My little low-carb n=1 continues to thrive. At 26 months, she is able to count to 14 and name a square, triangle and circle. She is very determined and wants to do everything herself, now. I think this is called the “terrible twos” although it appears to be a mild case. She continues to eat a low-carb diet of veggies, meats, fish and cheese supplemented with formula. Her sturdiness is remarkable with an unbroken record of no rashes and only an occasional sniffle when a virus comes around. We have put the boat away for the winter and are getting ready for ski season and I am sure this is going to be her break-out year on the mountain. The fact that she was skiing Whistler last season at 17 months is amazing but her strength and coordination are so much better now that I am sure she will be burning up the slopes this year. Her brother has been warned to keep a look out over his shoulder as she will be giving him serious competition soon. He is a very capable skier at eleven having done eight seasons at Whistler and climbing through the grades of the excellent ski school there. Although he skis the double black diamond runs with me, he is more laid back by nature and not interested in competitive programs. She, on the other hand, has an inner toughness and drive that is going to be fun to watch. So far, it appears that our little low-carb baby is staying well ahead of the curve in every respect.
There have been some interesting developments in the low-carb blogosphere. My friend Eddie from across the pond had his blog pulled by Google. You will recall from my earlier posts that he was waging a battle with the anti-low-carb crowd who were controlling the low-carb forum at www.diabetes.co.uk. He contacted me after I was banned from posting there and I arranged for Jimmy Moore to interview him. This shone some light on the perverse goings-on in what was supposed to be a low-carb forum for diabetics which resulted in the much-deserved sacking of the moderators. Eddie, who had been banned as well by those errant mods, had started his own counter-blog. After the moderators left DCUK, they, too, started a counterblog whose main purpose seems to be to attack Eddie. This has continued with jabs going back and forth and, on Eddie’s blog, at least, some other interesting and useful information posted on a daily basis ranging from reviews of recent research to recipes and photos of low-carb dishes. Although he was obviously an irritant to those who fake adherence to a low-carb diet or who try to defend the status quo, there was nothing terribly offensive about the postings in my opinion. Although quite pointed at times, most of it was witty and humorous. So it was a surprise to find the blog had vanished. I contacted Eddie to find out what happened. He said it was because he had violated the Google guidelines but that they would provide no details nor was there any avenue of appeal. Someone obviously convinced Google that his years of accumulated blogging should be deleted. It would appear to me that that someone did a number on Eddie and that Google, with their severe policies, were manipulated. Eddie, however, is not to be deterred and has started a new blog at: http://lowcarbdiabeticuk.blogspot.com/. I would encourage you to bookmark his site and offer him encouragement. He is fighting the good fight.
My friend, the Swedish low-carb physician, Dr Andreas Eenfeldt, who blogs at www.dietdoctor.com has been quite active lately and has contributed to recent events in Sweden. As you may know, the Swedish government investigated another low-carb physician, Dr Anna Dahlquist, who was publicly advocating ketogenic diet for the treatment of diabetes. A couple of nutritionists made a formal complaint of malpractice against her which compelled the Swedish Ministry of Health to investigate. When the report was published, it exhonorated the doctor and found that the low-carb diet approach she was using was a valid treatment option. This appears to have galvanized a resurgence of low-carb dieting in Sweden. A recent poll found that 23% of the population was restricting carbs and that 9% were eating a very low carb diet. There have also been reports that Sweden is experiencing a shortage of butter and that their advertising standards council has asked Unilever to remove their ads that suggest margarine delivers a health benefit. Andreas had published a book on low-carb dieting a couple of years back which became a best-seller and he has been gaining prominence in the low-carb blogosphere with his lecture at the Ancestral Health Symposium this summer which is available on his blog. He has now posted a video interview he did with Dr Robert Lustig at the recent American Society of Bariatric Physicians meeting in Las Vegas, entitled, “Beyond Gluttony and Sloth”, which is one of the better and more succinct explanations of the importance of carbohydrate restriction you will find anywhere. I would encourage everyone to visit www.dietdoctor.com to view that video.
Over at the Huffington Post, the liberal on-line news outlet, I have been making an effort to put a dent in their low-fat, vegan biased approach to health by making comments on their articles on diet. Some of you have already figured out that my nom de plume there is canuck1950. My efforts to press the case for low-carb have been hampered by the fact that Dr Dean Ornish was made medical editor there a few months back. I don’t know if they have me on a blacklist but it is increasingly difficult to get my comments published. I now refer to this as ‘getting through the Ornish filter’. A recent example occurred with an article on vegan diet which, of course, brings out all the zealots and the topic inevitably gets around to a discussion of their dietary Koran, “The China Study”. My attempts to interject in the discussion thread on that article were completely blocked.
Now, I will admit I have not read “The China Study” although I am more than passing familiar with it. I recall the first time I heard about it was at a meeting in Ottawa where a group of experts were gathered to discuss setting the health research agenda. Someone, who shall remain nameless, but who was highly placed in the nutritional science community at the time, started debating with me during a coffee break. He had read “The China Study” and believed it presented the best evidence on what is the ideal diet for humans which he described as consisting of whole grains, fruits, veggies and little or no animal products. I was, of course, arguing that a high-fat carb-restricted diet was better. The remarkable, and most memorable, thing about that encounter was the fact that throughout the whole discussion he was holding in his hand a large danish pastry literally dripping with some kind of liquid sugar coating. Obviously, only one of us was walking the talk when it came to our positions on a healthy diet. In the ensuing years I have seen “The China Study” put forward as the definitive guide on healthy diet in a number of settings. At the same time, I have read several critiques of both the study itself and the book that carries its title. Recently, a young woman in Oregon, has risen to prominence in the low-carb blogosphere for her excellent work in this area. Denise Minger apparently has a liberal arts background but also, obviously, has an amazing ability to read and critically analyze scientific work. She has a blog, www.rawfoodsos.com, where she has posted lengthy and incredibly detailed critiques of “The China Study” and the more recent film of the same ilk, “Forks Over Knives”. I would encourage you to go to her site and read both pieces to better understand how science can be manipulated to push an agenda. I have no problem with people who choose to be vegan out of concern for the welfare of animals. I do have a problem when they manipulate the evidence to try to convince others that this is the ideal human diet. One need only consider that, if we don’t eat animal products we will quickly suffer the consequences of vitamin B12 deficiency, to understand that we have evolved to rely on those foods. If you look at the history of human life on this planet, the emergence of vegan and vegetarian diets is a phenomenon of very recent times.
Meanwhile, people like Dr Dean Ornish, have gained a lot of credibility by showing that a very low-fat vegan diet delivers health benefits to people at risk of cardiovascular disease. This is true when you compare that diet to the crap most people eat today. What we need is a study that compares the Ornish diet to a very low-carb high fat-diet. I am not holding my breath, however, as Ornish currently has the upper hand in terms of profile and influence. Not only is he controlling the discussion at Huffington Post but he is also the medical editor at Newsweek. He has attracted iconic people like Bill Clinton and the late Steve Jobs to his corner and I am presuming Arriana Huffington, too. Clinton, I am sure, finds that his cardiovascular risk markers have improved now that he is no longer eating all the crappy junk food he was famous for. Jobs, on the other hand, didn’t do so well. You find nothing in the mainstream media that focusses on the curious fact that a lifelong vegan would develop a cancer of the neuro-endocrine system. Or that he eschewed early surgery, which might have saved his life, in order to double down on the diet for nine months. Or that one of his close friends and advisors throughout all this was none other than Dr Dean Ornish. I sometimes think that we in the low-carb arena are too nice. Just think what would have been the consequences if Jobs had been an Atkins adherent.
And for a very funny take down of Dr Neal Barnard of the Physicians Committee for Responsible Medicine, which is actually a PETA-affiliated group dedicated to the promotion of vegan dieting, go to www.thedailyshow.com (in Canada: www.thecomedynetwork.ca/Shows/TheDailyShow) and find the November 3, 2011 segment by Aasif Mandvi called, “Death from a Bun”. Hilarious.
Issy at 26 months.
I was under the impression that Jobs ate fish regularly, in which case he wouldn’t be a vegan.
Dr Jay’s Reply:
It is possible you are correct. I you search this topic you will find reports that he was vegan, vegetarian and pescetarian. In any case, it does appear that he used a vegan diet as therapy for his cancer and it is also likely this was the Ornish cancer diet which is very low-fat, vegan.
Here is an interesting rant on that topic:
http://www.bulletproofexec.com/steve-jobs-dr-dean-ornish-and-vegetarian-cancer/
Hi Dr. Jay,
We met at Nicole Foss’s talk in Vancouver, I hope you are well.
I asked you a few questions at the talk, and the Lustig interview you mentioned was linked on TAE today, which got me thinking again. I read the Taubes article Big Fat Lie and have requested “Why We Get Fat” from the library.
Most of what I read on this topic seems to be dealing with diabetes and obesity. I am curious about what healthy people should eat. And, I am concerned with an environmental diet.
As I understand it, part of the population is insulin sensitive, and would benefit from carb restrictions. But how do you know when you are sensitive?
I am 40, and am pretty lean, except for a small pain au chocolate, or my little brioche as my girlfriend calls it. She is a little thicker around the middle than she used to be, but both of us would be thought to be in good shape by someone seeing us on the street.
She studied French cooking, so we eat lots of butter, we garden and can lots of fruit. I grind flour and make whole wheat bread. So I don’t know, we eat like French hippies?
I would like us to eat less meat for environmental reasons. As you know, it takes a lot more land and water to feed people animal protein, and the oceans aren’t exactly in great shape. And, of course, in a worsening economy, it is a lot cheaper to eat potatoes and pasta than steak.
Could you share your thoughts. Are our slightly thickening middles the inevitable signs of old age, or of a low-level sensitivity? Is there something we could look out for that would indicate if a person should restrict carbs?
Thank you,
Ruben.
Dr Jay’s Reply:
Yes, I remember meeting you. Welcome to my humble blog.
I think you are referring to insulin resistance in your question, and, yes there is a growing epidemic of this. Lustig thinks that excess fructose consumption is driving this. I tend to agree. At a molecular level, saturated fatty acids are involved but the question is where do they come from? The conventional thinking is that they are from the fats we eat, therefore we should avoid saturated fats. In the paradigm that Lustig promotes, which I think is supported by good evidence, the source of the offending saturates is from the liver where fructose (and glucose to a certain extent) is converted to fat. In experiments by Volek et al, it was shown that people eating a higher fat and saturated fat intake who restricted carbs had less saturated fat in their blood and a significant reduction in fat produced by the liver. The people who ate a low-fat, low-saturated fat diet high in carbs did not demonstrate these benefits. So, it appears that we can eat lots of saturated fats and they won’t cause a problem unless we are eating a lot of carbs, too.
How does one know if insulin resistance is creeping up on them? Early signs would include slow, insidious weight gain, afternoon drowsiness, rising blood pressure and, if you have a cholesterol check and find that your triglycerides are a little high and your HDL (good cholesterol) is a little low. An oral glucose tolerance test would indicate if you are starting to lose control of you blood sugar. These conditions also tend to run in families, so if you have any close family members with type 2 diabetes, that would be a further concern.
The kinds of foods you need to cut down on to minimize this problem are the carbs, obviously, but also the more refined and sugary ones. That means even your whole wheat flour and the fruits you can. Sorry to break it to you, but fruit, especially when canned with added sugar (in any form) can be a major source of fructose in your diet.
As to whether someone not exhibiting signs of insulin resistance should reduce carbs, I think there is a case for that. I would certainly advocate the avoidance of sugar (in any of its forms) for everyone. Beyond that, I think eating carbs with lower glycemic value is a better choice. One problem with the glycemic index is that fructose flies under the radar so you have to factor that into your choice of low-glycemic foods. Fructose has a GI of about 20 as I recall. Foods high in fructose, like apple juice, for instance, can have a low GI but should still be avoided.
Grains are high in carb, even when they are unrefined. As Dr William Davis argues in “Wheatbelly”, there are other concerns about modern grains beyond the carb content. I tend to think of grains as suitable for bird food.
That whole question of eating for the environment is a tricky one. On the one hand, it is hard to figure out what is really going on because there are lots of people with mixed agendas in the debate, the ethical vegans, for instance. I personally think that we are heading for a Malthusian die-off event and that individual sacrifices will not make a difference. I worry about the potential collapse of the fossil fuel based industrial agriculture model we have come to rely on and how we are going to feed ourselves when it comes to the end of its rope. If we are going to revert back to a more primitive food system, fats and animal products will become very highly valued, more than they are now for the very reason that we are evolved to rely on these types of foods. Without fancy vitamin supplements and thousand mile long supply chains it’s going to be difficult for vegans. In the end, it’s a personal choice and I choose based on what I think is the diet that delivers optimum personal health.
I hope you find these musings helpful. I am sure you will find Gary Taubes’ book informative. If you are considering a lower carb diet, I recommend the new Atkins book or “The Art and Science of Low Carbohydrate Living” by my friends Jeff Volek and Steve Phinney.
Thank you for your thoughts on this Dr. Jay.
I am with you on the Malthusian die-off, though I tend to believe it will play out in the Long Descent catabolic collapse a lá John Michael Greer. Besides, an asteroid or nuclear bomb can’t really be planned for, so I am not going to bother with more than a spare tarp and a few bottles of water.
But your point that meat and fats will become more expensive is what worries me, as I think the chances of me becoming very rich are very small. I also agree the industrial ag system cannot continue–it is facing constraints on fuel, water, nutrients and soil vigour. I am trying to relocalize my food supply with a garden and fruit trees.
So, short of becoming a pig farmer (not entirely out of the question) it sounds like I should look into glycemic index as a guide to what I grow.
Thanks again.
Ruben.
“My friend Eddie from across the pond had his blog pulled by Google”
Are they still doing that??? There was a time a few years back when a lot of low carb Google blogs were shut down allegedly for “spamming”. Several people moved to WordPress, Regina Wilshire among others. They aren’t so gung ho on controlling content for financial (I assume) reasons.
Agree on Dr Andreas Eenfeldt whose blog I also recently discovered, and especially Denise Minger, if anything even better at taking down studies than Jenny and Michael Eades.
The carbs are definitely fighting back, a recent TV programme (vegetarian presenter) stated that our differentiation from other apes and protohumans was not down to hunting and eating meat but actually a result of our enhanced ability to digest starch . . .
There have been some comparative diet studies
http://scholar.google.co.uk/scholar?hl=en&sugexp=ppwl&cp=25&gs_id=39&xhr=t&q=ornish+atkins+south+beach&safe=off&gs_sm=&gs_upl=&bav=on.2,or.r_gc.r_pw.,cf.osb&biw=1016&bih=578&um=1&ie=UTF-8&sa=N&tab=ws
Dr Jay’s Reply:
I do have a hard time figuring out what might have been the crime that Eddie committed to justify erasure of his whole blog. I read pretty much everything there and, although it was pointed at times, I really didn’t see anything that should have justified its elimination. There is a prominent UK dietician who was targeted by Eddie and others for her defence of the status quo using an internet pseudonym. She was “outed” by Eddie and others. She complained to the police and Eddie was actually questioned by a police officer about this. It all seems way over the top to me. Go figure.
I like Dr Eenfeldt’s blog. I hope his book gets published in English for selfish reasons as it includes a passage referring to my work with Aboriginal people.
I think Denise Minger is great. Her analyses of “The China Study” and “Forks Over Knives” are must-reads in my opinion.
BTW – I could not get the link you provided to work.
Sorry, I just did a Google Scholar search on “ornish atkins south beach”. Try that, my version came from Google UK and probably involved tracking cookies.
Eddie was a sarcastic bugger, but no more than certain UK doctors who still have blogs, and which make me believe they should be kept away from patients using cattle prods if necessary. And as for dieticians on TV . . .
. . .right, that’s enough reading (and writing) for one day (there’s enough sources of information that I need to employ staff to keep up with it all), off out for a walk and some lifting with my photographic gear
Dear Dr. Jay,
I’m a physician, anesthesiologist, in Ontario. A colleague put me on to Paleo first, and after some more exploring and reading, have found you and LCHF. It’s early days but things make so much sense and the science looks convincing.
I just completed the mdBriefcase module “Plant Sterol and CV health”. Standard, current recommendations, with the addition of recommending margarine fortified with plant sterols. Of course I didn’t do too well with the post test, since I fundamentally disagree!
I feel it is as if I have opened a pandora’s box. Now when I see my patients preop with hypertension, obesity, sleep apnea, diabetes, non alcoholic steato hepatitis and I think how much more difficult their anesthetic and operative course will be because of it, I’m much more empathic toward them. They’ve been, and continue to be told the wrong things to help themselves. The hardest ones for me to face are the ones coming for bariatric bypass surgery. I’m not trained in nutrition, and other than telling them to be NPO I don’t feel I can let them in on the truth. I admit I’m worried about someone disagreeing and making a complaint to the college, I don’t have the time, space and strength in my life to take that on.
Anyway, keep up the good work.
Carol
Dr Jay’s Reply:
It used to puzzle me why our colleagues who saw the results of LCHF in their patients seemed to remain unaffected. I have seen people make incredible turnarounds in their health, losing heaps of weight, getting off meds including insulin and shedding the signs and symptoms of chronic disease, simply by avoiding carbs, yet their own docs are unmoved. I now think it is because most physicians are functioning at very close to the edge in terms of their capacity to cope with the demands and stress of their practices to the extent that if a patient came in with the secret to life or the cure for cancer, they might not notice. Add to this the phenomena of patients who subscribe to all kinds of internet-sourced information and expect their physician to comment and I think I can understand why many docs tune out. On the other hand, I think there is an opportunity to reach them when they are at a CME event. In that context, they are focussed on learning new things and will take the time to look at the science behind LCHF and engage in a discussion of its merits. This is why I jump at the chance to participate in CME events and why I am looking at developing one specifically on LCHF.
I agree that in your position, it would put you at risk if you were to interject LCHF into a pre-op discussion even though it must drive you a little bit crazy at times not to. I had an interesting discussion with a bariatric surgeon recently where he told me that they routinely put their patients on a pre-op low-carb diet because it was very effective in shrinking the liver sufficiently to allow for laparoscopic surgery.
I also agree that understanding LCHF allows one to shed the “blame the victim” posture that is implicit in the current paradigm.
At least you are on the right track now. Good luck with that.
Can I ask you to once again highlight the result s from Alert Bay ? Is there a way to make that info easier to find on this blog – since I haven’t successfully found it although I think you have provided this somewhere along the way….
Just stumbled across The Centre for Aboriginal Health Research here in Manitoba. It is worthwhile seeing if they are receptive to the traditional diet approach. Hopefully they are http://umanitoba.ca/faculties/medicine/units/community_health_sciences/departmental_units/cahr/index.html