Gary Taubes

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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 http://buff.ly/1xau9fp  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

Friday, August 15, 2014

Sugar, Sugar

Sugar Facts:

-CDC reports the lifetime risk of diabetes in America is currently at 40% for an average 20 year old
-American Heart Association reports American adults consume 22 teaspoons added sugars per day, teens 34 teaspoons per day. 
-Sugar promotes tooth decay. The news here is tooth decay and the need to brush/floss teeth is considered a fact of life for most Americans.  In wild animals and healthy hunter gatherers caries are almost unknown, sans dentists/tooth brushes, toothpaste and floss.
-Starch turns to sugar (glucose) in the mouth, and during digestion.   Plain, dry bagels and unsweetened cornflakes may not taste sweet, but they are still "candy" to our bodies.

-Sweetened or not, grain-based cereals are sugar. Period. Spraying vitamins on them does not make them food.
-Fruits are nature's candy.
-Of 60,000 products in grocery stores, 80% contain added sugar (Catie Couric, movie Fed Up)
-The amount of sugar in a product may be misrepresented on the label. In 2014 Whole Foods is sued over yogurt containing 5 times more sugar than the label shows (a discrepancy first reported by Consumer Reports).
-Agave Nectar contains as much as 95% pure fructose.
-Researchers at University of Guelph, Canada, found blood sugar spikes from white bread and sourdough bread pale in comparison to those from whole wheat bread. Whole wheat bread appears to rival some candy bars in this respect yet is thought to be healthy.
-Sugars found in most foods are fermentable carbohydrates. Fermentable carbohydrates promote tooth decay initially, and chronic modern diseases (diabetes, heart disease e.g.) decades later. (P Hujoel: Dietary Carbohydrates and Dental Systemic Diseases)
-Sugar promotes insulin.  Insulin stores excess sugar as fat. Sugar--> Fat
-Alzheimer's is increasingly referred to as Type 3 Diabetes, a disease of carbohydrate (sugar, e.g.) intolerance.
-Eat enough sugar and you may lose the ability to detect small amounts.  Go off for awhile and things you once ate or drank easily may taste too sweet. Broccoli and spring water taste sweeter on a low sugar diet.

-Refined sugars and starches are empty calories that promote fat storage at rapid rates.  
-A high sugar diet promotes mood swings, anxiety and poor concentration.
-Diets high in sugar and starch stiffen arteries.
-Consuming sugars at bedtime can result in frequent awakenings at night, even insomnia. 
-Refined sugars and starches are addictive.  Weaning off is not easy, but is well worth your while if you value your health.

Friday, December 27, 2013

LA asks: What's the best paleo cookbook?

Answer: The best cookbook depends on your needs and desires.  Are you feeding a family?  Is simplicity and speed important to you?  Will you entertain?  Would an on-line resource with photographic illustrations help you in your culinary journey?  A helpful basic cookbook for everyday use is Practical Paleo by Sanfilippo.  A book with artfully flavored dishes and clear prep times is Well Fed by Joulwan.   A book for Paleo entertaining is Gather by Staley.    Nom Nom Paleo has an online site (nomnompaleo.com) and a newly released cookbook.  There are many, many more great paleo books out there, but these should give you an idea of where to start.  Enjoy!

Thursday, December 12, 2013

SC asks: Are there natural remedies for psoriasis?

SC asks: What are the best natural remedies for reducing the irritation of plaque psoriasis caused by Candida overgrowth?

Answer: I cannot tell you the underlying cause of your psoriasis, or if there is one; however, autoimmune conditions are frequently connected to diet and Vitamin D status. You may wish to work with a healthcare provider familiar with common causes of psoriasis. In many cases an elimination diet helps find the culprit. I have patients with autoimmune related skin disorders who tell me their problems improve or clear when they eliminate certain foods, such as gluten and milk dairy. Vitamin D acts as a immune system modifier and your Vitamin D level should be included in your work-up. Candida thrives on dietary sugars and starches. A low carbohydrate, high fat (LCHF) diet can help rid you of Candida, as can some probiotics. I favor large spectrum probiotics containing Saccharomyces boulardii, a probiotic yeast, as it may compete with Candida. Garden of Life Primal Defense Ultra is one such formulation, and there are others. Be sure to check with your doctor before making any diet or supplement changes.

Tuesday, December 3, 2013

JG asks about replacing carbohydrates with protein:

Question:  I've started cutting carbs in my diet and replacing them with more protein. Should you start feeling tired a little as you begin?

Answer: Hello, JG, Yes, you will probably feel tired as you begin.  However, there is one mistake most people make when they start a low carbohydrate diet that makes this transition worse.  You say you are replacing carbohydrates with "more protein."  In reality, assuming you ate adequate protein before you started your new diet plan, you should only replace carbohydrates with fat.  That fat, and especially saturated fat, is a healthy part of a diet is a difficult concept for most Americans to understand, but without adequate dietary fat energy is low and you might not feel as satisfied with your meals.   Full fat meats, fish, eggs and (not skinless) poultry are good sources of natural fats.  The better these animals are raised (pasture finished livestock, low-contamination fish, e.g.) the better they are for your health.  The best diets for healthy weight loss are Low Carbohydrate, High Fat (LCHF) diets; with these diets you will probably end up eating more fat than what you are accustomed to.  Pasture finished butter (or clarified butter/ghee if you are lactose intolerant or want to fry with butter) and coconut oil are great fats to add.  These fats are excellent for cooking and keeping weight normal while enhancing health.  Also consider frying with lard, bacon grease, beef fat and duck fat. So, step up your fat, keep protein intake moderate and carbohydrates low.  Two good resources for low carbohydrate living are: livinlavidalowcarb.com and dietdoctor.com     Good luck, and bon appetit!

Thursday, November 28, 2013

CA, a 16 year old girl, asks:

I'm Interested in getting healthy and in shape, reducing sugar cravings, boosting energy level, any suggestions?

Answer: First discuss your diet plans with your parents. Also, check with your pediatrician/adolescent medicine doctor to make sure you are healthy enough to make a diet change, and learn whether my suggestions are right for you. 

Many adolescents and adults are afraid to eat fat, thinking they will just get fatter. This is not true. To quash sugar cravings humans must eat enough protein (meat, fish, eggs, poultry) and fat, including saturated fat, with every meal. 

I recommend saturated fats from healthy sources such as pasture fed or grass fed animals (meats, poultry, eggs, high fat dairy such as butter, sour cream, whipping cream, cheese; if dairy not tolerated try butter oil or ghee) and coconut oil. Fatty fish at least twice a week is recommended, another rich source of healthful fatty acids.  Your diet should consist of at least 50% of calories from fat, with adequate protein at every meal. There are a number of books on the market to help you achieve a healthy weight loss diet. Take a look at Primal and Low(er) Carbohydrate/High Fat approaches to your diet (carbohydrate = sugars & starches, fruit juice, sugary sodas, chips, dried fruits, etc). Vegetables that grow above ground are a good source of carbohydrates and highly nutritious. Learn which are best for you. Getting rid of junk food and eating healthy vegetables will help you achieve healthy weight loss goals. For better nutrition, top cooked vegetables with butter or ghee.   

Be sure to adjust the carbohydrates you eat to your activity; if you have low activity eat a little less carbohydrates and a little more fat; if you are athletic eat a little more carbohydrates (sweet potatoes, carrots and other below ground vegetables, e.g.), with a little less fat. And hardly ever eat carbohydrates from grains (wheat, barley, rye, oats, corn, etc). Caution: If you decide to stop wheat or gluten, and many people find weight loss and health success when they do this, it may cause problems at first. Some people call this the "low carb flu". You may experience body aches, headaches and other flu-like symptoms. It usually passes within a couple of weeks. But if it happens to you it is a likely sign you should avoid gluten, or at least wheat, from now on. 

Whatever dietary approach you take, choose one you can stick to for life and adjust to your lifestyle rather than eating a special diet until you lose the weight, then going back to your old eating habits. The process of dieting, then gaining, then dieting again is called "yo yo dieting”. Yo yo dieting can make you heavier and unhealthier in the long run. I suggest you check with a nutritionist who understands Paleo, Primal and Low Carbohydrate diets in adolescents for guidance. Bon Apetit!

RK asks:

What is the best low carb diet ????

Answer: My bias favors low carbohydrate, high fat Paleo for the first month, graduating to low carbohydrate, high fat Primal if high fat milk products are tolerated after a month off milk based dairy. Both systems help most people lose weight and feel good at the same time, features my patients tell me they do not experience with Weight Watchers. Both Primal and Paleo eliminate additives/preservatives/food colorings and include foods like pancakes (made with coconut flour or almond flour), not seen in other low carbohydrate diets. 

After the initial period of grain withdrawal and adjustment to fat burning, which may involve fatigue, flu-like symptoms and headaches, energy and sleep generally improve. Just last week one of my morbidly obese patients described less acid reflux, lower joint pain, looser clothing, improved sleep and increased energy after only 2 weeks of a low carbohydrate/high fat Paleo plan. Her skin cleared, she no longer experiences the urge to eat every 2 hours, and after a high fat breakfast, can wait until 4 PM for her next meal, features not typically seen with low fat diets. Add to this that studies show improvement in cardiovascular risk factors with low carbohydrate, high fat diets, with increases in HDLs, decreases in Triglycerides and an LDL trend toward Pattern A (low heart risk). And it's delicious to boot. 

In October of 2013 the American Diabetes Association position statement approved low carbohydrate diets for weight loss with safety shown for at least 2 years, and the British Medical Journal exonerated saturated fat. The Swedish government approved low carbohydrate/high fat diets for weight loss and nearly 1/4 of Swedes surveyed endorse a trend toward low carbohydrate, high fat diets with positive changes in weight, diabetes and cardiovascular risk factors. 

For more information, visit: www.marksdailyapple.com and www.dietdoctor.com 
Illustrated recipes can be viewed at www.nomnompaleo.com