Gary Taubes


Friday, February 13, 2015

Dietary Cholesterol Gets a Pardon

A rare and wonderful thing happened in December of 2014.  For the first time since 1977, dietary cholesterol received a government pardon: (See Page 7, Bottom)

The exact words are, "Cholesterol is not considered a nutrient of concern for overconsumption."

In other words, we should not be concerned about over-consuming cholesterol rich foods. Lobster, shrimp, liver, egg yolk, return to the table, without limits and without hesitation. Once pronounced bad, cholesterol is safe again.  After decades of egg white omelettes the US government corrected its false alarm.

While saturated fat remains vilified, a situation with which I do not agree, I remain grateful for this step in the right direction.

Why is this important?  Cholesterol provides the foundation for steroid hormones.  It aids in the formation of Vitamin D.  Cholesterol is an antioxidant and important for function and structure of the human body.   It protects your skin and performs a vast number of other important tasks.

So celebrate this week with your favorite high cholesterol food, one you perhaps have not enjoyed in decades.   Eat as much as you like.  Your government kept you from it long enough.  Bon appetit! 

Thursday, February 12, 2015

My Comment to the Washington Post

On February 5th, 2015 the Washington Post published the following article:

Where people around the world eat the most sugar and fat - The Washington Post

The article displays 3 graphics, each of which speaks volumes.  I felt compelled to comment on this article given that it's graphics tell us so much about the state of America.  When combined US Government data (below), an important tale is told: 

My reply: 

To be candid, the first graph (seen below) holds zero charm for me. 

The first graph (above) implies Americans eat too much "fat-and-sugar," as if fat-and-sugar are one food. In the press and in research "fat-and-sugar" is to blame for modern chronic diseases like obesity (now termed a disease), diabetes, heart disease, Alzheimer's, more. 

By separating fat and sugar the graphs that follow in the story above (please see original article at , graphs in blue)  reveal the truth of the matter. Americans, among the most obese in the world, do not consume as much fat as other countries. Americans, among the most obese in the world, consume the most sugar by far. 

It should be noted eating more carbohydrates and less fat only became the trend after 1977, the year the first Dietary Guidelines for Americans was issued. These new US guidelines recommended more carbohydrates, less fat. Americans complied. Obesity is the result of dutiful compliance by American citizens with US guidelines, not the non-compliance we are so often accused of.  

First Americans complied (see graph above), then Americans got fat and sick (see graph below).

We must wake up and smell the (pastured) bacon if we are to climb out of our sad predicament. We must turn back time to regain health. Modern America eats too many carbohydrates (>43% of calories, the percentage of carbohydrates calories we consumed prior to 1977) and especially refined carbohydrates (sugars, cereals, baked goods, etc). As a nation, we do not consume enough fat, particularly well-sourced (from pastured animals, virgin coconut oil, etc.) natural fats. A diet higher in well-sourced fats, moderate in high quality protein and lower in carbohydrates (43% or less of calories) with restrictions on refined carbohydrates could shrink our waistlines and re-capture our health. 

That is the real news. Thank you for reading.

Wednesday, December 31, 2014

Google's Top Diet Trends for 2014 and a New Year's Challenge

Dearest Readers,

With the New Year upon us we look back to view important events.  Diet related health is a number one concern worldwide.   Below I've posted a screen shot taken today of Google's top diet trends for 2014.  I am gratified to see people motivated to avoid processed and inflammatory foods (Paleo), markedly reduce refined carbohydrates (Atkins) and avoid gluten (Gluten Free Diet).

In the spirit of a healthy 2015 I propose a New Year's Challenge:  For a period of 30 days, eat a balanced diet but avoid all grains and added sugars/sweeteners.  At the end of 30 days write me a note to tell me how you feel and what you noticed.

For guidelines to this approach I recommend

Wishing you health and prosperity in 2015,
Ann Marie Childers, MD

Monday, December 22, 2014

What Do You Make of This?

The human digestive system is significantly different from those of primates that share a high percentage of DNA.

Our ability to ferment vegetation in order to digest it is on par with the abilities of cats and dogs.

The human stomach is nearly identical to the dog's, and very different from the two featured omnivores (rat and pig).

What, if anything, does this mean for us?  For our dietary requirements?

If vegetables are not cooked, fermented ("pickled", soured, e.g.), processed, pureed or bred for tenderness can humans digest them?  

A paper worth considering:

Placing politics and popular books aside, I ask:  Are humans omnivores? Facultative carnivores (like the dog)? Another category?  

What are your thoughts?

Tuesday, November 18, 2014

Eating Clean Over the Holidays

In my psychiatry practice many of my patients embrace a diet with low to no refined carbohydrates or processed foods and feel emotionally better within weeks. Some have not felt so mentally and physically well in decades. 

Then the eating holidays (Halloween through New Years) arrive. Unless they are hermits they must confront social pressures to abandon good eating habits (Halloween treats, Grandma's traditional turkey stuffing, the neighbor's Christmas fudge, candy canes, New Years' banquets, holiday ads, less time to prepare healthy meals, etc.)

Most report they feel dreadful with their first high sugar and starch food mistake, but as they continue eating such foods they grow used to not feeling their best. By the time January arrives they have gained weight and slipped back into depression, with the daily mood swings every 2-3 hours that accompany a refined carbohydrate diet (see graph below). 

From They Are What You Feed Them, by Dr. Alex Richardson
[A word on the graph above: When insulin rescues your body from slipping into a coma by taking excess blood sugar away it has to put it somewhere. So insulin helps convert blood sugar to fat and store it in fat cells for future use as fuel. But so long as insulin is high, stored fat cannot be released to use for fuel. Blood sugar drops, and hunger strikes again. People who eat high carbohydrate/low fat diets encounter this roller coaster effect throughout the day, suffering frequent hunger symptoms while gaining weight.--AC]

I start early to address this problem by documenting my patients' moods along with diet reports when they first undertake the low refined carbohydrate program. My notes tell me how well my patients felt when they ate one way v. eating according to unhealthy habits. 

You can do this yourself by starting a dated/timed journal of foods and moods using the ABCs (Date, Time, Antecedents, or what prompted you to eat the food; Behavior, or what you ate, and Consequences, such as how you feel/what your glucometer says/etc. In a separate column record weight gain/loss over time). Journaling helps move eating habits from unconscious to conscious.  It is also a way to get in touch with triggers for eating various types of food, and to solidify reasons to eat clean. Seeing the results of eating on and off target on paper helps make the process tangible for most people. 

It's important to know that starch = sugar, and both sugar and starch promote addiction-like blood sugar curves that increase hunger and food cravings, along with moodiness (see graph above). Once on this roller coaster it's hard to get off. 

One strategy set is to get with like-minded people for moral support over the eating holidays. Make healthy substitutes for your favorite holiday foods. When you go out to eat, don't be shy--ask for what you need. A large piece of lettuce can replace the traditional starchy hamburger bun, for example. 

For my patients considering a reduction in carbohydrates close to the 'eating holidays' I encourage them to go slow, learn as much as they can about the process then embrace their new way of eating fully as a New Year's resolution. 

Bon appetit!

A no-rollercoaster diet plan

Sunday, November 2, 2014

Mood, Anxiety and Diet: Change One Meal, See How You Feel

Mood swings can trigger anxiety and depressive episodes during the day.  If you experience daily mood swings, addressing your diet can help.  If your gallbladder is in good shape (a healthy gallbladder helps you digest animal fats) and your general health is good, try this experiment: Eat a hearty breakfast rich in natural fats (well-sourced saturated fats, such as butter; ghee; heavy whipping cream; uncured bacon) accompanied by about 30 g of complete proteins (in the US, typically meats, fish, shellfish, eggs and/or poultry-- 30g is the equivalent of ~4 oz of meat protein; whey protein may work as well), sans starches and/or sugars (non-starchy vegetables that grow above ground, topped with butter or ghee if cooked, are great; just no toast, orange juice, cereal or etc.).  Pay attention to your mood and hunger in the hours that follow.  How is your mood?  How many hours pass before you are hungry again?  

More on YouTube: Ann M. Childers, MD: Mood Swings and Diet

Friday, October 3, 2014

How Do Low Carb Diets Really Work?

  • I recently read an article featuring a number of misconceptions about how low carbohydrate diets achieve weight loss, and how the body works here: Fitness Truths: do carbs make you fat? - Telegraph  My answers do not address processes in depth, but I hope they are clear in conveying general concepts explaining how low carb diets work.  
  • Below you will find statements from the article, followed by my comments.  Article statements are in quotes:
  • "Low carb diets often work because they serve as a simple way to reduce overall calories."
    Yes, low carb diets reduce overall calories, but the mechanism is not simple. When carbohydrates are reduced and adequate proteins and fats are introduced hormonal changes take place such that people are satisfied with their meals and do not tend to overeat.
    "If we take our average male carbohydrate intake of 252g as above and we reduce it to 100g, we have reduced our carb intake by 152g per day. There are four calories (kcal) in a gram of carbohydrate, so we have effectively created a daily overall calorie deficit of 608kcal, which is certainly enough to elicit significant fat loss, especially if we are exercising."
    What is overlooked here is that, in most low carbohydrate diets, carbohydrate calories are not simply reduced but are replaced by dietary fats, and sometimes protein. The reduction of insulin that results from reduction in carbohydrates, with addition of appetite satisfying fats and protein, lead people to eat less food overall.
    Carbohydrates make people and animals hungry. Studies of meat pigs show the less satisfying the meal, the more fat they gain. The ideal commercial mix for meat pigs to promote the greatest fat gain is skim milk mixed with grains. This formula is sadly reminiscent of the American Food Pyramid of 1992 (6-11 servings of grain per day plus non-fat dairy and other low-fat foods).
    "It is worth noting however that we could have just as easily done this (added back calories lost when carbohydrates are removed from the diet--AC) with protein, given that the calorie load per gram is the same for protein as it is for carbohydrates, and that it is not necessarily the cutting of carbs per se that has caused us to lose weight, but rather the reduction of overall calories."
    It's really about insulin. Insulin is a storage hormone. Foods that provoke the production of insulin provokes fat storage. You see, insulin helps convert excess blood sugars to fat to prevent sugar toxicity. When circulating insulin is high, excess carbohydrate energy is locked away as fat and cannot used as energy. With energy continuously locked away, hunger strikes every few hours and people gain weight. We don't get fat because we eat more; we eat more because we're getting fat. In this way a high carbohydrate dietary strategy leads to excess food intake and weight gain. The only way to lose weight on a high carbohydrate diet is to restrict calories. But when calories are restricted on a high carbohydrate diet people most often become exhausted, depressed and irritable, making it nearly impossible to do.
    Starch and sugar, especially refined starch and sugar, provoke insulin to the highest degree. Protein comes in second (protein provokes the production of insulin via gluconeogenesis, the production of the blood sugar glucose from protein). Fat is least able to provoke insulin. Replace carbohydrate calories with fat (making sure high quality protein is about 23% of the diet for an average adult) and you are most likely to lose weight or maintain a more normal weight as a result of reduced appetite. Meal satisfaction is one reason people eat less on a low carbohydrate diet. It is how many obese people eat "all they want" on a low carbohydrate diet and lose weight; the trick is they want to eat less, as much as 1000 Cal less each day because they feel satisfied. Eating excess protein provokes gluconeogenesis, thereby adding carbohydrate back into the system.  In this way excess protein can sabotage a weight loss plan. 
    In America 49% of adults over age 20 are either diabetic or pre-diabetic. Our research team (Feinman, et. al. Nutrition, Elsevier 2014) demonstrates a low carbohydrate diet is an essential first step for treating Type I and Type II diabetes. I would add that those of us who are pre-diabetic or prone to become overweight (carbohydrate sensitive) can also benefit. Partner with your doctor if you will consider this or any diet. Cheers! --Ann