Low-carb gaining a foothold…with the mainstream
The video below shows Chris Gardner, Ph.D., researcher from Stanford University, giving a presentation about the data he generated when he compared the Atkins diet to the Ornish diet, the Zone diet and the LEARN diet. You all probably remember this study, which he published in JAMA in 2007, showing the low-carb diet brought about greater weight loss and better lab value improvement than the other three diets.
As you watch this long video (and you should watch it; it’s extremely entertaining and filled with a ton of good info), there are a few things you should note.
Before we get to that though, let me fill you in on the LEARN diet.
Most of you, I’m sure, are familiar with the ultra-low-fat Ornish diet and the 30-40-30 protein-carb-fat ratio of the Zone diet, but you may not be aware of the LEARN diet. LEARN stands for Lifestyle, Exercise, Attitudes, Relationships and Nutrition and is the brainchild of Kelly Brownell at Yale. The LEARN diet is a low-calorie regimen that recommends 55-60 percent of calories as carbohydrate and under 10 percent of calories as saturated fat. The LEARN program is big with academics (since it was created by one of their own) and is the diet typically used when a diet program is required as part of a study. In fact, the LEARN manual was developed to bring some consistency to the nutritional regimens followed in research. As a consequence of its widespread use in academia, it has also become the program that pretty much mirrors the national guidelines. Or, to put it another way, the nutritional guidelines set by academics pretty much mirror the LEARN program.
If you look at the carb content of the LEARN program and realize that it is the basis for the national nutritional guidelines, you can LEARN why we have an obesity epidemic. But that’s another subject.
First off, at about 17:10 in the video, Dr. Gardner talks about how Dean Ornish got mad at him for publishing this study. (So did Barry Sears, author of the Zone, but Dr. Gardner didn’t mention him.) Both Ornish and Sears got their noses out of joint after this study and sniffed that the study results didn’t really apply to their programs because clearly the data showed that the subjects assigned to their specific diets really weren’t following the diet as designed. Both missed the point.
As Dr. Gardner plainly says, the study is of specific diet books and how patients lose (or don’t lose) weight following these books. You can’t recruit a million people for a nutritional study in which you hold their hands throughout. But you can write a book that a million or more people read and follow. What Gardner was looking for in this study was how people would do following a diet book advocating a specific program as compared to others on different diet books promoting different diets.
As part of the structure of the study, he randomized subjects to the various diets, then had them come in weekly for eight weeks to visit with a dietitian who went over the book with them. He relates an interesting story at about 26:10 that I’m sure is absolutely true. Many of the people who were randomized to their particular diet were demoralized because they had already done that diet in the past and hadn’t done particularly well on it. After going through the book with the dietitian, these same people realized they hadn’t really read the book very well – if at all – the first time through. Once they really read and understood it, they were fired up and ready to go. Based on may questions MD and I have received about our books, I know this only too well.
Earlier in the video, at about the 17:10 point, Dr. Gardner makes an observation that all of us using low-carb diets know well. He is discussing how reducing carbs makes triglycerides go down and adding fat makes HDL go up. He then says that all these people have come into the clinic he is involved with after having been on Ornish or McDougall only to find their triglycerides have skyrocketed and their HDLs have dropped off the chart. He tells them to replace some of the carbohydrate with good quality “unsaturated fats” (sigh), and their labs revert to normal.
At about the 29:00 mark, Dr Gardner points out that as the data came in and was charted, it became apparent that it was difficult for people to stick with the Ornish or Zone diets, and when these subjects fell short of following their specific program, their macronutrient-consumption data ended up falling right smack into the middle of the LEARN data, or the national nutritional guidelines. Those on the Atkins diet morphed a little (toward a more Protein Power sort of plan, but not quite), but not nearly as much as those on the low-fat diets did. After a year, the data ended up showing a bunch of subjects essentially following the national nutritional guidelines and another, smaller bunch, following a semi-Atkins diet.
As Dr. Gardner points out, in virtually every parameter measured, those following the Atkins book who ended up following a semi-Atkins diet triumphed over those following the other books, all of whom ended up following the national nutritional guidelines. Which, of course, is no surprise to most readers of this blog.
But it was a huge surprise to Dr. Gardner, a 25-year-long vegetarian. He admitted it was a bitter pill to swallow, but the data are what the data are. And he was man enough to admit it. I think this study and Dr. Gardner’s engaging presentation style will start getting some notice from mainstreamers. King Canute couldn’t hold back the tide, and I don’t think the lipophobes will be able to hold back low-carb diets forever. This is a great video to show Doubting Thomases if they will take the time to watch it.
Aside from the finding that the low-carb diet was vastly superior, a lot of other data came to light as a consequence of this study. Some people did great on Ornish or the Zone while others did poorly on Atkins. Why? You would think that since all the subjects were humans, they would all respond the same way, but they didn’t.
This intrigued Dr. Gardner, so he began slicing and dicing the data to see what he could come up with. At about the 40:00 point on the video, he discussed a few papers showing that people who are insulin sensitive actually do better on high-carb diets than they do on low-carb diets, whereas those who are insulin resistant do just the opposite.
I pulled all the papers he discussed and plan on reading them over the next ten days while I’m spending (literally) about 24 hours in an airplane seat. (As part of our Sous Vide Supreme tour, MD and I leave tomorrow for Dallas, then Vancouver, Seattle, San Francisco, Chicago, New York, and Las Vegas, so I’ll have plenty of time to read.) I do find this information fascinating, but I have a few reservations as well. There are very few moderate to significantly overweight people who aren’t insulin resistant to some degree, so I’ll be curious to see how the authors of these papers define insulin resistance.
Based on my own experience with a whole lot of patients, there are a few, but not many, overweight people–usually women, but occasionally men–whose lab reports show normal insulin sensitivity. I treated them with a low-carb diet, and they did well. But I didn’t randomize these apparently insulin-sensitive overweight patients into two groups and put one group on a low-carb diet and the other on a low-fat, high-carb diet, so I can’t really say the ones I treated did better than they would have on a low-fat diet.
What I do know, however, is that those who have been overweight and insulin resistant, and who lose their weight and restore their insulin sensitivity with a low-carb diet, will regain in a heartbeat if they go on a high-carb diet for maintenance. So, it’s hard to reconcile this fact that I know from hands-on experience with the data Dr. Gardner presented.
It could have something to do with the genetics that prevent the development of insulin resistance in the first place. I’ll post on my thought about this paradox after I’ve read the relevant papers and reflected on them.
I had only one real objection to this presentation. At the end, during the Q & A, someone asked a question about ketosis, and Dr. Gardner was clearly in above his head. He did make the distinction between the ketosis one experiences on a low-carb diet and the dangerous ketoacidosis that those with uncontrolled type I diabetes are subject to, but he seemed to be uncertain as to whether low-carb ketosis was harmful over the long run. He did remark that everyone is in ketosis part of the day, but then he kind of tossed it off by saying that the people on the Atkins diet weren’t really following it that closely and so weren’t really in ketosis for that long. I wish had addressed the ketosis situation head on. There is no danger in being in ketosis for extended periods of time. Ketones are normal fuels of respiration and don’t pose any problems over the long haul. In fact, some research has shown that ketones are a preferred fuel of many organs including the heart. (Veech et al)
As I’ll be traveling a lot the next 10 days, and since I don’t know my exact schedule even yet, I can’t promise a lot of regular posting. But I will check the blog often and put up the comments as they come in. If any of you have experience with trying a low-fat diet after losing on a low-carb diet, I would love to hear about it.
I love how he handled that idiot at the end, who was SURE that there would be a direct correlation between the fast food industry and obesity.
Re your comment about the problems of going back to high carb for maintenance, have you read anything on the role of lectins and leptin resistance leading to weight gain? One interesting discussion is here (last three posts on page): http://wholehealthsource.blogspot.com/search/label/lectins
It’s a very interesting theory, and if true, has a lot of implications on the role of carbs in general and grains specifically in our diet.
Thanks for the meaty post. Hope you and MD make it down South on the Sous Vide tour! (No, Dallas doesn’t count) The method should work well for some Southern food favorites.
I’ve always noticed that most Southern dishes involve cooking food to death–I suspect due to the initial need to feed farm workers over a number of hours at different times of day and need to make tough pieces of meat palatable. For example, it wasn’t until I cooked my own food in college I discovered broccoli didn’t have to be mushy!
CNN (Sanjay Gupta) today reported on experimental suspended animation for animals and later humans by replacing oxygen with hydrogen sulfite(sulfate?) and KETONES. Can you explain?
Interesting how the study is as much a result in psychology as it is in nutrition.
I’m sure that if people really did follow every tidbit of Ornish’s advice, then based on any number of input variables (their current weight, genetics, etc), they COULD lose weight and become healthier, as scientifically hairbrained as Ornish is.
But the study considers the psychological nuances that go into following a diet, and getting results from the real-world approach — i.e. what dieters actually DO — versus idealistic approaches. And the psychological factors here are probably quite entangled with the biochemical factors of satiety across the different diets.
I’ll watch the video when I have time. Thanks Dr Eades.
Thanks for the post Mike, very useful as I start a lecture series on metabolism! By the way, when you visit Chicago and if your schedule allows, consider getting in touch, and please keep us posting of venues (radio shows, etc.) that you’ll be on while in the Windy City!
Cheers!
Gardner is indeed but one of many who are coming around to the idea that low-carb diets are an excellent way for people not just to lose weight, but get healthy. It’s important to have these mainstream voices standing up for low-carb living because they stand out in their contrast to the conventional low-fat, high-carb folly spewed forth by the rest of the dutiful members of the health community.
In the interest of helping low-carb go mainstream, as I think others have suggested before, would you and MD consider in your spare time (someday
when you have some) making some nice brochures that summarize the research and benefits of saturated fats and low carbohydrates?
My kids’ school constantly bombards us with offers to sign her up for one nutrition or health program or another, where they can tout the food pyramid and eating everything in moderation (except protein and saturated fat, those should be eaten sparingly)… I would love, LOVE to be able to hand them a pretty, factual brochure while I tell them they’re crazy and please keep their crap away from my kid (nicely of course).
In the meantime, have you seen the push to make public schools in Baltimore part of the ‘meatless monday’ effort? http://www.cnsnews.com/news/article/55355
Schools in Philly have started serving breakfast to all the students, and the menu shows a meat offering at breakfast just one day a week.
http://www.philly.com/philly/education/20091008_Breakfast_at_school_now_is_on_the_principal.html?viewAll=y
http://www.swenson.phila.k12.pa.us/Food%20Menu.pdf
Now, if Obama suceeds in extending the school day, soon the schools will be serving supper as well, and children will be getting even fatter while they scratch their heads and ban meat all together.
I lost about 40 lbs by eating low-carb after I had my 6th child, but I had a very difficult time sticking with the diet while the rest of my family ate differently. So I decided to go with Denise Austin’s diet program, counting calories and fat, and cooking food directly from her menus. I really loved the food, but I felt so hungry all the time and found myself thinking of my next meal or snack all day long. I gained back about 30 lbs in under a year (maybe even faster…I was in denial and wouldn’t look at the scale). At the end of the summer last year, my dad was added to the growing number of family members diagnosed with diabetes. I found a new sense of determination that I was not going to allow this curse to continue in my family, and I asked my husband’s support for putting our whole household on a low-carb diet. We started it on January 1st of this year, and our family has never been better. All of us are trimmer, and our blood work looks great! Our children understand that this is a lifestyle we plan to stick with for life, and they’ve adjusted to it beautifully.
what is the difference between insulin sensitivity and insulin resistance?
Dr. Mike, you described me to a T:
“What I do know, however, is that those who have been overweight and insulin resistant, and who lose their weight and restore their insulin sensitivity with a low-carb diet, will regain in a heartbeat if they go on a high-carb diet for maintenance.”
Even a weekend during which I have a couple drinks and a carby snack or two or dessert, I can easily gain 5 pounds. Granted, it comes off slowly over the course of the next week, but it sure throws a monkey wrench into actually losing. (And no, I never did this while on the 6WC!)
If you’d love to hear about low-fat vs. low-carb, well eat your heart out. I’ve got Eades vs. Fuhrman going on right now – testing out diets and taking morning glucose readings while posting nightly at my blog. It’s part of the research I’m doing for an upcoming eBook on reversing type II diabetes (aka, reversing insulin resistance, not just “controlling” or “managing” blood sugar levels. It’s incredibly interesting so far.
http://www.180degreehealth.blogspot.com
The problem is that you can’t boil this down to a brochure. You could hand them Gary Taubes book, although it is unlikely they’ll slog through it. As for the video, I’ll have to hook my wife’s computer up to my LCD screen.
I also meant to say that I’ve often wondered whether any diet (even a low carb diet) is suitable for every person, given our vast differences. For instance, I have friends who seem to have no problems eating high carb and can maintain their weight even without exercise. I, on the other hand, have to eat low carb or I find it hard to not be constantly hungry. I’m definitely insulin resistant, and perhaps they aren’t and perhaps they could benefit by eating high carb.
It’s wonderful to hear of an academic who has the guts and courage to look at the data and report it as it truly is, instead of trying to spin it toward the national nutritional guidelines. I’m going to add this video to my resources page. Thanks for sharing!
“It could have something to do with the genetics that prevent the development of insulin resistance in the first place. ”
Maybe just the seeds of a 10,000 years long awaited evolutionary change
(If and when it’ll stick we could all crave on carbs and be super healthy! Till then its meat for me :> )
Did you notice that at around the 52:00 mark when Dr. Gardner first utters the phrase “Paleolithic Diet” a significant portion of the audience giggles? It’s quite apparent that these folks are encountering the phrase for the very first time. That’s very telling. And it’s a bit troubling when you consider that the lecture was given at an esteemed university to what one must presume is an audience of students and practitioners in the field of nutrition.
I know I’m just one person, but I’ve found that the longer I stay on a low carb diet, the more impossible it is for me to increase my carbs and not gain weight.
I really honestly cannot go above 20 grams or so of net carbs without my weight starting to creep up. It’s kind of dismaying, because my weight was stable on far more carbs than that for quite some time!
I guess I’m pretty insulin resistant. I come from a long line of fat people.
Ellen: There is still some spinning going on. But it’s not like he is trying to change the results entirely.
I certainly applaud Chris Gardner, a 25 year vegetarian and main-stream nutritionist, for reporting the data faithfully rather than manipulating it (but wait, isn’t this what scientists are supposed to do?) However, most of his talk then centers around reconciling this with his vegetarian views. He goes on to knock saturated fats and animal protein and gives many suggestions on how to lower carbs (and fat) by eating plant proteins, unsaturated fats and whole grains.
He completely ignores the fact that the Atkins diet not only brought about the best weight loss but also the most improvement in disease markers (lipid profiles, blood pressure, etc.) and that employing the tactics he advises would eliminate the gains in these markers. He also ignores the fact that plant proteins cannot be assimilated by humans, that a complex carb does not result in a lower glucose load than a simple carb, and that vegetable oils are essentially poison. He still doesn’t get it.
He is also a calories-in, calories-out guy as he states that the 1900 calorie diets used here weren’t adhered to because it should have caused a 40lb weight loss in each individual. He supports this further by giving advice on how to eat more whole-grain and vegetable bulk and drinking a lot of water as a method to cut calories and increase satiety. Again he ignores the fact that animal protein and saturated fat are the best methods to increase satiety.
Finally, he knocks low-carb (calling it a Palieo diet this time) by saying that the variety is too limited which causes people to fall off of the diet. But the only way to increase variety over a Palieo diet is to include grains, starches and sugars. Yet this only serves to get the blood sugar roller coaster going, the cravings and the inevitable falling-off-the-wagon as you go face-down into a big plate of carbs. Seems very ironic and self-defeating to me.
The killer question came from a woman who insisted that low carbs had nothing to do with it, but rather the fat went up, and surely this must have been the benefit, implying that you could eat a high carb, high fat diet to get the same benefit. Gardner rightly points out that these were percentage nutrients and that if you lower one thing, another has to go up, and they didn’t study her suggest profile (and in fact, I believe that the average American eating “French Fires and Twinkies” is exactly that high-fat, high-carb diet.) But then Chris goes off the tracks by showing many slides extolling the benefits of the Atkins “high protein” diet even though the various diets all had roughly the same protein percentage (Ornish = 19%, Atkins = 22%)
Another interesting point is that the people in this study following the “Atkins” diet consumed on average 30% of their calories in carbs. Using a 1900 calorie diet, this resulted in 142g of carb daily. None of us here would consider this low-carb. For instance, I consume roughly 2700 calories a day and try to keep my carbs under 50g/day = < 7% carb content. They still aren't studying the right diets.
This is indeed encouraging. But like Bob, I wonder whether a LC WOE is right for everyone, or whether it even brings the weight loss that most people desire. There’s some extremely heated debate on the topic on lowcarb.ca, in this thread: http://forum.lowcarber.org/showthread.php?t=402239
To mallory: Maybe I can help… insulin sensitivity is when cells respond to the effect of insulin. When insulin binds to cells, there are a number of reactions that occur inside cells, and they should occur for cells to work normally. For example, when insulin binds cells, one of the responses to that is to take up glucose from the blood stream, that keeps glucose from accumulating in the blood (hyperglycemia). Insulin resistant, on the other hand is when cells don’t respond to the effect of insulin. Using the same example of taking up blood glucose, cells that are insulin resistant can’t take up glucose, thus resulting in hyperglycemia.
In the video, Gardner mentions metabolic syndrome as indicative of having insulin resistance or some degree of that, however, insulin resistance may happen everywhere or just in some tissues. Fat cells, for example, would seem not to have a limit to how much fat they can accumulate (getting fat into cells is an insulin-driven process as well as making fat inside the cell). However, if fat cells also become insulin resistant, chances are they will stop accumulating fat as well because they are now non-responsive to insulin. Drs. Eades discussed a little about that particular issue in one of their Protein Power books.
Hope it helped!
An excellent video and a fine blog as well. I have experienced what you described since I began VLC about seven months ago. My lab work last month showed that my LDL had increased 8 points to 132, but I know now that it’s “fluffy” and also that it’s not measured, but calculated. My HDL, however, also went up 8 to 66, giving me a ratio of 2, which is excellent. My triglycerides were also 66, a dramatic decline from six months earlier. And my total cholesterol, which I now know is pretty much meaningless, is 220. More importantly, my CRP is .02 and my A1C is 6, both much lower than before. As a survivor of open heart surgery and a pre-diabetic, I have bought your dietary beliefs completely, and am reaping the benefits. At 6′, 160 and at age 74 I’ve never felt better. Thanks so very much for your excellent blog.
To Matt Stone, if you are only measuring your morning blood sugar levels, that is really not proving much of anything. I’d be more interested in seeing your blood sugar numbers at 1 hour and 2 hours after you eat such high carb foods. Also, if you yourself are not diabetic, your blood glucose readings wouldn’t mean much of anything to “prove” that eating low-carb vs high-carb doesn’t affect blood sugars, since your body actually does what it’s supposed to do.
I’m an insulin-sensitive overweight person (as long as I stay off of synthetic progestins, and even then I’m well within normal, just not normal-for-me). I am ridiculously hourglass-shaped and also involved in a number of intense physical activities (so I’m almost always within 24 hours of having depleted glycogen stores). I do about equally well — which is to say frustratingly slow — on low-carb and conventional low-calorie diets, although in terms of lifestyle I’ve come to prefer lower-carb in recent years depending on my activity mix. I seem to regain weight almost as slowly as I lose it, there’s no “I went off my diet on vacation and gained 10lb” for me.
@Bob and @ jake3_14 As Dr. Mike has mentioned in his latest posts, and as Chris Gardner emphasis in this video, people really do not tend to follow diet’s well. Most people on a low carb diet just don’t realize their true carb count, and really aren’t following the diet. As evidenced by the people in this study, the average carb count was 150g/day by the end of the 1 year diet. I would assume that most of these people would claim that they were following the diet rigidly. Then there is all of the low-carb junk food out there with misleading claims of carb count centered on sugar alcohols and exaggerated reductions from fiber count. These food will really damage your success.
I refuse to believe nor can I see any logic to support the notion that a diet that ALL homonids evolved on for millions of years can somehow be bad for any modern human especially given the fact that most modern humans only have a couple of hundred to a thousand years (i.e. anybody not of middle-eastern descent) of grain consumption under their belts. Most anthropologist agree that it takes 100k -500k years to adapt to a huge dietary change such as this.
Dr. Gardner’s lecture is certainly going to attract attention of people who might not have listened before. My husband was a total non-believer in the Low Carb lifestyle. He is not one to pay any attention to nutrition and has patiently rolled his eyes at me during my LC journey – particulary after I read Gary Taubes GCBC. HOWEVER, I have to say that he’s come full circle after watching “Fathead: The Movie”. (My husband is not a reader, if it doesn’t have pictures or scantily clad women, he pays NO attention
So, the delivery of the LC message in the form of this movie really got thru to him. So, for those out there who have family members who are not on board, this movie may be a nice way to demonstrate the LC principles. Hats off to Dr. Gardner and, of course, Tom Naughton.. and Gary Taubes 
@Susan – Maybe your gain when increasing carbs is fluid related?
I mean the body discards excess fluid pretty fast when one is restricting carbs so its fair to guess the reverse (fluid retention) happens at a fast rate also when reintroducing carbs, right?
So perhaps when you increase carbs a little there will be a small gain when the body readjust its fluids but it will then stay still. (Not an unlimited steady increase as you might fear)
(I’m paraphrasing somewhat)
@11:20, he says “their calories popped back up, although she still showed that they lost more weight.” He establishes that calories don’t seem to matter yet he’s doubtful “I can’t reconcile the two.”
@20:00, he says something like “if all groups cut the same calories, they’d have lost the same weight.” But contradicts himself here. “I’m sure calories should count.”
@23:40, he says “There was no group that did better than Atkins in anything.” And continues with the line that calories don’t matter, it’s carbohydrate, and perhaps fat, that matters most.
@24:00, he asks “What if I lost the same weight but it was on a different diet, would I get the same results otherwise?” Sure, that would probably work. But we would need to eat a whole lot less calories to achieve the same weight loss.
@29:45, he says “In Atkins vs Nutritional Guidelines, all parameters were better on Atkins.” One more for carbohydrate reduction.
@32:00, he says “Most parameters remained better [on Atkins], even after adjusted for weight loss.” One more against calories.
@51:00, he starts on a logic streak which ends with him concluding that “he prefers fewer calories, less high yield carbohydrate but more carbohydrate overall.” I could pit Ancel Keys’ semi starvation study to his conclusion, and win.
@53:00, he speaks of increased satiety and decreased hunger when avoiding Neolithic foods. Another confirmation of the first established principle in his presentation.
@55:00-56:00, he speaks of energy density and satiety using a weekend-only study to show that energy density and satiety were unrelated.
Now that’s where I disconnect. We don’t know how much food these women ate during the week. As far as I know, satiety, and hunger, isn’t merely an immediate function. It’s entirely possible to eat less for a few days and still not be that hungry for this day and the next. Only to have hunger return stronger, relatively, the next day, or over the next few days thereafter. And end up with the same average hunger, and intake, at the end of the week.
Earlier he tried to make the point that Atkins worked because eating the same thing all the time (or rather cutting out certain palatable foods) cuts hunger. And continues with the same line of thought with the study that has women eating the same thing every weekend.
I will still pit that Ancel Keys’ experiment against his ideas here, and win. No, I will pit his own presentation against his conclusions, and win. Remember that all the other diets fared worse than Atkins in all health indicators including weight, even when they contained fewer calories?
@56:00, he ends a bit of energy density logic string and says “maybe that’s part of the trick.”
He advocates, or appears to advocate:
- Less sugar
- More fiber
- More filling (bigger portions)
- Lower energy density
Yet, by all accounts, Atkins is:
- Less sugar
- Less fiber
- Less filling (smaller portions)
- Higher energy density
His presentation contradicts his own conclusions in at least one respect. Meat is mostly water by weight. If adding water worked to reduce hunger by the mechanism of reduced energy density, then adding meat (or switching from a low meat diet to a high meat diet) would increase hunger and intake, and subsequently cause a failure to lose weight or fail to induce better health indicators, since meat is high energy density due to its fat content.
@1:06:30, he mentions low fat yogurt and regular yogurt and says that those who ate the low fat, ate more. That seems to contradict his own conclusions again. There are so many points which could be brought up to counter his conclusions, even in his own presentation. And where does he get the data that supports his advocacy of adding fiber to the diet? It’s not in this presentation.
Granted, it’s probably the first time he had to admit that he was wrong about everything. I’ll give him some more time. Then I’ll offer him a fat steak.
Thank you, Dr Eades.
That’s interesting. As a type 1 diabetic, I follow nutritional news on restricted carbohydrate diets and have tried varying of levels of low/moderate carbs. I am very insulin-sensitive to the point where 1/2 unit can send me hypo and I just don’t do well on very low carb. I lose too much weight and become lethargic on 30 carbs per day. I also become hypoglycemic-unaware and have suffered some dangerious lows in the 20s. I need about 90 carbs per day to function at my peak and have a normal degree of hypo awareness. I can also lose weight like crazy on calorie restriciton too. So, there may be something to insulin-sensitivity and carb levels.
At about 1:13, Dr. Gardner says a simple way to check for insulin insensitivity is to divide your triglycerides by HDL, and if it’s greater than 3 you are probably insulin resistant.
Mallory -
Insulin sensitivity – person eats carbs, glucose released in blood system, body detects too much glucose in the blood, pancreas releases insulin to transport the glucose out of the blood and into the cells, returning blood glucose levels in blood stream to normal levels.
Insulin resistance – person eats carbs, glucose released in blood system, body detects too much glucose in the blood, pancreas releases insulin to transport the glucose out of the blood and into the cells, glucose in blood system doesn’t seem to get the message so pancreas releases more insulin, glucose gets into some cells, other cells don’t open the door to glucose, a lot of the glucose is sent to the adipose tissues who accept the glucose with open arms and turn it into fat. Blood glucose levels in blood stream return to normal levels.
This person’s pancreas needs to pump out more insulin to mop up the same amount of glucose as someone insulin sensitive. In the early stages this person when tested will have normal blood glucose levels but they may have high insulin levels. A lot of doctors just test the blood glucose levels. If you test the insulin levels it tells you that something is going on. Eventually, the body can send as much insulin as it likes but it just can’t get the blood glucose levels down to normal. If it does get it down to normal most of the glucose is sent to your fat stores and the other cells miss out. They are starving so you eat more carb. If you eat low carb you give those poor starving cells alternative fuel – ketones. You give the poor pancreas a rest from pumping out all that insulin.
That’smy take.
Thanks for posting that; it is a thoroughly enjoyable presentation. He has a reasoning, nimble mind and makes speaking seem effortless.
Wow, what a coincidence…I was just reading and old issue of Science news about ketones and Richard Veech. You can see it here: http://www.thefreelibrary.com/Ketones+to+the+rescue:+fashioning+therapies+from+an+adaptation+to+…-a0111856325
On a related note, our newspaper was touting a great success for AARP/Blue Zones program for seniors in Albert Lea , MN. They lost an average of 2.6 pounds over 10 months. 2.6 pounds? I lose more than that when I sneeze!
What are the main differences between an Atkins diet and a Protein Power diet?
Dr Eades,
This video was a great find and I look forward to your further exploration of the studies re- insulin sensitivity and diet. Listening to Gardner reminds me that a good lecturer can make a subject much clearer.
Sitting here in Sydney I thought it was only appropriate that I thanked Dr Gardner. i sent him an email linking to an extended interview with Lierre Keith from the “Underground Wellness” podcast show. Perhaps he will be able to review it whilst sipping a soy latte at Cafe Barrone in Menlo Park.
More generally, I would like to suggest that you and your partner should consider doing some You Tube videos to support your works. When i think back to the presentations that have most influenced me over the last two years, I find that they inevitably have involved both a written work, such as GCBC, plus a video such as Taubes appearance at Steven’s.
When he started praising whole-wheat bread, I lost interest and stopped the video. I think this man is still clueless.
If you’re doing some sort of public appearance/demo thing in NY, let me know, I’ll try to pop by!
Great post. I have to say, I’m really looking forward to your next one, once you’ve read the research papers you’ve mentioned. I know it’s only anecdotal, but I’ve always noticed that some people just seem to do better on different kinds of diets. I know I can eat whatever I want, and only avoid starches to keep my sweet tooth under control. If there’s research out there that says that for people like me a sweet tooth is no problem, hooray! Somehow, I suspect that the research will show that some people can tolerate more different kinds of diets rather than that low-carb are actually bad for the insulin sensitive. Can’t wait to read what you discover.
It’s funny to me to think of “low carb” as not being mainstream, because I’m constantly surrounded by people who eat low (or moderate, really) carb diets full of animal protein with no cereals, legumes, etc (I own a CrossFit gym.) I guess I’m so used to people acknowledging that animal protein is good and bread is bad that I’m still surprised that most people still think pasta will make you healthy and fat is the culprit behind all of our diet based problems.
But I’m also still surprised that most people think the path to health and fitness is low intensity exercise involving jogging and swiss balls. I guess environment is everything.
Well a new military study has just been released which found that fatty food may be good for the brain… surprise, surprise!!
The news report is at http://www.stuff.co.nz/life-style/food-wine/2971475/Fatty-food-may-be-good-for-the-brain
I wonder if anyone has access to the actual research report?
I started low carb back in 2004 and was finally able to get truly in shape. I had lost a 100lbs earlier through a high protein, low fat, mod carb diet and lots of walking and kept it off, but could never get those last 10/15lbs I needed to get truly ripped (Abs showing, etc)
When I moved to NYC I went off it for a bit and got dreadfully ill, in the end they found out I got fluoridosis, but I did fine while they were trying to figure out what the hell was wrong with me that by going back on a strict low carb diet (cho <50/day) I was able to manage well and function normally. I've stayed low carb since then (06) but this past summer when I lost my job I switched up my eating for awhile and went back to a high protein/low fat/mod carb diet. It was horrible. I had indigestion all the time, my breath reaked, like I could be sitting 3 feet from my partner and he could smell my breath and would complain, even after I brushed my teeth, and I didn't have a good bowel movement.
After a mere 2/3 weeks of this, I went back to strict low carb and everything cleared up.
It sometimes makes me wonder if this isn't similar to what celiacs talk about. That when they were on gluten, their bodies were so run down it didn't know how to fight it, so it just lived with it. After they went gluten free for a few months and their bodies came down and started functioning normally again, they found the body could know "react" to allergens and became even more sensitive to gluten, even the tiniest of crumbs would know trigger them worse than before their diagnosis. Just thinking out loud.
And as other people have pointed out the lack of hunger on low-carb is really terrifying. I find I have to force myself to eat sometimes to keep my protein up adequately enough for weightlifting. Somedays I'll just have a burger patty for breakfast, two/three chicken thighs around noon, and then realize at 9pm that's all I ate all day and I've only taken in 80/90 grams of protein
It's really amazing how efficient low carb is.
Also, if you get your schedule fixed, and you'll be doing demonstrations of your new machine in NYC will you let us so the locals here can come by and see it in action?
Thanks, and good luck with selling it Dr. Mike.
@John The paper was presented at a meeting.
Dr. Gardner also thinks long term high protein intake is bad for the kidneys even though he has no data to prove it. Clearly this guy has a lot of cherished beliefs about nutrition that he needs to give up if he wants to be a true scientist.
Your Blog on nutrition and the lipophobia is awesome.
I have learned a lot from following this.
As I recently discovered I am a Type II diabetic (the medical professionals failed to alert me for over 14 years that I had impaired fasting glucose levels) I am on a very Low Carb, high protein and fat diet. Lost 35 lbs and now my blood sugars are in the normal range. Albeit with insulin since my beta cells burned out long ago.
Back to my main point.
You recently recommended the recent book on vegetarian diets etc. that it included a “green” section as it were, and the idea that it is not sustainable or good for the global environment.
You then expressed a personal opinion about global climate change and your doubts that it was man caused.
You might read this (link below) as there is no question that climate change it is currently underway and no question, in the credible world of science that it is man made.
http://climateprogress.org/2009/10/12/superfreakonomics-errors-levitt-caldeira-myhrvold/
You guys have gotta stop whining about having insulin resistance as if that is some genetic lot in life passed down from your ancestors. As long as your pancreas still secretes a fair amount of insulin, you can overcome insulin resistance in a week with the right nutritional approach – and fasting glucose levels drop to within the optimal range of 75 to 85 mg/dl regardless of the quantity of carbohydrates ingested.
Mimi said, “I think this man is still clueless.”
If that ain’t the pot calling the kettle black I don’t know what is. That’s like one of those 300 pound football fans that sits on the sidelines and talks about how horrible the quarterback is.
ok then so if i divide my trig’s and my HDL
Triglycerides: 39
HDL: 64
am i insulin resistant or insulin sensitive?
There’s a lot of good information here, if you ignore some of his commentary. I suppose it’s understandable that a 25-year vegetarian isn’t going to embrace things like the benefits of saturated fat all at once.
I get really frustrated at all the studies (like several he quoted) that claim to compare low-carb to other diets, and then the fine print shows the low-carb diet was 40:40:30 or something like that. I don’t know ANY low-carb diet that recommends anywhere near 40% of your calories from carbs. On a 2000 calorie diet, PP is 6% of calories from carbs in stage 1, and 11% in stage 2. Atkins is 4% in induction, and up to 20% after that, if you assume most people will stop at under 100 grams to keep losing weight.
They keep lining up these 30-40% carb diets as low-carb diets against 50-60% high-carb diets, and then saying how they do a little better but the difference isn’t significant enough to get excited about. Well, yeah, they’re not doing it right, and those aren’t low-carb diets. I can understand why regular people don’t keep their carbs low enough over time—like you and he point out, people often don’t really read and understand the book—but it’s ridiculous that people getting paid to do studies don’t bother to read the books.
It’s interesting to me that Jimmy Moore (who has a low carb blog and mostly eats meat) and Dean Ornish, a near vegan, both scored zero on a heart scan, meaning no detectable sign of plaque, maximum score 1000. This makes it sound like the critical issue for heart disease isn’t how much carbs, protein, and fat you eat, but rather the importance of avoiding sugar and flour which both Moore and Ornish insist on.
Toward the end, he suggests that the 8 glasses of water recommended by Atkins might explain the extra weight loss, because of the old nonsense about water “filling you up.” But he had pointed out just 50 minutes earlier that his own study showed that there was no difference in reduction of calorie intake between the four groups. Oops. I noticed how much the audience cooed over that suggestion, too. People really want to find out there’s some “trick” to why low-carb diets work, something they could do to get the advantages while keeping their high-carb diets.
Very near the end, he mentions a survey that found that one common factor among people who lost weight and kept it off for years was that they exercised at least an hour a day. Of course, he never mentioned that they could have been exercising because they were losing weight and that gave them extra energy they needed to burn off.
I know you’re not answering questions, but I thought I’d try anyway. For my 7-yr-old (57 lbs/52 inches) who has asthma, I’ve been squeezing one fish oil tablet equaling 1000 mg Fish Oil Concentrate (400 mg EPA, 200 mg DHA) onto some of her food. Now I have found the Mega Red Krill Oil that looks small enough for her to swallow. It has only 300 mg Krill Oil (Omega-3 Fatty Acids/45 mg EPA/27 mg DHA), but claims to be three times better than fish oil. Which would you give her and how much?
And for everyone that needed a laugh or needed to see what ten years of veganism can do to you…
http://newyork.grubstreet.com/2009/10/alicia_silverstone_is_not_temp.html?f=most-commented-grub-7d5
celebrity and vegan diet guru Alicia Silverstone explains what she ate. And how sure is like heroin. Both come from beautiful natural sources that are fine, until they’re refined. Sugar Cane becomes evil sugar, Poppy seeds become evil heroin.
I figured everyone could use a laugh
I don’t have personal experience with losing weight by low-carbing and then going low-fat but my brother lost about 50 lbs. low -carbing and then went vegetarian for over a year with his then vegetarian girlfriend. He got extremely small. I guess going vegetarian isn’t the same as low-fat, though. I’m sure he ate plenty of nuts and guacamole and high fat foods like that. Probably fairly high-carb with the smoothies and fruit, at least I would imagine.
Avoiding grains and sugar might get you 85% there but I don’t no if that’s the only thing needed. A vegetarian diet can avoid those but does that mean that it is optimal? What happens in the long-run. Generation after generation?
The chuckles at the paleo-diet almost made me stop watching. What makes the subject of nutrition and bariatrics complicated is that nutritionists use the modern diet, or a variation of, as the standard. The paleo approach gives a rational starting point (and most likely endpoint) for studying nutrition. If you begin your study of the human diet with the assumption that eating foodstuff closely approximating what our distant ancestors consumed for MILLIONS of years as the STANDARD and then study what happens when non-paleolithic substances (or much larger quantities of what was available) are added to the diet, much of the confusion, contradictions in data, and resultant rationalizations go away. Dr. Gardner is obviously a very well read, intelligent, and logical guy. But conclusions logically derived from false or irrational premises, at best, unnecessarily complicate and confuse the issue. Although, as he alluded to, it does keep him working.
What hubris to conclude that eating as we were genetically honed to is unsustainable and, therefore, we need to figure out how to get around it by introducing and manipulating substances that are alien to our make-up? If that’s where he wants to head, fine, but I would hope he uses the health status of the average paleolithic culture, not the average westerner, as his gold standard. For example, if a study of paleo vs. HCLF showed differences in blood pressure favoring paleo, then conclude that the HCLF raises blood pressure not that paleo lowers it. Otherwise, it’s like concluding that breathing fresh air improves oxygen utilization vs. breathing air infused with carbon monoxide.
Dr. Gardner is making an attempt, at least, at tempering his bias, but the questions and reactions from the crowd come from such entrenched ideas that I wonder if they’ll ever come around.
Thinkering: A New Model for Biotechnology…
There’s a Biomedical Mutual Organization (BMO) taking shape.I suspect William Baines and Seth Roberts would agree.It may still be in the start-up stages, but it’s building momentum as we speak….
The most annoying part of his lecture in his complete dedication to the calories in/calories out mantra, to the point where he assumes the subjects outright lied, rather than perhaps their metabolism slowed in response to the lowered intake.