Category Archives: Diets

Gary Taubes’ Typical Low-Carb Diet, And Lab Results

SteakEggs3Gary Taubes, author of “Good Calories, Bad Calories,” and “What If It’s All Been A Big Fat Lie?” is an advocate of low-carbohydrate diets. He posted the results of his blood test on his site about 3 years ago, along with this description of his usual diet:

“Keep in mind as you go through these that I do indeed eat three eggs with cheese, bacon and sausage for breakfast every morning, typically a couple of cheeseburgers (no bun) or a roast chicken for lunch, and more often than not, a ribeye or New York steak (grass fed) for dinner, usually in the neighborhood of a pound of meat. I cook with butter and, occasionally, olive oil (the sausages). My snacks run to cheese and almonds. So lots of fat and saturated fat and very little carbohydrates. A deadly diet, according to Dr. Oz.”

I don’t want to post his lab results here; I feel that’s invasive, even though he made them public. The only values that fell out of the lab’s “reference range” were his total cholesterol (204 mg/dl) and carbon dioxide (19 mmol/L, should be below 21). His LDL was 116.

This is the diet he purports will turn around the epidemics of obesity and diabetes. It is the diet he recommends for avoiding heart disease and cancer. Keep in mind that over 100 million people in this country have diabetes or prediabetes, more than a third of the entire US population. Can you imagine how things would change if suddenly millions of people started eating mostly animal food? No grains, no beans, no potatoes, no fruit?

Taubes’ foundation NUSI has already raised $40 million and is on track to raise $190 million. There’s a lot of funding behind this diet. I think that’s one reason we’re seeing it advanced more in the media.

Something That’s Red Is Invisible Against A Red Background

SaturatedFat1

When most of the participants in a study are consuming fat above a threshold that promotes disease, it will look like fat is not disease-promoting.

I often say that in studies comparing one group to another, you won’t detect a harmful effect of _____ if both groups are exposed to a level of ______ that is risk-producing. I said this recently about that saturated fat study (meta-analysis) that got so much attention in the media, and that spurred proclamations such as “Eat Butter” and “Saturated Fat Vindicated”:

“One way you can arrive at all your groups showing similar risk, which this study found, is when there isn’t much difference in consumption among your comparison groups. … Or when most of your participants are consuming saturated fat above a threshold where risk for CVD increases.”

As Jeff Novick pointed out:

“One major problem with this study is they did not look at any studies where the saturated fat intake was less than 7%, which is the level recommended by the [American Heart Association]. … Most of the diets had saturated fat intakes in the range of 10-15% (or more).”

I also said this in reference to the PREDIMED study. That was a big trial studying effects of the Mediterranean diet. It had three groups: “low-fat,” olive oil, and nuts. All the groups ate high-fat, even the “low-fat” group which ate 37% of their calories from fat! Not even the American Heart Association considers that low-fat. For perspective, a whole-food plant-based diet gets less than 15% of its calories from fat. The PREDIMED study found eating lots of olive oil was similar in CVD risk to eating “low-fat.” All groups suffered heart attacks at similar rates. All groups were exposed to a level of fat that was risk-producing.

I just saw a video that Dr. Greger posted about a month ago where he says essentially the same thing:

He cited this study:

Sick Individuals And Sick Populations, International Journal of Epidemiology, 2001

If everyone smoked 20 cigarettes a day, then clinical, case-control and cohort studies alike would lead us to conclude that lung cancer was a genetic disease; and in one sense that would be true, since if everyone is exposed to the necessary agent, then the distribution of cases is wholly determined by individual susceptibility.”

Within a population, that is, within a group with similar characteristics, you may not see a big range of exposure to something, e.g. in the US, most people eat around 30-35% fat, not a big range. But when you compare populations with different characteristics…

But at the level of populations it is a different story: it has proved easy to show strong associations between population mean values for saturated fat intake versus serum cholesterol level and coronary heart disease incidence, sodium intake versus blood pressure, or energy intake versus overweight.

The reason we know that smoking increases the risk for lung cancer is because:

In the case of cigarettes and lung cancer it so happened that the study populations contained about equal numbers of smokers and non-smokers, and in such a situation case/control and cohort studies were able to identify what was also the main determinant of population differences and time trends.

In sum:

But to identify the causal agent by the traditional case-control and cohort methods will be unsuccessful if there are not sufficient differences in exposure within the study population at the time of the study.

There are some real gems in this paper…

Grateful patients are few in preventive medicine, where success is marked by a non-event.

That’s so true! You don’t really know if your behaviors are adding years to your life.

And this. I can’t believe he said this:

Harder to overcome than any of these, however, is the enormous difficulty for medical personnel to see health as a population issue and not merely as a problem for individuals.

Just about 100% of the people I know, even those in the public health community, harp on about individual behavior. You will never, ever be successful in disease prevention if you only intervene at the individual level. Social norms, peer pressure, environmental pollutants, occupational hazards, there are just too many things an individual is up against, and doesn’t control. You have to change the environment in addition to, perhaps more than, changing individuals’ behavior.

Greger is right when he says:

This is one of the most famous papers ever written in preventive medicine. It should be required reading for all medical students.

Back to the point I was making at the beginning of this post… If you want to know if something is harmful – smoking cigarettes, eating saturated fat, watching television – make sure you have a comparison group that isn’t doing it, or isn’t doing very much of it. Something that’s red is invisible against a red background.

New Study: Dietary Fat Is “Essential For The Development Of Insulin Resistance”, A Precursor To Diabetes

BakedPotato4

Baked potatoes are a healthy component of a low-fat, whole food, plant-based diet.

For years, I’ve been citing studies that provide evidence for the contribution of dietary fat in the development of insulin resistance and type 2 diabetes. Here’s another, and it’s one great study. It shows that consumption of a high-fat diet makes you spectacularly sensitive to any amount of carbohydrate you eat. This could be why people say that eating carbs makes you fat … the carbs are being eaten against a backdrop of a high-fat diet. Strip away the fat and the carbs you eat won’t make you fat. They also won’t increase your cholesterol, blood glucose, blood insulin, or make you insulin resistant. So says this study:

A Small Amount of Dietary Carbohydrate Can Promote the HFD-Induced Insulin Resistance To A Maximal Level, PloS One, 23 July 2014

Mice were fed one of 5 diets:

  • Control diet: 65.1% carb, 23.1% protein, 11.8% fat
  • Various High-Fat Diets (HFDs) with increasing amount of carbs: 0.1%, 5%, 10%, 25.5% carb, 58% fat, (protein was varied to keep calories constant)

After 5 weeks:

  • “Mice on all high-fat diet (HFD) groups took less food and fewer calories than the mice on chow diet.”

Yet the high-fat-fed mice gained more weight, more body fat, and had higher levels of blood lipids:

  • Animals on HFD gained more weight when the level of dietary carbs was increased.
  • Mice on HFD with 5% carbs caused absolutely more body weight gain and the HFD with 10% carbs caused equal amount of body weight gain as the HFD with 25.5% carbs.
  • White fat proportion was increased in mice on HFD with little (0.1%) dietary carbs, but the increase was further enhanced by dietary carbs in a dose-dependent manner.
  • Serum levels of cholesterol, triglyceride (TG), and free fatty acids (FFA) were increased in all groups of HFD
  • Together, these results show that dietary carbs are not essential for the HFD-induced body fat gain but can enhance the HFD-induced body fat gain in a dose-dependent manner, and a very small amount of carbs (10%) in the HFD can cause the maximal level of body weight gain.

The high-fat-fed mice had higher levels of blood glucose, blood insulin, and development of insulin resistance:

  • Fasting blood glucose level was increased in mice of all HFD groups including the HFD with little (0.1%) carbs starting from week 1, and the increase was promoted by dietary carbs in a dose-dependent manner.
  • Fasting plasma insulin level was also increased in mice of all HFD groups, and the increase reached a maximal level when the carbs in the HFD reached 10%.
  • Insulin tolerance was significantly decreased in mice on HFD with little (0.1%) dietary carbs, and addition of carbs to HFD worsened insulin tolerance in a dose-dependent manner.
  • Animals on chow diet that is a typical high carb (65.1%) and low fat diet (11.8%) did not have insulin resistance.
  • Together, these results show that dietary carbs are not essential for the HFD-induced insulin resistance but can promote the HFD-induced insulin resistance dramatically1, and 10% calories from dietary carbs can promote insulin resistance to a maximal level in mice on HFD.

The high-fat-fed mice also had more fat accumulation in and around the liver. The high-fat diet also induced oxidative stress, not seen in control mice.

Did you see that? The control mice ate more, both in weight of food and calories. But all their lab values were better … and they weighed less!  This has been demonstrated in human studies, both clinical trials (e.g. Barnard’s 2006 study), and population studies, and recently in the experience of Benji Kurtz, who lost over 100 pounds in a year eating his fill of a low-fat, whole food, plant-based diet.

One reason the control mice didn’t gain weight was, as the authors noted, more thermogenesis or heat generation. Eating a low-fat, high-carb diet leads to more thermogenesis, while eating a high-fat diet leads to less body heat (and so more fat accumulation).

1 “Results from this study show that mice on HFD containing little carb (0.1%) developed severe insulin resistance (Fig. 2). How did that happen? … Glucose from gluconeogenesis is sufficient to stimulate sufficient secretion of insulin, which is necessary for the fat- or glucose-induced insulin resistance.”

Benji Kurtz Lost Over 100 Pounds In A Year By Eating A Plant-Based Diet

CNN just profiled Benji Kurtz, a man who lost over 100 pounds by eating a low-fat, whole food, plant-based diet:
Light Bulb Goes On: He Lost 100 Pounds With Plant-Based Diet, CNN, 28 July 2014

Dr. McDougall also profiled him, in a letter written by Kurtz himself:
Benji Kurtz: A Relatively ‘Healthy’ Obese Person

On Memorial Day weekend, 2013, Kurtz weighed 258 pounds. His highest weight was 278. Kurtz is 5’5″ tall. He was severely obese. He began by eliminating animal food and lost about 50 pounds. The rest came off after he stopped cooking with oil: “I was still eating oily pastas with fried tofu chunks.” And now, a year later:

“I’m down 110 lbs from when I started last year. From my all-time highest weight of 278, I’m nearly half-gone! My BMI is 24.4, and I weigh 146. My cholesterol is at 167 mg/dL, my HDL is 53 mg/dL , LDL is 99 mg/dL, triglycerides are 71 mg/dL, and glucose is 83. My blood pressure 117/77 mmHg and my resting pulse is 54 bpm.”

Kurtz was eating fruits, vegetables, whole grains, and beans. He ate oatmeal for breakfast. He ate red lentil chili, baked potatoes, split pea soup, steamed vegetables, and pastas for lunch and dinner. He ate fruits, nuts, and seeds in between.

“He discovered that he could eat as much as he wanted of the right foods and not gain weight. His new way of eating felt more like abundance than deprivation.”

His cholesterol dropped from over 200 to 167, his blood pressure dropped, his health insurance rates dropped. His energy levels increased, so did his ability to taste:

“Once you start eating this way, your palate totally changes,” Kurtz said. “You are tasting food the way food was supposed to taste in the first place. Like a film has been lifted off your taste buds.”

And:

“I don’t crave foods I no longer eat. I’m not going to bed hungry. Everything about life is better.”

These last two points about taste and cravings aren’t often addressed. Cravings change. Dr. Doug Lisle explains this in his book The Pleasure Trap. We crave the foods we eat. We stop craving the foods we no longer eat. If we continue to eat animal fat, we will salivate over animal fat. We are, in effect, “trapped” by our perceptions, and by behaviors based on those perceptions. This is the part people don’t appreciate. They think life will be hard without “______” and what’s the point in living without “______.” They don’t take the plunge and discover that “______” was just a perception and that it can, quite literally, disappear.

Some before and after photos of Kurtz:

Benji Kurtz Weekly Weigh-InBenjiKurtz4

BenjiKurtz3BenjiKurtz6

Study: Plant-Based Diet Reduces Diabetic Neuropathy Pain

DiabeticNeuropathyDiabetic neuropathy is weird. It’s also called diabetic nerve pain but I’ve seen it take forms other than pain … tingling or itchiness, a sense of cold or hot, even burning, a feeling of bugs crawling on your arms and legs, numbness and loss of feeling that comes and goes. That’s in the extremities, the fingers, toes, arms, and legs. Neuropathy also goes on inside the body, in the gastrointestinal tract (bloating, difficulty swallowing, gastroparesis which is difficulty emptying the stomach, sluggish bowels/constipation or diarrhea), in the brain (dizziness, memory problems, insomnia), the urinary tract (dripping or incontinence), the sexual organs (erectile dysfunction), the eyes (blurry vision). It’s pervasive. No tissue or organ that is innervated is left untouched.

Diabetic neuropathy doesn’t just develop in people with diagnosed diabetes. It’s happening in people on their way to getting diabetes … people with prediabetes, impaired glucose tolerance, impaired fasting glucose, people who don’t yet know they have metabolic abnormalities, people who think their indigestion was from eating gluten-containing bread, or their tingling fingertips are from wrapping dental floss too tightly. In fact, it’s the sensations of neuropathy that often send people to the doctor and lead them to discover their diabetes.

Antidepressants, analgesics, and good glucose control can lessen pain, but there isn’t a therapy that treats the underlying cause.

However … There was a small study several years ago that found complete pain relief in 81% of participants who ate a low-fat (10-15% of calories), high-fiber, vegan diet:

Regression Of Diabetic Neuropathy With Total Vegetarian (Vegan) Diet, Journal of Nutrition and Environmental Medicine, 1994

“This study reports alleviation of the sharp, burning pains characteristic of systemic distal polyneuropathy (SDPN) patients with adult-onset (Type II) diabetes mellitus (AODM).

Twenty-one patients with known AODM and SDPN, average age 64, were trained in a low fat (10–15% of cats), high fiber, total vegetarian diet (TVD) of unrefined foods and conditioning exercise in a 25-day in-residence life-style program.

Complete relief of the SDPN [neuropathy] pain occurred in 17 of the 21 patients in 4 to 16 days. The numbness persisted, but had noticeably improved. Weight loss averaged 4-9 ± 2-6 kg during the 25 days. By the 14th day, the fasting blood glucose level averaged 35% lower for the 11 patients who were above 6-6 mmoll1, and the insulin needs had dropped in half the patients. Five no longer needed hypoglycemic agents. Also, serum triglyceride and total cholesterol had decreased by 25-0 ± 23% and 13 ± 15% respectively (p <0-01) in 2 weeks.

Follow-up studies of 17 of the 21 patients for 1-4 years indicated that 71% had remained on the diet and exercise programme as advised in nearly every item. In all except one of the 17 patients, the relief from the SDPN had continued, or there was further improvement.

In our opinion, these results appear to be related to a factor(s) in the TVD, and not necessarily to an improved glucose control, since the serum glucose was not under good control until about the 10th day.”

So, there was something about the diet, apart from its ability to lower blood glucose, that reduced pain. This, to me, is the kind of startling finding that should have been pursued. Twenty years later, it’s still being reproduced. Here’s a presentation from this year’s annual meeting of the American Association of Diabetes Educators:

A Dietary Intervention for Chronic Diabetic Neuropathy Pain, American Association of Diabetes Educators Annual Meeting, 6 August 2014

Vegan Diet Eases Diabetic Neuropathy Pain, MedPage Today, 8 August 2014

Bunner et al. conducted a small trial in patients with type 2 diabetes and diabetic neuropathy. Patients (n=15, mean age 57) were randomized to either a low-fat, high-fiber (goal: 40 grams), plant-based diet plus vitamin B12 supplementation, or to B12 supplementation alone.

With good adherence (five of seven diet patients were fully adherent), those on the diet had significantly greater improvements in McGill Pain Questionnaire scores than those on B12 alone (P=0.04), Bunner said.

They also had significantly greater reductions in body mass index (BMI) compared with controls (P=0.01).

There were other benefits to the plant-based diet but since the study was so small and since medication changes weren’t consistent across groups (e.g. both lowered cholesterol but those on the plant diet lessened lipid drugs, while controls increased lipid drugs) it was difficult to ascertain an effect.

Go back and look at the symptoms at the beginning of this post and tell me they’re not worth trying a low-fat, whole food, plant-based diet.

If All You Ate Were Potatoes, You’d Get All Your Protein And Essential Amino Acids

I feel compelled to republish the following post from 6 years ago because people keep asking me how you can get enough protein by eating potatoes.

PotatoEAAs3

Me and my potatoes.

Doug asked:

“I still don’t understand why more care isn’t necessary to avoid deficiencies of the essential amino acids. Is it the case that these amino acids are present in all fruits and vegetables? (I didn’t think this was so, but you mentioned on that other thread that thinking has changed in this regard.) Or is it simply that easy to avoid a deficiency of an essential amino acid by consuming any mixture of fruits and vegetables?”

I would answer “Yes” to Doug’s last question. I thought it summed up the facts well.

Plants are capable of manufacturing all 20 amino acids, which include the essential amino acids (EAAs), although amounts vary. I checked a number of foods (potatoes, broccoli, tomatoes, asparagus, corn, rice, oatmeal, beans, and others) and found all EAAs in each of these foods. Even an apple which is listed as having 0 grams of protein has all the EAAs, albeit in small amounts.

Since I said in an earlier comment, “No mixing of foods is necessary. If all you ate were potatoes, you’d get all your amino acids,” I felt obliged to back it up. Below is my back-up.

  • The first column lists all 8 EAAs for adults.
  • The second column lists the World Health Organization’s recommended intake per body weight.
  • The third column lists the specific RDI for a 120 lb adult.
  • The fourth column lists the amount of each AA in a medium potato, with skin.
  • The fifth column lists the amount of each AA in 5 medium potatoes.
  • The last column lists the % of recommended intake (for a 120 lb adult) for each AA when 5 potatoes are consumed.

PotatoEAAs1
Some notes about this chart:
– The WHO’s recommended intakes represent the minimum amount for an individual with the highest need, multiplied by a factor of 2 for safety. So these are high amounts to begin with.
– Methionine + Cysteine = Total Sulfur Amino Acids
– Phenylalanine + Tyrosine = Total Aromatic Amino Acids
– WHO: World Health Organization
– EAA: Essential Amino Acid

For a 120 pound adult, five potatoes (960 calories) supply over 100% of the recommended intake for all essential amino acids. They also supply 25 grams of total protein.

It’s pretty difficult for an adult to eat a whole food, plant-based diet that doesn’t provide all the essential amino acids, as long as caloric needs are met.

Finally – The pool of AAs that our body uses to manufacture its own proteins isn’t limited by what we eat. Normal daily turnover of our cells provides a substantial pool from which to draw amino acids. Bacteria that line our colon also manufacture AAs, including EAAs, that we can utilize.

It is a misconception that plants provide “incomplete protein.”

Related: In Defense Of The Potato

In Defense Of The Potato

I think potatoes are some of the healthiest foods you can eat. They’re full of potassium (40% more than bananas), vitamin C, and fiber. They’re low in calories and they’re fat-free. They provide resistant starch that feeds intestinal bacteria, supporting a healthy gut microflora, characteristics of which (e.g. production of short chain fatty acids) have been shown to lower blood glucose and body fat. And they taste great!

Here’s Dr. McDougall defending the potato:

And here’s Chris Voight, the man that Dr. McDougall mentioned who ate nothing but potatoes for 60 days, about 20 potatoes a day. He lost 21 pounds. His cholesterol dropped 67 points. He lost body fat. His blood sugar came down. His triglycerides came down. Every lab value measured “either stayed the same or got better.”

Voight says, and I agree, that against a backdrop of a high-fat diet, potatoes, actually most high-carb foods can be a problem. In a whole food, plant-based diet, where less than 15% of calories come from fat, potatoes stand out as an excellent food.

Related: If All You Ate Were Potatoes, You’d Get All Your Protein And Essential Amino Acids

President-Elect Of The Heart Rhythm Society Endorses Plant-Based Diets

DrJohnDayDr. John Day is President-Elect of the Heart Rhythm Society (HRS, 2014-2015) and was program director for the Society’s 2014 Scientific Sessions in May of this year.

Atrial fibrillation (AF) is the most common abnormal heart rhythm, affecting ~2.3 million adults in the US. About 9% of people over the age of 80 are thought to have it. AF increases the risk for stroke fivefold.

Dr. Day caused a stir at the HRS conference by stating, “Does AF even need to happen?” He thinks it can be prevented by a change in diet (to predominantly plant-based) and lifestyle.

Is Atrial Fibrillation Necessary? The Most Important Study Presented at the Heart Rhythm Society 2014 Scientific Sessions, John M. Mandrola, MD, Medscape, 11 May 2014

During a session entitled “How to prevent and reverse AF,” Dr Day gave one of the most unusual talks I have ever heard at a medical meeting. He started with a personal confession:

“Until a few years ago, my life was about ablating AF, thousands of ablations, three per day. In the process of this, I didn’t give a whole lot of thought as to how the patient got AF or what was happening to my life.”

Next, as he showed images of his diet at the time—doughnuts, pizza, and soda—he told the audience:

At age 44, my health had hit rock bottom. I was overweight. I had developed high blood pressure, high cholesterol, palpitations, insomnia, and even an autoimmune disease. And I was taking five medications. Something had to change.”

He described trying the usual diets and solutions, even the “gluten-free thing.” Not much happened. Then he got interested in the famous book The China Study:

“I became fascinated with some of these rural Chinese villages where people lived long lives, free of heart disease and cancer. I speak Chinese, and we visited these places multiple times.

What I learned has taken my life in a whole new direction.

My entire perspective of AF has changed from one of ablation to one of … does AF even need to happen?”

Let me remind you that Dr Day is about to lead the world’s most influential electrophysiology society.

Then he showed an incredibly professional four-minute video of a Chinese village. [I’ve embedded that video below.] Alongside rolling streams were smiling 100-year-old Chinese women. A calm female voice narrates …

“They have such a sense of peace about them.”

Then this, in Dr Day’s voice:

“Whether you are 40, or 50, or 60, or 70, it’s never too late to make changes.”

The video stops, but Dr. Day continues:

I began to slow down. I started looking at the big picture, eating real food, sleeping. My extra weight came off without trying; my cholesterol fell nearly 100 points; my BP dropped 30 to 40 points and my CRP went below 1.

“I now take no medications. I feel good.”

In an interview with me the next day, Dr Day said he thinks (in most cases) AF may be unnecessary.

Dr. Day is writing a book about his experiences in rural China. In the video below, he documents some of those experiences. I love the interviews at the end where people who have obviously lived long lives say they are happy and do appear to be happy. There are aspects to life in a rural Chinese village that just don’t translate to life in a big American city. We live and work by the clock, in climate-controlled buildings. We eat industrially-produced food. But I think there are still lessons here. In calling this a trailer, it sounds like Dr. Day has a documentary up his sleeve. I hope so!

The American College of Cardiology1 and the Heart Rhythm Society are not wacky, fringe groups. They are mainstream medical establishments. And their upcoming Presidents have respectively come out in favor of plant-based diets. Not low-carb diets, not Paleo diets, not even the diets recommended by the American Heart Association or the American Diabetes Association. These respected, credentialed physicians are advising the consumption of plants. I’m beside myself.

1 President-Elect Of American College of Cardiology Promotes Vegan Diet After Lowering His LDL From 170 To 90 In 6 Weeks