The Blog of Michael R. Eades, M.D.

You think carbohydrates aren’t addictive?  You think it’s easy to give them up?  You don’t think it possible that people might prefer carbs to life?

Think again.

A story appeared in the online version of Time Magazine last year that I read when it came out, put aside to blog about later, then got sidetracked.  A reader sent me a link to it a few days ago, which brought it back to the front of my mind.

The article discusses a study being done in Germany using a carb-restricted diet to fight cancer.  In pre-WWII days, a German scientist, Otto Warburg, received a Nobel Prize for his work in sussing out the fact that cancer cells don’t generate energy the same way that normal cells do.  Cancer cells get their energy, not like normal cells, from the mitochondrial oxidation of fat, but from glycolysis, the breakdown of glucose withing the cytoplasm (the liquid part of the cell).  This different metabolism of cancer cells that sets them apart from normal cells is called the Warburg effect.  Warburg thought until his dying day that this difference is what causes cancer, and although it is true that people with elevated levels of insulin and glucose do develop more cancers, most scientists in the field don’t believe that the Warburg effect is the driving force behind the development of cancer.

But it stands to reason that it can be used to treat cancer that is already growing.  Since cancers can’t really get nourishment from anything but glucose, it stands to reason that cutting off this supply would, at the very least, slow down tumor growth, especially in aggressive, fast-growing cancers requiring a lot of glucose to fuel their rapid growth.

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I had a question from a friend today about migraine headaches. I remembered reading about them in Dr. Larry McCleary’s new book The Brain Trust Program, so I thumbed through the book to see what he had to say. (I had read the book in manuscript form, but couldn’t remember the specific recommendation for migraine headaches.) I became engrossed in the material all over again, and after a couple of hours of reading it dawned on me that I hadn’t reviewed the book for this blog.

First, a bit of disclosure. Dr. McCleary is a good friend of mine as well as a business partner for a number of years. And MD and I wrote the Introduction to his book. But we didn’t write it because he was a friend and partner, but because the book is so good.

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Based on the number of comments I get and the number of questions that come through the email on our website, it seems that there is much confusion about the interplay of calories, the caloric deficit, weight loss, and weight gain. I’ll use this space to expand on my views of these complex and confusing issues.First, let’s look at a concept that will help explain a lot. It’s a concept that Gary Taubes explores in great detail in his book Good Calories, Bad Calories, which, by the way, is available now. (Grab a copy and spend a fascinating couple of days poring over it. The rewards will be immense.) The concept in question is interpretation of the energy balance equation, which looks like this:

ΔWeight = Calories in - Calories out

What this equation basically says is that the change in weight (ΔWeight) equals the number of calories consumed minus the number of calories burned off in the process of daily living.

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Since posting the piece on ketone bodies and their causing breathalyzer problems I’ve had enough comments and emails to make me realize that there are probably many people unsure of what ketones really are, where they come from and why. Let’s take a look at the goals and priorities of our metabolic system to see what happens. I’m going to try to keep the biochemistry to a minimum, so fear not.

The primary goal of our metabolic system is to provide fuels in the amounts needed at the times needed to keep us alive and functioning. As long as we’ve got plenty of food, the metabolic systems busies itself with allocating it to the right places and storing what’s left over. In a society such as ours, there is usually too much food so the metabolic system has to deal with it in amounts and configurations that it wasn’t really designed to handle, leading to all kinds of problems. But that’s a story for another day.

If you read any medical school biochemistry textbook, you’ll find a section devoted to what happens metabolically during starvation. If you read these sections with a knowing eye, you’ll realize that everything discussed as happening during starvation happens during carbohydrate restriction as well. There have been a few papers published recently showing the same thing: the metabolism of carb restriction = the metabolism of starvation. I would maintain, however, based on my study of the Paleolithic diet that starvation and carb restriction are simply the polar ends of a continuum, and that carb restriction was the norm for most of our existence as upright walking beings on this planet, making the metabolism of what biochemistry textbook authors call starvation the ‘normal’ metabolism.

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