Category Archives: carbohydrate restriction

Fat Fiction: this movie could save your life

The USDA Dietary Guidelines are about to be published again with an update. Unfortunately, despite much input from the scientific community requesting that the dietary guidelines address the epidemics of obesity and diabetes, it looks like nothing will change. More than 50 scientific papers that support a Very Low Carbohydrate approach to address obesity, diabetes and pre-diabetes will be ignored.

But if you want a more scientific perspective I suggest you watch this movie. You can watch it free on Amazon Prime.

If you have read Good Calories Bad Calories by Gary Taubes or Big Fat Surprise by Nina Teicholtz. then you have already been exposed to the sad history of dietary recommendations in the United States and the tragic results.

Both books are well researched and present accurate science. The movie Fat Fiction reviews the sad history of dietary advice in the US. It presents many examples of patients whose lives were changed and improved by following the advice of nutritionists and physicians who have instead, followed the science and abandoned the ideological-unscientific USDA dietary guidelines.

The American Diabetes Association has finally recognized a VLC ketogenic diet as a valid approach to treating type 2 diabetes. In fact, a ketogenic diet is the only diet that has ever been documented in controlled clinical trials to reverse diabetes type 2 and get patients off insulin and oral medications used to treat diabetes.

Unfortunately, the USDA guidelines and the American Heart Association recommendations continue to recommend unhealthy inflammatory refined “vegetable oils” (processed/refined oils from corn, soy, safflower, peanuts, cottonseed, etc.) and high carbohydrate/low fat meals. The high carb/low fat approach to cardiovascular disease, obesity, and diabetes has been an absolute failure, increasing rather than decreasing the risk of heart attack and stroke as well as contributing to the explosive epidemics of obesity and DM2. The low fat dogma has fostered the obesity and diabetes epidemics since this dogma was first introduced in the mid 20th century. The low-fat ideology remains fully supported by financial contributions from the processed-food industry, creating a financial conflict of interest for the AHA and similar organizations.

In the context of the COVID 19 pandemic, where obesity, insulin resistance, pre-diabetes and diabetes type II are major risk factors for death from the infection, it is even more imperative that individuals suffering from these risk factors stop using medications to treat problems created by food and instead clean up their diet.

You can’t throw drugs at a nutritional disease and expect it to work” (Dr. Sarah Hallberg, TEDtalk)

You can fight systemic inflammation with the anti-inflammatory diet I present on this website, but if you have obesity, diabetes or pre-diabetes, the very low-carb version is the most effective and sustainable nutritional approach. Full fat dairy is optional (although technically not part of our evolutionary nutrition) and if you are obese, overweight, diabetic or pre-diabetic and full fat dairy is necessary for you to achieve a ketogenic diet, then go for it. But make sure you include an abundance of non-starchy vegetables which are an important component of a healthy ketogenic diet.

In the context of our present pandemic I will repeatedly say:

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory vegetable oils from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

USDA Dietary Guidelines Flawed

The NUTRITION COALITION is a non-profit organization dedicated to bringing science to dietary recommendations in the US. The COALITION recently called upon the USDA to hold off on publishing it’s updated Dietary Guidelines for US Citizens because of reported improprieties in the process of scientific review.

https://www.nutritioncoalition.us/news/usda-members-blow-whistle-flaws-in-process

The guidelines since their inception have been biased and flawed, ignoring much of the dissenting scientific opinion in testimony before the committee and cherry picking studies without a balanced approach to the scientific literature.

The confluence of the Covid-19 pandemic with the epidemics of obesity and diabetes in the US have created a perfect public health storm, as discussed in my last post. The USDA Dietary Guidelines Committee chose to ignore more than 50 studies that confirm the benefits of a Very Low Carbohydrate nutritional approach to address obesity and diabetes.

Because of the importance of the guidelines influencing US dietary choices in the context of COVID-19 I have copied the informative letter from the NUTRITION COALITION below. There is a link in the letter that will allow you to send emails to your senators, congressman, and the Secretary of Agriculture, supporting the recommendations of the NUTRITION COALITION.

Here is the letter.

Dear Friends and Colleagues, 

In a remarkable development, one or more member(s) of the Dietary Guidelines Advisory Committee recently came forth and blew the whistle, identifying serious flaws in the Dietary Guidelines process. I write to you today to ask that you contribute your voice to our effort to have these allegations taken seriously by the U.S. Departments of Agriculture and Health and Human Services (USDA-HHS). We are specifically asking these federal agencies to delay the Committee’s report, which is due out in just a matter of weeks, until the allegations can be investigated and addressed.  

The Dietary Guidelines are considered the “gold standard” of science and are a powerful lever on government feeding programs, military rations, professional medical associations, and much more—including nutrition guidelines around the world. It is imperative that they be based on good science.  

However, the current 2020 process is clearly flawed. We know, for instance, that almost all studies on weight loss have been excluded from consideration. We also know that virtually all studies on carbohydrate restriction have been excluded. Some USDA reviews of the science include the science only up to 2016, despite a Congressional mandate that the Dietary Guidelines include a comprehensive review of the science “that is current at the time.” It’s clear that the expert committee, in addition to excluding crucial science, has not been given enough time to do its work and has, essentially, had to cut corners.  

Moreover, the Advisory Committee, in its draft conclusions, indicated that the cap on saturated fats is likely to stay firmly in place. The evidence linking saturated fats to heart disease was judged to be “strong,” not only for adults, but also, for the first time, children. Yet scientific justification for a continuation of these caps is lacking, and the Subcommittee presented weak evidence to make its case. The past decade has seen a thorough reconsideration of saturated fats, and now, there are close to 20 review papers reexamining the evidence—which have near-universally concluded that saturated fats have no effect on cardiovascular or total mortality.  

Delaying the report will give time for a thorough investigation into these allegations. 

By signing this letter, you are helping to push for Dietary Guidelines that are based on a comprehensive review of the science and are therefore more likely to help the public regain its health. Thank you for any contribution to this effort!  

Click here to sign a physicians’ letter of support. In addition, it would be extremely helpful if you could also take time here to contact your representatives in Congress and let them know the importance of getting the Guidelines right. As an expert in the field, your voice will be able to resonate more than most, I hope you will take some time to try to help generate change to our far-reaching nutrition policy. 

Thank you,  

Nina Teicholz 

Executive Director 

The Nutrition Coalition  

Read more about the allegations in our press release and letter to USDA-HHS. 

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19, Lifestyle interventions more effective than drugs.

So far drug intervention trials for treating COVID-19 have been disappointing. No studies have shown benefit for hydroxychloroquine, with or without azithromycin. This topic has been covered in previous posts. Remdesivir has been FDA approved based upon one study that showed reduction in duration of symptoms. The mortality rate with Remdesivir, however, did not demonstrate a statistically significant difference when compared to “usual care”. https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

Another study published in Lancet failed to show any clinical benefit from Remdesivir.

“No statistically significant benefits were observed for remdesivir treatment beyond those of standard of care treatment. Our trial did not attain the predetermined sample size because the outbreak of COVID-19 was brought under control in China. Future studies of remdesivir, including earlier treatment in patients with COVID-19 and higher-dose regimens or in combination with other antivirals or SARS-CoV-2 neutralising antibodies in those with severe COVID-19 are needed to better understand its potential effectiveness.”

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

But we do know that certain underlying conditions such as obesity, diabetes, pre-diabetes (insulin resistance) and hypertension significantly increase risk of DEATH AND COMPLICATIONS with COVID-19. Since there are lifestyle interventions that can quickly and effectively mitigate these problems (diet, exercise, sleep, stress reduction….) now would seem like a good time to take our epidemics of obesity and diabetes in hand with aggressive lifestyle interventions to decrease the mortality rate of COVID-19 infection. Such measures do not require expensive drugs or expensive drug trials, they simply require knowledge, guidelines and the will to implement change in our daily habits. Yet there has been little discussion about this in the media or on the part of public health officials.

Lets look at obesity in the US.

From 1999–2000 through 2017–2018, the age-adjusted prevalence of obesity increased from

30.5% to 42.4%, and the prevalence of severe obesity increased from 4.7% to 9.2%.

The most effective tool for addressing obesity and diabetes is a very low carbohydrate diet.

Effects of the Low Carbohydrate, High Fat Diet on Glycemic Control and Body Weight in Patients With Type 2 Diabetes: Experience From a Community-Based Cohort

https://pubmed.ncbi.nlm.nih.gov/32193200/

This study was a done in a community-based program, not an academic practice setting. That is significant since it demonstrates feasibility outside of academic centers with standard community resources. The results of this study confirmed the results of many previous studies done in academic settings including better blood sugar control, reduction or elimination of diabetic medications, and significant weight loss.

All patients following the LCHF diet who initially took
insulin had either a reduction or discontinuation of
this therapy by their healthcare provider when clinically
indicated, compared with less than a quarter of
those receiving usual care.

In another study done in Italy, significant weight reduction (7 kg), waistline reduction (7 cm.), fat mass reduction (3.8%) and systolic blood pressure reduction (10.5 mmHg) were achieved in 3 months with a Very Low Carbohydrate diet.

Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-Sectional, Clinical Study (https://pubmed.ncbi.nlm.nih.gov/25986079/

Nina Teicholz had an opinion piece published in the Wall Street Journal on May 30, discussing the USDA dietary guidelines that have largely ignored a massive body of evidence supporting a Very Low Carbohydrate Diet for obesity and diabetes. She cites many studies that have been ignored by the USDA dietary guidelines committee. Here is here opening statement.

“Americans with obesity, diabetes, heart disease and other diet-related diseases are about three times more likely to suffer worsened outcomes from Covid-19, including death. Had we flattened the still-rising curves of these conditions, it’s quite possible that our fight against the virus would today look very different.”

You can read the full article here:

https://www.wsj.com/articles/a-low-carb-strategy-for-fighting-the-pandemics-toll-11590811260

But think about that simple statement, THREE TIMES MORE LIKELY TO SUFFER WORSENED OUTCOMES FROM COVID-19. Yet these conditions are highly responsive to lifestyle interventions that not only mitigate obesity, insulin resistance and high blood pressure, but also enhance immune function.

More from Teicholz’s opinion piece:

Other studies have found that dietary changes can rapidly and substantially improve cardiovascular risk factors, including conditions like hypertension that are major risk factors for worsened Covid-19 outcomes. A 2011 study in the journal Obesity on 300 clinic patients eating a very low-carbohydrate diet saw blood pressure quickly drop and remain low for years. And a 2014 trial on 148 subjects, funded by the National Institutes of Health, found a low-carb diet to be “more effective for weight loss and cardiovascular risk factor reduction” than a low-fat control diet at the end of the 1-year experiment.

In a recent letter to the editor published in the journal METABOLISM, Dr. Casey Means points out:

A diagnosis of diabetes has been a key indicator of the severity of
COVID-19, and in this regard, the virus has relentlessly highlighted our
global Achilles heel of metabolic dysfunction, and points to a prime opportunity
to fight back.
That fight, however, is not going to be won with Clorox, Purell,
masks, or anti-IL-6 drugs. The fight will only be won through a serious
commitment to improving everyone’s foundational metabolic health,
starting with the lowest hanging evidence-based fruit: dietary and lifestyle
interventions.

Read the full letter here: https://www.metabolismjournal.com/article/S0026-0495(20)30118-9/pdf

In 2 pages the letter describes multiple benefits of better glucose control relative to COVID -19 infection and the immune system as well as reduction of factors that lead to cytokine storm (terminal event for many COVID-19 patients). The letter also discusses the benefit of reducing environmental toxins (discussed in previous posts about COVID-19 and other health problems) that would likely benefit COVID-19 patients.

Research published April 18th, 2020 found that patients exposed to
highest amount of environmental nitrogen dioxide (NO2) had increased
risk of death fromCOVID-19, and that long-term exposure to this pollutant
may be one of the most important contributors to fatality by
compounding lung inflammation [20].

Minimizing exposure to environmental
pollutants may serve a role in quelling the underlying pro-inflammatory
state that characterizes metabolic disease and COVID-19 associated
cytokine storms
.

Other environmental toxins, including persistent organic pollutants
(POPs) found in air, water, and food generated from pesticides
and industrial chemicals, are also strongly implicated in the pathogenesis
of metabolic syndrome; promoting “clean living,” toxin-avoidant
strategies for patients as simple as emphasizing organic foods, home
air purification, and non-toxic home supplies could be considered, although
the clinical utility of these measures in the acute setting is unknown
[21].

In discussing the white elephant in the room he states:

What is starkly missing is the clear, simple, and strong recommendation for no added
sugar or ultra-refined carbohydrates, both of which are known drivers
of postprandial hyperglycemia and inflammation. As a medical community, we must not miss the opportunity to serve patients with straightforward, evidence-based nutritional and lifestyle strategies to assist in glycemic control.

I would encourage you to follow the link and read the 2 pages supported by multiple peer-reviewed references.

Evidence based nutritional and lifestyle strategies, so often discussed on this website include:

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

If you have obesity, diabetes or pre-diabetes the Very Low Carbohydrate version of the anti-inflammatory diet linked above would be the fastest and most effective intervention you can immediately employ to reduce your risk of succumbing to COVID-19. (Of course wear a mask, follow good hygiene with hand-washing frequently, and practice social distancing)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Ketogenic Diet, Keto-Medicine

I have spent a few days watching lectures from various low-carb-healthy-fat meetings. There is an impressive amount of solid clinical data to support Very Low Carb (with healthy fat)  diets to treat obesity, insulin resistance, diabetes, pre-diabetes, metabolic syndrome, and seizure disorders. Eric Westman MD, author, Associate Professor of Medicine, Past Chairman of the Obesity Medicine Association,  and director of Duke University Lifestyle Medical Clinic gave an impassioned and authoritative talk on the success of LCHF in treating all of these disorders here.

 

Dr. Steven Phinney,  Professor Emeritus UC Davis and presently Chief Medical Officer for VIRTA has given numerous talks on the beneficial effects of a ketogenic diet. He and Jeff Volek Ph.D. have done research for decades on the physiology of low carbohydrate diets. They elucidated the changes that occur in high level athletes as they adapt to burning fat as their major fuel source during and after a period of “fat adaptation”. It turns out that endurance athletes, after a period of 1 to 3 months of adaptation to a low carb-high fat diet (variable from person to person) perform at equal or higher levels as compared to their performance when previously on a high carbohydrate diet. In fact, because lean athletes have much greater energy stored in fat as compared to glycogen (carbohydrate) they can go for many hours longer than an athlete who is dependent on carbohydrate metabolism (not fat adapted). Glycogen is the starch source of energy that humans store in the liver (100 grams) and in muscle (400 grams). Compared to glycogen, fat stores in lean individuals, including buff athletes,  can provide more than 10 times the amount of energy. Endurance athletes who are keto-adapted (fat burners) can ride a bike all day or run an ultra-marathon (100 miles) without taking in any energy source. (They must of course replace fluid and electrolytes). Whereas athletes who have followed a traditional high carb diet must start consuming calories after about 3 hours of moderate-high intensity exercise. Doctors Phinney and Volek have done clinical research on humans with obesity, pre-diabetes and diabetes and they have demonstrated superior results when compared to any other dietary approach.

You can learn about their work here:

And here:

So what is this all about? If carbohydrates are restricted to very low levels and instead we consume (healthy) fat as our major source of energy with moderate amounts of protein, then the human body starts to burn fat. This process results in the production of ketones (in the liver) which serve not only as a source of energy but also act as “signaling” molecules that turn on beneficial genes that fight inflammation and turn off genes that produce inflammation. When a well formulated ketogenic diet is followed under medical supervision, diabetics can often get off most or all of their diabetes medications within weeks to months as they lose weight. Improvements are seen quickly in blood pressure, fasting blood sugar, liver function tests, insulin sensitivity, inflammatory markers, subjective energy levels, mental clarity and mood. Triglycerides are reduced, HDL increases, and improvements are seen in the “atherogenic profile” with reductions in small dense LDL particles with a shift to large buoyant LDL particles. On a ketogenic diet humans spontaneously consume lower caloric intake because fat and protein are more satiating compared to carbohydrate. Circulating saturated fat in the blood DECREASES on a keto-genic diet. Refined carbohydrates and sugar (so prevalent in processed foods) produce increased circulating fat in the blood and increased fat storage throughout the body, often leading to fatty liver disease and the long list of chronic diseases caused by and associated with insulin resistance.

A ketogenic diet is also part of Dr. Dale Bredesen’s effective treatment program for early dementia (ReCoDe-Reversal of Cognitive Decline). I have discussed Dr. Bredesen’s approach before. Here is one of his discussions.

You can read Dr. Bredesen’s report of 100 patients who have reversed cognitive decline using a ketogenic diet as PART of the ReCoDe program here.

So what are the healthy fats in a low carb high fat diet?

They include fats found in whole foods such as nuts and avocados, pasture raised animals free of hormones and antibiotics, free range poultry and eggs, wild fish and seafood (avoiding large fish that have high mercury levels), extra virgin olive oil, avocado oil, butter from pastured grass-fed animals, and coconut oil. (yes butter is included despite that fact that strict paleo excludes dairy)

You should avoid all of the processed/refined oils that come from seeds, grains and legumes including soy oil, corn oil, cottonseed oil, canola oil, safflower oil, sunflower oil, sesame oil. You can learn why these (misnamed) “vegetable oils” are dangerous and how they were marketed to an unwitting public with the help and support of faulty science by listening to Nina Teicholz here:

There are many great lectures about the low-carb-high-fat ketogenic diet in addressing obesity, insulin resistance, pre-diabetes, metabolic syndrome, diabetes, seizures and more. Go to youtube and search “keto diet”, “low carb high fat”.

Before I sign off I will provide one more link:

Remember, this website offers educational information only. Consult your health care provider for medical advice.

Sleep well, exercise outdoors, laugh, love, engage in meaningful work, drink filtered water, eat clean, eat whole foods, get plenty of sunshine, spend time with those you love.

Doctor Bob

 

 

Obesity Epidemic Requires a Paradigm Shift

The obesity epidemic requires a paradigm shift. Several medical myths stand in the way of taking the most effective steps to safely help patients lose weight. The most important myth relates to saturated fat. Saturated fat consumption does not contribute to cardiovascular disease. This must be understood and accepted by the medical community so that sound advice can be given.

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.( Am J Clin Nutr. 2010 Mar;91(3):497-9. )

In fact, as early as 2004, Mozaffarian et. al. investigated the influence of diet on atherosclerotic progression in postmenopausal women with quantitative angiography and found that:

In multivariate analyses, a higher saturated fat intake was associated with a smaller decline in mean minimal coronary diameter (P = 0.001) and less progression of coronary stenosis (P = 0.002) during follow-up. (Am J Clin Nutr. 2004 Nov;80(5):1175-84)

In addition, they further found that:

Carbohydrate intake was positively associated with atherosclerotic progression (P = 0.001), particularly when the glycemic index was high.

            Polyunsaturated fat intake was positively associated with progression when replacing other fats (P = 0.04)

These findings should come as no surprise given the basic science of atherosclerosis. Oxidized and glycated LDL stimulate macrophages to become foam cells initiating the creation of plaque. Cellular receptors that allow macrophages to ingest oxidized LDL are specific for oxidized LDL. These receptors do not recognize normal LDL to a significant degree.

Holovet et. al. studied the ability of oxidized LDL versus the Global Risk Factor Assessment Score (GRAS) to detect coronary artery disease. GRAS identified coronary artery disease 49% of the time, while oxidized LDL was correct 82% of the time.

In a large prospective study, Meisinger et al found that plasma oxidized LDL was the strongest predictor of CHD events when compared to conventional lipoprotein risk assessment and other risk factors for CHD.

Polyunsaturated fats are easily oxidized, saturated fats are not. It is the polyunsaturated fatty acids (PUFA) in the membrane of LDL particles that become oxidized and then initiate the cascade of inflammatory events leading to atherosclerosis. The major source of these PUFA in the American diet are “vegetable oils” (corn oil, soy oil etc.)  rich in the omega-6 PUFA, linoleic acid.

So why is this important to understand relative to the obesity epidemic? Because the most effective weight loss “diet” is arguably a low carbohydrate/high fat (LCHF) diet. This approach does not require calorie counting. This approach has been demonstrated to spontaneously reduce caloric intake whereas low fat diets require calorie counting and result in persistent hunger.

When compared to low fat calorie restricted diets  the LCHF approach has been equal or superior with respect to weight loss, insulin sensitivity, blood pressure reduction, and lipid profiles whenever these parameters have been measured.

But LCHF has not been embraced by the medical community due to the perceived dangers of saturated fat consumption and a low-fat ideology that lacks legitimate scientific evidence.

Once we dispel the mythology of saturated fat, the safety and efficacy of LCHF will be more readily accepted by physicians, the media and the lay public.

The nutritional villains in our society are highly refined and easily oxidized “vegetable oils” filled with pro-inflammatory omega-6 PUFA (linoleic acid), added sugar (especially HFCS) so prevalent in most processed foods and soft drinks, and the nutrient poor wasted calories of processed flour foods. These three culprits are responsible for our epidemics of obesity, insulin resistance and metabolic syndrome. These three conspire together to generate fatty liver disease, atherosclerotic plaque, and chronic inflammation.

When a LCHF approach is combined with  eating only fresh whole foods and avoiding added sugar, refined flour, and unhealthy  “vegetable oils”, we have the perfect recipe for our obesity epidemic.

The following references provide examples of studies that have demonstrated the efficacy, safety and  usual superiority of the LCHF  approach to weight loss.

Dig Dis Sci. 2007 Feb;52(2):589-93. Epub 2007 Jan 12. The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study. Tendler D, Lin S, Yancy WS Jr, Mavropoulos J, Sylvestre P, Rockey DC Westman EC.

Interview with Dr. Ede about preventing Alzheimer’s

My friend and colleague, Dr. Georgia Ede, was recently interviewed concerning dietary interventions to prevent Alzheimer’s Dementia. Great interview, lots of information, references provided at the bottom of the transcript.

Here is the link.

Are You On The Road To Alzheimer’s? Interview With Dr. Georgia Ede – Choc & Juice

Another reason to eat a clean Paleo diet.

Eliminating sugar, flour foods, and fruit juices will also improve your gut flora and help to prevent dysbiosis.

Regards

Bob Hansen MD

The Obesity Code, a must read book by Dr. Jason Fung.

Doctor Jason Fung just published a terrific book titled The Obesity Code: Unlocking the Secrets of Weight Loss: 

Dr. Fung’s genius excels at simple, direct explanations with clarity and humor. His analogies are often hilarious and through his humor and logic he communicates simple but important truths. The major message is that obesity is a hormonal problem. Obesity is not a disease of excess caloric intake, nor is it a disease of sedentary lifestyle. Dr. Fung cites study after study in which obese patients (young and old alike) consumed less calories and exercised more with dismal results. He reviews the medical literature on the effects of refined carbohydrates and sugar on insulin and other hormones. He explains how sustained high insulin levels cause insulin resistance and weight gain. He clearly and decisively explains how 100 calories of sugar or flour effects the human body in a manner immensely different from 100 calories of broccoli.

“Have you ever seen anyone get fat from eating too much broccoli?”

Most importantly, Dr. Fung provides the solution that has helped hundreds of his patients. The solution is elimination of refined carbohydrates and sugar in combination with intermittent fasting. Intermittent fasting (consuming only water, coffee, tea, broth) for 24 -36 hours a few to several times per month helps to reset the brain’s set point for body weight. When combined with restriction of sugar and refined carbohydrate (foods made with flour) intermittent fasting presents a powerful tool to not only lose weight but to manage diabetes and prevent the many complications of obesity and diabetes.

Intermittent fasting increases the human metabolic rate, Your body actually burns more calories at rest per hour during fasting. The effects of intermittent fasting are distinctly different from what has been referred to as the “starvation response”. The “starvation response” ironically and confusingly refers to human studies that restricted (reduced) caloric intake but continued low calorie meals throughout the day.  It is unfortunate that those studies coined the term “starvation response” which is a decrease in resting metabolic rate. Caloric restriction diets reduce the human metabolic rate and therein lies the cause for the failure of all caloric restriction diets.

The confusion of these two approaches and their effects on human metabolism have clouded the discussion of obesity for decades.

Dr. Fung’s communication skills can be enjoyed by reading his book and viewing his many talks on YouTube.

His book and lectures should be mandatory for every medical student, physician, nutritionist and public health official. His book’s exhaustive medical references document the science that supports his theory and his clinical solution.

So take a leap, click on the link above for his book and the links below for some of his videos which are free on-line.

I think that Dr. Fung’s book is the most important book published on this topic in the 21st Century. His work will have profound influence during the next few decades. I encourage you to enjoy his genius.

Bob Hansen MD

The BigFatFix, a crowd funded film that explores the proper nutritional approach to diabetes epidemic

This new film created by a GP in UK, funded by small contributions, describes how elimination of added sugar and implementation of carbohydrate restriction can cure diabetes and result in weight loss. The film also covers how the low-fat craze, based on bad science (ignoring the full data) began with Ancel Keyes and evolved into arguably the worst public health disaster experienced by the modern world.

Bariatric surgery is NOT superior to lifestyle changes

There have been multiple studies comparing “lifestyle” interventions to bariatric surgery in treating obesity and diabetes. Repeatedly the authors conclude that bariatric surgery is superior to “lifestyle” interventions.

But none of these studies have utilized very low carbohydrate diets or medically supervised fasting as a lifestyle intervention. Instead, the diets employed for the “lifestyle” intervention are typically an ADA calorie restricted low-fat diet. I find this very frustrating as a physician.

The science in this area has demonstrated that very low carbohydrate diets consistently out-perform the low fat calorie restricted diet in terms of weight loss, blood sugar control, blood pressure control and lipid profiles.

Bariatric surgery carries a mortality rate of up to 3% depending on the surgeon, hospital and other circumstances. As an anesthesiologist and pain management physician I have seen multiple complications of bariatric surgery including but not limited to multiple chronic nutritional deficiencies (malabsorption), hernias, sepsis, renal failure, rhabdomyalisis, respiratory failure requiring prolonged ventilation, multi-organ failure requiring prolonged ICU care, and death.

And although many patients have profound weight loss in the first year after bariatric surgery many patients ultimately gain back most of the weight initially lost.

We need studies that compare bariatric surgery to very low carbohydrate and paleo diets. We need studies that compare bariatric surgery to intermittent medically supervised fasting. Until those studies are performed we should not conclude that bariatric surgery is superior to lifestyle interventions, particularly given the high complication rates of this surgery and the proven effects of VLC diets and medically supervised fasting.

Here are links to videos that discuss this topic.

They are all worth watching.

The SkinnyNews-Tim Noakes

The Aetiology of Obesity Part 1 of 6: A New Hope

The Science and Practice of Low-Carb Diets {Duke University Office Hours}

Prof. Tim Noakes; Medical aspects of the low carbohydrate lifestyles

Low-Carb Experts: Eric Westman, MD, MHS – Segment One (9:30)

Dr Eric Westman – Duke University New Atkins Ketogenic Diet for Weight Loss and Health

Dr Eric Westman about the new Atkins diet, part 1/2

Debunking Low Carb Myths with Dr. Eric Westman

Insulin Toxicity and How to Cure Type 2 Diabetes

How to Reverse Type 2 Diabetes Naturally

I have previously discussed the issue of carbohydrate restriction, diabetes and obesity with multiple scientific references provided in previous posts.

Peace,

Bob Hansen MD

 

 

Great lecture videos available on line

In January I attended the annual meeting of Physicians for Ancestral Health. There were great presentations on many topics related to lifestyle and health. Take a look at the website linked below to learn about many topics relating nutrition, exercise, and lifestyle to health.

Open Video Archives | Physicians for Ancestral Health

I presented a lecture titled “The Lipoprotein Retention Model, What’s Missing?” This discusses many factors (root causes) that contribute to the formation of plaque in arteries and what can be done to prevent this insidious process by adopting a “Paleo Lifestyle“.

Other videos include:

Paleopathology and the Origins of the Paleo Diet. Keynote speaker Michael Eades MD, author of several books and a well known website.

Medicine Without Evolution is like Engineering Without Physics– Randolph M Neese, MD Director of the Arizona State University Center for Evolution.

The Roles of Intermittent Fasting and Carbohydrates in Cancer Therapy– Dawn Lemanne, MD, MPH, integrative oncologist.

 23 and Me: Practical First Steps-Deborah Gordon MD, discusses a practical approach to utilizing information from this genetic test.

Histamine Intolerance-Why (food) Freshness Matters– Georgia Ede MD.

 

Mood and Memory: How Sugar Affects Brain Chemistry-Georgia Ede, MD.

Systems Analysis and Multiple Sclerosis– Tommy Wood MD, author, blogger and lecturer, frequently interviewed on topics related to exercise and nutrition.

Cholesterol OMG– Jeffry Gerber, MD “The Diet Doctor” in Denver Colorado

Bob Hansen MD