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

115 comments:

1. David, 28. May 2008, 1:11
   

   So calories do count after all, but weight loss is still also a hormonal event? Maybe there is a third factor in the equation, that of psychology or the “Hedonistic urge” as You describe it?
   I can see quite clearly that my obese friends clearly eat alot more than other people do.

   I have tried doing a one day fast each week for some time now and the results have been very good. Fasting one day for 15-36 hours each week trains the mind to view hunger in its right context. It makes one more resistant to the “Hedonistic urge”. Exercise with high intensity and short duration has also started to make the last kilograms of fat start to melt.

   Best Regards

   David

   Sweden

   Hi David–

   The hormonal event is the reduction of insulin allowing fat to exit the fat cells. As long as there is a caloric deficit, the fat will exit and be burned. If no caloric deficit, no fat leaves the cell. I don’t know about the psychology of the hedonistic urge, but I do know that too many people believe that if they simply keep their carbs below a certain level, they will lose weight no matter how much they eat. Unfortunately, it doesn’t work this way.

   Cheers–

   MRE

    
2. peter, 28. May 2008, 1:52
   

   Great post, and so true, though i’ve been lucky enough to drop body fat relatively easy while consuming plenty of nuts and cheese. Speaking of nuts and cheese, they make a good combination; i like snacking on almonds with thin slices of cheese. A good friend of mine is not as lucky as me. Like the women in John Yudkin’s study, he constantly craves bread, and more specifically, peanut butter and honey on bread. He could easily eat an entire loaf of bread throughout the day, in addition to other foods. Luckily for him, he doesn’t gain weight, and has a good physique to boot. However, he complains of hunger all the time, and says that he gets very confused, disorientated, irritable, shaky, and so forth, whenever he goes without carbs, typically bread. Classic symptoms of low blood sugar, i suspect. Needless to say, his attempts at low-carbing have not been good. He can manage throughout the daytime hours, but in the evening, he says he can’t relax or even fall asleep without eating sufficient carbs. This guy has even managed to low-carb for one month before, but eventually his carb-cravings got the better of him. He tried eating peanut butter and honey without the bread, but that did not suffice; he ‘needed’ the bread. I’d love to help this guy adapt to a low-carb diet, but i don’t know how to help him. I often suspect that some people are more deficient in serotonin than others, and thus, explains their strong cravings for carbs.

   If your friend’s problem is serotonin he can take 200 mg of 5-hydroxytryptophan at about 5 PM. This is a direct precursor to serotonin and will provide him with plenty by the time he goes to bed. He can also try taking at least 300 mg magnesium at bedtime as well. No one ‘needs’ carbohydrates in a physiologic sense just as no one ‘needs’ cocaine, but both can be addictive. Pretty much everyone knows that cocaine is not a good thing for the long run, but people with carb addiction can easily find the justification for eating carbs almost anywhere they look.

   Cheers–

   MRE

    
3. Jenny, 28. May 2008, 4:13
   

   Dr. Eades,

   One other rarely mentioned problem is that as we get older our basal metabolic rate drops steeply. I’m a small woman who is almost 60 years old and all the BMR calculators show that even with my daily exercise regimen I only need about 1600 calories a day to maintain my current weight. Not that 2000+ that makes dieting relatively easy.

   But after many weeks of logging and weighing my food portions during a prolonged stall I’ve learned that the number the calculators come up with for the proper level to diet at is actually too high, probably because I’m maintaining a significant weight loss. Significant weight loss has been shown in many studies to slow the metabolism.

   So I face an unpleasant choice of eating no more than 1200 calories a day and losing very slowly, or of accepting that I’m going to stay a bit heavier than I would like. I’m going to go with the latter, because the last thing I want to do is to slow my metabolism any further and I learned during my weight loss phase that the calorie level that you lose at is going to be very close to the calorie level you will have to eat at to maintain.

   Hi Jenny–

   What you say is true - metabolic rate does fall with age, making it more difficult to lose as you become older. But a reduced caloric intake from a low-carb diet doesn’t seem to have the same metabolic-rate reducing effect that a reduction of calories from a reduced-calorie, low-fat diet. Probably because the body doesn’t go into starvation mode with the low-carb diet. Were I you I would keep my carbs restricted but allow my calories to go almost 1600 calories and see what happens.

   Good luck.

   MRE

    
4. G R Sampson, 28. May 2008, 4:26
   

   Dr Eades:

   Thank you so much for your blog. I believe there must be something else going on in the body that prevents weight loss after a person has been dieting for a while. I lost from around 170 to 130 pounds on a low-carb diet over several months (I am 5 feet 31/2 inches and 54 years old) but the weight loss stopped and wouldn’t budge. I wanted to lose 10 more pounds. I had been walking two miles a day for exercise and I started jogging part of the way. I also started counting calories and I never ate more than 1000 calories a day, many days I ate less than that.

   After weeks of trying to lose more it seemed that all I accomplished was to lower my daily calorie requirements to an extremely low level (800 - 1000 calories a day or so) and if I ate even a few calories more than that I gained weight. I was incredibly frustrated. The idea of living on 800 calories a day for the rest of my life merely to maintain 130 pounds was a bleak and depressing thought. I read the Taubes book, Atkins books and everything else online I could find about weight loss. I really found no answer to my predicament. I finally concluded that my strenuous dieting had been self-defeating and stopped dieting and merely tried to maintain. It has been a couple of years since my initial weight loss and
   I have regained some of the weight. I really don’t think we fully understand how dieting affects metabolism but I have proven to myself that merely cutting more calories from an already low daily total is not the answer.

   You are right, simply cutting more calories isn’t the answer because the body adapts by decreasing calorie expenditure. The best thing you can do is to diligently restrict carbs and eat plenty of meat, green vegetables and salads while avoiding cheeses, nuts and other caloric-rich low-carb foods. If you do this, you should send the hormonal message to the fat cells that it’s okay to release fat. You should continue to lose weight slowly without further decreasing your metabolic rate.

   Cheers–

   MRE

    
5. Mike Callaghan, 28. May 2008, 4:42
   

   I’ve read and heard a lot lately about caffeine also stimulating an insulin response. People who have been LCing for awhile may tend to start adding sugar-free caffeine-laden beverages back into their lives. Do you think there may be anything to that? -Mike

   Caffeine is also lipolytic, which means that it moves fat out of the fat cells. The lipolytic nature of caffeine probably offsets the tiny increase in insulin. But the only way to tell in a specific case is to stop drinking coffee and maintain caloric intake at the same rate and see what happens.

    
6. Martin Levac, 28. May 2008, 5:55
   

   I enjoy reading your blog, Dr. Eades. But I must play devil’s advocate on this post.

   The whole premise, too many calories in stalls fat loss, implies that eating even more calories would induce fat accumulation and thus weight gain. There is nothing in the scientific literature, as far as I know (I don’t know much but if there was, it would be sung high and far), that would show how eating too much fat on its own can produce fat to accumulate with the net result of a weight increase. This would suggest that the premise is somehow flawed. Here are two individual experiments:

   http://magicbus.myfreeforum.org/ftopic846-0-asc-100.php
   http://www.hypertrophy-specific.info/cgi-bin/ib314/ikonboard.cgi?act=ST;f=19;t=14917

   Granted, they can only be considered as anecdotal evidence at best. Yet the subjects themselves, I’m sure, couldn’t be swayed by any argument contrary to their own observations. They saw what they saw and that’s that. We could disagree on their opinions of the experiments, but not on the facts that they reported. One ate way too many calories and still did not gain weight. The other ate at calculated maintenance level (calculated based on a high carb diet) and reports losing weight and losing fat. Maybe the fact that they are athletes changes things somewhat but even that couldn’t change the mechanisms involved in fat accumulation or fat loss. The mechanisms can’t change just because we lift an object or we don’t lift an object. What differs must be in the amplitude. And this is the question, what’s the mechanism that determines at what amplitude, or what rate, do we accumulate or lose fat? This implies both a threshold mechanism and a rate limiter mechanism which could be the same mechanism.

   We have insulin as the primary suspect. And carbs as the primary regulator of insulin. But we’ve cut that out so we’re left with fat and protein as the secondary suspects. Fat itself doesn’t do anything for or against fat accumulation in terms of an insulin response. It may act otherwise for instance on ASP (acylation stimulating protein) yet there’s no evidence to show how ASP could make us grow fat the same way insulin does. Which leaves us with protein as the only factor left to consider in fat loss stall. Or even fat accumulation if that’s the case.

   Protein causes an insulin secretion and release although not as much as carbs. Why not consider that as we cut out carbs, as insulin drops accordingly and as we lose fat, eating too much protein could somehow affect the rate of reduction of insulin? I don’t know that anybody could grow fatter by eating too much protein but it’s reasonable to consider it as an agent that could stall fat loss through its action on insulin. From this point of view, reducing protein intake, if not permanently, at least temporarily sounds like a reasonable alternative to me.

   I would also venture a guess that protein requirement drops as we cut out carbs from our diet. By how much, I don’t know. Bodybuilders will tell you that as they cut, they lose some muscle. They eat a diet high in carbs even during a cut. As far as I know, a low carb diet doesn’t do that. If anything, a low carb diet would result in a net lean tissue gain either by re-gaining lost tissue during a high carb period or simply by gaining new lean tissue as the inhibiting effect of carbs disappears with the carbs. The point is, the protein requirement of a low carb diet would drop thereby supporting the view that we eat too much protein to begin with.

   Another point. The sight of food can affect our response to insulin even before we put any food in our mouth. I read this in GCBC from Taubes. It’s a conditioned response apparently that comes probably from the regular intake of carbs which will subsequently result in an insulin secretion and release so that eventually, we need only to look at the cake for insulin to be release in our bloodstream thereby emptying the blood of nutrients causing a corresponding increase in hunger. I don’t think it’s the eyes themselves that would trigger this conditioned response so I would go further with this logic by saying that the mere thought of food would cause hunger to rise. Considering the effect of a high carb diet on hunger, it’s understandable that as we eat a high carb diet and as our hunger increases and as we obsess with food, our hunger only increases accordingly. The point is, by its action on insulin, this conditioned response could somehow stall fat loss to some extent. So the advice here would be don’t think about food. But then if we’re hungry the advice would be don’t eat food that make you hungry either.

   The point is to suggest that merely total caloric intake without distinction of the quality is not the cause of a fat loss stall, that there is some underlying mechanism that controls this fat loss and that it is therefore both the quantity, after having determined the quality, of calories that is the cause of a fat loss stall.

   Hey Martin–

   I don’t think the subjects you linked to are lying at all. You are getting into an area that I’m going to write about in another post. When insulin levels stay down, the fat cells open, but fat doesn’t really come out unless it needs to. With enough dietary calories to provide for energy needs, the fat stays in the fat cells. The other side of this equation says that if insulin is down, fat won’t go into the fat cells either. So people can consume large amounts of calories on low-carb diets and not gain weight either, which is what is happening to the subjects in your links. I plan a post on this phenomenon in the near future.

   Cheers–

   MRE

    
7. Vesna, 28. May 2008, 5:56
   

   Dr. Eades, I’m a big fan of yours and I’ve been eagerly awaiting this long-promised post about LC weight loss difficulties. But I’m disappointed. Essentially, this post addresses the question, “Why am I not losing weight even though I’m eating too much while low-carbing?” — a question with a built-in answer.

   However, the big question is this: “Why am I not losing weight even though I’m low-carbing and can’t possibly be eating too much?”

   For instance, I recently lost no weight at all over the course of about two months following a strict regimen of whole, homemade foods including VLC veg (salad-type stuff). 70-75% fat, carbs under 20g. No nuts, nothing with natural or artificial flavorings, MSG, etc listed on the label. No dairy products except cream and its derivatives (butter, cream cheese, sour cream). After the first few days, calorie intake fell naturally to around 1200-1500 per day, and I naturally quit snacking. My weight varied between 143 and 139 over the course of this experiment, then seemed to stabilize at about 142. (I should weigh around 125-130.)

   From reading posts around the Net, I gather I’m not the only person in a similar situation. Many are much farther from a goal weight/body shape than I am — even though they stick with low-carb, natural foods, low-ish calorie eating for much longer periods than me, and even though some exercise a lot more than me — and for that I can only thank my lucky stars, I guess. Jimmy Moore, for one, recently posted about the rough time he’s having with a seemingly unexplainable substantial weight gain that he’s still having a rough time losing.

   I trust you to take this seriously and not assume we’re all doing something silly like underestimating calorie intake or snacking mindlessly. We’re not overlooking newly built tremendous muscles. We’re not dropping inches and clothes sizes even though the scale isn’t moving. We’re not consuming hidden carbs in our Frankenfoods. When all this is the the case and still the body hangs on to every stored gram of fat, what’s going on? And how do we get it to let go?

   Hi Vesna–

   I can’t really say what’s going on without looking at food diaries and knowing a little more about you and your health. I’m assuming that the “butter, cream cheese, sour cream” are accounted for in your daily caloric measuring. One thing you can try that almost never fails is to go on an all-meat diet for a week or two. That always seems to get things moving. Eat meat only morning, noon and night. Drink non-caloric beverages. It works like a charm.

   Once your weight is where you want it to be, go back on a regular low-carb multi food diet. As I’ll point out in a future post, it’s almost impossible to gain weight on a diligently-followed low-carb diet, so once you get to where you want to be, you should be able to stay there. The meat diet is just a temporary therapy to get you there quickly.

   Cheers–

   MRE

    
8. Jeff Walzer, 28. May 2008, 6:00
   

   Dr. Eades,

   As always I learn something new every time I read a post - I am guilty of using cheese and nuts as snacks (although I do my best to limit myself for each) during my low-carb dieting and now I know I need to switch to something else to snack on.

   However, I do have a question on food consumption for someone who works out 4 days a week with weights and does interval training (in the form of sprints) 3 days a week after lifting - from what I’ve read after one is done working out, one should consume simple carbs to replenish the glycogen stores in the body so after a grueling workout I usually consume 2 egg whites, a protein shake, and two cherry pop tarts. How should one approach low carb dieting when exercising intensely? Is there a need to still consume simple sugars after a workout?

   Thank You,
   Jeff

   Hey Jeff–

   Studies have shown that you don’t really have to replenish glycogen by consuming carbs after a workout if you’re adapted to a low-carb diet. The enzyme glycogen synthase will be upregulated and you will make glycogen easily from protein. What you need is protein and fat after a workout once you are low-carb adapted. Another thing you can take to replenish the muscles is a teaspoon of D-ribose, a type of sugar available at most health food stores. I’m going to post on D-ribose soon.

   Best–

   MRE

    
9. Craig, 28. May 2008, 6:09
   

   What about Taubes’ implication that the body will naturally adjust caloric intake/energy expenditure to allow for weight loss to the point where the body is “comfortable”? It has also been my experience with weight loss clients that if they religiously follow a lowish carb regimen, they tend to bottom out quite easily at ~10% BF for males, ~15% for females. They are also CrossFitting regularly, which dramatically increases their lean mass while on this regimen.

   I agree that the body will naturally adjust for most people. I wrote the post for those who have trouble losing while following a low-carb diet to the letter. Most of these people fall into the trap of overconsuming calories by snacking on high-caloric-density foods.

    
10. Eddie, 28. May 2008, 6:10
    

    Hello Doctor Mike,

    First of all, thank you for the great information and all your efforts in making it available.

    Some time ago, you posted about the “meme” of “eat less, move more” to lose fat, making the point, if I understood correctly, that this formula does not really work. Today’s post suggests that (health benefits aside,) fat loss on a low carb approach is still somewhat calorie dependent.

    Which of your books or online references that you might link to would be best for providing a simple, lay-person friendly understanding of the relative importance of low carb and (or versus) low calorie, as an optimal approach to fat loss.

    BTW, on a not completely unrelated point, as it might be helpful to some of your readers, I’d like to share something I’ve been doing lately that has been extremely helpful in improving the quality of my nutrition, and the results therefrom. To wit, writing down what I eat & drink. I’ve done this before with great results and then abandoned the practice when I was satisfied with the outcome. Starting again recently, I’m reminded of how powerful this simple practice can be. I carry an index card in my shirt pocket and simply take notes. ( I then log it into a program that tracks nutritional data, providing a great “feed back” motivational tool.)

    Thank you again for creating and maintaining this blog Dr. Mike.

    All the best,

    Eddie

    Hey Eddie–

    I think for most people following a low-carb diet will bring about weight loss. I wrote the post for those who do follow a low-carb diet strictly and still don’t lose. Most of those people simply consume too many calories and need to cut back to lose.

    Your notion of writing everything down is indeed powerful. It’s been my experience that people virtually never, ever overestimate their consumption - it’s always the opposite. Writing everything down helps create an accurate picture of what’s going on. Remembering food intake is like remembering golf scores: no one ever gives puts down too many strokes. We forget the strokes we don’t want to remember. It’s the same for food intake.

    Cheers–

    MRE

     
11. Brian, 28. May 2008, 6:23
    

    I was afraid you were going to say that! I have lost over 50 pounds using a low carb diet and lifting heavy weights. I have hit a bit of a plateau lately. I have also been going to town on Blue Diamond brand flavored almonds (specifically Salt and Vinegar…omigod). I also eat a lot of cheese as a snack. I don’t want to give them up because they are so delicious, but I guess I will have to. These almonds also have some chemicals in the flavoring which I have somehow convinced myself is ok to consume because they are so delicious.

    We’ll see what happens when I cut these out. Although I am pretty sure I already know…

    Keep me posted. I’m pretty sure I know what will happen, too. The good news is (which is also the topic of a future post) that once you get down to the weight you want, the almonds and cheese can come back without causing a weight gain. You just need to ditch them to lose.

    Are there really Salt and Vinegar flavored almonds? I could be in real trouble.

    Cheers–

    MRE

     
12. SusanJ, 28. May 2008, 6:34
    

    Thanks for this. I could have written this letter except I’m 20 years older and my weight loss hasn’t been as great as hers but the time scale has been almost identical.

    I understand that what you are saying is (1) I need less calories than I did before I lost some weight and (2) I’m probably eating more calories than I realize. It can’t hurt to check this by keeping a very accurate record.

    I can do the math and realize that consuming an extra 250 calories of fat a day adds up to a half pound of fat a week that my body can hold on to.

    However, I’ve also read that eating too few calories isn’t good as it will just slow my metabolism to compensate. How do I find the sweet spot?

    You find the sweet spot by simply following a good quality, whole-food low-carb diet at mealtimes. And by not snacking. This usually does the trick. The good news is that once you achieve the weight loss you’re looking for, you can go back to the low-carb snacks without gaining.

    Best–

    MRE

     
13. Bill, 28. May 2008, 6:50
    

    So, if you eat too much fat your body won’t burn your stored body fat, it will use the fat you eat for energy instead of body fat? I dunno, is this correct?

    Thanks, Bill

    Hey Bill–

    It is exactly correct. As long as you eat enough calories to meet your energy needs, you won’t harvest the calories in the fat cells.

    Cheers–

    MRE

     
14. peter, 28. May 2008, 7:20
    

    Dr. Mike,

    I completely agree with your carb/cocaine analogy. Carbs act upon one’s brain much like drugs. I know from firsthand experience, as i am sure you do as well. For instance, years ago, after a hard day at college, i would dig into a huge bucket of ice cream. The sugar and insulin spike created a calm and almost euphoric state. The next morning, though, i would be famished, most likely because of the resultant low-blood sugar and the nutrient-robbing effect of the sugars in the ice cream.

     
15. Michael, 28. May 2008, 7:43
    

    Hi Michael,

    Thanks for a very useful post. I’ve just found your work in the last 6 weeks or so, and I’ve really got so much out of your blog!

    You didn’t mention excess protein intake in this post. I presume excess protein will also result in fat stores not being released into the blood. Am I correct in this?

    I have been on a low-carb diet for about 4 weeks now… a LOT of protein (300-350g a day with the help of 90% protein powder on top of steaks, eggs etc). I want to GAIN muscle — I’ve put on about 3-4kg of muscle in the last month (now 87kg at 193cm)… my body fat stays at 9-11% range (according to skin calipers) on this low carb-diet ONLY if I do fast walking 2 hours a day (or similar cardio like swimming & I do interval training too). If I cut back too much on the protein my muscle gain slows down tremendously.

    So relating to this post — how does one stimulate release of fat from my cells & make sure that they have enough protein for muscle growth? Is dietary protein the key for muscle growth (as well as training obviously) rather than high protein & high calories? In this case, I could simply keep high protein and cut back on the fat (keeping carbs low still). Or, are muscle gain and fat loss largely incompatible at the same time, being based on a calorie-excess and a calorie-deficit respectively?

    Thanks for your input and thanks for helping me understand the biochemistry better!

    Michael

    P.S. I know I have already low body fat, but my goal has been 6-7% for the last year with little progress.

    Hi Michael–

    No, muscle gain and fat loss are not incompatible. Both can and indeed do happen at the same time. Often people aren’t losing weight because they are building muscle thanks to the increased protein from a low-carb diet. They gain a couple of pounds of muscle while losing a couple of pounds of fat, giving then no change on the scales, but a big change in terms of body size.

    Protein can be burned for fuel, but usually isn’t as long as dietary fat or fat from the adipose tissue provides the fuel to meet the body’s energy needs. And if the protein isn’t burned for energy, it’s available for muscle growth.

    Sounds like you are doing what you need to do to achieve your goals.

    Cheers–

    MRE

     
16. Elle, 28. May 2008, 7:45
    

    I’m 43 years old, very healthy but terribly active with organized exercise, but I have 3 children under 7. I’ve been what I call “high-fatting” for a while now–getting 75% - 80% of my daily caloric intake from fat.

    I lost from 178 to 145 pounds then stopped cold eating about 1500 to 1700 calories a day and about 100 grams of protein a day and 20 grams of total carbs (clean carbs: mostly veggies, no grains or legumes). I went from losing 1-2 pounds a week to nothing for over 5 weeks. But I really wanted to break into the 130’s so I decided that instead of cutting calories (fat), which I simply was NOT willing to do, I would try to eat only my protein minimum, my 20 g carbs, and make up the rest of the calories with fat (about 150 g per day).

    I immediately started to lose again, like the next DAY started losing again, and got into the 130’s in no time with LBM remaining essentially unchanged, muscles becoming more visible.

    Most people’s first inclination is to cut fat and calories, and you guys do seem to offer that as the first line stall-breaker. But I know that I will start to binge if I try to decrease fats, even in the presence of good protein intake. There is something about fat, and LOTS of it, that keeps me very happy, happier than lots of protein.

    Do you have any thoughts as to why increasing fat intake and decreasing protein intake, while keeping calories unchanged (actually my calories went UP a little bit) would stimulate weight loss to resume? If it’s not the calories, then it has to be something hormonal or biochemical?

    Hi Elle–

    It’s difficult to decrease protein without decreasing fat a little since foods containing protein also contain fat. There are few foods - butter, coconut butter and cooking oils being the exception - that are totally fat, so when one cuts protein, one usually cuts fat as well.

    How were you able to cut protein and allow fat to go up?

    Cheers–

    MRE

     
17. Elle, 28. May 2008, 7:48
    

    Gosh, I’m sorry, I meant to say I’m NOT terribly active with organized exercise…Sheesh. That mistake could radically change your answer if you think I’m a big exerciser, which I’m not.

    I figured that’s what you meant.

     
18. marly, 28. May 2008, 7:53
    

    I’m still confused despite your excellent explanations. I did a two-month all-meat program and lost nothing. I felt wonderful and had normal bowel function daily without having any fiber in my diet. So, apparently I have to determine the caloric content of meat and fat even in the absence of any carbs.

    Marly

    Some people can consume a lot of calories even while following a low-carb diet without snacking. If you fall into this category - and it seems that you do - you’ve got to watch your portion sizes until you lose to your goal. Then you can add back the fats without gaining.

    Best–

    MRE

     
19. Bob, 28. May 2008, 7:59
    

    Another interesting aspect I’ve found is almost the opposite problem. I can consume beverages that have ‘0′ calories, but still gain weight. Diet soda does that to me, for example. Also, I find I can lose weight much more easily when I’m drinking green tea (Usually with pomegranate essence) than when I’m drinking coffee. It’s easy to tell that there’s a lot more going on there than just the calories, and, with the coffee and green tea, the caffeine.

     
20. Charles, 28. May 2008, 8:12
    

    [Quote=Dr. Eades]
    The doors of your fat cells will be open and fat can easily come out to be burned. But if you’re throwing back a few ounces of cheese or nuts (or both) here and there, you’re going to be providing your body with enough fat to meet all its energy needs with some left over. And your weight loss will come to a screeching halt.[/quote]

    With all due respect, the problem with this analysis is that fat doesn’t just sit in fat tissue “waiting for the doors to be open.” Yalow and Berson proved this with their Nobel-winning radioimmunoassay that they turned on the fat tissue. Fat is dynamic. The problem is, triglycerides are handled in the same way. Moreover, your analysis doesn’t inform us why people would overeat on cheese, nuts, and other so-called good carbohydrates.

    It’s true that the body does not care whether the fatty acids come from the diet or the fat tissue, but this is because the two are combined in our long term fuel supply that flows throughout the bloodstream and the body. Therefore, the new fatty acids are indistinguishable from fatty acids that were there from yesterday or last week.

    Insulin disrupts the free flow of fatty acids by clearing the bloodstream of all fatty acids, amino acids, all nutrients and anything that could be used for fuel prior to a meal and during digestion to deal with dietary carbohydrate and to provoke hunger. As the meal is digested, the fatty acids return under normal conditions unless something keeps them out of circulation longer than they’re supposed to be. Since that’s the case as the Krebs cycle says it is, then our investigation has to start and stop with reasons why these lipids are delayed from flowing freely longer than they should be.

    When the insulin-level is high, this causes lipids to become trapped in the fat tissue and there they stay until insulin ebbs. Hyperinsulinemia combined with the effect of those nuts and possibly cheese on insulin cause this. It has nothing to do with the number of calories. The change in the fat stores (due to insulin) affects energy-in and therefore people consume too many carbohydrates in the form of things you described.

    The other problem is hyperinsulinemia which doesn’t seem to get enough attention and press. Those with this condition not only secrete insulin in anticipation of and in response to meals, they also may secrete between meals and this contributes to the high insulin condition.

    That the effect of calories has been overstated has been known to some since the 1960s when Yalow and Berson’s technology was used on the VMH-lesioned rats. Obesity could be prevented by short-changing the exaggerated insulin response by severing the vagus nerve. Similarly, the hypersecretion of insulin was reported to be the earliest detectable abnormality in genetic strains of obesity-prone mice and rats. Some ate more and others ate less. When the lesion was administered, obesity followed regardless of the number of calories.

    What is important to know is that the fat cells of adipose tissue are exquisitely sensitive to insulin, far more so than other tissues in the body. This means that even low levels of insulin, far below those considered the clinical symptom of hyperinsulinemia, will shut down the free flow of fatty acids from the fat cells. Elevating insulin even slightly will increase the accumulation of fat in the cells. The longer insulin is elevated, the longer the fat cells will accumulate fat and the longer they’ll go without releasing it.

    [quote=Dr. Eades]The low-carb diet is a wonderful, healthful way to lose weight quickly, but you do have to watch your calories as well to a certain extent. If your plugging along losing away, keep doing what you’re doing. But if you quit losing, take a look at your cheese and/or nut consumption. Cut those out, and I’ll just about guarantee that your weight loss will pick up again.[/quote]

    Let’s not confuse an association with cause as your hero John Yudkin did. He couldn’t imagine a world where calories did not matter due to his construal of the law of conservation of energy and unfortunately was unable to convince his counterparts of his position. We can’t have it both ways. Calories matter or they don’t. The science says they don’t. I lost 66 pounds by avoiding carbohydrates, plain and simple. If I eat them, I gain weight. If I avoid them, I effortlessly maintain my weight regardless of calories.

    If weight is not being lost, the carbohydrates have to be dropped even further to the point of zero if necessary. This is all that is possible from a dietary perspective. If there is some hormonal issue, then that must be solved first.

    Regards,

    Charles

    Hi Charles–

    I agree that fat is dynamic in that it moves in and out of the fat cells - I just didn’t want to complicate the issue by going into all that. In essence if the same amount of fat moves into the fat cells as moves out of it, there is no difference in the end result, and it isn’t all that inaccurate to say that the door to the fat cells is shut.

    I don’t agree with your assessment of Yudkin’s opinion on the calorie issue because Yudkin came around to a different way of thinking in his later years, but he didn’t publish it in the medical literature. He did publish it in a diet book written and published in the UK a few years before he died.

    Irrespective of what Yudkins opinion was of the caloric issue, the laws of thermodynamics haven’t yet been overturned. Consequently, calories do matter. And the science shows very much that they do. There is a difference in what happens to the calories on a low-carb diet as compared to what happens to them on a low-fat diet, but something does happen to them. They don’t disappear nor can they be ignored.

    You may have effortlessly lost weight and maintained a lower weight by doing nothing but reducing carbs to zero, but you are a study of n=1. I can assure you that in my many years of taking care of patients I have seen many who have struggled to lose weight with diets in which the carbs have been severely restricted. And in those patients, once we started looking at the calories, the weight loss picked up.

    Cheers–

    MRE

     
21. mrfreddy, 28. May 2008, 8:15
    

    In my case, I don’t think it’s the cheese and nuts to blame.

    Here’s my story. 51 years old. 5′11 1/2′ tall. Low carbing got my weight down to 195 - 200ish (from 230 and climbing) within six months. Stayed that way for five years. I started a daily IF routine (fast-5) six months ago, more or less, that got it down to just under 190, on most days. According to Fred Hahn’s sci-fi measuring device, I have about 13 - 14 % body fat.

    I should be happy, but I still have a visible belly that I want to get rid of, I would guess I am about 10 or 15 pounds overweight.

    With the IF routine, just counting food calories, I don’t think I eat much more than 1800 calories a day, with or without cheese and nuts. It’s hard to imagine dropping my calories much lower, I would be too hungry all the time.

    There is one other suspect. You were holding a glass of it in that last picture you posted of yourself, hahaa. Ah yes, the booze. I love a good scotch or three (especially the 30 year old kind!), glass or four of wine, occaisional beers, etc.

    I am afraid that if I really want the belly to go, I’ll have to drop the hooch first. But for now, bartender, another round of Guinness, if you please…

    Hey mrfreddy–

    You are indeed right about the booze. In weight loss as in reduction of risk for heart disease, a little booze is good, a lot is deadly.

    Whenever I pick up a few pounds, the first thing I do is go cold turkey on the alcoholic libations, and my excess weight disappears.

    Thanks for bringing this issue up.

    Cheers–

    MRE

     
22. Steve, 28. May 2008, 8:38
    

    Assuming all hormones are working properly, isn’t appetite supposed to be self-regulating? I can understand that weight loss slows as people lose weight because there’s less of a calorie deficit, but this assumes that people are eating the same amount of food as they lose weight. How come people can be sated at one level of calories, but seemingly still require that same level of calories to be sated as they lose weight?

    Is it psychological? Maybe people eat the amounts they’re used to eating even as they lose weight? Or maybe there’s some sort of base level of intake that you can eat and still feel sated? And as you lose weight that level doesn’t really change, so weight loss slows? I dunno. That’s always confused me.

    I understand that your post kind of addresses this by saying that people may eat differently as they progress on low-carb. But let’s assume they stay on the plan and only eat low-carb until sated. If I understand the idea of a self-regulating appetite correctly, theoretically it should be as easy to lose the first pound as it is to lose the 50th pound. But I don’t think that’s most people’s experience.

    Hi Steve–

    You are correct in that it is not the experience of most people that losing the first pound is as easy as losing the 50th. People vary in their appetites. Most people spontaneously reduce calories when switching to a low-carb diet. Some, however, are able to consume huge numbers of calories while keeping carbs within the 20-30 gm/day limit. It is these people who don’t lose weight easily until they consciously start to restrict calories while on their low-carb diets.

    Cheers–

    MRE

     
23. SusanJ, 28. May 2008, 8:52
    

    While we are discussing things that might be limiting weight loss I wonder what you think of this research?

    http://www.ncbi.nlm.nih.gov/pubmed/17914136

    If I’m understand it, the article suggests that certain compounds in tea (not caffeine) can raise your insulin levels. I’m a longtime tea drinker and had been sipping hot (plain) tea fairly often. I’ve now switched back to coffee (which I don’t like as well) but it’s too soon to tell if it’s going to help my stall.

    I think that perhaps the compounds in tea and/or the caffeine in coffee may minimally inhibit weight loss on low-carb diets, I pretty sure it’s the overconsumption of calories that is the real problem. If you’re wondering about it from a personal perspective, it’s pretty easy to ditch the tea and coffee for a bit while keeping everything else the same and see what happens.

    Keep me posted.
    

     
24. Bob, 28. May 2008, 9:27
    

    I should have waited a while before posting my previous comment! I saw that you mentioned d-ribose in a later post. I’ve been wondering about ribose for a while. I was re-reading some articles by Jonny Bowden (some of which relate to the green tea-coffee differences that I mentioned above, particularly the EGCG in tea). In one of them he talks about what Dr. Steven Sinatra calls ‘The Awesome Foursome’ (With a name like Sinatra, shouldn’t it be ‘The Rat Pack?’) Three of the four I think you’ve written about at length either here or in PPLP: Magnesium, CoQ10, and l-Carnitine. D-ribose was the only one that was missing!

    I know I’ve seen you and Dr. Bowden refer to each others’ work from time to time. I don’t know how you feel about Dr. Sinatra, though, and all I really know about him is his four-fold recommendation above for heart health.

    I’m looking forward to your post!

    I think Dr. Sinatra is a pretty bright guy who is on track. We disagree on a few issues, but I don’t hold that against him.

     
25. Kevin, 28. May 2008, 10:09
    

    So it seems that Anthony Colpo is right; There is no metabolic advantage except perhaps in cases of extreme obesity. For everyone else, calories count. If one can’t lose beyond a certain point, they aren’t being honest with themselves about calorie intake.

    I knew that sooner or later I would get this comment. No, I don’t think Anthony Colpo is right on the metabolic advantage issue. In the post I wrote that a caloric deficit is required for weight loss. A metabolic advantage implies that a different caloric deficit may be created as a function of the type of diet consumed. In other words, a low-carb diet of 1800 kcal may provide a caloric deficit whereas a 1600 kcal low-fat diet wouldn’t. The difference is the metabolic advantage created by the low-carb diet. In the case of the above example: 200 kcal.

    The body does three things with calories: it uses them for energy, it uses them (proteins and some fats) for rebuilding tissues, and it wastes them. If the body wastes more calories on diet A than it does on diet B, then diet A is said to provide a metabolic advantage.

    Both Anthony Colpo (and I think I am speaking for him correctly on this) and I believe that there has to be a caloric deficit for weight loss to take place. I believe (and he doesn’t) that different diets waste different amounts of calories, meaning that diets that waste more - low-carb diets - create more of a caloric deficit with a caloric intake identical to diets that don’t waste more calories - low-fat diets.

     
26. Ryan, 28. May 2008, 10:59
    

    Couple of things come to mind reading the comments here and on other low carb sites. One is that unless one weighs (not just measures) every bite that goes into their mouth and calculates calories, they are probably under estimating how much they are eating. Just looking at it and thinking “Oh, that’s about a cup” isn’t going to cut it. There is a great Youtube video about it (which I don’t have a link to currently). This includes all the little things like licking the spoon, cream in coffee, taking “just a taste” while preparing food, etc. Even the weighing isn’t foolproof as it is difficult to tell how much fat is in a cut of meat, how much cooked out, etc.

    Second is that many people spontaneously cut their movement down when cutting calories, just as some spontaneously increase movement when increasing calories (the effect is called N.E.A.T.). This lowers the amount of calories used for the day and leads to a much smaller deficit than expected (and a much lower rate of loss). Add in water fluctuations and hormonal weirdness and it can lead to near stalls at lower calories, Throw in the occasional frustration cheat and “poof” - a plateau.

    Great blog post, Dr. Mike, though I am betting you will incur the wrath of the low carb community because of it.

    Hey Ryan–

    Not a lot of wrath so far. But, who knows?

    You’re right about measuring. And about underestimating. Golf is a great analogy. I don’t know anyone who cards a higher score on a hole than that actually scored. Everyone tends to put either the correct score or a lower score because people don’t remember the extra chunked shot. It’s the same with food estimating. People constantly underestimate the amount of food they eat.

    Having said this, most people do fine on low-carb diets and spontaneously restrict calories enough to lose weight just fine without having to measure and record every bite. The post I wrote was for all the people who seem to stall and write me wondering why.

    Cheers–

    MRE

     
27. Zbig, 28. May 2008, 11:42
    

    Thank heavens you’re back to life, dear Doc!
    Very interesting post that explains (or at least reminds) me a lot

    I have a proposal for maybe some other future post by you - what happens if you overdose proteins?
    I bring up this idea because in my country there is a low carb author who disseminates information that the best proportion for humans (adults, healthy) is P : F : C equal 1 : 2,5-3,5 : ~.8 in grams (multiplied by their natural body weight in kilograms (divide pounds by 2.2)
    I don’t know if its clear to everyone so I will give an example: if I should weight in at 198 lbs (90kg) then I should take in daily about 90g proteins, 220-320 g fat and 70g carbohydrates.
    He strongly emphasizes that eg. Atkins’s diet suggest eating to much proteins (which I took no notice by the way but never mind) and to much proteins (in our example this will be more than 90g) causes accelerated aging and maybe some other disasters. What’s your take on that.

    best regards,

    Hi Zbig–

    I don’t think there is a ‘golden rule’ about these ratios. I think people ought to get a minimum amount of protein and keep their carbs restricted, then let the ratios fall wherever they may. I don’t think that extra protein accelerates aging, and I don’t think it causes other ‘disasters.’ Body builders consume huge amounts of protein relative to the rest of us, and they don’t have lives any longer or shorter than non-body builders, so I take that as proof that a whole lot of protein isn’t harmful. If a whole lot isn’t harmful, then I don’t think 50-100 grams extra is going to cause any problems. Plus the literature is full of papers showing that increasing protein in the diet brings about a reduction in waist size, a decrease in body weight, an increase in bone mass and a host of other improvements over isocaloric diets with less protein.

    Cheers–

    MRE

     
28. KarenJ, 28. May 2008, 11:47
    

    “Are there really Salt and Vinegar flavored almonds? I could be in real trouble”

    Yes: and Smokehouse, Chili Lime, and Wasabi. But the Salt and Vinegar almonds are evil. :0 Stay away!

    This is precisely the reason why I have not lost that final 10 pounds. Cheese & nuts. I have found it funny that I can eat so much and not gain, but your post made me realize why- AND why I never lost that last 10 in the first place.

    I’ve been the same weight now (120lbs) for 4 years after losing an initial 30 or 40 pounds. I’ve been unwilling to lose any more because I have not wanted to alter the luxurious amount of food that I currently enjoy. Skipping nuts & cheese in favor of meat for awhile sounds completely logical.

    Thanks for the great blog, DH & I are glad you’re back.

    Hi KarenJ–

    The good news is that if you suck up and toe the line for as long as it takes to get down to where you want to be, the evil Salt and Vinegar almonds can come back and you won’t gain. I’ll explain why in the next post or two.

    Cheers–

    MRE

     
29. Jessica, 28. May 2008, 11:53
    

    I would like to suggest to people who have hit a plateau in their weight loss to consider Intermittent Fasting (fasting for 24-30 hours) once or twice a week.

    I had been eating a reduced, healthy carb diet for about 4 years (whole grains), and a very low carb diet since December, but didn’t see much of a result until mid-February, when I started 24-hour fasting once a week. The weight came off without effort as soon as I started Intermittent Fasting - I lost about 20lbs in 8 weeks, even though in March I also increased the fat content of my diet to about 60 or 70%.

    I recently added potatoes and bananas back into my diet about once or twice a week to stop the weight loss, and now I fast once every other week or so, just to keep my metabolism on its toes.

    Whether it’s due to the complete exclusion of grains, the increase in fats (particularly real, rendered lard), the fasting - or, the combination of all three - I have noticed wonderful changes in addition to the loss of excess body fat, including: better sleep, fewer allergies, and a general boost in mood, motivation and energy. Plus, I have never enjoyed food so much!

    Hi Jessica–

    A reasonable suggestion, indeed, that may work for many people. Thanks.

    Cheers–

    MRE

     
30. Stargazey, 28. May 2008, 12:51
    

    Dr. Mike,

    You said, “But a reduced caloric intake from a low-carb diet doesn’t seem to have the same metabolic-rate reducing effect that a reduction of calories from a reduced-calorie, low-fat diet. Probably because the body doesn’t go into starvation mode with the low-carb diet.”

    The Kimkins Survivors blog tells the stories of many women who did a reduced calorie, low-fat, low-carb diet. They seem to have gone into starvation mode and have not only damaged their health but have reduced their metabolic rate as a result. Is this an incorrect interpretation of the data?

    I agree. The Kimkins diet is/was a low-everything diet. Very low in both carbs and calories. One couldn’t help but lose in the early stages, but at what expense?

     
31. simon fellows, 28. May 2008, 13:57
    

    thanks that post. Nice one Sister.

    Glad you enjoyed it. You’ve been requesting it for a while.

    Cheers–

    MRE

     
32. Caroline Belli, 28. May 2008, 14:35
    

    Hi Michael,

    I just love all the wonderful information you have. I found it a bit daunting to translate at first, but now I’m getting it! It’s great to have such a scientist to detail all the ins and outs for us. I was wondering–I have been eating this way for two months. I’m satiated, not bingeing, slow-burning and exercising. But I’m not sure what ratio should be fat, and how much should be protein. I am 130 lbs, and 5′8. How do I figure out without guestimating. I am not overeating for the first time in my life, so it’s hard to figure out what to eat. As you talked about, I’m not so hedonistic, which is a miracle. But I would like to be as healthy as possible. Any suggestions?

    p.s. Thanks so much for all your wonderful research in exposing the diet misconceptions. Loved your article on the inept studies and bad reporting.

    Hi Caroline–

    Thanks for the kind words. I really appreciate it.

    If you’re doing fine, I wouldn’t worry about the ratios. Just eat plenty of good quality meat along with green and colorful vegetables and a few low-carb fruits, and you’ll do fine without ever calculating a ratio.

    Cheers–

    MRE

     
33. Vadim, 28. May 2008, 16:00
    

    I will not be original and let me thank you for a wonderful work you have been doing. I have been struggling with weight related issues for the most of my adult life. I am 36 years old, Russian- American guy . I have suffered paralysis from analysis on many occasions to only realize finally that low carb is the way to go. I have many degrees, including minor in nutritional studies. I am a product of Suny Downstate, graduated with a degree in DMI ( diagnostic medical imaging, fancy for ultrasound) and currently working as a night manager here on campus. Thanks to you I also discovered and talked to Dr Feinberg, what a jewel! I have tried almost every diet known to man, kind of a diet rat, and eventually started looking like one. I had tried everything and anything from Ornish, Zone, Atkins, Dr Bregg starvation miracle diet and so on. My question regarding this post is following: some people state that even though they tried to go on all meat diet they were still unsuccessful losing weight, does it matter if the meat product they chose were organic or not. I am curious to know if there were ever studies done on consuming organic grass fed meat vs hormonally, antibiotic and chemically induced meat? Can it be that all those hormones and GH in chickens, beef and so on contribute to difficulty loosing weight in most metabolically challenging people? Sorry for the spelling, I am operating on 3 days lack of sleep.

    Hi Vadim–

    I have read a study or two (one, of course, that I can’t put my hands on right now) that appear to show some benefit from eating organically- verses non-organically produced meat products. I don’t think it makes a huge difference, though. I think there is little doubt that the accumulation of pesticides in human adipose tissue makes weight loss much more difficult, and the continued addition of more by consuming non-organic meat can only make things worse. But, having said, that, I don’t think that is the major factor in preventing weight loss. I think the overconsumption of calories probably adds more than the pesticides.

    Cheers–

    MRE

     
34. Ironjack, 28. May 2008, 17:17
    

    Isn’t it also possible that protein is going too high as a percentage of calories, creating an environment of gluconeogenesis, thus throwing your usual fat burning metabolism into whack. Shouldn’t the first step of this analysis be–check to make sure fat is making up 50%+ of your daily calories. If not, fix that, and if the problem persists, then reduce kcals?

    Also, to be clear, you’ve previously discussed the idea that low carbers can eat A LOT of calories and not gain weight, what you’ve referred to as being the real metabolic advantage. So I suppose your points here comport with that. Low carbers have the same caloric floor as others, but a much higher ceiling.

    Protein doesn’t drive gluconeogenesis - it’s only the substrate for the process. Gluconeogenesis is driven by a need for glucose, not an abundance of protein. I need to do a comprehensive post on this subject because I get this question all the time.

    People with type I diabetes can have gluconeogenesis driven by protein consumption because they have no insulin, which is the signal that there is plenty of blood sugar. The livers of those with diabetes constantly think there isn’t enough sugar and so constantly produce sugar from protein. It doesn’t work that way in the rest of us.

    And, yes, that’s a good way to put it about low-carbers and the metabolic advantage.

     
35. ida, 28. May 2008, 17:23
    

    hi dr. eades,

    that’s a great post…i’ve found that intermittent fasting (i do a twenty hour fast each weekday, a bit more lenient on weekends) has totally changed my low carb experience. while i’ve been successful doing tradional low carb, i never really got my overeating under control and never lost that last 20 pounds. one of the reasons i think diets are potentially dangerous is that they label some foods as “approved” and many people (myself included) take that to mean you can shovel them in and still lose. intermittent fasting has really shown me the supreme satisfaction of eating only when truly hungry. i was apprehensive that i would stuff myself silly during my eating window but it just never happened…in fact, i’m eating much less than before, have more energy than before and it broke my weight loss plateau after only 3 days.

    thank you sir, your blog always gets me thinking and is totally enjoyable to read.

    best,
    ida

    Hi Ida–

    I’m glad you enjoy the blog, and I’m delighted that the intermittent fast has worked so well for you.

    Best–

    MRE

     
36. Cecelia Spitznas, 28. May 2008, 18:46
    

    Great post Dr. Eades. I have a couple of questions.

    Where does the magic number of 50 carbs come from? Is that for the average person or is there something happening like everyone can have 2 carbs an hour and not slam the door shut? Are there individual differences based on exercise vs sedentary in the number you need to keep to to keep the fat cells open?

    Also what’s that scary looking cell in the middle of the fat cells?

    Thanks!

    Hi Cecelia–

    Here is an old post that discusses the 50 gram limit:

    http://www.proteinpower.com/drmike/low-carb-diets/we-never-failed-to-fail/

    The ’scary looking cell’ in the middle of the fat cells isn’t really a cell - it’s the cross section of a small artery coursing through the fat tissue. What you’re seeing is looking down the tube of the blood vessel.

    Cheers–

    MRE

     
37. Subramanya, 28. May 2008, 21:11
    

    Dr. Eades,

    Thanks for starting the posts again. I was kind of starved while you were busy
    with your book.
    I am a newcomer to Protein power and started on low carb diet in March this year
    (based on your original protein power book). The weight loss is nice but
    not spectacular since I was only 10-13% overweight. I am a diabetic and
    PP diet worked like a charm to bring down my sugar levels. I have improved
    the diet after getting your second book (PPLP) for which I had to wait
    for 8 weeks after placing the order (I am in Bangalore, India) but it was worth it.
    Now my wife is also on PP diet and we are trying to convince others.
    Thanks for showing us a nice way of improving our health.
    I am a bit confused with carb restriction during intervention.
    PP says < 30gms/day.
    PPLP says < 40 gms/day.
    This post gives an impression that < 50gms/day is OK.
    Could you please enlighten me on this? Since we are ovolactovegetarians, 10-20gms/day
    of carb increase (from 30gms/day) would be a great boon. We are not very much
    overweight but as I said, I am a diabetic.
    Regards,
    Subbu

    Hi Subbu–

    Pretty much anything below 50 grams of carb is going to get you started. After that, it’s a matter of fiddling with it to find the carb restriction that works best for you. Same holds for sugar control. If your blood sugars are good on 10-20 g per day, give 30 g a try and see what happens. If your sugar goes crazy, drop back to 10-20 g. If it doesn’t, you can push the envelope a little and go out to 40 g. As long as you’re below 50 or so, you’re going to get plenty of benefit, but you have to fiddle with it a little to find the right level for you.

    Hope this helps.

    Best–

    MRE

     
38. Rick Sinn, 28. May 2008, 23:14
    

    So, to beat a dead horse:

    Eat low carb = you CAN’T GAIN fat.

    Eat low carb ≠ you WILL LOSE fat.

    That’s pretty much it in a nutshell. Well put. Maybe you should try for a Haiku.

    Cheers–

    MRE
    

     
39. Stargazey, 29. May 2008, 4:41
    

    Dr. Mike,

    I am surprised that, to end a stubborn plateau, you recommend going on an all-meat diet for a week or two. John Yudkin has said:

    “Excess intake of nitrogen leads in a short space of time to hyperammonaemia, which is a build up of ammonia in the bloodstream. This is toxic to the brain. Many human cultures survive on a purely animal product diet, but only if it is high in fat. …A lean meat diet, on the other hand cannot be tolerated; it leads to nausea in as little as three days, symptoms of starvation and ketosis in a week to ten days, severe debilitation in twelve days and possibly death in just a few weeks.”

    http://www.second-opinions.co.uk/fat-not-protein.html

    Was John Yudkin wrong?

    Nope, I don’t think Yudkin was wrong. Neither was Vilhjalmur Stefansson, the explorer and advocate of an all-meat diet. Stefansson pointed out that when fatty game was scarce and the native populations turned to rabbits and other small game to survive, that they got rabbit fever, which was a disorder of too much protein in the absence of fat. Small animals have much less body fat than do large animals, so when rabbits and other small game provide the only food, the protein to fat ratio is too high. A steady diet of such can lead to problems.

    When I said an all-meat diet, I didn’t mean a diet of lean, lean meat; I meant a diet of steaks, chops, chicken (with skin), bacon, etc., all of which have plenty of fat so the above is not a problem.

    Cheers–

     
40. Vesna, 29. May 2008, 4:47
    

    Dr. Eades,

    Thank you for your thoughtful reply to my comment and for your suggestion to try all meat for a while.

    Could you explain what the mechanism would be that would make this effective? Is it simply a way to make it easier to reduce total calories, or would something else be going on? If it’s the former, I’ll be skeptical, because I already did low calories without experiencing weight loss. However, if you have reason to believe this regimen will somehow pulls some trigger that tells the fat cells to let go of what they’ve got in storage, then I will eagerly try it and let you know what happens! I’m planning a June 2 start.

    (marly, above, said she did two months of all meat without weight loss; you assume, in your response to her, that she was eating too much. We won’t know if that’s the case unless she writes back.)

    I also wonder if you can fill in a few practical specifics, such as: Is there a total calorie goal to aim for? What about the fat/protein ratio? Rendered meat fat like tallow OK? By all meat, I assume you mean not even eggs or butter? How about noncaloric seasonings like salt, pepper, cumin and the rest? Processed meats like bacon and sausage OK, if their ingredients list is reasonably good? Noncaloric sweeteners? Any particular cuts or cooking methods to focus on?

    If you’ve described all this in another post (or a book chapter), please feel free to point me to it!

    By the way, I’m in my mid-40s and have enjoyed lifelong excellent health. My frame is very slender and my legs are a few inches longer than most women of my height, so although I’m 5′7″, my ideal weight would be that of someone a few inches shorter than me. At 125, I looked fine; now, at around 145, I have a chubby, chunky torso (and am slender everywhere else). I would say I accumulate fat in an atypical pattern. Hope that info is helpful.

    The more I work at this and communicate with others on the same path, the more I’m convinced that it’s really not calories, but metabolism. A metabolism that wants to cling to stored fat will do that, even when intake is reduced. A metabolism that doesn’t want to store fat won’t, even when intake is increased. I’m convinced that what I need is to coax my metabolism to behave a certain way. How to flip the switch — that, I believe, is the question. For me, and many others.

    Thanks so much for your time and for all you and MD do!

    Hi Vesna–

    When I put my patients on all-meat diets I have them start with chops, ground beef patties, steaks, chicken (with skin), etc. three times per day. I don’t really care what kind of meat it is as long as it has the fat with it, i.e., not stripped of all fat. (Eggs are okay for one meal because they’re nothing but fetal meat.) A little butter and season is fine. Most (most - not all) respond to this regimen with fairly quick weight loss. I tell them to continue. For those who start off losing, then stop, we need to start looking at calories. Most people do fine and self limit the amount of meat they can eat and so keep their overall calories in the weight-loss range. Others can consume enough meat to get the caloric count high enough to stall weight loss. Those people have to limit their meat intake to a level that allows them to lose.

    You’re right in that it is a metabolic response to caloric restriction that seems to reduce the metabolic rate of those losing weight on standard calorically-restricted diets. I don’t have any studies to prove it, but I feel pretty certain that people who restrict their calories by eating fat/protein foods to satiation, don’t suffer the same metabolic slowdown.

    Cheers–

    MRE

     
41. Dave, 29. May 2008, 5:01
    

    Hi Dr. Eades,

    So let’s say I’m 280 lbs. I want to get down to 200 or less. According to an online calculator a sedentary 280 lb. person should eat about 3000 kcal to maintain that weight. A 200 lb. person would eat about 2200 kcal. Should I just eat the recommended daily calories for a 200 lb person? (All low carb/zero carb of course.) Or would this caloric deficit make my 280 lb. body think it’s in starvation mode? How low can I set my daily caloric intake without causing other problems?

    Cheers,

    Dave

    Hey Dave–

    If I were you, I wouldn’t worry about the calories as long as I were losing weight. Just follow a good quality low-carb diet and forget the calorie and see what happens. I suspect you will lose weight just fine. It’s only when you stop losing weight and want to continue to lose that the calories become an issue.

    Cheers–

    MRE

     
42. donnyrosart, 29. May 2008, 5:59
    

    I’m pretty much convinced that a high-fat diet is the way to go for health, and a high protein moderate-fat diet is the way to go for washboard abs. I tend to wobble between the two in priority. So no washboard abs.
    I was looking at a video of a seminar by Luigi Fontana on calorie restriction the other day.
    In the question period, someone mentioned that lower bmi did not correlate to longevity, and his answer was that in calorie restriction studies, the mice in a given genetic line that had the highest levels of bodyfat at a given level of calorie restriction tended to have the greatest longevity. I guess if that’s true, the survival advantage of being able to store fat easily could appear at rather low actual levels of storage. Maybe it’s more for surviving lean years rather than lean months? I thought this might be heartening for anyone who has to work a little harder to lose the final five or ten or more.
    It’s pretty easy to lean towards healthy vs washboard abs style eating when healthy includes thirty percent sourcream mixed with cocoa and a packet of splenda. It’s to live for.

    I wouldn’t put a whole lot of stock in what works or doesn’t work longevity-wise for mice because mice aren’t just little furry humans. In many respects they’re way different, and I don’t think that all that holds for them holds for us. I don’t think that a few extra pounds significantly affects our longevity as long as these pounds don’t come along with insulin resistance, hyperinsulinemia and glucose intolerance.

    Cheers–

     
43. Stephen, 29. May 2008, 6:04
    

    Great blog post. Good explaination, it really hits it out of the park in terms of clarity on the how the body consumes fat by source. BTW, in 3 months I have lost 90 pounds with 75 to go on a less than 20 g carb per day and 1200-1300 cals a day diet. (I am 6ft 7 to give some perspective) Only hungry when it is meal time and I do a moderate amount of cardio.

    This question that was touched on but not clearly addressed as far as I can tell was what happens in the case of excess calories that come only from protein. So for the sake of argument assume that carbs are being successfully limited to less than 30 g and fat is being consumed but that there is an excess of calories being caused by overconsuption of protein calories (if this is possible)

    Would the body turn the excess protein calories into fat as storage or would it dispose of protein calories that were not required. This, of course is an assumed scenario and may not be possible in real life, but I am trying to surface the ideas around type of calories, what your body does with them and how much calories matter (they clearly matter in carbs and fat do they matter in protein?)

    Great blog and wonderful articles. Thanks again.

    The scenario you describe would be possible in real life, but it would take some effort. There is a high thermogenic effect occasioned by protein consumption so you would burn up an extra load of calories just dealing with the protein. Since your only consuming 30 g of carb, you would convert a fair amount of dietary protein to blood sugar to make up the deficit between the 130 or grams you need and the 30 grams your providing in the diet. But if there is still protein left over after that used to convert to sugar and that used to repair and replace protein tissues, it could be burned for energy. But, due to the thermogenic effect of the protein, you would get way less bang for the buck than you would with fat. And ultimately you would run into the problem of rabbit fever as described in one of the previous comments.

    Cheers–

     
44. Michael, 29. May 2008, 6:59
    

    Hi Michael,

    Thanks for your reply to my post. I appreciate it!

    Quick question please — you said:

    “Protein can be burned for fuel, but usually isn’t as long as dietary fat or fat from the adipose tissue provides the fuel to meet the body’s energy needs”

    Does this mean that the body will tend to use muscle protein only as a “last resort”?

    If this is the case then I presume a person looking to build muscle mass but reduce body fat (such as myself) could keep dietary intake of protein high, carbs low, and reduce dietary fat as the variable for speed of fat loss. Am I correct here that this would still allow plenty of muscle growth but also reduce body fat stores?

    Many thanks!

    Michael

    You are correct. If you keep carbs low, a part of the dietary protein will go to glucose conversion, but if you’re eating enough, you will certainly be able to build muscle and lose adipose tissue at the same time.

     
45. Vadim, 29. May 2008, 8:31
    

    I posted my comment last night but I dont see it today. I am a little puzzled.

    Don’t feel like the Lone Ranger; I’m way behind on dealing with the comments.

     
46. Vadim, 29. May 2008, 8:32
    

    lol, ok found it, sorry!

    No problem.

     
47. Elle, 29. May 2008, 9:53
    

    Dr Eades wrote:

    “How were you able to cut protein and allow fat to go up?”

    Hi Dr Eades,

    The short answer is that I simply added more of those “pure fat” items you mentioned to my day.

    I will add more fat to veggies than “usual.” I absolutely LOVE pureed veggies (asparagus, broccoli, cauliflower, celery, you name it) and I find that pureeing them with nothing but butter is a very tasty way to get my veggies and my fats. I will eat a bigger (more carbs) serving of veggies if they are pureed than if they are left whole and topped with butter or roasted with olive oil, although roasting green beans is my favorite way to eat those. (They taste like french fries if you cook them right!)

    I’ve always preferred fattier meats over leaner ones–even before learned about LC. To add fat, I’ll cover the meat on my plate with the pan drippings from pan-fried or roasted meats. I’ll top my grilled meat with butter. I spread those “Revolution Rolls” with butter or dip them in seasoned olive oil.

    I make high fat LC desserts (like cheesecake, pumpkin bars and chocolate brownies) and top then with whipped heavy cream. One of my favorite desserts is an “iced coffee” made with 1/2 C of heavy cream and just a capful of DV syrup. I get a lot of “raised eyebrows” on forums for drinking/eating pure cream, but hey, I like it, and it works for me. There is something about pure cream that makes me feel calm and relaxed. There’s something about pure fat that makes feel that way–where a lot protein makes me crave sweets. Another favorite is chocolate whipped cream. I sometimes make chocolate candies out of coconut oil.

    Another answer is that when you decrease protein and add a little more fat to the meal, and keep the carbs very low, the percentage of calories coming from fat increases quite rapidly.

    I adopted this style of eating, which I regard as a “variation” of PPLP, after reading up on the Polish “Optimal Diet” and also reading things from GCBC about high fat diets producing weight loss and also remembering that moving in the direction of increasing fat and decreasing protein could break a stall.

    I eat only lunch and dinner (about a 6 hour eating window), I don’t tend to snack between meals and even though my overall volume of food has decreased, I’m much more satisfied than I ever was before. My “typical” daily caloric intake is 1500-1800. I find that my desire to binge, which after reading GCBC I now attribute mostly to the natural response to calorie-restriction, while eating 80% fat is greatly reduced. Instead of a binge, it’s more like a weekly “refeed,” if you will, where I’ll be hungry and eat a lot of protein that day, with no weight gain and no interruption in weight loss. Calories may go as high as 2500 or more that day. The next day my appetite is essentially nil, and the day after that, I naturally resume the lower protein, high-fat eating.

    I easily reached my goal and am now maintaining easily.

    My sweet tooth, which was ravenous on higher protein, is reduced to next to nothing. I do eat a LC dessert every evening, but I find that I’m using less and less stevia and splenda and am preferring less and less sweet tastes in my desserts. I love 85% cocoa chocolate and now and then I drink seltzer. I enjoy that dry taste it offers and the diet soda seems too sweet now.

    Anyway, I still don’t understand how it could possibly work, that simply shifting around the balance of protein and fat could stimulate weight loss without cutting calories? (I also realize that there is a chance the weight loss would have resumed anyway, had I stuck it out. And I can’t say with certainty that my body wasn’t still changing, even during that “stall.”)

    Thank you for your time and all you do to help us!

    And thank you for the interesting response.

    You’ve got to tell us how to roast the green beans so they’ll taste like French fries. Inquiring minds want to know.

    Cheers–

    MRE

     
48. Lula, 29. May 2008, 10:15
    

    I have recently found that writing down (despite my deep resistance to it) every bite and tallying up carbs and protein worked in breaking my 3-month stall. I had carb creep and was not aware. I am extremely sensitive, it seems, and even a tiny bit over 30 g ECC per day puts me in maintenance mode. I found that I didn’t need to cut fat in order to move things…

    However, my biggest frustration with (myself on) this WOE is that despite promises that after a while of being vigilant I’ll lose my carb cravings I have never experienced this to be the case. I have intense cravings for the bad stuff and have to struggle to hold back and stay in control. Some days are easier than others, but it’s just a matter of time before my ignored, pent-up cravings explode during moments of weakness (and/or hormonal cycle troughs…) and I go ‘face down in the carbs’ as you call it, Dr. Mike. And then I feel physically and emotionally disgusted with myself. If I could solve *that*, I’d be SO happy…

    Thanks for all you do! And for this great blog!

    Hey Lula–

    I understand your frustration. Why don’t you give the approach Elle from the previous comments tried: cut protein back to the minimum for your weight and go up on the fat. It might make a difference. I would think it would be worth a try.

    Let me know if you try it out.

    Best–

    MRE

     
49. Brian, 29. May 2008, 10:32
    

    I’m going off topic here but I seem to remember a few months back the hoopla generated over lap-band and bypass surgery having positive benefits for type II diabetics. In my news feed just yesterday came the post linked below. It’s about low-carb diets being good for type II diabetics.

    Any thoughts on whether this study will receive the same publicity as the lap-band and bypass study did?

    I think I know your answer in advance…just wanted to let you know that some positive press is coming out, slowly but surely.

    Brian

    http://health.yahoo.com/news/reuters/low_carb_dc.html

    Hey Brian–

    I’m well aware of this study. I saw it in its prepublication form. I think it’s a terrific study, but, no, I don’t think it will garner the press coverage that the bypass study did.

    Cheers–

    MRE

     
50. david, 29. May 2008, 11:06
    

    Hey Dr Mike. Does an all meat diet include chicken, pork and eggs or is it really all meat(beef)?
    Is ground beef ok or is a cut of steak better? Thanks in advance.

    Meat is all the above. Eggs are fetal meat. Both ground beef - as long as it’s ground with the fat - is okay as is steak.

    Cheers–

    MRE

     
51. cariss, 29. May 2008, 15:29
    

    Hi.
    I tried reading through most of the posts. I am glad I found this. I have a question that hasn’t been answered clear enough since I started researching.
    Dr, first–what is your take on a woman in her 50s, overweight, in menopause, and can’t seem to get her weight down? Yes, it’s me. I went PP in 2000, stayed on in and merged into a low carb way of eating for at least 6 years. Started running 10ks, etc. Then, Menopause, stress, no time for exercise, and different eating habits slowly crept in. I tried to start low carb over again, but it seemed that it was going to take twice as long to get going. One month went by, and I didn’t lose a pound. Is this normal? I didn’t see it in your PP book I purchased in 1999 or 2000.
    I have no known illnesses, no diabetes. Do you have anything to help me in this? Besides my getting up and moving my body, how do I/do I start lowcarb again and take half year to see any differences?
    Thanks much .
    DeltaD

    Hi DeltaD–

    The first thing I would do were you a patient of mine is check your hormone levels. Menopause plays havoc with weight loss and gain - don’t let anyone tell you it doesn’t. You’ve got to get your hormones regulated first, then the weight loss should pick up. If your hormones are not what they ought to be, find a doc that will prescribe bioidentical hormones, not the Premarin/Provera crap. That would be the first step I would take. Another avenue to explore is thyroid hormone deficiency and low iodine levels. I’m planning a post on that soon as well.

    Good luck.

    MRE

     
52. Sue, 30. May 2008, 1:34
    

    Dr Eades you suggested Vesna try an all meat diet for 2 weeks. Does she have to keep track of the calories and I presume the meat should contain a good amount of fat.?
    Would this work if one was to just eat eggs for 2 weeks?

    I don’t see why it wouldn’t, but it would be a dull diet. A paper published a few years back (I wrote about it in Protein Power) described how an 88 yo man did nicely on nothing but two dozen eggs per day.

    Keep me posted.

     
53. peter, 30. May 2008, 2:09
    

    Dr. Mike,

    I ha