Well, my beautiful little low-carb n=1 has had her first fever. Just a few days shy of her 2nd birthday she started running axillary temperatures between 39 and 40. No other symptoms, just a fever and lethargy. She was the perfect little patient, she stayed in our big bed all day sleeping and watching Max and Ruby on the tv. Not a peep of complaint. By the following morning, she was back to her normal active, chatty self, running around the house, dancing, chasing the cat, playing with balls in the yard – it’s hard to keep up. I think these mild childhood illnesses exist partly to strengthen the bond between parent and child. You feel so protective and close to them when they are sick at that age. Anyway, I can no longer boast that she has been completely free of fever although she is still yet to have a rash.

She is talking in complete sentences, now, too and she definitely has a lot to say. This morning, after sharing my breakfast of frittata, tomato and mayo, she said, “Thanks for the nice breakfast, Dad”. And she has discovered that it pleases me when she says, “Daddy’s car is good”. We are still on track with her low-carb high fat diet. It’s not so much that we don’t allow any carbs but that she isn’t attracted to them. My 11 year old son, for instance, sometimes eats brown toast with almond butter for breakfast and will offer some to his sister. She will sample the almond butter and leave the toast untouched. He has actually switched to scrambled eggs now with a little sausage or bacon which makes me happier. He is currently taking a sailing course where he spends all day on the water, solo in a small dinghy, so he needs a good breakfast. Both of them are thriving on diets virtually devoid of sugar and very low in starch. I really can’t see any justification for adding those types of foods into their diet.

Even though we are approaching the end of summer, the traditional time for reading a book or two, I want to talk about books because there have been a number of new ones published in the last year or so that I am recommending.

The first of the new batch, of course, is the latest in the Atkins diet series, “The New Atkins for a New You”. The Atkins Nutritional corporation, which owns the publishing rights, contracted with three researchers I know well to write the definitive update of this popular low-carb diet. Drs Steve Phinney, Eric Westman and Jeff Volek have all done excellent research on low-carb diets. Steve did his PhD work at MIT on high-fat low-carb diets in the late 1970s. He showed that exercise tolerance, which drops when you cut carbs, actually will return to baseline or better if you stick with the diet. This was lost on earlier researchers who stopped their studies before their subjects had sufficient time to adapt. Steve figured this out by reading the diaries of European explorers who lived among the Inuit and who ate the Inuit diet of 80% fat and 20% protein. He has continued to contribute to our understanding of diet and metabolism over the years both in academia and in the corporate world. His focus has been on the use of nutrients for therapeutic purposes and he holds several patents in this area. Eric Westman runs a clinic at Duke University where he treats diabetics with a low-carb diet and gets excellent results. He started researching low-carb diets about 12 years ago when he observed some of his patients using this method to shed weight and get off meds. He actually went up to Manhattan and met with Dr. Atkins to learn firsthand how the diet worked and what kinds of results one could expect. He then did one of the first modern trials of a low-carb diet which was published in 2002 and has continued to do research and publish in this area since that time. Dr Jeff Volek is a kinesiologist and registered dietitian at the University of Connecticut where he has a large lab and, at any given time, about 20 grad students. He has been publishing very well executed studies which show the benefits of low-carb dieting on a range of conditions associated with insulin resistance. I use his material in my lectures because they are the best resources we currently have to demonstrate the “efficacy” of low-carb diets vs the usual studies which demonstrate “effectiveness”. This is an important distinction since efficacy is what we want while effectiveness can be influenced by any number of factors that reduce compliance. When you look carefully at most of the low-carb studies, especially the ones that get published in high impact journals, they make a mess of the low-carb arm and therefore get poor compliance. Then an “intention-to-treat” analysis is used on the data which waters down the reported benefits of low-carb. Jeff’s studies are done properly, with high compliance, so that the benefits of low-carb are more clearly represented in the results. All that to say that this team of authors has the scientific and clinical chops to deliver when it comes to writing a guide on how to effectively do a low-carb diet. They have done a good job with this book and I have been recommending it to all and sundry. One of the things I especially like is that you don’t even need to read the book to get started, you can just go to page 246 where there are extensive meal plans, and start eating according to the diet. You can then read the book at your leisure as the pounds fall away.

The second recent book is the latest from my friend Gary Taubes, “Why We Get Fat and What To Do About It”.  After his 2002 New York Times article, “What if it’s all a Big Fat Lie”, and his subsequent opus, “Good Calories, Bad Calories”, established him as arguably the most knowledgeable and prodigious critic of the foibles of nutritional science in the western world, Gary has become an icon in the low-carb universe. I recommend GCBC but I know that many people find it too densely scientific to get through. To me it reads like a whodunnit and I couldn’t put it down but I had already been immersed in the science of nutrition for awhile. I think Gary’s publisher noticed that this was an issue, as well, and pressured Gary to write a lighter version that would be more accessible to the general reading public.  He has done a good job of that with WWGF. My wife couldn’t put it down and her science background is in math and computers. For anyone who wants to understand the history of nutritional science and that there are actually competing ideas as to what might be a healthy diet, I highly recommend this book. If you are new to this area, you will find things you assumed were bedrock in terms of nutritional advice are, in fact, highly debatable and, in some cases, outright wrong. One of the things my wife tells her friends when recommending the book is that it is not just about weight, it is about all aspects of health.

If those two books weren’t enough to completely fill a beach vacation reading list, my friends Phinney and Volek recently came out with, “The Art and Science of Low Carbohydrate Living”. After they wrote the new Atkins book, they wanted to develop a manual that could be used by physicians to manage their patients on a low-carb diet. I gather that the Atkins people weren’t interested so Steve and Jeff decided to go ahead on their own. I had met with an Atkins VP last summer at a conference in Switzerland where we had several conversations about where they could go with the brand. I felt strongly that there was enough evidence now to advocate this type of diet for the treatment of metabolic syndrome and type 2 diabetes and that the corporation should start targeting physicians. It seemed to me that to go in this direction would enhance their brand by getting more widespread buy-in from physicians and anything that promotes the diet would, I believe, increase sales of their products. The books, for example, could be recommended by physicians to their patients to guide them on the diet. At any rate, I gather that this was a no go, in fairness, possibly because the corporation was in the throes of another take-over at the time so Steve and Jeff set out to write the definitive physician’s guide on their own. The result is a book that, while it targets physicians, is accessible to the general reading public. It is written in a casual and, at times, witty style while providing lots of good information on the why’s and how’s of low-carbohydrate dieting. Some people who have read it have told me it is the most convincing of the low-carb books so far. The authors certainly have the scientific background to deliver what you need to know about the metabolic consequences of high-fat low-carb vs the alternatives and they do so in a way that is readily understandable and backed up with the appropriate citations. Another good book for anyone who is starting to question the current dietary recommendations for healthy living.

Okay, one more to go. Jeff O’Connell was a writer for Men’s Health when I first heard from his a few years back. He was interested in the study at Alert Bay and wanted to do a story on it for the magazine. He had developed an interest in diabetes and had begun to write about it. As it turned out, he was not able to get up here to visit the study but in the meantime did arrange for me to be featured as one of the 20 “Health Heros” in their 20th anniversary commemorative edition. A couple of years went by and then, out of the blue, I heard again from Jeff asking if he could visit. By this time the study had wound down so I suggested he follow me as I visited a string of First Nations communities in the north and spoke at a local diabetes conference in a small northern town. During those few days I learned that Jeff had developed pre-diabetes, that his father was severely affected by advanced type 2 diabetes and that he had a book advance to write about this epidemic that is now gripping the world. The result is his just published book, “Sugar Nation”. Now I am perhaps a little biased, and you may see why when you read his flattering portrayal of me in the book, but I am again highly recommending this book to anyone interested in learning about the diabetes epidemic and how we got into such a fix. His personal quest to understand his condition and his travails in obtaining helpful advice from the medical profession and the other authorities who are supposed to be leading us out of this morass becomes a damning expose of the madness of the current approach. His down-to-earth writing style and his ability to discuss the science in easy to understand terms make this book very accessible. He concludes that a combination of carbohydrate restriction and exercise is the solution to both the prevention and the treatment of diabetes and insulin resistance. I agree with him, although my focus has been more on the carbohydrate restriction side of things. I have to confess that after reading his book, however, I did shift my morning exercise routine from cardio to high intensity interval training. So far, so good. I’ll let you know how that has worked out once ski season starts.

I hope you find these mini-reviews helpful and I certainly encourage you to read any or all of these books to better understand how a seemingly simple shift in your diet can have huge beneficial consequences in your life.