I’m going to tell you about the best low-carb book I’ve ever read. In fact, it’s exactly the book I wish I had written myself.  And I’ll tell you why I didn’t in a bit, but first I want to clear up a few misconceptions I may have spread in my last post.

I get feedback on the posts I write from three sources.  First, MD looks at them and tones them down if I’ve gone off on some sort of political tangent or if I’ve scattered in a bit of too colorful language.  After she gives me the go, I put the posts up and wait to see what the commenters have to say.  The third source for feedback is my friends, some MDs and/or PhDs and some not, who pick up the phone and call me.

MD okayed what I wrote. The readers who commented seemed to realize what I was trying to say.  But the phone calls were a different story.

One friend called to say she had been low-carbing since Jan 1, and when she read my post she became so depressed she almost quit.  “How can you tell people it’s hard,” she said.  “It’s the easiest thing I’ve ever done. I can eat till I’m full.  I’m losing weight; I’m losing the water I’ve been retaining; I feel great.  What a downer that post was.”

I heard different versions of that rant from three other people.  They all wanted to know why I would be idiotic enough to put up such a post right at the time everyone was trying to commit or recommit to losing weight.  Depressing was a word everyone used.

I guess I got off easy with the written comments on the blog.

I didn’t really mean for the post to be a downer.  Really.  I wanted to tell people who might be struggling to lose that MD and I fall prey to all the same problems.  We gained weight over the holidays.  We are back on the straight and narrow.  I was trying to say that we were right in there with everyone else working away to reestablish our own thinner selves.  (In fact, we’ve made great progress in the week or so we’ve been on the plan.)  I just wanted people to be aware that long-term weight loss requires effort and constant vigilance.  And to view the process as a life change and not a quick one-time fix. My goal was to get people to recommit seriously, not to depress them.

Obesity is a medical problem caused by a damaged metabolism, which is why one person, without the damage, can eat the same foods without gaining weight that pack the pounds on someone else.  Once you realize you have the underlying problem that leads to obesity, you simply have to recognize that you have to deal with it for the long term.

Let’s look at it in terms of another medical problem: high blood pressure.  For argument’s sake, let’s ignore the fact that about 80 percent of cases of high blood pressure can be reversed with a low-carb diet, and let’s just assume that the case we’re talking about is responsive only to high blood pressure medication.  If you were the patient with the high blood pressure, and I gave you a pill that brought your blood pressure down to normal, you would consider the medication effective.  Would you then say, Hey, my blood pressure is normal, yippee! now I can quit taking the medicine?   I doubt it.  You would say, Great, the medicine is working.  Furthermore, if you quit taking the medicine and your blood pressure went back up to what it was before you started taking the medicine, would you say the medicine didn’t work?

Of course not.  Your high blood pressure was kept in check with the medicine, and your BP, not surprisingly, went back up when you quit taking the medicine.  The medicine itself was effective.

Same thing with dieting.  If you have an obesity problem that responds to a low-carb diet and you lose to your target weight, then go back to your old way of eating and gain your weight back, it isn’t the low-carb diet’s fault.  You have a problem that responds to a low-carb diet, and you pretty much have to stick with a low-carb diet (although not in nearly as extreme a structure as when you are trying to lose) for the long haul.

Having said all that, I can tell you that in my experience there is nothing that helps people lose weight more quickly and with less deprivation than a good quality, whole food low-carbohydrate diet.  You don’t have to be hungry.  You can eat rich, delicious foods, you’ll get rid of heartburn, drop your blood pressure, ditch excess fluid, and feel remarkably better.  You’ve just got to hang in there until you lose what you need to lose (which process you can speed along if desired with a little Metabosol), then you can loosen up and start adding some of the foods you’ve been foregoing.  And continue to eat them in moderation on maintenance.

Virtually all the studies in the medical literature show that at worst the low-carbohydrate diet equals the low-fat diet in all parameters and at best completely leaves it in the dust.  As far as I’m concerned, there is no faster, safer, more delicious way to lose weight. Hell, a study was just presented recently showing that women who did low-carb just two days a week lost almost twice as much weight as women following a calorically-restricted Mediterranean diet daily.  So, to be clear: Is weight loss tough?  Sure.  Is it easier when you cut the carbs? Absolutely! Low carb rocks!

Which brings me to the book that started this post.  In my opinion, The Art and Science of Low Carbohydrate Living is simply the best how-to book on low-carb dieting ever written.  As I wrote above, it is the book I wish MD and I had written.

The reason we didn’t write it is because a) some of this information wasn’t available when we last wrote a book (much of it is now available thanks to the work of Drs. Volek and Phinney), and b) no mainstream publisher would pay an author for this book.  If a mainstream publisher would buy it, the editor would force the authors to change it.  What do I mean by that?

All books fall into different genres, as they’re called in publishing.  One genre is diet/nutrition books.  So if you come to a publisher offering a diet/nutrition book, it gets pigeonholed into that genre and has to conform structurally to that genre’s standardized format.  Editors of mainstream publishing houses believe that the great mass of readers of nutritional books are not very bright and so have to be served real scientific information in small, small bites and not very many of them at that.  So the genre formula for a diet book is to have the actual diet regimen way up front because these editors don’t believe the readers of these books are smart enough or patient enough to wade through the explanations of why a particular diet works in order to get to the plan.  They want the plan up front within the first couple of chapters so people can get started without really having to read the book.  They also want a ton of recipes and meal plans to fill up the last half of the book.  Squeezed in between the plan and the recipe section is where they want to meat of book cubbyholed, and, in their view, with as little science as possible.

MD and I fought this structure tooth and toenail with Protein Power and ended up beating our editor down by agreeing to write a summary of each chapter called The Bottom Line that explained what each chapter said in non-scientific terms.  (Fortunately, we’ve been able to use this strategy in most of our books.) We worked well with our first editor, but we ended up in the hands of another editor when the paperback came out.  Editor Number Two hated all the stuff on the Paleolithic diet and the data from the ancient Egyptians.  This info was the first time in the popular press that the pre- verses post-agricultural diet was used as an argument for low-carb dieting.  And she wanted to ditch it from the book.  We went postal on her, so she ended up agreeing to leave it but only if we buried it in the very back of the book as an Epilogue.  That was one of the chapters of the book I wrote, and I thought it was pretty exciting information.  So, apparently did many others. But not this editor.  Sadly, she is not unusual.  Most want to conform to the genre.

Drs. Volek and Phinney self-published their book, and, as a consequence, could write it however the flip they wanted.  It is extremely well written and suffers none of the usual flaws of a self published book.  And it lays out the rationale for a low-carb diet as the treatment of obesity and other related disorders in a linear fashion instead of adhering to the typical diet book format.

As I finished writing the above paragraph, I clicked over and checked for comments on my latest post and found one with the following line:

This low-carb world can be a lonely place if one needs a navigator…

I can think of no better navigators than the authors of this book. Both of them have done a large part of the hardcore research on low-carb dieting that is in the medical literature today.  Go to PubMed and enter Volek JS or Phinney SD in the search window, hit ‘Search,’ and you will be rewarded with more peer-reviewed scientific papers on low-carb dieting than you will have time to read.  Many of the experiments described in these papers are explained in easy to understand language in their book.

Disclosure: Both Dr. Volek and Dr. Phinney are friends and colleagues of mine.  But they did not send me a copy of their book for review.  I purchased it from Amazon and paid the full price of $29.95 (it is now $19.95).  I bought it months ago and carried it with me all over Europe and on a half dozen other trips since but didn’t have time to even crack it until I was on the last leg back from our holiday trek.  It sounds cliché, but I couldn’t put it down.  I read and annotated the entire book over the course of two long flights.  Virtually anything anyone could want to know about the science behind low-carbohydrate dieting can be found in this book.

I’ll give you just one example.  It is common knowledge among many nutritionist, doctors and journalists that saturated fats are bad for us.  Most believe eating saturated fats leads to higher levels of saturated fats in the blood, which they inevitably describe as ‘artery-clogging saturated fat’.  Drs. Volek and Phinney, who certainly don’t believe this nonsense, understand adaptation to a low-carbohydrate diet changes the way the human body metabolizes different fats.  Eating more fat on a low-carbohydrate diet speeds up the burning of fat in general and saturated fat in particular.

There are only three things the body can do with saturated fat from the diet (or saturated fat made from dietary carbohydrate — and, yes, the body can and does make saturated fat from dietary carbohydrate).  It can burn them, store them, or convert them to a mono-unsaturated fat.  When people go on low-carbohydrate diets, they reduce their insulin levels, which in turn allows fat to escape from the fat cells to become the body’s primary fuel.

But what happens when a person increases saturated fat intake as part of a low-carbohydrate diet?  Drs. V & P knew that saturated fat burning would increase, but would enough burn to offset the extra amount of saturated fat coming in as part of a high-fat, low-carbohydrate diet?

To find out, they put 20 subjects on a low-carbohydrate diet for 12 weeks and another 20 subjects on a low-fat, high-carbohydrate weight loss diet for the same length of time.  The subjects in the low-carb group consumed three times the saturated fat per day (36 g vs 12 g) as did those in the low-fat group.  The blood from the subjects in both groups was then tested to determine total triglyceride level and specific fatty acid composition.

What did the good docs find?

In the serum samples done at baseline and again after 12 weeks, serum triglycerides  in the low fat group went from 187 to 151 mg per 100 ml, a tidy 19% reduction.  But in the low carb group, the before and after values were 211 and 104, a whopping 51% fall.  Both visually (just looking at the numbers) and statistically, the low carbohydrate group had a much greater (better) reduction in serum triglycerides.

The above should come as no surprise, because everyone knows that a low-carb diet reduces triglyceride levels.  But what about the amount of saturated fat in the blood?

As a proportion of the total, the low carb group had 33% saturates [saturated fatty acids] at baseline and 29% after 12 weeks, whereas the low fat group started at 30 and ended at 29%.  So after 12 weeks of dieting, the proportion of saturated fats in the blood triglycerides was the same for both groups despite the fact that the low carb group was eating three times as many grams per day of saturated fat in their diet.

But there’s more.  Because the low carb group ended up with blood triglycerides of 104 mg per 100 ml compared to the low fat group’s 151, they actually had about 30% less total triglycerides circulating in their serum.  So although the two groups had similar relative proportions of saturates, this means that the absolute serum content of saturates in the low-carb group was 30% lower than the low fat diet group.  So what we found, in a nutshell, is that despite a higher intake of saturated fat, the proportionate blood level of saturated fats did not increase, and their absolute levels fell dramatically with the low carbohydrate diet.

The bottom line on this point is that when our metabolism adapts to a low carbohydrate diet, saturated fats become a preferred fuel for the body, and their levels in blood and tissue triglyceride pools actually drops.

To summarize, a three times higher intake of saturated fats leads to a 30% drop in saturated fats in the blood of those following a low-carb diet as compared to those following a low-fat, high-carb diet.

Which means, of course, that if you want to decrease the artery-clogging saturated fats (should that be what you want to call them) in your blood, a low-fat, high-carb diet, the very diet almost every health care professional recommends for the job, isn’t the way to do it.  All you have to do is simply follow a low-carb diet.

The description of what happens to saturated fats in the blood during a low carb diet took two pages out of a 300 page book, so you can imagine how much content the entire book contains.

There is so much invaluable information in this book that I’m having to fight back the impulse to quote the whole thing.  You’ll learn

why you need more sodium on a low-carb diet and why the sodium prevents lean tissue loss,
why you need to increase fat intake during maintenance,
why a low-carb diet decreases inflammation,
why the low-carb, high-fat diet improves gall bladder function,
why excess carbohydrate converts to saturated fat and how,
what all the lipid parameters mean and how they’re affected by a low-carb diet,
and what the Paleolithic evidence tells us about diet.

And this list is just scratching the surface.  As I read this book, I kept marking parts that I needed to use for this blog.  In going back through, I would have to practically reprint the whole thing to give you just the important parts because the entire book is a gem.

Unlike most traditional diet books, The Art and Science of Low Carbohydrate Living doesn’t contain a lengthy section on how to execute a low carb diet.  There are plenty of books out there – some written by MD and me – that do that.  The book does have about 10 pages of the authors’ favorite recipes for low-carb foods and a seven day meal plan incorporating many of these recipes. (Another disclosure:  The authors recommend Protein Power as a good book on low-carb dieting, but I would have written this review the same had they never mentioned our book.)

The strength of this book isn’t in its meal plans and recipes, although those are delicious, it is in the wealth of information about all aspects of low-carb dieting.  If you have a question, almost any question, about any facet of low-carbohdyrate dieting, this book will have the answer.  And the answer will grounded in science, and in many cases from work done by these two scientists on the front lines of low-carbohydrate research.

As far as I am concerned, if you are planning on going on a low-carb diet and can afford only one book, make The Art and Science of Low Carbohydrate Living that one book.  If you are a long time low-carber, this is the one essential reference book you should have on your shelf.

If you are getting going on a low-carb diet the first part of this year, grab this book before you do another thing.  Once you see the world of benefits that will accrue to you from following such a diet, you will probably be able to overcome any depression that may have been inflicted on you from my last post.  So don’t hold off, grab a copy of this book today.  You will be very glad you did.

Over a half decade ago Professor Jared Diamond, in his Pulitzer Prize-winning book Guns, Germs, and Steel, famously wrote

“The adoption of agriculture, supposedly our most decisive step toward a better life, was in many ways a catastrophe from which we have never recovered.”

Dr Diamond was referring, of course, to the devolution of human health that took place as mankind suffered the corporal transformation driven by the mismatch between hunter-gatherer genes and an agricultural diet and lifestyle. Smaller stature, decreased cortical bone thickness, obesity, increased incidence of infectious diseases, dental caries, periodontal disease, vitamin deficiencies, and even famine – all common in agriculturists – were not, for the most part, the lot of pre-agricultural man.

Humanity doubtless gained more than it lost in this hunter to farmer changeover when viewed in a big-picture sort of way.  Farming made possible larger communities filled with workers, workers who, for the first time, made specialization of labor a possibility.  And fewer people could till the fields and provide food for the many, freeing the others to pursue the arts, business, politics, and warfare.

Stephen Budiansky, author of one of my favorite books, Covenant of the Wild, describes how domestic animals formed a pact with humans in which the animals traded a period of safety and survival for their lives.  Had this covenant not been made, it is highly likely – virtually a certainty – that cows would now be extinct.  Big, slow, stupid and tasty, had they not been amenable to domestication and entered into the covenant with their domesticators, cattle would have been hunted to extinction long, long ago.  But they did – however unwillingly – make the covenant and so exist by the tens of millions today.  The deal they cut was a phenomenal deal for cattle as a species, but not a particularly good deal for the individual cow when the time comes to pay up at slaughter.

Homo sapiens entered an almost mirror image of this same covenant when they domesticated cereal grasses.*  We gave up our independence and mobility for the promise of a constant and plentiful food supply.  But, as with our covenant with domestic animals, there is a catch.  And this time it’s with us.  Humans emerged from this deal with the short end of the stick.  In the same way as did cattle, we made a good-for-humans-as-a-species/bad-for-the-individual-human trade.  Like it or not, we traded the health of the individual human for the overall good of mankind and the development of civilization.

We traded a diet based primarily on fat and protein with a little carbohydrate thrown in from roots, shoots and tubers for one centered predominantly on carbohydrate.  The main source of the carbohydrate was cereal grains, chiefly ancient forms of wheat, the predecessor of the wheat that now occupies a large part of the human diet everywhere.  Ancient forms of wheat didn’t do our forebears a lot of good, and, according to Dr. William Davis’s new book Wheat Belly, the modern forms of the grain do us even less good.

Before we get to the problems modern hybrid wheat causes us, let’s take a look at the afflictions a diet of primitive wheat visited upon our predecessors.

The ancient Egyptians consumed a diet that would be considered optimal by many people today.  Both wealthy and poor Egyptians consumed primarily bread and a type of cloudy, almost gruel-like beer.  To these staples were added a variety of vegetables (mainly onions), and a small selection of game, fish and meat.  The bread was made from coarse ground, whole grain emmer wheat, a primitive, high-protein wheat.  Sugar didn’t come on the scene until about 1000 AD, so the Egyptians used honey sparingly (it was expensive) as a sweetener along with figs.  In short, these people consumed a diet the vast majority of modern nutritionists would prescribe to people to prevent obesity, heart disease, obesity and the rest of the diseases associated with the Western diet.

But, as their mummified remains and their contemporary artwork demonstrate, the ancient Egyptians were often fat and were riddled with heart disease, dental caries, bad periodontal disease and no doubt diabetes and hypertension.  Many people have argued that since only the wealthy were mummified, the mummy data applies only to them, and since the wealthy ate more red meat, the rates of obesity, heart disease and the other disorders common to them didn’t apply to the rest of the population.  Even the common man, however, was often portrayed as obese in Egyptian artwork, and despite greater consumption of meat, the main staple of even the wealthy was bread and beer. And it didn’t do them a lot of good.

The 5,300 year old mummy of Ötzi the Iceman found in the Italian Alps showed a bad case of dental caries and periodontitis along with a stomach-full of einkorn wheat (another primitive variety). Said the researchers who examined Ötzi:

Although the Iceman did not lose a single tooth until the his death at an age of about 40 years, he had an advanced abrasion of his teeth, profound carious lesions, and a moderate to severe periodontitis.

In particular, the molars of the upper jaw showed loss of alveolar bone as a sign of periodontitis (inflammation of the ligaments and bones that support the teeth), while evidence of “mechanical trauma” was found on two teeth.

…the most surprising find is the high frequency of cavities.

These dental pathologies are a sign of change in the Neolithic diet.

We already know that he was eating grains, such as einkorn or emmer. The contained carbohydrates clearly increased the risk of developing dental diseases

One would assume these findings would be common among the rest of Ötzi’s contemporaries, who doubtless consumed a similar diet.

Sadly, these same findings are also common among modern man who consumes a more malign version of primitive wheat.

Until I read Dr. Davis’s book Wheat Belly, I didn’t really think much about wheat other than its being a major source of carbohydrate in the American diet.  It never had occurred to me that the wheat we eat today is not the same wheat of our great-grandmothers cooked with nor probably even our grandmothers.  And it really hadn’t dawned on me how pervasive wheat is in the diet.  Since reading Michael Pollen’s The Omnivore’s Dilemma I had been conscious of the amount of corn in our modern diet, but I hadn’t thought much about wheat.  As Yogi Berra supposedly said, “You can see a lot just by looking.”  So I went out and looked.  And I can tell you that we are much more Children of the Wheat than we are Children of the Corn.

In most grocery stores, an entire aisle is devoted to nothing but bread in all its forms.  Then there is typically another large aisle full of cakes, cupcakes, cookies, pies, tarts, sweet rolls, bagels, croissants, brownies, and other sweet baked goods.  The vast majority of the cereal aisle displays products containing primarily wheat.  And if you look at processed foods of all kinds, you’ll find wheat in there.  If you make or buy gravy, roux, or just about any kind of sauce, you’ll find it’s thickened with wheat flour. (MD bought some demiglace a few days ago, and noticed as she was removing it from the container that even it had added wheat.) Then there is the aisle full of different beers, many of which are made with wheat.  These are just a few of the items you can find containing wheat in a grocery store; don’t even get me started on restaurant fare.  Wheat is everywhere – corn should be so lucky.

When I was roaming around looking for pictures of dwarf wheat (more about which later), I came upon the website for the Kansas Wheat Commission that listed a few facts about wheat.  Here are several that caught my eye.

Wheat is the primary grain used in U.S. grain products.  Approximately three-quarters of all U.S. grain products are made from wheat flour.

More food is made with wheat than any other cereal grain.

U.S. Farmers grow nearly 2.4 billion bushels of wheat on 63 million acres of land.

About half the wheat grown in the United States is used domestically.

A little back-of-the-envelope calculating using the above statistics tells us that each of us in the United States consumes about four bushels of wheat per year.  Another statistic from the linked website states that each bushel of wheat makes about 90 one-pound loaves of whole wheat bread.  So, we all eat the equivalent of 360 loaves of bread per year, or approximately one loaf per person per day. That’s a lot of wheat, in fact, it’s almost approaching ancient Egyptian levels. (Moreover, since MD and I don’t eat any, that means two other people out there are each eating two loaves per day.)

It would be bad enough if we consumed all this wheat as emmer or einkhorn or other primitive varieties, but we don’t.  We get most from a hybrid of Triticum aestivum – our great grandmother’s wheat – called dwarf (or semi-dwarf) wheat, which now comprises more than 99 percent of all wheat grown worldwide.

As Dr. Davis tells it, the hybridization of wheat came about in an effort to improve yield, which is now about tenfold greater per acre than it was a century ago. Older strains of wheat were taller and more prone to damage from wind and rain.  And

When large quantities of nitrogen-rich fertilizer are applied to wheat fields, the seed head at the top of the plant grows to enormous proportions.  The top-heavy seed head, however, buckles the stalk.  Buckling kills the plant and makes harvesting problematic. A University of Minnesota-trained geneticist…is credited with developing the exceptionally high-yielding dwarf wheat that was shorter and stockier, allowing the plant to maintain erect posture and resist buckling under the large seed head.  Tall stalks are also inefficient; short stalks reach maturity more quickly, which means a shorter growing season with less fertilizer required to generate the otherwise useless stalk.

In the photos below you can see the difference between wheat grown in the Middle Ages and the dwarf wheat grown today.

Dr. Davis writes that modern wheat is approximately 70 percent carbohydrate by weight.  The carbohydrate is in the form of a starch called amylopectin A.

The most digestible form of amylopectin, amylopectin A, is the form found in wheat.  Because it is the most digestible, it is the form that most enthusiastically increases blood sugar.  This explains why, gram for gram, wheat increases blood sugar to a greater degree than, say, kidney beans or potato chips.  The amylopectin A of wheat products, “complex” or no, might be regarded as a supercarbohydrate, a form of highly digestible carbohydrate that is more efficiently converted to blood sugar than nearly all the other carbohydrate foods, simple or complex. [Italics in the original.]

But what about the much vaunted whole grains.  Won’t ‘whole grain’ bread or wheat products be better?  Not according to Dr. Davis:

…the degree of processing, from a blood sugar standpoint, makes little difference: Wheat is wheat, with various forms of processing or lack of processing, simple or complex, high-fiber or low-fiber, all generating similar high blood sugars.  Just as “boys will be boys,” amylopectin A will be amylopectin A.  In healthy, slender volunteers, two medium-sized slices of whole wheat bread increase blood sugar by 30 mg/dl (from 93 to 123 mg/dl), no different from white bread.  In people with diabetes, both white and whole grain bread increase blood sugar 70 to 120 mg/dl over starting levels.

And aside from the blood sugar and, consequently, insulin problems caused by the consumption of too much wheat, there are other problems.  As with almost any food, the newer the food, the greater the likelihood that it will be problematic to some humans who consume it.  Since dwarf wheat has been around for less than 50 years, it should come as no surprise that it does indeed cause it’s share of problems.  Dr. Davis spends the better part of his excellent book detailing many of these problems and describing his clinical experience in helping many of his patients shuck their wheat habit.  He describes the increase in celiac disease over the past 50 years and believes, as I do, that celiac disease is a continuum.  The severe form of it that is recognized as celiac disease is pretty easy to diagnose (if a doctor has sense enough to look for it), but there are milder forms that manifest themselves as anything from mysterious rashes that come and go to diarrhea and other GI disturbances to arthritic aches and pains. And we can’t forget a number of other afflictions that may well have their basis in wheat intolerance that include osteoporosis, acne (bagel face?), neurological disorders, and the creepily- dubbed ‘man boobs.’

It’s good to learn in Wheat Belly that Dr. Davis has finally shucked his bred-in-the-bone cardiologist’s antipathy toward fat in general and saturated fat specifically and has come over to what most of his peers must view as the dark (read: low-carb) side:

The fat phobia of the past forty years turned us off from foods such as eggs, sirloin, and pork because of their saturated fat content — but saturated fat was never the problem.  Carbohydrates in combination with saturated fat, however, cause measures of LDL particles to skyrocket.  The problem was carbohydrates more than saturated fat.  In fact, new studies have exonerated saturated fat as an underlying contributor to heart attack and stroke risk. [Italics in the original.]

Dr. Davis wraps up his meticulously researched book with a straightforward plan to help free the reader from the tyranny of wheat, while at the same time providing instructions for a delicious and satisfying wheat-free diet.  He furnishes an extensive list of wheat-containing foods that should be avoided and imparts his caveats about going facedown in products advertised as being gluten-free.  And best of all, he provides a short section filled with matchless wheat-free recipes for many meals that would otherwise be wheat-laden. (MD and I have tried a few of these recipes and found them to be superb.  I especially enjoy his wheat-free granola recipe even though I go a little easy on the rolled oats part of it.)

Wheat Belly hit the New York Times Bestseller list shortly after it came out (and has been there for two weeks now), which I can tell you from experience, is not an easy thing to do.  As a result (because being on the NY Times list means a book has had big sales numbers), the wheat producers have not taken their hits lying down.  They’re fighting back with full venom, because a book like this one can do them serious economic damage. Expect it to get worse. (Remember all those shelves in the grocery stores stuffed with wheat-containing products? They don’t want to see that go away.)  You can read about some of their tactics here and read Tom Naughton’s interviews with Dr. Davis here and here.

I can’t recommend this terrific book highly enough.  Wheat Belly is fully referenced and indexed (unless you somehow got the little freebee paperback review version that I received from the publisher), and is a must have for the library of any serious low-carber or anyone concerned about health.

*MD and I wrote about this domestication of humans by grains in The Protein Power LifePlan.  In that book we referenced an interesting paper by a couple of Australian researchers on the hypothesis that the addictive nature of cereal grains helping this domestication along.

Of all the dangerous ideas that health officials could have embraced while trying to understand why we get fat, they would have been hard-pressed to find one ultimately more damaging than calories-in/calories-out. That it reinforces what appears to be so obvious—obesity as the penalty for gluttony and sloth—is what makes it so alluring. But it’s misleading and misconceived on so many levels that it’s hard to imagine how it survived unscathed and virtually unchallenged for the last fifty years.

It has done incalculable harm. Not only is this thinking at least partly responsible for the ever-growing numbers of obese and overweight in the world—while directing attention away from the real reasons we get fat—but it has served to reinforce the perception that those who are fat have no one to blame but themselves. That eating less invariably fails as a cure for obesity is rarely perceived as the single most important reason to make us question our assumptions, as Hilde Bruch suggested half a century ago. Rather, it is taken as still more evidence that the overweight and obese are incapable of following a diet and eating in moderation. And it puts the blame for their physical condition squarely on their behavior, which couldn’t be further from the truth.

Gary Taubes from Why We Get Fat

While trying to catch up on my reading before piles of Financial Times, New York Times and Wall Street Journals consume our living space, I came across a review of Donald Rumsfeld’s book, Known and Unknown.  The title of which was taken from one of his orotund responses to a reporter about the various kinds of knowledge we have.  Said he:

There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know.

Mr. Rumsfeld believes the last of the above, the things we don’t know we don’t know, is the most problematic.  I disagree.  I think the first gets most people in trouble most of the time.  And this includes Rummy himself.

It ain’t so much the things we don’t know that get us into trouble. It’s the things we know that just ain’t so.

So opined Henry Wheeler Shaw (AKA Josh Billings), who said it a lot more memorably well over a century ago in a quote often misattributed to Mark Twain, Will Rogers and others.

One of the things countless people ‘know’ that just ain’t so – or at least that ‘just ain’t so’ as they think they know it – is that people get fat because they eat too much or exercise too little.  In the minds of many, it’s all a matter of calories in versus calories out.  Which is a really meaningless statement of the problem, but which leads inexorably to the conclusion that people get fat because they are either gluttonous or lazy or both.  The so-called Gluttony and Sloth model for obesity.

Why is the calories in vs calories out notion so meaningless?  If more calories come in than go out, you gain weight, and if more calories are expended than come in, you lose weight.  Seems reasonable.  It’s a bewitching notion, because it is absolutely true but at the same time absolutely meaningless.  It tells us nothing.  Let me digress to explain using a painful example from my own past.

Almost 20 years ago I singlehandedly dragged my family into the restaurant business.  I bought a franchise for a Mexican food place. (If you’re interested, you can read more about it here.) I recruited (read: dragooned) all our children to operate it, and despite all our best efforts, the venture ended in disaster.  But during the run, I spent a lot of time in the restaurant.  And one of the constant conversational threads was why it was or wasn’t busy at any given time.  We would have a Saturday afternoon during which few people came in.  As a consequence, the next Saturday we would schedule a skeleton crew, and we would be slammed.  Then someone would realize that there was a Razorback football game in Little Rock that weekend, which would explain it.  Or so we thought. Sometimes for no apparent reason we would have people swarm in.  There would be a line out the door with more showing up by the minute.  We would all be working like dogs to get everyone served, all the while saying to ourselves and to one another: What the #$&**!!# is going on? Why are we so packed?

Now imagine if during one of these rushes, one of us had said, It’s really quite simple:  we’re so crowded because there are way more people coming into the restaurant than there are people leaving.  We all would have looked at the person uttering such nonsense as if he/she were the village idiot.  But the statement is absolutely 100 percent correct.  That’s why we were so busy.  More people coming in than going out.  But it doesn’t really answer the question at hand.  What we want to know is why so many people are coming in?  A Razorback game? A big sale at the department store next door? A good review in the paper that we weren’t aware of? A bus full of people broken down outside the front door?  Why are there so many more people coming in than going out? If we could figure out the why, then we would have an easier time scheduling staff.*

It’s the same with the calories in/calories out notion.  If you’re fat, you’ve been taking in more calories than you’ve been expending.  No one would argue that.  At least no one with good sense.  But the question is, why?  Why have you been taking in more than you’ve been expending?  That’s the question you want to have answered, because only when you discover the answer can you figure out why you’re fat and what to do about it.

Gary Taubes has done the figuring and writes about it in his new book, Why We Get Fat And What To Do About It (WWGF).  As most readers of this blog know, a few years ago Gary wrote a long, detailed book on what we can call the Carbohydrate Theory of disease, titled Good Calories, Bad Calories (GCBC).  Now he has come out with what many think is a slimmed-down version of GCBC, called by some GBGC-Lite. But it’s not really a lite version of GCBC – it’s something much different.  I call it GBGC-Fat.  I would append the term ‘fat’ because it’s about fat – adipose tissue – and why so many of us struggle so mightily to rid ourselves of superfluous wads of it.

WWGF is a great primer on fat gain, fat loss and just about everything having to do with obesity.  I read GCBC three times, starting with the first manuscript version and ending with the actual book.  I’ve done the same with WWGF, so I can assure you that it is not a rewrite of GCBC, but is mainly new material presented in a much easier to assimilate way.  As many people have discovered, trying to get their doctors or other non-believers to read GBGC is a tough sell.  Few, who aren’t already converts, can summon the will to dig in to a book that large.  The new book is much less intimidating than GCBC, but just as compelling.  Even the title is better and more seductive.  Who wouldn’t want to know why we get fat?

In his efforts to ferret out why we do get fat, Gary, an obvious follower of the Samuel Johnson admonition that we more often need reminding of old truths than instruction in new ones, looks to the pre WWII scientific literature for the ‘old truths’ that are still valid. One of which is that carbohydrates fatten both livestock and people.  If you think about it, it’s difficult for the current crop of academics to intuitively grasp this notion, because they have been inculcated from the time they entered kindergarten with the ‘dietary fat is bad’ mantra.  That kind of deep-seated learning is hard to shake.  Especially so, since when today’s academics were students, their mentors, who had built their own careers (all way post WWII) on the very same mistaken notion about fat, wouldn’t likely have provided much inspiration for their young charges to change.

So, why do people get fat?  Let’s look at it as Gary does and start from the beginning.

When we talk about obesity, we’re talking about the excess accumulation of fat.  The excess fat is stored in the fat cells (adipose cells), which, collectively make up the adipose tissue.  With that as our starting point, where do we go?

If we ask how the fat gets into the fat cells, we will discover that all the pathways of fat storage were worked out years ago and are so uncontroversial that they’re described in detail in every biochemistry and physiology textbook currently in use.  It’s well known that the metabolic hormone insulin stimulates an enzyme on the surface of the fat cell that moves the fat into the cell.

So if insulin moves fat into the fat cells, it would seem that a lot of insulin would move a lot of fat into the fat cells.  And indeed it does.  Given this, the rational person trying to figure out the previous step in our progression would ask What causes a lot of insulin?  Or the rational person, should he/she have been steeped for a lifetime in the marinade of ‘fat is bad’ might ask, What about fat?  If there is a lot of fat in the blood as a result of fat in the diet, wouldn’t that fat get into the fat cell?  If so, then doesn’t dietary fat lead to fat?

A good question, but the answer is no.  Type I diabetics can have a lot of fat in their diets and in their blood, but if they have no insulin, they can’t store that fat.  In fact, most pre-diagnosis type I diabetics lose enormous amounts of weight despite eating ravenously because without insulin they can’t store the fat.  So dietary fat itself – even large amounts of it – won’t find its way into the fat cell without the help of insulin.

When you hack through the thicket of all the biochemical pathways involved in the metabolic process, you find that insulin is the primary force involved in the storage of nutrients.  Insulin is the body’s storage hormone: it puts fat in the fat cells, protein into muscle  cells and glucose into it’s storage form, glycogen.  Insulin, along with its counter-regulatory hormone glucagon (the Yin and Yang of metabolism), are involved in nutrient partitioning – the process of stashing nutrients away in different parts of the body and/or harvesting them for the body to use as energy.

If we have a lot of insulin, the insulin dominant-pathways (the storage pathways) hold sway, and fat is partitioned away in the fat cells; if insulin is low, then the glucagon-dominant pathways (the energy-release pathways) take over and start moving fat out of the fat cells, so it can be consumed by the body as fuel.  This is how it is supposed to work.  We eat.  Insulin comes out and stores away the energy.  We go for a while without eating, insulin goes down and glucagon comes out to retrieve our stored fat so we’ll have a continuous energy supply.

Problems arise when this system goes off the rails, which most commonly happens when people develop insulin resistance, a problem of disordered insulin signaling.  Insulin talks, but the cells don’t listen.  So insulin keeps talking louder until the cells finally get the message. In other words, the pancreas keeps producing insulin and the blood levels continue to rise until the cells finally get the message.  But it’s a message that has taken a lot of insulin force to deliver.

If all the different types of cells developed resistance to insulin at the same rate, we wouldn’t have as much of a problem.  But they don’t. Different cells develop insulin resistance at different rates.  Typically the first cells to become insulin resistant are the liver cells.  The liver cells are continuously producing sugar and dumping it into the blood.  Insulin shuts this process down.  If the insulin level drops to zero, as it does in type I diabetes, the liver dumps a huge load of sugar in the blood causing all the blood sugar problems associated with this disease.  Under normal circumstances, just a little insulin stops the liver cells in their tracks.  But if these cells are resistant to insulin, much more is required to get them the message to turn off the sugar spigot.

In most people, the fat cells develop insulin resistance later, which creates the problem.  If insulin levels are high to control the liver’s sugar factory output, then these elevated insulin levels are sending a strong message to the non-insulin-resistant fat cells.  The message is take this fat and store it.  High insulin not only drives fat into the fat cells, it prevents it from getting out.  Fat is packed into the fat cells and kept there.

Between meals when insulin levels would normally fall, allowing the liberation of fat to feed all the body’s tissues, insulin remains high in an effort to keep the liver in check.  Fat can’t get out of the fat cells, and the tissues begin to starve.  Even though there is plenty of stored fat, the body can’t get to it because elevated insulin is preventing its release.

Starving tissues send a message to the brain, saying ‘we’re hungry.’  The brain responds by increasing the drive to feed.  We eat, and the carbs we eat are consumed by the cells for immediate energy, and insulin stimulated by the dietary carbohydrate drives the fat into the fat cells where it is trapped with the rest of the fat already there.  The fat cell mass gets larger and larger, and we become obese.

The above scenario explains a lot.  Why can some people eat like crazy and not get fat?  Perhaps because they develop insulin resistance in their fat cells just as they do in their liver cells.  They don’t get fat, but they typically have all the other insulin-driven problems of the obese: high blood pressure, elevated triglycerides, increased risk for heart disease, etc.  And all while staying skinny.

How about morbid obesity?  Easy.  Those people don’t develop insulin resistance in their fat cells until late in the game, if ever.  They continue to push fat into the fat cells and become more and more obese until they weight 400-500 pounds or even more.  The average person will finally develop fat cell insulin resistance before the morbid obesity stage.  When this happens, weight and level of obesity stabilize and stay the same, almost irrespective of how much is eaten.

We now know why we get fat.  Excess insulin drives fat into the fat cells increasing the fat cell mass, ultimately leading to the state we call obesity. If we keep walking this progression back, the next question has to be, Why do we make too much insulin?

We make too much insulin because we eat too many carbohydrates, especially sugar and other refined carbohydrates.  With that statement, we’re starting to edge into controversial territory, but it’s only territory populated by the ignorant.  The hard science is emphatic that carbs are a pure insulin play.  Eat them and your insulin goes up.

Some people with a little learning may be quick to point out that protein drives insulin up as well.  This is true, but with a catch.  Protein drives both insulin and glucagon up, so you don’t have the pure insulin effect.  Only carbs will give you that.  With carbs, insulin goes up while glucagon goes down.  With meat and other proteins, the effects of the elevated insulin are muted by the concomitant rise in glucagon. (Glucagon isn’t called insulin’s counter-regulatory hormone for nothing.)

As Gary lays out the progression, carbs increase insulin, excess insulin drives excess fat into the fat cells, the fat cell mass grows, and we become fat.  This chain of cause and effect leads to the ineluctable conclusion that excess carbohydrate intake leads to obesity.  And each and every link forged in this chain is scientifically unimpeachable.

So if you are fat and want this progression to reverse itself, wouldn’t it make sense to reduce your carbohydrate intake?  All the science is valid.  But don’t just take my word for it. Gary writes of a former Harvard professor responsible for much of the early work in the field of the regulation of fat accumulation who summed it up like this:

Carbohydrate is driving insulin is driving fat.

If you put that in reverse, you should cut the carbs, reduce the insulin and lose the fat.  Seems simple, but here is where all kinds of controversy rears its head. Even the very smart Harvard professor who did the original work and uttered the above quote, when asked by Gary why there is so much obesity, responded that people didn’t exercise enough. Which also proves true what Saul Bellow wrote years ago:

A great deal of intelligence can be invested in ignorance when the need for illusion is deep.

As I’ve written numerous times in the pages of this blog, food is made of three things: fat, protein and carbohydrate.  When you decrease one, you typically increase the other.  If you cut the carbs, you’re going to increase the fat and protein in your diet.  And it’s the increased fat in particular that leads to all the controversy.

The current zeitgeist is that dietary fat, especially saturated fat, is bad.  And not just bad, but extremely bad.  So, even though they may understand that carbs drive fat storage, the ingrained fear of fat keeps many otherwise smart people from accepting the merits of the low-carbohydrate diet.  To escape the cognitive dissonance, they default to the calories in/calories out argument, which, as we’ve seen, is meaningless.  But they feel safe taking refuge in what they believe is a known known. More’s the pity since it will end up doing them about as much good as it did Rummy in the Iraq war.

Most rational people will find the above argument understandable and be able to connect the dots showing that carb intake leads to excess insulin leads to obesity.  The difficult concept for many to grasp, however, is the other problem with too much insulin: it prevents the stored fat from being accessed for energy. Normally adipose tissue acts as a reservoir of energy.  We eat, we convert the food we don’t immediately use into fat, and the body – acting via insulin – stashes it away for later.  When later comes, insulin falls, glucagon rises, and the body starts harvesting it’s stored fat to provide energy for all the cellular functions.  Then we eat, and the process starts anew.

In obese people it’s different.  They eat, they use the food for immediate energy needs and store the rest away.  In other words, they store excess energy away in their fat cells just like non-obese people do.  It’s the second part of the formula that is different.  In obese people, insulin is almost always elevated – even when they haven’t just finished a meal.  These chronically elevated insulin levels trap the fat in the fat cells, and, in fact, turn the fat pathway into the fat cell into a one-way street.  Fat can get in, but it can’t get out. If the fat does get out, the excess insulin tells the mitochondria not to burn it anyway, so it just gets sent back to the fat cells.

What does this mean for an obese person?

Let’s look back at the non-obese person to explain.  A non-obese person eats, uses the energy from the food and stores the rest.  During the time between meals and during sleep, the non-obese person draws on the stored fat to provide energy.  When the fat cell mass decreases to a certain critical point, the body signals the brain that the fat cells need a refill, so the brain initiates the hunger response.  The non-obese person eats, uses some energy for immediate needs, fills the fat cells with the rest, uses the stored energy as needed, and then the cycle repeats.

It doesn’t work that way in the obese.  Obese people eat, use the energy required for immediate needs and store the rest.  But–and this is the extremely important ‘but’– during the time between meals and during sleep, obese people can’t access their fat stores because their baseline insulin is too high.  When they can’t get to their stored fat, the lack of access to energy sets in motion all the same biochemical signals in the obese person that get sent in the non-obese, who have depleted the energy storage in their fat cells.  And these signals are converted by their brains into the drive to feed, i.e., intense hunger.  They have to eat to provide for their immediate energy needs because, thanks to chronically elevated insulin levels, they can’t get into to their own stored fat, even though it’s there waiting in massive quantities.

To use an analogy, it would be like being out of cash when you desperately needed it yet having a huge amount of money in the bank.  You hustle to an ATM machine and find your card won’t work.  It’s the same with the obese – they have plenty of energy to go without eating for months, but their fat ATM cards don’t work.  And since their fat ATM cards don’t work, the only option they have for immediate energy is to eat.

So fat people are fat not because they overeat – they overeat because they’re fat.

A real debt of gratitude is owed Gary for combing the old literature and ferreting out this notion.  As early to mid-twentieth century, researchers both in Europe and America had determined obesity is a disorder of fat accumulation, not a problem of ‘perverted appetite,’ self control, or gluttony and sloth.  Louis Newburgh, Ancel Keys, Jean Mayer and a few others were responsible for turning the herd thinking of academia in a different direction, and the ‘eat less, exercise more’ paradigm has been with us since. It’s doubtless not a coincidence that the obesity and diabetes epidemics have flourished as a consequence.  As I say, Gary deserves a lot of credit for resurrecting this old work and starting to turn opinion in the other direction.

In addition to the chapters describing and discussing the mechanisms by which we get fat, Gary has included other important material in his book.  One of my favorite chapters is the one titled “The Nature of a Healthy Diet.”  Although you wouldn’t know it from this title, the chapter fairly presents most of the arguments against low-carbohydrate diets and refutes them.  I’m sure many will find these refutations helpful in their dealings with naysayers, who seem compelled to point out non-existent problems with carb-restricted dieting.  There is one in particular that I plan to deploy at the next opportunity.  Since I have my own arguments against the rest of the anti-low-carb idiocy, it annoys me greatly that I didn’t think of this one myself.

Here is a scenario I often endure at a party or other get together after my identity as a diet book writer and low-carb expert has been revealed:

Other person, OP (typically an overweight female): I tried a low-carb diet once.

Me: (Dreading what’s sure to follow.) Oh, really.

OP: Yes, and it worked for a while, but I couldn’t stick to it.

Me: Oh, really?  Why not?

OP: Well, I felt tired and spacey headed.

Me: People sometimes experience those symptoms early on, but they usually resolve after a couple of weeks.  And there are steps you could’ve taken to prevent or minimize them.

OP: No, I don’t think so in my case.  I know my body, and I know what it’s telling me.  I’m just one of those people whose body needs carbs.  As soon as I started eating carbs again, I felt much better.

Me: (Fighting down the impulse to point out that she’s still fat…) Hmmm.  Maybe so.
Now, thanks to WWGF, I’ll know just what to say.  I’ll leave you with the relevant paragraph from the book along with my highest recommendation to grab a copy and read it.  I can promise you won’t be disappointed.

The more technical term for carbohydrate withdrawal is “keto-adaptation,” because the body is adapting to the state of ketosis that results from eating fewer than sixty or so grams of carbohydrates a day.  This reaction is why some who try carbohydrate restriction give it up quickly. (“Carbohydrate withdrawal is often interpreted as a ‘need for carbohydrate,’ ” says Westman.  “It’s like telling smokers who are trying to quit that their withdrawal symptoms are caused by a ‘need for cigarettes’ and then suggesting they go back to smoking to solve the problem.”)

* Full disclosure:  In the first draft of WWGF I read, Gary had used the crowded restaurant example to explain why the calories in/calories out explanation was so ridiculous.  It reminded me of our dismal times in the restaurant business, and I thought it was a brilliant way to demystify the problem.  In one of the later drafts I read, the restaurant example was missing.  I asked Gary about it, and he told me he and his editor had decided it wasn’t the best way to describe the situation.  I disagreed (probably because my financial wounds from the restaurant biz, though long past, were still painful) and told Gary I thought it was a terrific way to explain it and that if he didn’t use it, I would rip it off and use it as my own.  Although he has used the examples in lectures, Gary didn’t use it in the book, so, true to my word, I ripped it off as my own.

Meat eating made us human. The anthropological evidence strongly supports the idea that the addition of increasingly larger amounts of meat in the diet of our predecessors was essential in the evolution of the large human brain.  Our large brains came at the metabolic expense of our guts, which shrank as our brains grew.

In April 1995 an article appeared in the journal Current Anthropology that was an intellectual tour de force and, in my view, an example of a perfect theoretical paper.  “The  Expensive-Tissue Hypothesis” (ETH) by Leslie Aiello and Peter Wheeler demonstrated by a brilliant thought experiment that our species didn’t evolve to eat meat but evolved because it ate meat.

The ETH is an example of the kind of scientific detective work I love.  In fact, this paper is one of my all time favorites.  (An amazing bit of trivia about this paper is that it almost didn’t get published.  I had the opportunity to talk with Leslie Aiello at a meeting a few months ago, and she told me the journal was reluctant to publish the paper because the editors thought it too technical for their readers.  I suspect they also found it too controversial.  Now I’m sure they’re glad they published because I would imagine it is the most cited of all the papers ever published in Current Anthropology.)  The authors methodically lay the scientific foundation for their experiment, then, like Sherlock Holmes, progress step by step, accumulating little pieces of data until they reach the ineluctable conclusion that meat eating made us human. I would like to walk us all through their thought processes as laid out in their brilliant paper.

Let’s start with the problem.

For years anthropologists have speculated about why humans developed such large brains so quickly – from softball size to what we have now in just a short 2 million years.  Below is a graphic showing hominid/human brain growth over time.

A number of hypotheses have arisen to answer this question.  Some say that humans developed large brains because they had to contend with problems involving group size, others posit that large brains came about as a consequence of developing complex foraging strategies, others yet say the development of a social or Machiavellian  intelligence was the driving factor.  And even others say that the complexities of learning to hunt expanded brain size.

Any or all of these hypotheses may be valid, but the problem isn’t really as much a matter of why as it is a matter of how.  Other primates deal with groups and have complex foraging strategies; and many deal with social problems within their groups, and some even hunt.  Yet they still have small brains.  (Granted, their brains are larger for their size than those of other mammals, but primates sport small brains as compared to humans.)  How did the human brain grow?

This isn’t an easy question to answer because of the thermogenics involved.  Brains consume a large amount of fuel and, consequently, throw off an enormous amount of heat for their size.  The metabolic rate of brain tissue is nine times that of the average of  the metabolic rate of the rest of the body.

So what? you may say.  So we’ve got a big, hot-running, energy-burning brain.  What difference does that make?  It’s reflected in our overall metabolic rate, right?  Well, sort of, and therein lies the crux of the problem.  As we will see below, our total metabolic rate – even with our huge brains – is the same as that of any other animal our size. Or to say it another way, animals our size with much smaller brains have the same metabolic rate that we do with our huge brains.  This fact was the starting point for the authors of the ETH.  So let’s start there as well.

In keeping with a great scientific tradition, Aiello and Wheeler were able to see what they saw because they stood on the shoulders of giants who came before them.  In their case the giant was Max Kleiber, an animal physiologist working at the University of California at Davis, who published a groundbreaking paper in 1947 and a scholarly text titled The Fire of Life in 1961.  Kleiber’s work involved the meticulous measurement of the metabolic rates of numerous animals, including humans.  As he plotted the various metabolic rates, he discovered an extremely strong correlation between the mass of an animal and its metabolic rate.  Kleiber found that this relationship held constant across numerous species.  His October 1947 paper in Physiological Reviews simply titled “Body Size and Metabolic Rate” was a classic.  By using the equations Kleiber worked out, the metabolic rate of virtually any animal could be determined simply by knowing the animal’s body size.  Or, as Kleiber put it in the paper:

Does a horse produce more heat per day than a rat or do some rats produce more heat than do some horses?  Almost anybody who understands what is meant by “heat production per day” will not hesitate to give the correct answer and will even be convinced that the daily rate of heat production of men or sheep is greater than that of rats, but smaller than that of horses.  Thus most people (among those who understand the question) are convinced that in general the bigger  homeotherms produce more heat per day than the smaller homeotherms, that, in other words, the metabolic rate of homeotherms is positively correlated to body size.

The answer to the next question: “does a horse produce more heat per day per kilogram of body weight than a rat?” requires some biological training.  Most biologists, however, will not hesitate to answer that the rate of heat production per unit body weight of the big animal is less than that of the small animal.

The positive correlation between metabolic rate and body size, and the negative correlation between metabolic rate per unit weight and body size, establish two limits between which we expect to find the rate of heat production [basal metabolic rate] of a horse if we know the rate of heat production of a rat.  We expect the metabolic rate of the horse to be somewhere between that of the rat, and that of the rat times the the ratio of horse weight to rat weight, provided of course that we do not regard these two correlations as simply accidental.

If we are firmly convinced that the metabolic rate of horses, and other homeotherms of similar size, is never outside these two limits, then we admit to recognize a natural law between body size and metabolic rate.

This natural law, carefully calculated by Kleiber, is now known as Kleiber’s law.  Below is Kleiber’s law graphed out by him as it appeared in his seminal paper.  And this is exactly as it appeared in the journal, but with the addition here of colors for better legibility.  Since their was no Excel nor graphics software in Kleiber’s time, the graph was hand drawn and appeared in the pages of Physiological Reviews as such.  How times have changed.

As you look along the line running from lower left to upper right, you can find rats and horses and a host of other mammals including humans.  Over the years, mammals that Kleiber didn’t have the opportunity to work on have been measured, and they all fit nicely along Kleiber’s line, following Kleiber’s law.  Because of this tight correlation, Kleiber’s equations can be used to precisely estimate the metabolic rate of any animal just by knowing its size.

Aiello and Wheeler used Kleiber’s law as the jumping off point for their grand thought experiment.

Since all animals measured have conformed to Kleiber’s law, Aiello and Wheeler postulated that animals now extinct – including our human and pre-human predecessors – would have fallen along the same line. Using skeletal remains paleontologists have been able to calculate body sizes of extinct animals along with pre-Homo and early-Homo species.  Then using Kleiber’s law, it is possible to closely estimate the metabolic rates of these creatures.  And here’s where it gets interesting.

According to Kleiber’s law, an australopithecine weighing 80 pounds would have the same metabolic rate as a human weighing 80 pounds despite the disparity in brain size between the two.  The much larger brain of the human would have 4-5 times the metabolic rate of the brain of the australopithecine, yet would have the same overall metabolic rate.  What gives?

That’s precisely what the authors of “The Expensive-Tissue Hypothesis” wondered.

Because the human brain costs so much more in energetic terms than the equivalent average mammalian brain, one might expect the human BMR [basal metabolic rate] to be correspondingly elevated.  However, there is no significant correlation between relative basal metabolic rate and relative brain size in humans and other encephalized animals.

Where does the energy come from to fuel the encephalized brain?

The authors postulated a solution.

One possible answer to the cost question is that the increased energetic demands of a larger brain are compensated for by a reduction in the mass-specific metabolic rates of other tissues.

In other words, if one organ – the brain, for example – is chewing up a lot of energy and contributing a disproportionate amount of the basal metabolic rate for the animal as a whole, then maybe another organ or group of organs are consuming less energy to compensate.  The heart, the kidneys, the liver, the skeletal muscles, the GI tract – all consume energy and contribute to metabolic rate.  Maybe one of these organs became smaller as the brain became larger over time.

We can hone our analysis a little finer if we begin to look at an energy-balance equation, but an energy-balance equation of a different kind.  I have written a number of times in this blog about the energy-balance equation that applies to weight loss: change in weight equals energy in minus energy out.  That is not the equation we’ll be talking about here.  The other energy-balance equation says that the total metabolic rate is the sum of all the metabolic rates of the various organs and tissues in the body.  If you add the metabolic rates of the kidneys, the heart, the brain, the muscles, the digestive tract and so on together, you will get the total metabolic rate of the body, which makes sense because it is the sum of the parts.

Total BMR = brain BMR + heart BMR + kidney BMR + GI tract BMR + liver BMR + the remainder of the body’s tissues.

The authors of the ETH set out to look at the metabolic rates of the various organs.  By a diligent search of the literature, they found that along with the brain, the the heart, the kidneys, the liver and the gastro-intestinal tract account for the vast majority of the total BMR.  They dubbed these organs as ‘expensive tissues’ because they consume a large amount of energy as compared to their size.  (Surprisingly, muscle mass doesn’t contribute all that much to the total metabolic rate (skin and bone contribute even less), which gives the lie to that old notion — that I, myself, have fallen prey to — that replacing fat with muscle increases metabolism significantly.)

Aiello and Wheeler reasoned that if the total metabolic rate stayed the same while the energy-expensive brain grew over time some other expensive tissue had to get smaller.  There could be no other solution.

But which of the expensive tissues got smaller?

Aiello and Wheeler examined the data on the metabolic rates and sizes of the various expensive tissues and learned that for a 65 kg primate, the heart, the kidneys, and the liver were approximately the same size as those of a 65 kg (143 lb) human.  The greater metabolic rate of the large human brain was compensated for by a GI tract significantly decreased in size.  It turns out that the GI tract of a 65 kg human is just a little over half the size of the GI tract of a similar sized primate.

The combined mass of the metabolically expensive tissues for the reference adult human is remarkably close to that expected for the average 65-kg primate, but the contributions of individual organs to this total are very different from the expected ones.  Although the human heart and kidneys are both close to the size expected for a 65-kg primate, the mass of the splanchnic organs (the abdominal organs) is approximately 900 g less that expected.  Almost all of this shortfall is due to a reduction in the gastro-intestinal tract, the total mass of which is only 60% of that expected for a similar-sized primate.  Therefore, the increase in mass of the human brain appears to be balanced by a almost identical reduction in size of the gastro-intestinal tract.

Below is a graphic from the ETH showing the sizes of the different organs as based on predictions from a 65-kg primate and the observed size in humans.

So we know that as humans evolved larger brains they simultaneously co-evolved smaller guts in order to maintain a set BMR.  And this is where the story gets interesting. Why?  Because

the logical conclusion is that no matter what is selecting for brain-size increase, one would expect a corresponding selection for reduction in the relative size of the gut.

Some researchers believe that increasingly complex activities drove the brain to enlarge.  As the authors of the ETH summarized it:

The relationship between relative brain size and diet is often mentioned in the literature on primate encephalization and is generally explained in terms of the different degrees of intelligence needed to exploit various food resources.  For example, [some] have argued that a relatively large brain and neocortical size correlates with omnivorous feeding in primates , which requires relatively complicated strategies for extracting high-quality foodstuffs.  Alternatively, [others] have suggested that frugivores have relatively large brain sizes because they have relatively larger home ranges than folivores, necessitating a more sophisticated mental map for location and exploitation of the food resources.

But it doesn’t matter whether our brains got big because our predecessors were socialized, developed complex foraging strategies, lived in and had to deal with groups or were skilled hunters, in order to obey Kleiber’s law, something had to force our guts to get smaller at the same time.  What could that be?

According to Aiello and Wheeler, it was increased diet quality that allowed the gut to get smaller while still absorbing the necessary nutrients to fuel the metabolism.  As they put it

The results presented here [in the ETH] suggest that the relationship between relative brain size and diet is primarily a relationship between relative brain size and relative gut size, the latter being determined by dietary quality.  This would imply that a high-quality diet is necessary for this encephalization, no matter what may be selecting for that encephalization.  A high-quality diet relaxes the metabolic constraints on encephalization by permitting a relatively smaller gut, thereby reducing the considerable metabolic cost of this tissue.

What the authors are saying is that it doesn’t matter how much more brain power was required, the brain couldn’t enlarge without something else giving.  What obviously gave was the size of the GI tract, and the only way a smaller GI tract could provide the fuel for the body was to have a higher-quality diet. How did the our most ancient relatives the early hominids increase the quality of their diets?

A considerable problem for the early hominids would have been to provide themselves, as large-bodied species, with sufficient quantities of high-quality food to permit the necessary reduction of the gut.  The obvious solution would have been to include increasingly large amounts of animal-derived food in the diet.

Increasing the amount of easily-digested food of animal origin allowed us to shrink our guts while expanding our brains.  Had we remained on a diet high in vegetation, we would no doubt not have been able to expand our brains irrespective of how much more thinking those brains would have needed to do.  It just wouldn’t have been possible to do so without violating Kleiber’s law.

Take the gorilla, for example, almost pure vegetarians that spend their entire ‘working’ day foraging and eating, which they have to do to get enough calories to maintain their enormous bulk.  They have large guts and pay for it by having small brains.  Even smaller than that of our most primitive ancestors, the australophthecines.

Gorilla has one of the lowest levels of encephalization of any haplorhine primate, and the much higher level of encephalization of all the australopithecines suggests a diet of significantly higher quality than that of this genus.

Which makes sense when you consider that carbon 13 isotope analysis has shown that Australopithecus africanus (the species that came right after Lucy) consumed meat.  As you go up the lineage from Australopithecus and through Homo, you find that more and more meat was consumed the higher up the tree you go.

It’s easy to see that, as compared to humans, chimps and gorillas have large, protuberant bellies, which supports the fact that they have larger GI tracts, but what about our ancient ancestors.  All we have to go on are skeletal remains, which show nicely that their heads (and brains) were much smaller than ours, but what about their guts?  How do we really know their guts were larger?  According to Kleiber, they would have to be, but how to we really know they were?

The large gut of the living pongids gives their bodies a somewhat pot-bellied appearance, lacking a discernible waist.  This is because the rounded profile of the abdomen is continuous with that of the lower portion of the rib cage, which is shaped like an inverted funnel, and also because the lumbar region is relatively short (three to four lumber vertebrae).

The drawing below from the ETH shows the inverted-funnel shape of the ribcage of the chimpanzee on the left.  You can mentally draw the lines downward from these ribs and envision the pot-bellied look of the abdomen that these primates evidence.  Looking at the image on the right, you can see that Australopithecus afarensis (Lucy’s species) has the same inverted-funnel shaped rib cage, indicating a large belly and a low-quality diet.

The drawing in the middle is of a modern human.  If you extrapolate the lines down from the human rib cage, you can see that they lead to a more narrow waist.  Makes you think more of a lean, rangy wolf or other slim-waisted carnivore, whereas the other two don’t.

The authors conclude:

If an encephalized animal does not have a correspondingly elevated BMR [which according to Kleiber, it can’t], its energy budget must be balanced in some other way.  The expensive-tissue hypothesis suggested here is that this balance can be achieved by a reduction in size of one of the other metabolically expensive organs in the body (liver, kidney, heart of gut).  We argue that this can best be done by the adoption of a high-quality diet, which permits a relatively small gut and liberates a significant component of BMR for the encephalized brain.  No matter what was selecting for encephalization, a relatively large brain could not be achieved without a correspondingly [sic] increase in dietary quality unless the metabolic rate was correspondingly increased.

At a more general level, this exercise has demonstrated other important points.  First, diet can be inferred from aspects of anatomy other than teeth and jaws.  For example, an indication of the relative size of the gastro-intestinal tract and consequently the digestibility of the food stuffs being consumed is provided by the morphology of the rib cage and pelvis.  Second, any dietary inference for the hominids must be consistent with all lines of evidence.  Third, the evolution of any organ of the body cannot be profitably studied in isolation.  Other approaches to understand the costs of encephalization have generally failed because they have tended to look at the brain in isolation from other tissues.  The expensive-tissue hypothesis profitably emphasizes the essential interrelationship between the brain, BMR, and other metabolically expensive body organs.

I hope you are now armed with enough knowledge to be able to see through these articles and/or charts that are all too common showing how the GI tract of humans is closer to that of a gorilla than it is to that of a cat or some other carnivore.  It seems to me that Aiello and Wheeler have pretty thoroughly demolished the notion that humans are actually designed by the forces of natural selection to be vegetarians.  Based on the data and the argument they present, it is actually the opposite:  we evolved to be meat eaters.

It was our gradual drift toward the much higher quality diet provided by food from animal sources that allowed us to develop the large brains we have.  It was hunting and meat eating that reduced our GI tracts and freed up our brains to grow.  As I wrote at the start of this post, the evidence indicates that we didn’t evolve to eat meat – we evolved because we ate meat.

Lierre Keith had it right in The Vegetarian Myth:

The wild herds of aurochs and horses invented us out of their bodies, their nutrient-dense tissues gestating the human brain.

If we evolved because we ate meat, why would we want to stop now?

Note: I found the full text of this article available on Scribd.  If it gets taken down, let me know, and I’ll put it up here.  I’m just trying to save space on my server.

Painting at top: Monkey Before Skeleton by Gabriel Cornelius von Max

Is the body in the photo at left the new look for today’s man?  If so, it appears that MD and I may have missed the boat yet again.

It seems as though we possess a positive genius for having our timing screwed up.  Our past is littered with missed opportunities to promote our various books, all occasioned by situations beyond our control.  Let me give you a few examples.

We were scheduled to be the guests for the biggest part of one of Soledad O’Brien’s shows when word came down that Hillary Clinton was going to declare her candidacy for the U.S. Senate.  We were in NY (brought by our publisher, thank God) prepared to go on the show the next day when we got bumped to another time.  Another time that never materialized.

I was scheduled to be on O’Reilly live and, in fact, was in the limo sent by Fox to take me to the studio when I got a call on my cell telling me that the Texas fugitives had been captured in Colorado.  Since I was on the way, O’Reilly went ahead and did the interview, but it was taped and played a couple of months later when John Kasich (who is now apparently running for governor of Ohio) was the guest host and viewership was probably lower than had it been O’Reilly live.

MD and I were on our way to Miami (sent by our publisher once again) to appear on a couple of big live TV shows there when we got word that Elian Gonzales had been snatched by the Feds and was being sent back to Cuba.  Bumped again never to return.

We were to appear one afternoon on national TV rebutting the PCRM’s Neal Barnard, who had been all over the airwaves that morning with his ridiculous ‘study’ about low-carb diets.  We were in Santa Barbara at the time, and the network (I can’t remember which on now) had arranged for us to go to a local studio to be interviewed via satellite.  Just as we were about to leave for the studio, we got a call telling us our gig had been canceled because Michael Jackson’s plane was en route to the Santa Barbara airport where he was to turn himself in conjunction with the sexual molestation charges.  After that the news was all Michael Jackson.

I could go on, but you get the picture.  MD and I seem to be snake bit when it comes to book- and/or self-promotional timing.

Now we’ve finished a book, about to be released tomorrow, that is filled with all the latest science, much of it never before published other than in scientific papers, and we may be scooped again.  But in a different way.

Our new book includes info on saturated fat, fatty accumulation in the liver, diacylglycerol, D-ribose, L-leucine, visceral and subcutaneous fat, sagittal abdominal diameter, evolutionary psychology, and on and on, showing how all these things relate to the accumulation and loss of middle-aged fat.  But did we come out with it too late?

Maybe so according to a recent New York Times article titled “It’s Hip to Be Round” with the distressing picture below of various potbellies emblazoned across the top of it.

If this piece is to be believed, men at least have given up the flat-belly look in favor of the more portly Ralph Kramden body habitus.  If you’re of an age, you’ll remember Ralph Kramdem.  He was the character Jackie Gleason played on the television show The Honeymooners.  Taking a look at the photo at left.  That’s Jackie playing Ralph.  Remember Jackie Gleason’s nickname?  The Fat Man.  He was remarkable for his obesity because there was so little of it back then.  Notice, too, how Jackie, aka Ralph, wouldn’t have merited a second look today.  Half the people you see on TV today are more overweight.  And you think we don’t have an obesity epidemic?

According to the Times:

This summer the unvarying male uniform in the precincts of Brooklyn cool has been a pair of shorts cut at knickers length, a V-neck Hanes T-shirt, a pair of generic slip-on sneakers and a straw fedora. Add a leather cuff bracelet if the coolster is gay.

In truth this get-up was pretty much the unvarying male uniform last summer also, but this year an unexpected element has been added to the look, and that is a burgeoning potbelly one might term the Ralph Kramden.

Too pronounced to be blamed on the slouchy cut of a T-shirt, too modest in size to be termed a proper beer gut, developed too young to come under the heading of a paunch, the Ralph Kramden is everywhere to be seen lately…

The article goes on to lay out what I believe is an idiotic rationale (but obviously tongue in cheek) for all this (they blame it on Obama),  then adds

“I sort of think the six-pack abs obsession got so prissy it stopped being masculine,” is how Aaron Hicklin, the editor of Out, explains the emergence of the Ralph Kramden. What once seemed young and hot, for gay and straight men alike, now seems passé. Like manscaping, spray-on tans and other metrosexual affectations, having a belly one can bounce quarters off suggests that you may have too much time on your hands.

“It’s not cool to be seen spending so much time fussing around about your body,” Mr. Hicklin said.

And so guys can happily and guiltlessly go to seed.

So, there goes half our audience.  Always a day late and a dollar short.  I suppose we should have written a book describing how to develop the middle-aged middle before middle age.

On another note, if you still don’t think there is an obesity epidemic right now, take a look at this old video of Manhattan, NY filmed in the early 1920s.

Click here to view the embedded video.

Check at 1:50 and 9:16 to see the crowd scenes.  The people look like stick people.  They wouldn’t look that way if the film were made today.

And, if you want to read a little more about our new book, Tim Ferriss has excerpted part of one of the chapters here.

Last but not least, we’ve gotten some photos back of the first testimonials for our news book.  The photo on the right is the before, the one on the left, after six weeks on the plan.

Just kidding, of course.

Photo credits:

Troisdorf man

Large belly

Thin waist

The day after Labor Day (six days from today) our new book comes out, and our publisher finally gave us permission to excerpt it.  I’m going to post the entire introduction so you’ll know why we came to write this particular book.

The story you will read will be true and the names won’t be changed to protect the ‘innocent.’  Until the events transpired that you will soon be reading about, I was not especially a proponent of fast weight loss.  I mean a low-carb diet will make people lose weight quickly, but that’s not what I’m talking about.  I’m talking about the people who used to come into my office saying, “I’ve got my high school reunion in a month.  How much weight can I lose by then?’  I always considered these as fairly ludicrous requests because the requesters clearly weren’t concerned about health issues, but simply about how they would look in the short run, without an eye to maintaining their lifestyle.

As a consequence of dealing with so many of these patients, I really developed an aversion to the notion of quick weight loss to meet some sort of deadline where appearance counted.  But, as with so many things in life, it’s easy to pontificate until you find yourself in the same position as the people to whom you’re pontificating.

Go ahead and read this excerpt so you can see what I’m talking about, and we’ll pick up this conversation after.  This excerpt is from the manuscript version and not from the actual book so there may be slight differences, if you’re comparing the two.  I used the manuscript version because I could paste it in – had I used the actual book version I would have had to type it in.

Bob Hope famously quipped that middle age is when your age starts to show around your middle, and the audience always obliged him with a hearty laugh.  But for millions of adults the sad irony of the middle-aged middle is anything but funny.  Except for a select few metabolically-gifted individuals, crossing the threshold into middle age heralds the beginning of a battle of the bulge that seemingly never ends.  Granted some reach that threshold sooner than others; some acquiesce to the larger belt and the broader silhouette with some degree of aplomb, while others rail against time and fate. They take up and discard first one diet and exercise program and then the next in a frustrating quest to recapture the slender waist they can still recall, but no longer see in the mirror.

We’ve spent the majority of our medical careers helping people of every description with just this battle, combating overweight and weight-related health issues.  Although some were in their teens and twenties and some were in their seventies and eighties, the vast bulk of the many thousands of patients we guided to better health and lower weights were in middle age.  What we learned from these many years in the diet trenches is that middle-aged weight is stubborn; it’s different to deal with; it doesn’t respond readily to modest dietary changes or the incremental increases in exercise usually recommended by the purveyors of received medical and nutritional wisdom.  The factors driving middle-aged weight gain—which really does go straight to the middle—are like a perfect storm, metabolically speaking.  A confluence of changes in hormones, stress, lack of sleep, alcohol intake, medications, fat and cholesterol phobias, and a mountain of other nutritional misinformation combines to create a mid-life tsunami that seems to swamp the metabolism and fill every nook and cranny of the middle of the body with fat.

For more than twenty years we have researched this area of science, refining the tools to deal with it effectively, writing about it, lecturing on it, so you’d think that our expertise would make protect us from the tsunami, if it came our way.  But it didn’t.  Like everyone else, when the middle-age wave hit, we found ourselves floundering in the tide, paddling as fast as we could, and still not making much headway.  At least not until we dug back into the medical bag of tricks we had used with success in our middle-aged patients and applied them to ourselves.  Here’s how it all began.

Mike’s Story

Our wake up call came the morning we walked onto the set to film the pilot for our TV cooking show. Years before, I had gained a tremendous amount of weight while pursuing my career as a busy, practicing physician, then lost it on a diet I cobbled together from information I got rereading my old medical school texts and delving into the medical literature.  My weight loss did not go unnoticed by my patients, and soon many were clamoring for me to put them on the same diet I had developed for myself.  I did so with great success.  In short order my practice changed.  My wife, Mary Dan, left her busy family practice and joined me in what became a huge bariatric (the treatment of obesity) practice.  We refined the original diet and wrote about our methods in Protein Power, a book that sold nearly 4 million copies.  During the never-ending promotion of the book, we met a producer who proposed that we star in a TV cooking show designed around the precepts of our diet and a cookbook we had written.   We said “Let’s do it.”  He put the deal together and set the shooting schedule for the pilot.

We walked onto the set in sunny Southern California one morning filled with both enthusiasm and apprehension.   As we wandered through the semi-organized chaos that is a film studio, stepping over giant cables, ducking under the scaffolding for the overhead cameras, and dodging production assistants darting here and there, we began to wonder what we had gotten ourselves into.  The whirlwind of activity and the 30 or so people on the set were intimidating to say the least.  We had done countless live and taped television and radio interviews in the previous years, but never a project in which we were the sole actors on the stage, the ones who had to carry the entire show on our own shoulders.  A young man recognized us and directed us to the Green Room, telling us the director would be in to talk with us shortly.

The director, a total stickler for every aspect of the production, didn’t mince words when he joined us in the Green Room.  “We’re going to have to do something,” he said, “you guys are too fat to be starring in this kind of a cooking show.”

We were stunned.  I was a much lesser version of my former fat self and thought of myself as pretty slender.  Mary Dan had gained a little weight in the ten years since the publication of Protein Power, but certainly wouldn’t have been considered fat by anyone’s estimation.  People we met at lectures, book signings, and other appearances uniformly commented on how thin and healthy we looked and always added that we were good advertisements for our diet.

“Yeah, well, it doesn’t work that way on TV,” said the producer.  “If you’re the stars of a show on healthy eating, you’ve got to be thin.  Granted, you look better than the average Joes and Janes out there, but they don’t have their own health show.  TV is a youth-driven medium.  You’ve got to look young to make it on TV and young means thin, especially around the middle.  It’s like the golfer, Lee Trevino, says, the young guys are the ‘flat bellies.’  You’ve got to have a flat belly if you want to make it in this biz.  The camera is going to put 10 pounds on you and you’ve both got bellies starting out.  Imagine 10 pounds added to that.”

Bellies…?

“When you do lectures you’re dressed up, right?  You wear suits, don’t you?”

We nodded.

“At book signings you sit behind a desk, shake a few hands and sign books.  It doesn’t work that way on TV.  You’re going to be moving around, bending over, putting stuff in the oven; you’re going to be seen from all angles.  If we try to hide the fact that you’ve got a little extra weight around the middle, which will be hard since the camera will magnify it, the viewers will know.  Putting you in baggy sweaters or loose clothing will just make them think you’re fat and trying to disguise it, and the show will lose all credibility.”

In a flash, Mary Dan and I had both gone from being confident in our own 50-plus-year-old bodies to being aware of the small paunches that had suddenly seemed to materialize out of nowhere.  What before had seemed nothing more than a little tightening of the waistband now suddenly assumed Falstaffian proportions.

“What can we do?” we asked. “If we try to hide it, they’ll think were fat; if we don’t, they’ll know for sure.  It’s a Catch-22.  We can’t win.”

Our director said, “I haven’t worked in this biz for over 40 years and not learned a trick or two.  Here’s how we’re going to make this work.  Since you, Mary Dan, are going to be the main cook, we’ll keep you standing behind the counter.  You’re short enough that with the height of the counter and a little work with wardrobe we can keep you covered without appearing to do so.  Mike, we’ll have you do all the moving and bending, so you’re going to have to take the bullet.”

“Take the bullet?  What do you mean?”

He reached into his large canvas bag and pulled out what appeared to be a giant piece of black foam rubber.  “Before you go to wardrobe, let me help you put this on under your t-shirt.”The giant piece of foam rubber turned out to be a device called an abdominal censure; in other words, a giant girdle.

“I can’t wear that…” I said.

“Hey, don’t think you’re the Lone Ranger,” he replied, “why do you think I have this?  I didn’t buy it just for you.  A surprising number of the people you see on TV daily are wearing one of these.  Lift up your shirt.”

“Who?” I asked.

“I’m not going to tell anyone about you and I’m not going to tell you about anyone else.  Lift your shirt.”

I lifted my t-shirt; he wrapped the thing around my abdomen and put his knee in the middle of my back to cinch me in.  Feeling a little like the male equivalent of Scarlett O’Hara in the corset scene, I dropped my t-shirt down and looked in the mirror.  I had to admit, I looked better.

I wore the girdle and Mary Dan stayed behind the counter for the two days it took to film the pilot.  (Now we shoot two shows per day, but then we were raw beginners.)  Our show got picked up by PBS and we scheduled to start shooting about three months later.  Fortunately, the pilot was only shown to others in the industry, and now the show with me squeezed into neoprene and Mary Dan cloistered behind the counter has been relegated to the never-to-be-shown file.  What we took away from that day was the certainty that something had to be done and quickly…but what?

Not long after returning home from this experience we attended a large charity event at which we were seated at a table with several middle-aged women.  One was significantly overweight, but the others would be considered within or close to their normal weight range.  The discussion turned to weight loss.  The constant thread through the conversation was how much easier it was to lose weight overall, compared to the difficulty of losing it in the waist.  All the women bemoaned their stubborn middles.

Meanwhile, still stinging from our recent brush with abdominal truth, we had begun looking at the mid-sections of non-obese middle aged men and it quickly became clear that they all had paunches of various sizes.  It appeared that there were no (or damned few) middle-aged flat bellies out there of either gender.  Young people who were a little overweight didn’t seem to have protuberant guts; they carried their excess weight all over.  But in middle age, it went straight to the middle.  Even young people with guts don’t look the same as middle-aged people with big bellies; there is a difference, easily recognized.  We realized that our director had been right; it’s not just normal body weight, but a flat belly that is the real sign of youth, so we set out to get one, too. .  Drawing on two decades of experience in clinical practice, helping thousands of patients of all ages, we dusted off and examined every weight loss trick in our armamentarium. We did the same thing we had done years before when we did our research for Protein Power, combing the worldwide medical literature for insight and scientific substance, but instead of concentrating on weight-loss in general, we focused our search on abdominal weight loss, more specifically abdominal fat loss.  We discovered that, although spot reducing is impossible, the diameter of the mid-section can be reduced quickly with the right nutritional tools.  Fortunately, many of those tools dovetailed perfectly with those we’d used successfully over the years with patients in our clinical practice.  After a couple of weeks of intense effort, we put together a flat-belly program for ourselves that combined a reworking of our old Thin So Fast and Protein Power diets that we had used in many thousands of patients, a number of nutritional supplements we had learned about from our wide-ranging medical research in the intervening years, and a unique, but simple, abdominal exercise plan, based on the laws of physics.

We had exactly 6 weeks before our next shoot, so we launched into the program with full vigor, with the goals of avoiding the dreaded cinch and the safety of the counter.  The regimen vastly exceeded our expectations.  The greatest changes occurred in the first two weeks with smaller, but still significant, changes taking place over the course of the next 4.  We appeared for the shoot with flat bellies, much to the delight of our director.  and were able to move from refrigerator to sink to counter, showing full physique and with nary a trace of neoprene.   We no longer had to suck it in every time we changed positions for fear that the camera might catch our mid-sections at an unfavorable angle. The regimen had been a slam dunk.

It’s been a little over two years (and 26 episodes of our show) since we developed and took The 6-Week Cure ourselves, but our success has inspired countless readers, viewers, relatives, patients, friends, and friends of friends to want to know exactly how we did it.  This book provides those answers.  In it, you will discover not only what happens in middle age that drives fat into your middle body, but more importantly, what you can do, physically and nutritionally, to harness the metabolic forces at work and turn the tide.  With a little hard work over a very short stretch, you, too, can regain a more youthful silhouette. When you do, we’re sure you’ll agree with what we discovered: there’s nothing that restores youth like curing your middle-aged middle.

MD and I have been on a low-carb diet (sometimes stringently; sometimes not so stringently) for about the last 25 years, so some may take this story to be a repudiation of such diets, but it isn’t.  Our diet wasn’t really at fault; it was the inexorable creep of time that caused the problem.

As we age, things change.  What worked 25 years ago, doesn’t work exactly as well now.  Especially when we get a little sloppy with it.  One of the problems with carb restriction is that people who do it for a while, get good at it.  They become experts at both abiding by the carb restriction yet consuming a lot of calories and tending to overlook small carb indiscretions—a small piece of bread at dinner, just a bite or two of dessert, an extra glass or two of wine or beer—that they would have scrupulously avoided during the first heady days of low-carbing.  We were certainly experts on low-carb diets and we fell into those traps.   And time marched on making us even more susceptible to little indiscretions and to carb creep.

Now, we never came close to Orson Welles or Mamma Cass proportions – in fact most people would have described us a slim – but we had picked up little middle-aged middles.  So we set out to lose them.  Fast.  To do so, we relied upon our 25 years in clinical practice, pulling out every tool we had learned to help solve stubborn cases of middle- aged overweight.

As we describe in the book, the kind of fat people pack on around their middles in middle age is different than fat packed on earlier in life, which is both good news and bad.  Middle-aged fat is, by and large, visceral fat, the kind that accumulates within the abdominal wall and around the organs.  The bad news is that it is a dangerous kind of fat – the good news is that it’s relatively easy to lose.  Especially if you do it the right way.  Which is why you can make enormous strides in only six weeks even if you have a lot to lose.

Although it does contain plenty of information you’re not likely to have read before, this book isn’t intended as a giant treatise on everything known about health and weight loss.  It’s, quite simply, a primer on how to get rid of middle-aged abdominal fat fast and safely.  We solved our own problem.  I hope those of you who grab a copy and give it a try achieve the success that we did.  And I hope you give us your feedback so that we can improve future editions.

Before I get into a discussion of the absolutely phenomenal book you see pictured at the right, I’ve got a few disclosures to make.  First, I’m not much of a believer in the notion of man-made global warming or climate change (as they now call it since temperatures have been constantly falling instead of rising).  I’m a denier, in the pejorative term used by those who are believers.

Second, I’m not particularly pro-feminist.  And I certainly don’t hang around with any self-proclaimed radical feminists.  I have a wife who is smarter than I am, who is more talented than I am, and who, pound for pound, is probably a better athlete than I am, and I’m not bad. (In my defense, I can read much, much faster than she, but, she has better comprehension.) I long ago gave up the idea (if I ever really considered it seriously) that men are superior to women in any ways other than brute strength.  Having said that, however, I do believe that men are better suited to certain endeavors than woman and vice verse, but that doesn’t mean either men or women should be denied the opportunity to give whatever it is they want to do a whirl just because of their sex.  I guess I consider myself an egalitarian.  But from what I’ve seen of radical feminists, I’m not sure that I would count myself a big fan.

Given the above, you wouldn’t think I would enjoy and recommend a book written by a self-proclaimed radical feminist who is obviously a believer in global warming and the impending end of the earth as we know it.  I wouldn’t think so, either. Not my cup of tea even when it is sort of preaching to the choir.

But I can tell you that Lierre Keith’s book is beyond fantastic.  It is easily the best book I’ve read since Mistakes Were Made, maybe even better.  Everyone should read this book, vegetarian and non-vegetarian alike.  If you’re a radical feminist, you should read this book; if you’re a male chauvinist, you should read this book; if you have children, especially female children, you should read this book; if you are a young woman (or man) you should read this book; if you love animals, you should read this book; if you hate vegetarians, you should read this book; if you are contemplating the vegetarian way of life, you should definitely read this book; if you have a vegetarian friend or family member, you should this book and so should your friend.  As MD said after she read it, “everyone who eats should read this book.”

Anyone who has ever read a book on writing has come across the hackneyed piece of advice to cut open a vein and bleed on the page.  Lierre Keith, the author of this book, has come closer to literally doing that than almost any writer I’ve ever read.  Not only does her passion for her subject bleed through in almost every sentence, she is a superb lyrical prose stylist.  My book is dog eared, underlined and annotated from front to back – I can’t remember anything I’ve read that has contained so many terrific lines.

In fact The Vegetarian Myth is filled with so many good quotes (most by the author but some from other authors) that I was reminded of the old joke about the redneck who went to see a performance of Hamlet.  When the show let out, someone asked him what he thought of it.  Replied he:  It wasn’t nothin’ but a whole bunch of quotes all strung together.  As you’ll see when I ‘quote’ them below, The Vegetarian Myth contains quotable lines and paragraphs at about the same rate Hamlet does.

Ms. Keith was a practicing vegetarian (vegan) for twenty years, driven by her passion for kindness and justice for all creatures.  She couldn’t bear the thought of even killing a garden slug, or, for that matter, even removing a garden slug from her garden to a place where something or someone else might kill it.  Her years of compassionate avoidance of any foods of animal origin cost her her health.  Her story of coming to grips with the realization that whatever she ate came as a consequence of some living being’s having to die form the matrix onto which her narrative hangs.

You can read the first 14 manuscript pages of the book on the author’s website.  I have quoted from these 14 pages liberally below.

The introduction to The Vegetarian Myth explores Ms. Keith’s rationale for writing such a book, a book that, given her years of walking the vegetarian walk, must have been incredibly difficult to write.  She says as much with her first sentence.

She ponders the idea of factory farming, which she loathes, and the misbegotten idea that most people hold (not most readers of this blog, but most of the people in the world) that grains are good, not only for people, but for many animals as well.  And the common misconception that agriculture, the growing of annual grains and plants, is a wonderful, kind, sustainable activity.

This misunderstanding is born of ignorance, an ignorance that runs the length and breadth of the vegetarian myth, through the nature of agriculture and ending in the nature of life. We are urban industrialists, and we don’t know the origins of our food. This includes vegetarians, despite their claims to the truth. It included me, too, for twenty years. Anyone who ate meat was in denial; only I had faced the facts. Certainly, most people who consume factory-farmed meat have never asked what died and how it died. But frankly, neither have most vegetarians.

The truth is that agriculture is the most destructive thing humans have done to the planet, and more of the same won’t save us. The truth is that agriculture requires the wholesale destruction of entire ecosystems. The truth is also that life isn’t possible without death, that no matter what you eat, someone has to die to feed you.

I want a full accounting, an accounting that goes way beyond what’s dead on your plate. I’m asking about everything that died in the process, everything that was killed to get that food onto your plate. That’s the more radical question, and it’s the only question that will produce the truth. How many rivers were dammed and drained, how many prairies plowed and forests pulled down, how much topsoil turned to dust and blown into ghosts? I want to know about all the species—not just the individuals, but the entire species—the chinook, the bison, the grasshopper sparrows, the grey wolves. And I want more than just the number of dead and gone. I want them back.

After she had seen the error of her ways as a vegan and had been eating meat for two years, for reasons unknown to her, the author continued to surf the same vegan websites and message boards she had for years.  Until she read one post that was so bizarre that she finally realized the large intellectual gap that had widened between her rationale thinking and the cult like thinking of, well, a cult.  It would be funny if it weren’t so pathetic.

But one post marked a turning point. A vegan flushed out his idea to keep animals from being killed—not by humans, but by other animals. Someone should build a fence down the middle of the Serengeti, and divide the predators from the prey. Killing is wrong and no animals should ever have to die, so the big cats and wild canines would go on one side, while the wildebeests and zebras would live on the other. He knew the carnivores would be okay because they didn’t need to be carnivores. That was a lie the meat industry told. He’d seen his dog eat grass: therefore, dogs could live on grass.

No one objected. In fact, others chimed in. My cat eats grass, too, one woman added, all enthusiasm. So does mine! someone else posted. Everyone agreed that fencing was the solution to animal death.

Note well that the site for this liberatory project was Africa. No one mentioned the North American prairie, where carnivores and ruminants alike have been extirpated for the  annual grains that vegetarians embrace. But I’ll return to that in Chapter 3.

I knew enough to know that this was insane. But no one else on the message board could see anything wrong with the scheme. So, on the theory that many readers lack the knowledge to judge this plan, I’m going to walk you through this.

Carnivores cannot survive on cellulose. They may on occasion eat grass, but they use it medicinally, usually as a purgative to clear their digestive tracts of parasites. Ruminants, on the other hand, have evolved to eat grass. They have a rumen (hence, ruminant), the first in a series of multiple stomachs that acts as a fermentative vat. What’s actually happening inside a cow or a zebra is that bacteria eat the grass, and the animals eat the bacteria.

Lions and hyenas and humans don’t have a ruminant’s digestive system. Literally from our teeth to our rectums we are designed for meat. We have no mechanism to digest cellulose.

So on the carnivore side of the fence, starvation will take every animal. Some will last longer than others, and those some will end their days as cannibals. The scavengers will have a Fat Tuesday party, but when the bones are picked clean, they’ll starve as well. The graveyard won’t end there. Without grazers to eat the grass, the land will eventually turn to desert.

Why? Because without grazers to literally level the playing field, the perennial plants mature, and shade out the basal growth point at the plant’s base. In a brittle environment like the Serengeti, decay is mostly physical (weathering) and chemical (oxidative), not bacterial and biological as in a moist environment. In fact, the ruminants take over most of the biological functions of soil by digesting the cellulose and returning the nutrients, once again available, in the form of urine and feces.

But without ruminants, the plant matter will pile up, reducing growth, and begin killing the plants. The bare earth is now exposed to wind, sun, and rain, the minerals leech away, and the soil structure is destroyed. In our attempt to save animals, we’ve killed everything.

On the ruminant side of the fence, the wildebeests and friends will reproduce as effectively as ever. But without the check of predators, there will quickly be more grazers than grass. The animals will outstrip their food source, eat the plants down to the ground, and then starve to death, leaving behind a seriously degraded landscape.

The lesson here is obvious, though it is profound enough to inspire a religion: we need to be eaten as much as we need to eat. The grazers need their daily cellulose, but the grass also needs the animals. It needs the manure, with its nitrogen, minerals, and bacteria; it needs the mechanical check of grazing activity; and it needs the resources stored in animal bodies and freed up by degraders when animals die.

The grass and the grazers need each other as much as predators and prey. These are not one-way relationships, not arrangements of dominance and subordination. We aren’t exploiting each other by eating. We are only taking turns.

That was my last visit to the vegan message boards. I realized then that people so deeply ignorant of the nature of life, with its mineral cycle and carbon trade, its balance points around an ancient circle of producers, consumers, and degraders, weren’t going to be able to guide me or, indeed, make any useful decisions about sustainable human culture. By turning from adult knowledge, the knowledge that death is embedded in every creature’s sustenance, from bacteria to grizzly bears, they would never be able to feed the emotional and spiritual hunger that ached in me from accepting that knowledge. Maybe in the end this book is an attempt to soothe that ache myself.

How anyone who can read these 14 pages and not purchase and read this book is beyond me.

After the introduction which deals with why the author wrote the book, The Vegetarian Myth is divided into four sections: Moral Vegetarians, Political Vegetarians, Nutritional Vegetarians, and To Save the World.

The first three of these sections are the author’s in-depth refutations of the moral, political and nutritional arguments that vegetarians are constantly putting forth.  She does a masterful job.

In the Moral Vegetarians chapter, the author addresses the moral issue of killing animals for our own food.  She beautifully makes her case by cutting to the heart of the matter:

What separates me from vegetarians isn’t ethics or commitment.  It’s information.

And while she was in her 20-year trek in the vegetarian wilderness, she shielded herself from information as most cultists do:

I was on the side of righteousness, and like any fundamentalist, I could only stay there by avoiding information.

She finally realized the truth about agriculture; she figured out that the amber waves of grain are as death dealing as any slaughterhouse.

And agriculture isn’t quite a war because the forests and wetlands and prairies, the rain, the soil, the air, can’t fight back.  Agriculture is really more like ethnic cleansing, wiping out the indigenous dwellers so the invaders can take the land.  It’s biotic cleansing, biocide. … It is not non-violent.  It is not sustainable.  And every bite of food is laden with death.

There is no place left for the buffalo to roam.  There’s only corn, wheat, and soy.  About the only animals that escaped the biotic cleansing of the agriculturalists are small animals like mice and rabbits, and billions of them are killed by the harvesting equipment every year.  Unless you’re out there with a scythe, don’t forget to add them to the death toll of your vegetarian meal.  They count, and they died for your dinner…

Soil, species, rivers.  That’s the death in your food.  Agriculture is carnivorous: what it eats is ecosystems, and it swallows them whole.

In Political Vegetarians she refutes the politics (predominantly liberal) of the vegetarian movement and describes the dark side of political meddling in our ecosystem approved of in the main by PETA and other vegetarian groups.  She follows the money.

Rice, wheat, corn – the annual grains that vegetarians want the world to eat – are thirsty enough to drink whole rivers.

The result has been an unending river of corn, drowning our arteries and our insulin receptors, our rural communities, and poor subsistence economies the world over.  The corn comes at a huge environmental toll: there’s a half gallon of oil in every bushel.  And it’s essentially a massive transfer of money from the US taxpayer to the giant grain cartels, who are able to command the price of grain to be lower than the cost of production, with all of us making up the difference – five billion dollars in subsidies for corn alone, straight into the pockets of Cargill and Monsanto.

Nutritional Vegetarians is about the nutritional inadequacies of a vegetarian and especially a vegan diet.  And she does an absolute bang up job of laying out the rationale for following a no-grain, low-carb diet.

I have a disclosure to make here.  Much of the information in this chapter is based on Protein Power and The Protein Power LifePlan.  MD and I are listed in the acknowledgments, but I swear I didn’t know this until I bought the book.  We aren’t the only ones, but there are plenty of quotes from us in this chapter.  Gary Taubes, Malcolm Kendrick and (dare I say it) Anthony Colpo are quoted liberally as well.  I would have loved this book just as much if we had never been quoted.

Ms Keith has made a few minor innocuous errors in this chapter, but, all in all, she has done a tremendous job of synthesizing the scientific information into an easy to read, informative format.

The Nutritional Vegetarians section isn’t just about the science of why vegetarianism is bad and meat eating is good, it gets into the nutritional politics (as opposed to the vegetarian politics in the previous section) as well.  Ms Keith shows how we got to where we are by the nutritional strong arming by the McGovern committee back in the late 1970s.  George McGovern (a senator from a grain-producing state) and his cronies basically set the nutritional standards under which we are still oppressed.  They have been a disaster, as some scientists at the time predicted they would be.

And some scientists knew ahead of time that they would be.  Phil Handler, the president of hte National Academy of Scientists asked Congress, “What right has the federal government to propose that the American people conduct a vast nutritional experiment, with themselves as subjects, on the strength of so very little evidence that it will do them any good?”  Dr. Pete Ahrens, an expert on cholesterol metabolism, told the McGovern committee that the effects of a low-fat diet weren’t a scientific matter but “a betting matter.”

It’s twenty-five years later and we aren’t winning this bet.  Each US American now eats sixty pounds more grain per annum and thirty pounds more cheap sugars, mostly from corn.  [Is it any wonder we're all fat?]

The result, Dietary Goals for Americans, set in motion a cast sea change in the public’s beliefs and behaviors. … Dietary Goals was a predictable victory in a war that started ten thousand years ago.  What really won were those annual grasses that had long since turned humans into mercenaries against the rest of the planet.  We would now enshrine them like demi-gods, those whole grains and their sweet, opiate seductions, believing in their power to bestow health and long life, even while they slowly ate us alive.

I don’t think I’ve ever read a book review that was positive from beginning to end, and this one is no exception.  Based on the many comments I’ve gotten on this blog and my response to them, I’m sure many of you will find my main objection surprising.  There is too much politics in the book.  Not nutritional politics, but feminist politics.

I know, I know, I let my libertarian leanings come through in all kinds of blog posts and comment answers, but there is a difference.  My blog is just that – a weblog of things I find interesting or informative.  And it’s free.  I don’t particularly like to pay for a book (and I paid full price for this one plus shipping) on a given subject then be beaten over the head with a political viewpoint.  I guarantee you that our new book has zero politics in it.  And if people bought our book expecting to learn about getting rid of their middle-aged middles and were fed a generous dose of my politics mixed in with the information, I would expect them to be flamed.

To give the author her due in this matter, the vegetarian ideology that had her in its grasp for 20 years was intertwined with her feminist politics, so a bit of said politics are necessary to describe how she was so taken in for so long.  But I think she went a little overboard with it.

And, I think the last section of the book – To Save the World – is the weakest part of the book.  The author makes several recommendations, all of which (save one) are, in my opinion totally unrealistic.  But I’ll leave it to you to draw your own conclusions after you’ve read the book.

I’ve read that when people are asked to recall what they remember of something they read, they tend to remember the first thing in the piece and the last thing.  Most of the middle melds into a vague memory of what the article was about.  I certainly don’t want people to remember this last negative part I wrote and let it dissuade them from reading this book.  The good parts of the book so far outweigh the not-so-good parts that there is really no contest.

At a time when PETA and other vegetarian groups are mobilizing and ramping up their activity levels, a book such as this one bringing sanity to the debate is more important than ever.  And don’t think these groups aren’t becoming more active.  In the past, PETA and PETAphiles pretty much devoted their educational efforts toward the idea that eating animals was cruel.  Now they are starting to make the case that a vegetarian diet will solve the obesity epidemic.  Take a look at this billboard in Jacksonville, Florida.

If you find this sign annoying, buy The Vegetarian Myth and do your part to fight back. And if you have or know anyone with a daughter who is contemplating going vegetarian (young females are the most common victims), please make this book available.  It could be the most important thing you ever do for the long-term mental and physical health of a young woman.

If you’ve made it this far in this long review, take a couple of minutes and watch this YouTube of Lierre Keith at a book event; she’s as fascinating to listen to as she is to read.

Click here to view the embedded video.

While looking for an old post for a reader, I came upon one of the bestseller lists I did last year, which reminded me that I hadn’t posted one of these in a while.  I had been trying to keep them up quarterly so that readers of this blog could see the books other readers were buying, but, what with all the links required, these posts are a real hassle to put up. So, since I, like most everyone else, gravitate toward pleasure and away from pain, I’ve not kept up with my quarterly timetable.

I can probably muster up the gumption to do it annually, so here is the list of the bestselling books from 2008.  These are the books that readers of this blog purchased through Amazon by clicking on the links or book icons on my blog, MD’s blog and the home page of the website.  I’ve listed only books not written by MD and/or me.

The number one bestselling book was Mistakes Were Made, which is one of the better books that I’ve read in a long, long time.  It’s now out in paperback, so if you haven’t read it, get a copy.  It explains in an easy-to-read way how the confirmation bias works and why we all need to carefully examine why we believe what we believe.  And it shows the validity of Stuart Chase’s famous quote:

For those who believe, no proof is necessary. For those who don’t believe, no proof is possible.

I’ve read a slew of books on the confirmation bias and why we believe what we believe, but, in my opinion, Mistakes Were Made is by far and away the best of them all.

Here are all the books in descending order of sales:

#1. Mistakes Were Made by Carol Tavris and Elliot Aronson (my full review)

#2. Good Calories, Bad Calories by Gary Taubes (my review)

#3 Crucial Conversations by Kerry Patterson et al (my review)

#4 The Brain Trust Program by Larry McCleary, M.D. (my review)

#5 500 Low-Carb Recipes by Dana Carpender

#6 The Great Cholesterol Con by Malcolm Kendrick, M.D. (my review)

#7 200 Low-Carb Slow Cooker Recipes by Dana Carpender

#8 Dr. Bernstein’s Diabetes Solution by Richard Bernstein, M.D.

#9 How to Cook Everything by Mark Bittman (MD’s review)

#10 The Low-Carb Baking and Dessert Cookbook by Ursula Solom

As always, I appreciate all of you who have supported this site by purchasing your books, CDs, DVDs, clothing, electronics and all the other stuff you’ve purchased through the Amazon portal on this site.

For those of you who don’t realize how this all works, you can click on one of the above links or one of the book icons on the front page of this blog or the home page of the website and you will be taken to that particular book’s page on Amazon.com.  Once there, you can search for anything Amazon has available, and if your purchase it, I get a little kickback for providing the entry portal.  It is one of the few truly win-win deals out there.  You get your book (or whatever) at the regular (usually heavily discounted) Amazon price, and I get a little dinero to help pay the web guys who keep the site updated and running.  In looking over last year’s records, I was able to pay about two thirds of my tech bills with my Amazon kickback (I hate that word, but I can’t think of a better one), so thanks very much to all those who helped.

I’m constantly telling my own family members, most of whom order a lot of stuff from Amazon, to go to Amazon through the portal on this blog instead of just logging in on amazon.com and buying away.  But it often falls on deaf ears, so maybe I’ll have a little better luck with readers here.  I know it’s a little extra hassle to pull up this blog and click on one of the books to get to Amazon than it is to simply click on Amazon directly, but if you do take the extra couple of seconds, you’ll make an old man very happy.

Seattle skyline from the plane window as we flew in a couple of days ago

I’ve long thought the critical thinking skills of the majority of Americans have been decaying over time.   More and more people seem to accept whatever they hear from a television commentator or a newspaper reporter without ever considering that whatever they’re hearing may be incorrect.   In many ways we’ve become a nation of sheep, and kind of stupid sheep, at that.   When I ponder on this, I always think of my favorite George Carlin quote:

Think of how stupid the average person is, and realize half of them are stupider than that.

Forget for a minute the notion of overall intelligence and think of nutritional intelligence only, then apply Carlin’s reasoning.   Think of someone you know who has what you would consider an average amount of nutritional knowledge, then realize that half of the US population has less nutritional knowledge than that.   And they don’t care.

Whenever I think about George Carlin and my favorite quote of his, I’m always reminded of my next favorite quote:

I do this real moron thing, it’s called thinking, and I’m not a very good American because I like to form my own opinions.

Sadly, in our culture, thinking is becoming more and more of a moron thing.

A reader sent me an opinion piece on the state of American intelligence and critical thinking that I want to share.   There are a couple of paragraphs in this essay that I especially thought hit the mark.

We live in two Americas. One America, now the minority, functions in a print-based, literate world. It can cope with complexity and has the intellectual tools to separate illusion from truth. The other America, which constitutes the majority, exists in a non-reality-based belief system. This America, dependent on skillfully manipulated images for information, has severed itself from the literate, print-based culture. It cannot differentiate between lies and truth. It is informed by simplistic, childish narratives and clichés. It is thrown into confusion by ambiguity, nuance and self-reflection. This divide, more than race, class or gender, more than rural or urban, believer or nonbeliever, red state or blue state, has split the country into radically distinct, unbridgeable and antagonistic entities

The core values of our open society, the ability to think for oneself, to draw independent conclusions, to express dissent when judgment and common sense indicate something is wrong, to be self-critical, to challenge authority, to understand historical facts, to separate truth from lies, to advocate for change and to acknowledge that there are other views, different ways of being, that are morally and socially acceptable, are dying.

I had never been on the website where this piece appeared, so I had no preconceived notions of what the article was going to be about when I started reading it.   As I read it, however, I started suspecting that the writer was from the far right, then I started thinking he was maybe a libertarian.   After reading the piece, I checked the guy out only to discover that he is an avowed socialist. Who would’ve thought it?   At any rate, whatever his own political views, I think he hits pretty close to home with his essay.  The vast majority of people don’t want to think for themselves – they want to be told what to do. And what they want more than anything is to be entertained.    And the more passive the entertainment the better.    How many Americans do you know that, given the choice, wouldn’t rather veg in front of the TV than read a book?    Even an easy, fun-to-read book?  It’s just too much work.  Why learn when it’s so much less difficult and so much more fun to be passively entertained.  It’s so much easier to sit in a comfy chair and let the talking heads do your critical thinking for you.  It is a sad, sad state of affairs.

But, there is hope.    At least among the tribe of low-carb dieters there are some readers.    A lot of readers, in fact.    And most people who do read develop better critical thinking skills than those who don’t.

Before I get to how I know low-carbers are readers, at least as compared to low-fatters, let me digress a little to discuss bestseller lists, a subject near and dear to my heart.  (Especially since, with your help, I hope to be back on one again soon.)

There are countless bestseller lists.  Practically each newspaper has it’s own.   If you make it on to the bestseller list of some rinky dink local paper, you are a bestseller.  I’m not kidding.   When you see the term ‘bestseller’ or bestselling’ applied to an author – as in ‘Bestselling author Dr. Michael Eades’ or ‘the bestselling book Protein Power’ you can figure that Dr. Michael Eades’ book Protein Power made it onto the bestseller list of some small, regional newspaper.  If a book makes it on to the bestseller list of a larger newspaper, one that has a bit of national circulation, then that book is said to be a ‘national bestseller,’ a term frequently used.   I don’t know what makes a paper fall into the ‘national’ category, but they all know in the publishing biz.   The Denver paper, for example, is considered a national paper, so if your book makes it onto the Denver Post, then you are not just a bestseller, you are a national bestseller.

The Big Daddy of all the bestseller lists (at least in the US) is the New York Times bestseller list.  Every author wants to figure a way to weasel onto this list.  Why?  Because all the book stores key off the NY Times list, especially the big chain bookstores.  All the books on the NY Times list get moved to the front of the store and discounted.  Which, of course, increases their visibility and sales.  Which tends to keep them on the list even longer, perpetuating the cycle.  Which is why everyone – including yours truly – wants to make it onto the NY Times bestseller list.  Once there, you stay for a while.  And once there, for ever after your are a New York Times bestselling author.  Not just a bestselling author or a national bestselling author, but a by God New York Times bestselling author.

With all the folderol that goes with the New York Times bestseller list, you would think that it would at least semi-accurately be a measure of how many books of any title are actually sold, but it’s not.  For that you have to go to the USA Today list.  A less prestigious list in terms of what you can say about yourself, but vastly more important in terms of tracking book sales.  Here’s why.

The New York Times list is divided into multiple categories by type of book (fiction vs nonfiction) and by cover (hardcover vs softcover).  Even the softcover category is divided into trade paperback and mass market paperback sections.  (Trade paperbacks are those that are the same size as a hardcover book; mass market paperbacks are the small ones you find on racks that you think of as paperback books.)  The number of categories of books has expanded with the whining of authors wanting to get on the list.  It used to be that there were fiction and nonfiction lists.  All the self-styled ‘serious’ nonfiction authors had to compete with diet book authors (God forbid) and other lesser authors of how-to and self-help books and usually came up short.  The Times caved and started a new category called Advice, How-To and Miscellaneous so that these serious nonfiction authors wouldn’t have to mingle with (or, more importantly for them, compete with) us more low-brow types in the self-help section.  Since there are multiple categories of NY Times bestseller lists, all you can really do is compare books within a given list.  There may be 20 times more of the #4 book in the Advice, How-To and Miscellaneous list sold than the book that is #1 on the nonfiction list, but there is no way to know this.  But you can find this out from the USA Today list.

The USA Today bestseller list published every Thursday lists the top 50 bestselling books based on sales irrespective of category.  If your book is #1 on the USA Today list, that means more copies were sold than any other book.  You want to be on the NY Times list for the prestige but you want to be on the USA Today list because it means you’re selling a whole lot of books.

Last week USA Today published a list of the top selling 150 books of the past 15 years.  Considering that there are several thousand new book titles published each year, the USA Today list represents the bestselling books out of some 50,000 to 75,000 titles published over the past decade and a half.  That’s thousands of different titles.  Some of these titles had small print runs of only a thousand or so copies while others – The Da Vinci Code and the Harry Potter books, for example – had print runs in the millions, making this list represent millions and millions of books sold.

Taking a quick look at the list is enlightening.  Of the 150 bestsellers over the past 15 years, nine of them are diet/nutrition books or six percent.  When you take a look at these specific diet/nutrition titles, a trend emerges.

#2    Dr. Atkins’ New Diet Revolution

#11  The South Beach Diet

#58  Dr. Atkins’ New Carbohydrate Gram Counter

#61  The South Beach Diet Good Fats Good Carbs Guide

#87  You: On a Diet

#121 Sugar Busters!

#129 The Ultimate Weight Solution

#130 Protein Power

#143 The Zone

As you can see from this list, seven out of the nine books are low-carb (or semi-low-carb) books.  The two that aren’t (#87 & #129) were by celebrity authors who were given their starts and shamelessly promoted by Oprah. (Also, as an aside, if you take the time to pull down the Amazon pages of all these books, note which one has the highest star rating. )

The other books on the list had to make it their on their own without Oprah’s help.  And, in fact, with Oprah openly saying that low-carb diets are bad.  I think the fact that there are so many of these books on this list says a lot about low-carb aficionados.  At the very least, it says that low-carbers buy books and they read.  Where are all the low-fat books on this list?  There were a gazillion published over the past 15 years.  Some made the NY Times list.  But where are they now?  Where are Ornish’s ultra-low-fat books?  Not a single mention.  Yet you see him all over the place in the media.  I’ll leave it to you to draw your own conclusions about what all this means.  But remember, low-carb books outsold The Da Vinci Code and a bunch of the Harry Potter books, all of which were quite the bestsellers.  If you add up all the low-carb books and counted them as one, that book would have been #1 on the list.  Quite an accomplishment for a discredited diet theory, I would say.

Think about all the negative press reports low-carb diets and meat-based diets get, and yet people continue to buy and read low-carb books.  My take is that there are still some thinkers out there who don’t let the media lead them by the nose and who want to take responsibility for their own health and well being.  And I consider it a good sign.  At least when the revolution comes, it will be lead by those who follow low-carb diets because they may be the only thinkers left.

A bit of housekeeping.  MD and I are in the midst of three major projects right now, requiring travel all over the place, and time is at a premium.  I just looked and there are almost a hundred comments undealt with in the queue right now.  I’m going to make my way through them, so don’t despair if you’ve been waiting.  But for the next bit – at least until we get through this crunch time – I’m simply going to post any future comments as they come in.  I don’t have time to answer them individually.  When the time frees up, I’ll probably start back.  But until then, don’t feel slighted if your question just gets posted as it comes in.

(Hat tip to Dave Dixon for the essay at the start of this post)

Skulls in our library. See bottom of post for description.

In 1981 MD and I read a book that changed our lives.  I don’t know why because I didn’t have a particular interest in paleontology or anthropology at the time, but I picked up a copy of Lucy: the Beginnings of Humankind by Donald Johanson.  The book sat around the house for awhile before I found the time to read it, but when I started reading, I couldn’t quit.  It was an absolutely riveting read.

I carried the book with me and read it everywhere.  At the time, I was doing a lot of emergency room medicine, so I took the book along on one of my 24 hour shifts.  As luck would have it, I had a slow night, so instead of sacking out as I would have usually done, making sure I got some shut eye before the inevitable car wreck or gunshot wound showed up to shatter my peace, I read Lucy.  I finished it sometime during the middle of the night and the couldn’t get back to sleep for thinking about it.  I couldn’t wait to get home to MD and tell her about it and force her – at gunpoint, if necessary – to read it.  I couldn’t live with myself if I were this enthusiastic about something and had no one to discuss it with.

She started reading it, and before I knew it, she was as fired up about it as I was.  She read a lot of it in bed before we went to sleep, and our conversations went much like this:

Me: What part are you reading?

MD: I’m at the part about the ‘R’ and ‘K’ factors.

Me: Isn’t that cool.  Then on to a general conversation between us about R and K.

MD: (Exasperated) Let me get back to the book.

Ten minutes later.

Me: What part are you reading now?

When she finally finished, it seemed that Lucy was all we could talk about for about a month.  Just around the time we finished the book, the Little Rock public library had its big, once-a-year, friends of the library sale.  People donate old books, new books, magazines, and any and all kinds of reading matter to this fundraising event.  I knew that there were usually a lot of old medical and scientific journals there, so MD and I headed on down.  When we got there, we hit pay dirt.  We found EVERY one of the original journals that contained all the papers written on the discovery of Lucy and the anthropological and paleontological work to figure out what she actually was.

It has just occurred to me in my stream of consciousness writing, driven by my excitement from just thinking about those days, that, for those who don’t know, I haven’t explained who Lucy is.  Lucy was a little upright walking creature who lived about 3.2 million years ago in what is now

Ethiopia.  Anthropologist Donald Johanson and is team found her almost complete fossilized skeleton while on a dig there about 30 years ago.  Although her skeleton (seen at right) might not look like it’s almost complete, it represents a huge find paleontologically.  When you consider that many paleontologists go their whole careers and find only a small bone or two.  Over a career.  Lucy has most of her parts.  And those she doesn’t have on one side, she has on the other, so it’s relatively easy to reconstruct her entire skeleton.

The book Lucy details not only Lucy’s discovery, but the history of paleontology until that point (that part probably sounds dreadful, but it’s truly a wonderful read), and all the work to figure out what Lucy really was and where she fit into the hominid spectrum.  At the time she didn’t fit into any of the categories of hominids that were known, so Johanson and team ended up calling her Australopithicus afarenses, the forerunner to Australopithicus africanus.  The descriptions of how tooth and jaw structure were used to place her where she belongs sound like boring reading, but they aren’t at all.  That part of the book was where I got my first notions of the idea that there might be a diet we had evolved to eat.

MD and I swore to one another that somehow, someway we were going to by God see Lucy’s actual skeleton (it wasn’t really her actual skeleton, it was a fossil of her skeleton), even if we had to go to Ethiopia to do it.  Not long after we made this vow, we learned that an entire Lucy exhibit was going to be presented at the Museum of Natural History in New York.  Neither of us had ever been to New York at that time, but we made plans to go.  When the exhibit opened, we were there.  And a fabulous exhibit it was.  It had the Taung child skull, which figures prominently in the history of man, and many of the other famous fossils we had read about.  When we finally got to Lucy and read the little plate on the display case with her skeleton, we were devastated to learn that it wasn’t really Lucy’s skeleton we were seeing, but a reproduction of Lucy’s skeleton.  The real Lucy’s skeleton was still in Ethiopia where it had been repatriated.  And the Ethiopian authorities weren’t about to let her go on tour.

We were mightily disappointed and figured we would probably have to go to Ethiopia to see Lucy if we were ever going to see her in the flesh, so to speak.

But a couple of days ago we were driving along in Seattle and I noticed a sign advertising a Lucy exhibit at the Pacific Science Center.  I found out that the exhibit was called Lucy’s Legacy: The Hidden Treasures of Ethiopia.  The brochure promised that the exhibit

provides visitors with an extraordinary opportunity to come face to face with Lucy, the oldest, most complete, and best preserved adult fossil of any erect-walking human ancestor.

Hmmm, thinks I.  Could it really be?  I worried about the styling of the exhibit.  Lucy’s Legacy?  What does that really mean.  Hidden treasures of Ethiopia?  What hidden treasures?  We were in the midst of an extremely busy few days, but we didn’t want to miss out if this truly was an opportunity to see the real Lucy.  We got tickets and showed up at the appointed time (they were letting people in in 15-minute increments).

When we got in, we walked through exhibit after exhibit of Ethiopian history, Ethiopian languages, Ethiopian religion, Ethiopian writing, Ethiopian art, Ethiopian everything, but no sign of Lucy.  As I was beginning to despair, we finally rounded a corner and there was at least an exhibit on hominid fossils.  We went through that part of it and finally came to the same reproduction of Lucy (or at least one that looked the same) as we had seen in New York.  Then we found, in a case in a darkened room, the actual, real, honest-to-God fossil of Lucy.  It was the same size and shape as the model we had seen, but was a different color.  Whereas the model looked kind of yellowish, the way old bones look, Lucy’s fossil was a grayish white.  It looked like, well, rock.  Which it is.

At any rate, now we don’t have to go to Ethiopia because the Ethiopian authorities made Lucy available to us.  Despite the fact that these authorities used Lucy to pimp for Ethiopia, we were damned glad to see her.

I can’t recommend the book Lucy enough.  It should be a part of every low-carbers library.  Once you read it, you will know what it means when you read that Australopithicus africanus had elevated levels of Carbon-13.  You will realize how far back in our lineage we were meat eaters.  And you will find out what happened to the branch of pre-humans who evolved down the plant-eating road.

The photo at the top of this post are of skulls and skull models in my library.  The one on the left is Australopithicus robustus, a branch that came to a bad end.  The skull next to that one is a mountain lion, the next is Homo habilis (a descandant of Lucy’s), and the one on the far right is a black bear.  Looming behind them all is the cave bear skull we wrote about in the Protein Power LifePlan.