on February 2, 2017 at 09:16

    Thanks Richard. I have tremendous respect for Eades and love to read what ever he has to say. It was big of him to let you present his email although it obviously stands to defend his friend and colleague and perhaps his own convictions. However, I don’t understand his pot-shot at Guyenet, “Guyenet seems to be trying to make it out that Gary is definitively saying all the evidence is in and sugar is bad, when that’s really not the case. He’s simply presenting the anti-sugar case.” Correct me if I am wrong, but aren’t the previous two statements saying the same thing?

    I remember Taubes stating in the closing synopsis in one of his books that the morbidly obese were pretty much doomed and the only possible attempt to fix things was a diet as close to zero carbs as possible. Eades does admit that obesity and disease are multi-factorial problems. Perhaps good health is multi-factorial as well? So much for occam’s razor theory in science. Science writers always tout that correlation doesn’t equal causation but it does get factored in to simple science especially when self serving. I used to love reading about health and science and guess I still do although now believe published science to be too biased to be trusted.

  19. Martin Archer on February 3, 2017 at 11:11

    John Arnold Made a Fortune at Enron. Now He’s Declared War on Bad Science. He invested money in Taubes’ non-profit:

    “…the Arnold Foundation made a $4.7 million seed grant to the Nutrition Science Initiative (NuSI), the nonprofit Taubes cofounded to support fundamental research on diet and health. The next year the Arnolds promised $35.5 million more…”

    https://www.wired.com/2017/01/john-arnold-waging-war-on-bad-science/

    • Richard Nikoley on February 3, 2017 at 11:19

      Read that the other day. Enjoyable piece, actually.

      Anyway, I was told this morning that he’s no longer funding NuSI. Would make sense, given the nowhere results, as I judge them. But I have not verified the claim that their funding had dried up.

  20. […] the other day, I signaled a bit of conciliation towards low-carb diets that, depending on your point of view, may sound like backpedaling, refining the message, or […]

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