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Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease Hardcover – Deckle Edge, September 25, 2007
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For decades we have been taught that fat is bad for us, carbohydrates better, and that the key to a healthy weight is eating less and exercising more. Yet with more and more people acting on this advice, we have seen unprecedented epidemics of obesity and diabetes. Taubes argues persuasively that the problem lies in refined carbohydrates (white flour, sugar, easily digested starches) and sugars–via their dramatic and longterm effects on insulin, the hormone that regulates fat accumulation–and that the key to good health is the kind of calories we take in, not the number. There are good calories, and bad ones.
Good Calories
These are from foods without easily digestible carbohydrates and sugars. These foods can be eaten without restraint.
Meat, fish, fowl, cheese, eggs, butter, and non-starchy vegetables.
Bad Calories
These are from foods that stimulate excessive insulin secretion and so make us fat and increase our risk of chronic disease—all refined and easily digestible carbohydrates and sugars. The key is not how much vitamins and minerals they contain, but how quickly they are digested. (So apple juice or even green vegetable juices are not necessarily any healthier than soda.)
Bread and other baked goods, potatoes, yams, rice, pasta, cereal grains, corn, sugar (sucrose and high fructose corn syrup), ice cream, candy, soft drinks, fruit juices, bananas and other tropical fruits, and beer.
Taubes traces how the common assumption that carbohydrates are fattening was abandoned in the 1960s when fat and cholesterol were blamed for heart disease and then –wrongly–were seen as the causes of a host of other maladies, including cancer. He shows us how these unproven hypotheses were emphatically embraced by authorities in nutrition, public health, and clinical medicine, in spite of how well-conceived clinical trials have consistently refuted them. He also documents the dietary trials of carbohydrate-restriction, which consistently show that the fewer carbohydrates we consume, the leaner we will be.
With precise references to the most significant existing clinical studies, he convinces us that there is no compelling scientific evidence demonstrating that saturated fat and cholesterol cause heart disease, that salt causes high blood pressure, and that fiber is a necessary part of a healthy diet. Based on the evidence that does exist, he leads us to conclude that the only healthy way to lose weight and remain lean is to eat fewer carbohydrates or to change the type of the carbohydrates we do eat, and, for some of us, perhaps to eat virtually none at all.
The 11 Critical Conclusions of Good Calories, Bad Calories:
1. Dietary fat, whether saturated or not, does not cause heart disease.
2. Carbohydrates do, because of their effect on the hormone insulin. The more easily-digestible and refined the carbohydrates and the more fructose they contain, the greater the effect on our health, weight, and well-being.
3. Sugars—sucrose (table sugar) and high fructose corn syrup specifically—are particularly harmful. The glucose in these sugars raises insulin levels; the fructose they contain overloads the liver.
4. Refined carbohydrates, starches, and sugars are also the most likely dietary causes of cancer, Alzheimer’s Disease, and the other common chronic diseases of modern times.
5. Obesity is a disorder of excess fat accumulation, not overeating and not sedentary behavior.
6. Consuming excess calories does not cause us to grow fatter any more than it causes a child to grow taller.
7. Exercise does not make us lose excess fat; it makes us hungry.
8. We get fat because of an imbalance—a disequilibrium—in the hormonal regulation of fat tissue and fat metabolism. More fat is stored in the fat tissue than is mobilized and used for fuel. We become leaner when the hormonal regulation of the fat tissue reverses this imbalance.
9. Insulin is the primary regulator of fat storage. When insulin levels are elevated, we stockpile calories as fat. When insulin levels fall, we release fat from our fat tissue and burn it for fuel.
10. By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity. By driving fat accumulation, carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity.
11. The fewer carbohydrates we eat, the leaner we will be.
Good Calories, Bad Calories is a tour de force of scientific investigation–certain to redefine the ongoing debate about the foods we eat and their effects on our health.
- Print length640 pages
- LanguageEnglish
- PublisherKnopf
- Publication dateSeptember 25, 2007
- Dimensions6.75 x 1.5 x 9.5 inches
- ISBN-101400040787
- ISBN-13978-1400040780
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Editorial Reviews
From Publishers Weekly
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From Booklist
Review
-Richard Rhodes, winner of the Pulitzer Prize
“If Taubes were inclined to sensationalism, he might have titled this book ‘The Great Low-Fat Diet Hoax.’ Instead, he tackles the subject with the seriousness and scientific insight it deserves, building a devastating case against the low-fat, high-carb way of life endorsed by so many nutrition experts in recent years. With diabetes and heart disease at stake as well as obesity, those ‘experts’ owe us an abject apology.”
-Barbara Ehrenreich
“Good Calories, Bad Calories is a remarkable accomplishment. From a mountain of diverse scientific evidence Gary Taubes has drawn an amazingly detailed and compelling picture of how diet, obesity, and heart disease link together–and how some of the world’s most important medical researchers got the story colossally wrong. Taubes proves, I think beyond doubt, that the dietary advice we’ve been given for the last three decades by the federal government and the major medical bodies rests on, shall we say, a slender empirical base.”
–Charles C. Mann, author of 1491
“A brave and bold science journalist . . . Taubes does not bow to the current fashion for narrative nonfiction, instead building his argument case by case . . . much of what Taubes relates will be eye-opening.”
-The New York Times Book Review
“A watershed . . . Deeply researched and profoundly unsettling, the book proposes a seismic paradigm shift that could well undo our perceptions about the relationship between food and health. It could also literally change the way you eat, the way you look and how long you live . . . an unwavering challenge to conventional thinking . . . Taubes’ most elegant and surprising arguments examine long-held assumptions . . . lucid and lively.”
-Star Tribune
“Fascinating . . . Mr. Taubes has a gift for turning complex scientific principles into engaging narrative.”
-The Wall Street Journal
“A watershed . . . Deeply researched and profoundly unsettling, the book proposes a seismic paradigm shift that could well undo our perceptions about the relationship between food and health. It could also literally change the way you eat, the way you look and how long you live . . . an unwavering challenge to conventional thinking . . . Taubes’ most elegant and surprising arguments examine long-held assumptions . . . lucid and lively.”
-Star Tribune
“Fascinating . . . Mr. Taubes has a gift for turning complex scientific principles into engaging narrative.”
-The Wall Street Journal
“Bound to stir renewed debate . . .”
-Miami Herald
“His major conclusions are startling yet surprisingly convincing . . . his writing reflects his passion for scientific truth . . . offers plenty of food for thought.”
-Chicago Sun-Times
“I think this is a very important book. I’ve been recommending it to my medical colleagues and students. There are some very big ideas in this book…[Gary Taubes] has done a meticulous job of showing that many of the assumptions that are held by the conventional medical community simply rest on nothing…It’s very important to get these out to the medical community because a lot of the ways we try and prevent and treat obesity are based on assumptions that have no scientific evidence.”
-Dr. Weil, speaking on Larry King Live
About the Author
From The Washington Post
In 2002, science journalist Gary Taubes published an article entitled "What if It's All Been a Big Fat Lie?" He argued that reputable scientists were coming around to the idea, advanced by diet gurus like Dr. Robert Atkins, that carbohydrates, not fat, are the ultimate dietary villain. If so, he wrote, "the ongoing epidemic of obesity in America and elsewhere is not, as we are constantly told, due simply to a collective lack of will power and a failure to exercise. Rather it occurred . . . because the public health authorities told us unwittingly, but with the best of intentions, to eat precisely those foods that would make us fat, and we did."
The article helped revive the low-carb craze. Bread vanished from restaurant tables, and "dieters" began ordering steaks with a side of bacon. Many lost weight and became believers, but many did not, and the conventional wisdom on how to lose weight shifted only slightly.
In Good Calories, Bad Calories, Taubes tries to bury the idea that a low-fat diet promotes weight loss and better health. Obesity is caused, he argues, not by the quantity of calories you eat but by the quality. Carbohydrates, particularly refined ones like white bread and pasta, raise insulin levels, promoting the storage of fat.
Taubes is a relentless researcher, shining a light on flaws in the scientific literature. For example, he charges that when scientists figured out how to measure cholesterol in the blood, they became "fixated on the accumulation of cholesterol in the arteries as the cause of heart disease, despite considerable evidence to the contrary."
He also reveals how charismatic personalities can force the acceptance of unproven theories. For instance, nutritionist Jean Mayer persuaded Americans that exercise leads to weight loss when in fact, writes Taubes, exercising may increase hunger and calorie intake. According to a 2000 review of the medical literature, "some studies imply that physical activity might inhibit weight gain . . . some that it might accelerate weight gain; and some that it has no effect whatsoever." Yet the latest government dietary guidelines, released in 2005, recommend 60 to 90 minutes a day of moderately intense exercise and a low-calorie diet to achieve weight loss. Once again, Taubes shows, conventional wisdom wins out.
Good Calories, Bad Calories goes a long way toward breaking the link between obesity, gluttony and sloth by demonstrating that genes, hormones and chemistry play as much of a role in weight gain as behavior does. Taubes's tales of lame science and flawed laboratory tests are at times brilliant and enlightening. But they can also become repetitive and wearying. In the end, the most compelling case Taubes builds is one against stark dietary advice of any kind; nothing simple can capture the complex reasons for the epidemic rise in obesity. H.L. Mencken once said, "There is always an easy solution to every human problem -- neat, plausible, and wrong." Taubes cites this quote in his book; he, and all of us, would do well to remember it.
Copyright 2008, The Washington Post. All Rights Reserved.
Excerpt. © Reprinted by permission. All rights reserved.
Farinaceous and vegetable foods are fattening, and saccharine matters are especially so….In sugar-growing countries the negroes and cattle employed on the plantations grow remarkably stout while the cane is being gathered and the sugar extracted. During this harvest the saccharine juices are freely consumed; but when the season is over, the superabundant adipose tissue is gradually lost.
–Thomas Hawkes Tanner, The Practice of Medicine, 1869
William Banting was a fat man. In 1862, at age sixty-six, the five-foot-five Banting, or “Mr. Banting of corpulence notoriety,” as the British Medical Journal would later call him, weighed in at over two hundred pounds. “Although no very great size or weight,” Banting wrote, “still I could not stoop to tie my shoe, so to speak, nor attend to the little offices humanity requires without considerable pain and difficulty, which only the corpulent can understand.” Banting was recently retired from his job as an upscale London undertaker; he had no family history of obesity, nor did he consider himself either lazy, inactive, or given to excessive indulgence at the table. Nonetheless, corpulence had crept up on him in his thirties, as with many of us today, despite his best efforts. He took up daily rowing and gained muscular vigor, a prodigious appetite, and yet more weight. He cut back on calories, which failed to induce weight loss but did leave him exhausted and beset by boils. He tried walking, riding horseback, and manual labor. His weight increased. He consulted the best doctors of his day. He tried purgatives and diuretics. His weight increased.
Luckily for Banting, he eventually consulted an aural surgeon named William Harvey, who had recently been to Paris, where he had heard the great physiologist Claude Bernard lecture on diabetes. The liver secretes glucose, the substance of both sugar and starch, Bernard had reported, and it was this glucose that accumulates excessively in the bloodstream of diabetics. Harvey then formulated a dietary regimen based on Bernard’s revelations. It was well known, Harvey later explained, that a diet of only meat and dairy would check the secretion of sugar in the urine of a diabetic. This in turn suggested that complete abstinence from sugars and starches might do the same. “Knowing too that a saccharine and farinaceous diet is used to fatten certain animals,” Harvey wrote, “and that in diabetes the whole of the fat of the body rapidly disappears, it occurred to me that excessive obesity might be allied to diabetes as to its cause, although widely diverse in its development; and that if a purely animal diet were useful in the latter disease, a combination of animal food with such vegetable diet as contained neither sugar nor starch, might serve to arrest the undue formation of fat.”
Harvey prescribed the regimen to Banting, who began dieting in August 1862. He ate three meals a day of meat, fish, or game, usually five or six ounces at a meal, with an ounce or two of stale toast or cooked fruit on the side. He had his evening tea with a few more ounces of fruit or toast. He scrupulously avoided any other food that might contain either sugar or starch, in particular bread, milk, beer, sweets, and potatoes. Despite a considerable allowance of alcohol in Banting’s regimen–four or five glasses of wine each day, a cordial every morning, and an evening tumbler of gin, whisky, or brandy–Banting dropped thirty-five pounds by the following May and fifty pounds by early 1864. “I have not felt better in health than now for the last twenty-six years,” he wrote. “My other bodily ailments have become mere matters of history.”
We know this because Banting published a sixteen-page pamphlet describing his dietary experience in 1863–Letter on Corpulence, Addressed to the Public–promptly launching the first popular diet craze, known farther and wider than Banting could have imagined as Bantingism. His Letter on Corpulence was widely translated and sold particularly well in the United States, Germany, Austria, and France, where according to the British Medical Journal, “the emperor of the French is trying the Banting system and is said to have already profited greatly thereby.” Within a year, “Banting” had entered the English language as a verb meaning “to diet.” “If he is gouty, obese, and nervous, we strongly recommend him to ‘bant,’ ” suggested the Pall Mall Gazette in June 1865.
The medical community of Banting’s day didn’t quite know what to make of him or his diet. Correspondents to the British Medical Journal seemed occasionally open-minded, albeit suitably skeptical; a formal paper was presented on the efficacy and safety of Banting’s diet at the 1864 meeting of the British Medical Association. Others did what members of established societies often do when confronted with a radical new concept: they attacked both the message and the messenger. The editors of The Lancet, which is to the BMJ what Newsweek is to Time, were particularly ruthless. First, they insisted that Banting’s diet was old news, which it was, although Banting never claimed otherwise. The medical literature, wrote The Lancet, “is tolerably complete, and supplies abundant evidence that all which Mr. Banting advises has been written over and over again.” Banting responded that this might well have been so, but it was news to him and other corpulent individuals.
In fact, Banting properly acknowledged his medical adviser Harvey, and in later editions of his pamphlet he apologized for not being familiar with the three Frenchmen who probably should have gotten credit: Claude Bernard, Jean Anthelme Brillat-Savarin, and Jean-François Dancel. (Banting neglected to mention his countrymen Alfred William Moore and John Harvey, who published treatises on similar meaty, starch-free diets in 1860 and 1861 respectively.)
Brillat-Savarin had been a lawyer and gourmand who wrote what may be the single most famous book ever written about food, The Physiology of Taste, first published in 1825.* In it, Brillat-Savarin claimed that he could easily identify the cause of obesity after thirty years of talking with one “fat” or “particularly fat” individual after another who proclaimed the joys of bread, rice, and potatoes. He added that the effects of this intake were exacerbated when sugar was consumed as well. His recommended reducing diet, not surprisingly, was “more or less rigid abstinence from everything that is starchy or floury.”
Dancel was a physician and former military surgeon who publicly presented his ideas on obesity in 1844 to the French Academy of Sciences and then published a popular treatise, Obesity, or Excessive Corpulence, The Various Causes and the Rational Means of Cure. Dancel’s thinking was based in part on the research of the German chemist Justus von Liebig, who, at the time, was defending his belief that fat is formed in animals primarily from the ingestion of fats, starches, and sugars, and that protein is used exclusively for the restoration or creation of muscular tissue. “All food which is not flesh–all food rich in carbon and hydrogen–must have a tendency to produce fat,” wrote Dancel. “Upon these principles only can any rational treatment for the cure of obesity satisfactorily rest.” Dancel also noted that carnivores are never fat, whereas herbivores, living exclusively on plants, often are: “The hippopotamus, for example,” wrote Dancel, “so uncouth in form from its immense amount of fat, feeds wholly upon vegetable matter–rice, millet, sugar-cane, &c.”
The second primary grievance that The Lancet’s editors had with Banting, which has been echoed by critics of such diets ever since, was that his diet could be dangerous, and particularly so for the credibility of those physicians who did not embrace his ideas. “We advise Mr. Banting, and everyone of his kind, not to meddle with medical literature again, but be content to mind his own business,” The Lancet said.
When Bantingism showed little sign of fading from the scene, however, The Lancet’s editors adopted a more scientific approach. They suggested that a “fair trial” be given to Banting’s diet and to the supposition that “the sugary and starchy elements of food be really the chief cause of undue corpulence.”
Banting’s diet plays a pivotal role in the science of obesity–and, in fact, chronic disease–for two reasons. First, if the diet worked, if it actually helped people lose weight safely and keep it off, then that is worth knowing. More important, knowing whether “the sugary and starchy elements of food” are “really the chief cause of undue corpulence” is as vital to the public health as knowing, for example, that cigarettes cause lung cancer, or that HIV causes AIDS. If we choose to quit smoking to avoid the former, or to use condoms or abstinence to avoid the latter, that is our choice. The scientific obligation is first to establish the cause of the disease beyond reasonable doubt. It is easy to insist, as public-health authorities inevitably have, that calories count and obesity must be caused by overeating or sedentary behavior, but it tells us remarkably little about the underlying process of weight regulation and obesity. “To attribute obesity to ‘overeating,’ ” as the Harvard nutritionist Jean Mayer suggested back in 1968, “is as meaningful as to account for alcoholism by ascribing it to ‘overdrinking.’ ”
After the publication of Banting’s “Letter on Corpulence,” his diet spawned a c...
Product details
- Publisher : Knopf; 1st edition (September 25, 2007)
- Language : English
- Hardcover : 640 pages
- ISBN-10 : 1400040787
- ISBN-13 : 978-1400040780
- Item Weight : 2.15 pounds
- Dimensions : 6.75 x 1.5 x 9.5 inches
- Best Sellers Rank: #474,655 in Books (See Top 100 in Books)
- #266 in Low Carb Diets (Books)
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About the author

Gary Taubes is an investigative science and health journalist and co-founder of the non-profit Nutrition Science Initiative (NuSI.org). He is the author of Why We Get Fat and What to Do About It and Good Calories, Bad Calories (The Diet Delusion in the UK). Taubes is the recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research, and has won numerous other awards for his journalism. These include the International Health Reporting Award from the Pan American Health Organization and the National Association of Science Writers Science in Society Journalism Award, which he won in 1996, 1999 and 2001. (He is the first print journalist to win this award three times.) Taubes graduated from Harvard College in 1977 with an S.B. degree in applied physics, and received an M.S. degree in engineering from Stanford University (1978) and in journalism from Columbia University (1981).
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An Eco-Atkins diet can give you all the advantages of the high-meat Atkins without increasing the risk of heart disease or cancer. In a study by Jenkins et al in 2009, a plant based, low carb diet (26% carbs) produced an extremely good lipid profile, outperforming a low fat diet (25% fat) and the traditional Atkins diet. And in a 26 year study by Fung et al in 2010, an Eco-Atkins diet with only 12% animal protein showed a 43% decrease in all cause mortality compared to a reduced carb diet with 18% animal protein controlled for other variables. (This is not some uncontrolled epidemiological study; it's the kind of study that can be used to establish cause and effect. The high-meat group actually ate slightly less omega-6 and refined carbs so there`s no reason to think something other than grain fed meat caused them to do poorly.)
Both high-meat Atkins and Eco-Atkins are good at producing short term weight loss and blood sugar control. But a long term study of patients on a high-meat diet by Fleming in 2000 showed a worsening of blood flow after one year with an overall 39.7% progression of coronary artery disease. And a study that lasted over 10 years by Sjogren et al in 2010 showed that elderly men eating a Mediterranean diet were 37% less likely to die of heart disease, while elderly men eating a high meat, carbohydrate restricted diet were 44% more likely to die of heart disease.
This book leaves many readers strongly convinced that meat and full fat dairy are the best replacements for refined carbs. But the evidence is mostly based on stories of individuals which tell us nothing about the average person; uncontrolled observational studies of other cultures with many confounding variables (such as genetic differences, calorie restriction, cholesterol lowering saponins, grass fed meat high in CLA and omega-3, absence of alcohol and tobacco, greater vitamin D, organic produce, higher exercise levels etc.); and clinical trials where people practicing low carb were also practicing calorie restriction which is totally misleading about the maintenance phase and about the long term risk of heart disease and cancer. A study in 2009 by Miller et al that compared three diets (Atkins, South Beach and Ornish) during weight maintenance showed Atkins produced less favorable results for lipids and flow-mediated vasodilatation than the other two.
People are different. In a study by Corella et al in 2010, when saturated fat intake was greater than 10% of calories in individuals carrying the APOE4 allele, the risk of heart disease was over 300% higher. About 25 to 30 percent of Americans carry this allele. But cholesterol skeptics have convinced many Americans with the APOE4 allele to try a high animal fat diet and it's giving them heart disease.
Taken together these six studies show that weight loss, fluffy LDL etc. are not protecting people from heart disease. The incomplete risk profile in studies used to promote a high-meat Atkins diet fail to accurately predict what will actually happen decades in the future. They are giving people a false sense of security.
Some people think Denise Minger's blog proves a high-meat diet is safe. But the Tuoli data that Denise makes a big deal about, can't tell us anything about health because it doesn't represent the way the people were eating all year long. The people are nomadic and eat different foods at different times of year and they were feasting to impress the visitors. And the Tuoli culture has confounding variables just like the examples in GCBC. And the fact that the protein deficient rural Chinese benefited from a small amount of animal protein doesn't mean that Americans who are already eating ten times as much animal protein as the rural Chinese need even more. There are places in China as well as the rest for world where high wheat consumption is not associated with heart disease. Denise' analysis does not distinguish between low glycemic index forms of wheat (like pasta cooked al dente) and high glycemic index forms of wheat (like white bread.)
WATCH OUT FOR CONFIRMATION BIAS
According to Wikipedia, "Confirmation bias refers to a type of selective thinking whereby one tends to notice and to look for what confirms one's beliefs, and to ignore, not look for, or undervalue the relevance of what contradicts one's beliefs."
For example, Mr. Taubes is nihilistic about any evidence against animal fat. To him, every study has a flaw, nothing is ever certain. But when it comes to uncontrolled observational studies of other cultures (evidence that's much weaker than the evidence he finds fault with), he accepts it without critical thinking.
"Confirmation biases contribute to overconfidence in personal beliefs and can maintain or strengthen beliefs in the face of contrary evidence. Hence they can lead to disastrous decisions, especially in organizational, military, political and social contexts."
"Individuals have to constantly remind themselves of this tendency and actively seek out data contrary to their beliefs." Since this isn't easy, most of the time we're stuck with bias. Nobody can be completely free of bias but we can make an effort. But we should always be biased in favor of studies published in peer reviewed journals over opinions published in books or on web sites. (Peer review attempts to find obvious errors and correct biased interpretations that go beyond the data.) And we should always value long term studies that measure disease more than short term studies that only measure risk factors.
For example, if Mr. Taubes had submitted his book to peer review, someone would have pointed out that the Masai are not a good argument for eating a high animal fat diet because they have several factors that contribute to low cholesterol. Eighty two percent of their plant food additives contain potentially cholesterol lowering saponins and phenolics. And eating raw blood exposes them to parasites which also lowers cholesterol. They live at a high altitude which also lowers cholesterol. And there's evidence they have genetic hypocholesterolemia. In metabolic ward studies, when the average American eats a lot of animal fat and they're not losing weight their total cholesterol goes up drastically. So without all these cholesterol lowering factors the serum cholesterol of the Masai would be much higher.
FULL REVIEW
POINTS OF AGREEMENT
1) I agree that low carb is effective for diabetes and weight loss (but so are low fat, high fiber diets.)
2) I agree that high glycemic index carbs should be included in the long list of risk factors for heart disease (but animal fat is as least as bad and probably worse.)
3) I agree that total cholesterol below 150 is associated with a greater risk of stroke, but only for people with untreated hypertension or who smoke or drink alcohol or caffeine.
POINTS OF DISAGREEMENT
1) MISLEADING ABOUT THE DIET OF HUNTER GATHERERS : On page 69 of GCBC, Mr. Taubes cites a study by Loren Cordain et al that says hunter-gatherers ate 28% to 58% total fat. Taubes uses this study as evidence that all humans are adapted to a high saturated fat diet. But when you look at the details, Taubes completely misrepresents what Cordain believes. Here's what Cordain says about saturated fat, "The typical Paleolithic diet compared with the average modern American diet contained 2 to 3 times more fiber [from fruits and vegetables], 1.5 to 2.0 times more polyunsaturated and monounsaturated fats, 4 times more omega-3 fats, but 60% to 70% less saturated fat." This is in spite of the fact that they consumed the entire carcass of the animal. This is because they ate wild game (average of .89 grams saturated fat per serving) instead of grain fattened domestic animals (average of 7.04 grams saturated fat per serving). Grass fed meat also contains more CLA and omega-3 fatty acids which are associated with a reduced risk of heart disease and cancer.
2) MISLEADING ABOUT HEALTHY CARBS: Beans have a low glycemic index and if eaten on a regular basis their fiber and resistant starch (depending on the variety) can lower fasting blood sugar, insulin, triglycerides and improve the HDL/total cholesterol ratio. Oats and barley contain beta glucan and resistant starch which can lower fasting blood sugar, insulin and improve the HDL/total cholesterol ratio. Insoluble fiber like wheat bran is very important for digestive health. For the small percentage of people with celiac disease (1%) or gluten sensitivity (3 - 15%) there are many grains without gluten. Cultures where people live the longest eat more whole grains, beans and yams than the average American.
Most people handle low glycemic index, high fiber carbs just fine (these include fruit, non-starchy vegetables, peas, beans, whole grain pasta cooked al dente, rolled oats, corn on the cob, brown rice, sprouted grain bread, yams etc.) They don't cause the metabolic syndrome or increase the number of small dense LDL particles. The American public has never tried replacing saturated animal fat, sugar, white flour and baking potatoes with low glycemic index, high fiber carbs, nuts, olive or canola oil and fish. And the average American is eating out more often (sometimes twice a day instead of twice a week) and getting bigger portions than we would at home. Therefore the obesity epidemic proves nothing about beans and peas and whole grains and yams.
On page 454 GCBC says "By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity. The fewer carbohydrates we consume the leaner we will be." If there is even one exception then there is something wrong with the hypothesis. In rural China during the 80s, they ate 75.8% carbs (but they're healthy carbs) and more calories than Americans and they had extremely low rates of obesity, diabetes and heart disease. These facts about China are not in dispute. By ignoring them GCBC misleads us about the complexities of physiology and the fact that some people do best on low carb while many others do best on low fat.
3) MISLEADING ABOUT DIABETES : Following the diet recommended by the American Diabetes Association reduced HbA1c by 0.4 percentage points, but eating an ultra low fat diet with low glycemic index, high fiber carbs reduced HbA1c by 3 times that amount. This is a greater effect than taking a diabetic medication. (See Dr. Neal Barnard's Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs .) So both low fat and low carb diets lower blood sugar and improve insulin resistance compared to the standard American diet.
Excess insulin is just one factor in a long list of things that affect Western diseases. Excess calories, excess IGF1, vitamin D insufficiency (See Vitamin D Prescription: The Healing Power of the Sun & How It Can Save Your Life ), a sedentary lifestyle, a shortage of phytochemicals from fruit and vegetables, a shortage of omega-3, eating too much salt, excess alcohol and smoking all have huge effects on Western diseases. And according to Weston Price free range meat and dairy, organically grown food, minimally processed food, calcium and fat soluble nutrients and whole grains were important reasons for the health of the people he studied. Since just eating less carbs can't correct all these problems, even the beneficial Eco-Atkins is not a panacea for Western disease.
4) MISLEADING ABOUT HEART DISEASE : Dr. Esselstyn used a 10% fat, low glycemic index, high fiber diet to reverse heart disease. (See Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure .) We know it worked because of before and after coronary angiograms and cardiac PET scans. People given less than a year to live are alive and healthier 20 years later. Done right, the 10% fat, low glycemic index, high fiber diets reduce small dense LDL particles, inflammation, homocysteine, insulin resistance, blood sugar and increase nitric oxide which dilates arteries like nitroglycerin. There is no requirement to count calories or exercise to get these results.
Dr. Ornish also reversed heart disease using similar diet plus exercise and meditation. Since then Dr. Ornish has enrolled at least 3800 patients in demonstration projects (to demonstrate savings on surgery) which resulted in over 40 insurance companies including Medicare covering a program in diet and lifestyle for heart disease patients. According to Dr. Ornish, "In brief, we found that almost 80 percent of patients who were eligible for bypass surgery or angioplasty were able to safely avoid it for at least three years."
The book leads us to believe that lowering cholesterol may reduce heart disease but not increase longevity and that cholesterol levels don't matter in elderly people. But a meta-analysis by Afilalo et al. shows Statins reduce all-cause mortality 22% in elderly heart disease patients.
On page 454 GCBC says "Through their direct effect on insulin and blood sugar, refined carbohydrates, starches, and sugars are the dietary cause of coronary heart disease and diabetes." The initial studies by Dr. Esselstyn and Dr. Ornish that reversed heart disease on a low fat, high carb, high fiber diet are over 20 years old and something he knew about (because he debated Dr. Ornish in 2002) but chose not to mention!
5) MISLEADING ABOUT CANCER : The book leads us to believe that low cholesterol causes cancer. But calorie restriction lowers cholesterol and reduces the risk of cancer and heart disease at the same time. The latest meta-analysis of statin use, based on 26 randomized trials and 170,000 patients, shows they are not associated with higher cancer rates. Countries with low cholesterol have lower rates of prostate, breast and colon cancer than the U.S. In clinical trials, ultra low fat diets slow cancer growth. So why would low cholesterol levels in this country be associated with cancer? Because cancer and other chronic diseases cause lower cholesterol, not the other way around.
Complete protein is the main thing that raises IGF1 which increases the risk of cancer (whey seems to be the only exception). Cancer patients who eat low fat and low meat have much higher survival rates. GCBC tells us people can be healthy eating 100% meat, but fruit, vegetables, whole grains and beans contain phytonutrients that act like low dose chemotherapy. (See Foods to Fight Cancer: Essential foods to help prevent cancer .) Even Sally Fallon, cofounder of the Weston Price Foundation, in her book Nourishing Traditions admits "... meatless diets often prove beneficial in the treatment of cancer ..." although she does not believe that meat increases the risk of getting cancer.
However in the Fung et al study mentioned earlier, people eating a version of reduced carb with 18% animal protein were 32% more likely to die of cancer than the Eco-Atkins group eating 12% animal protein. In other studies, red meat is associated with an increased risk gastric and colon cancer; saturated fat is associated with an increased risk of breast cancer and dairy is associated with an increased risk of prostate cancer. And in animal studies, cancer rates increase rapidly when complete protein is more than 10% to 12%.
According to the World Health Organization, modern adult humans only require about 0.38 g/lb per day of protein with a protein digestibility-corrected amino acid score (PDCAAS) value of 1.0 to be healthy and maintain nitrogen balance. And the average American eats about 50% more than this. (Pregnant women, children, adolescents, elderly people with congestive heart failure and people recovering from an infection or injury need extra protein.)
6) MISLEADING ABOUT PHYSICAL EXERCISE: Just walking 30 minutes a day reduces the risk of heart disease, cancer, diabetes, hypertension, and Alzheimer's. (See The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health .) Conductors in double-decker buses have about half the rate of heart disease as the drivers who sit all day long. And exercise benefits your health whether you lose weight or not.
CONCLUSION : THERE ARE SEVERAL WAYS TO BE HEALTHY
People are different but medical research can only tell us what is likely to be true for the average person in a carefully defined group using statistical analysis. Some people do best with low fat or Mediterranean and others with Eco-Atkins. Most people with heart disease do well on the diet of Dr. Ornish or Dr. Esselstyn. But there's no evidence that a diet high in grain fed meat is good for anybody in the long run.
1. Vegetarian Adventist men and women live an average of 87 and 89 years, respectively and have a typical cholesterol level in the 180s. They abstain from alcohol and tobacco, exercise regularly and eat nuts, eggs and dairy products.
2. In the 50's and 60's Crete had the best longevity in the world. They ate 40% fat mostly from olive oil, but only 8% saturated fat. The total red meat, poultry and fish consumed per-person, per-week in Crete was only about 371 grams (13 ounces). Ancel Keys followed the Mediterranean diet and lived to be 100 years old.
3. Japan has the best life expectancy of any country. The average man lives 79.4 years and the average women 86.1 years. They eat more carbs (about 59% versus 49%) and less fat (about 28% versus 38%) than the U.S. They eat more seafood than they do meat.
4. Iceland has the best longevity in Europe. The average man lives 80.1 years and the average women 83.5 years. They eat less carbs and more fat than the U.S. They eat more seafood than they do meat and their meat is grass fed. (In France they also eat grass fed meat.)
5. If you have heart disease, a low-fat diet with low glycemic index, high fiber carbs can save your life. This diet is associated with higher levels of telomerase, an enzyme that maintains telomere length which is associated with health and longevity. Skim milk and egg whites are allowed. People without heart disease can eat more fat including wild salmon
6. An Eco-Atkins diet with regular meat, that includes 12% or less animal protein and 12% or less saturated animal fat has been shown to be healthier than the standard American Diet. Lower values give even better lipid profiles.
7. Eat like a hunter gatherer. But unless you have the right genes, eat grass fed meat and copy most of their protective behaviors you are not likely to get good results for heart disease and cancer (even if you lose weight and lower your blood sugar.)
Two bad choices
1) Follow the USDA pyramid version of low fat and eat lots of sugar, white flour, white rice and potatoes. It will increase your risk of the metabolic syndrome and diabetes.
2) Eat low carb with grain fed meat. It will increase your risk of heart disease and cancer.
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TAUBES' BOOK AND THE REAL CAUSE OF OBESITY
I just finished reading Gary Taubes' book, Good Calories, Bad Calories. It's superbly researched and contains crucially important information, but it's a hard read - long, dense, meandering, and repetitive. I fear that many people won't get all the way through it. And while the extensive detail on studies is great, the forest gets a bit lost among all the trees. So here is a summary of the book's main findings, which start with this revolutionary notion:
Overeating is not the cause of obesity, but rather its consequence - a form of body wisdom caused by dietary fuel being abnormally locked away as fat. The cells of your body don't have enough usable energy, so you eat more and move less. Sound crazy? There's actually voluminous research to support this theory.
A Heart-Healthy Diet is High Fat
The book starts with a thorough debunking of the idea that saturated fat and cholesterol cause heart disease. I'm not going to repeat all the evidence here (read the book for that), but there is no question that the dietary cause of atherosclerosis is excessive dietary carbohydrate, not excessive saturated fat. In fact, eating saturated fat is protective of your heart.
Study after study shows this is true. But unfortunately, before the evidence became so clear, the government and medical establishment made some premature pronouncements about low-fat diets being good for your heart, and now they can't find a face-saving way to back off from it.
In addition to the experimental evidence, there is the cultural evidence. The chapter on "Diseases of Civilization" gives example after example of hunter-gatherer cultures that never experienced heart disease, diabetes, obesity, cancer, or the rest of the diseases that plague our society - until they started eating the Western diet dominated by white flour, white sugar, and white rice.
Human breast milk is very high in cholesterol. We evolved as hunter-gatherers eating a high-fat diet composed chiefly of red meat. How in the world could this be bad for us? The new food in our diet - processed and excessive carbohydrate - is the obvious cause of the new diseases. There is a wonderful quote about this from Peter Cleave's testimony before George McGovern's Senate Select Committee on Nutrition and Human Needs:
I don't hold the cholesterol view for a moment. For a modern disease to be related to an old-fashioned food is one of the most ludicrous things I have ever heard in my life. If anybody tells me that eating fat was the cause of coronary disease, I should look at them in amazement. But, when it comes to the dreadful sweet things that are served up ... that is a very different proposition.
Low-Fat Diets Make You Fat
The gigantic mistake that the government and medical establishment made in advising a low-fat diet also affected the advice to people struggling with obesity and diabetes. Doctors who recommended a high-fat, low-carb diet for weight loss risked censure because of the widespread - and erroneous - notion that this was bad for the heart.
All obesity research results were interpreted - sometimes tortuously - to be compatible with the idea that carbs are good for you. And one entire area of evidence - the biology of fat metabolism - was completely ignored, because there was no way to reconcile this with the bad advice to eat lots of carbs.
When you eat carbohydrates - particularly processed carbohydrates like white flour, white rice, or sugar - your body secretes insulin to remove the sugar from your blood. Insulin is the hormone necessary to store fat into your fat cells, and also inhibits the release of fat from your fat cells. You can't get fat without insulin, and you can't lose fat with insulin. Obese people virtually always have chronically elevated insulin levels, a precursor to Type 2 diabetes that makes it almost impossible to lose weight.
The only way you can lose weight on a low-fat, high-carb diet is by restricting calories - a semi-starvation diet. Not only is undereating unbearable - for experimental subjects as well as dieters - people almost always regain weight lost from semi-starvation, usually plus some. Study after study shows this to be true, whether you start out fat or lean.
So why isn't everyone fat on a Western diet? People differ in their sensitivity to carbs - they differ in the amount of insulin released after eating carbs, and the sensitivity of their fat tissue to insulin. Some people can eat cake for every meal and not gain weight, but others will quickly fatten on a high carb diet. Unfortunately, people who don't struggle with weight often have little sympathy for those who do because they don't understand that their bodies are different. They think they're morally superior.
Obesity is Not Caused by Gluttony and Sloth
The nice way of saying "gluttony and sloth" is "overeating and lack of exercise". But however you say it, the fact remains: The common wisdom is that fat people cause their own problem by committing two of the seven deadly sins. No wonder there is so much fat bias.
The conventional wisdom is that you get fat if you eat more calories than you expend - the positive caloric balance hypothesis. But the fact that semi-starvation diets almost never produce long-term weight loss strongly suggests that positive caloric balance - overeating and lack of exercise - is not the underlying cause of obesity.
The positive caloric balance hypothesis assumes that (1) the source of the calories doesn't matter - a calorie is a calorie, and (2) energy intake and energy expenditure are independent variables. Neither of these assumptions is true:
- A carb calorie has a very different affect on the body than a fat calorie (see above).
- Energy expenditure is highly dependent on energy intake. Our bodies work hard to maintain a constant body weight. Research shows that if you undereat, your metabolism slows to compensate, and if you overeat, your metabolism speeds up. The idea that you can gain or lose weight over time by altering your intake by 100 calories a day is ridiculous. Your body easily compensates for this small variation (and much larger variations).
Growing children have a positive caloric balance. But the reason they are growing is not because they are eating more calories than they are expending. They are eating more calories than they are expending because they are growing. The cause of their growth is growth hormone, not overeating. The same is true in obesity.
Obesity is a fat storage disorder, not an eating disorder. The body is storing too many of the calories you eat as fat instead of making this dietary energy available to your muscles and organs. On a cellular level, you are experiencing semi-starvation. So you eat more, and you conserve energy by moving less. You don't get fat because you're overeating and under-exercising, you overeat and under-exercise because you're getting fat. Just as vertical growth is driven by hormones, so is the "horizontal growth" of obesity - in this case, insulin. Insulin becomes elevated by a diet too high in carbohydrates.
Have you noticed that people who are fat don't gain weight continuously? You gain weight and then stay at that weight. This is not because of some "set point" that your body is stuck at. Your body maintains a dynamic equilibrium around usable energy, not fat. One hypothesis is that as fat cells expand, it becomes easier for them to release their fat - just as the pressure inside a blown-up balloon will push out the air. Once enough fat is in the cells that it can be mobilized (burned for fuel), a new equilibrium is reached and you stop gaining. Once fat can be mobilized, you don't need to eat as much because your cells have fuel.
The more insulin circulating in your blood, the harder it is to mobilize your fat stores and burn fat for energy. The more carbohydrates you eat, the more insulin will be circulating in your blood. For those who are genetically vulnerable, a high carb diet eventually causes insulin levels to become chronically elevated, while muscle cells become increasingly resistant to insulin (unable to use dietary glucose for energy). Eventually, fat cells also become insulin resistant, and diabetes is the result.
The cellular semi-starvation from excessive fat storage may be why obese women have trouble getting pregnant. It's actually similar to what happens to women who are underweight.
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SOMETHING TO TRY...
Taubes' book is quite long and extremely detailed. I'm just highlighting its main conclusions. For the evidence - which is voluminous - read the book. Or try some experiments on your own body.
I wrote in a previous post that there are two main reasons that people become overweight: emotional eating and processed food (which is generally high carb). Processed carbohydrates are an unnatural food that cause our body wisdom cues to go haywire. Even if you vanquish emotional eating entirely, you will tend to overeat processed carbohydrates because they induce cravings.
Processed carbs taste good, but they don't make your body feel good. They give you a buzz followed by a crash, and then constant cravings. They also can affect mood, making you depressed. If you've never gone without carbs for a period of time, you may not even realize you feel this way because of what you eat. If you have nothing to compare it to, you may think it's just you. This is why food experiments are such an important part of Stage 2 of Normal Eating. You have to experience first-hand how different foods make you feel to internalize the body wisdom. You can't read this and believe it, you have to feel it.
So in the spirit of experimentation, try reducing your carb intake for a few days or a week and see how you feel. Don't get black-and-white about it - just see if you can slowly push down your carb intake over time. In particular, try to minimize white flour, white rice, and sweets of all kinds - including honey and artificial sweeteners. If you're feeling ambitious, try minimizing all grain for a few days - even whole wheat and brown rice. Grain is a Neolithic food, introduced with agriculture. It's not what we evolved eating, and now it's the staple of the Western diet.
Why cut out artificial sweeteners? Research has found that artificial sweeteners will cause the body to secrete insulin, same as sugar - sweet is sweet. When I read that, I wondered if some people failed to lose weight on low-carb diets because of overuse of artificial sweeteners. If you try lowering your carbs, don't go the Atkins route of weird ingredients, using highly processed substitutes for flour and sugar. Just skip the bread and the sweets. Stick with real food, recognizable from nature.
I've been trying this myself the last few weeks. I had no problem cutting out grain, but sweets were a sticking point. No sweet taste at all? That was tough. But I was able to taper off it, and then - surprisingly - it didn't bother me. It's really true that eating carbs induces carb craving. The physiological reasons are detailed in Taubes' book. Once you wean off it, you stop craving it. It's a bit like quitting smoking.
Years ago I tried the Atkins diet and didn't even last a day because I felt so dizzy and weak. I now realize this is because I wasn't eating fat. One day last week I again tried eating zero carbs, but this time with lots of bacon and sausage (from the farmer's market - no nitrates), and I felt fine. Actually, I felt better than fine, to my great surprise. My energy level was high and I didn't feel hungry at all. And I've lost a few pounds since I started experimenting.
People in the forum hate when I talk about nutrition; they say it feels like a diet. But it's not a diet if it's just an experiment to see how you feel, and it's not a diet if you choose to eat a certain way because you feel good eating that way.
An important part of Normal Eating is understanding, on a deep level, that it is your right to eat whatever your want. But with rights come responsibilities, and this other side of the coin is just as important. No one can tell you what to eat, and that means you must take responsibility for your own eating. In the end, nutrition matters.
So what do you think? Are you willing to try lowering your carbs as an experiment? If not, why not? If yes, post your experiences in the blog, where this article is cross-posted:
[...]
Sheryl Canter
Author of "Normal Eating for Normal Weight"















