"Vegan Propaganda"

“Vegan Propaganda”

It’s been very strange to watch some of the reaction to the The Primitive Nutrition Series.

I provided a quality reference for practically everything I said in it. I tried to make my arguments as data- and logic-driven as I could. Yet I was still called a propagandist.

This was expected. Any time a vegan voices a rational case for a plant-based diet, he comes off to some as radical and shrill. Vegans shouldn’t promote their ideas. If they do, it just comes off as propaganda.

When my videos are called propaganda, an insinuation is made that I have been somehow dishonest. In this video, I’ll show you what I think propaganda looks like.

Two prominent bloggers who criticized my work in the Primitive Nutrition Series were Anthony Colpo and Denise Minger. Both are what I would call cholesterol deniers, or confusionists, and both are critical of veganism. I’ll address them both at length later.

One of the major benefits of veganism is lower cholesterol and consequently a lesser chance of suffering from heart disease. When you hear a doctor talk about the importance of keeping your cholesterol down, you are hearing advice based on the lipid hypothesis.

According to the lipid hypothesis, high blood cholesterol causes heart disease. Because fatty animal foods contain saturated fat and dietary cholesterol, they can raise blood cholesterol. Therefore, according to the lipid hypothesis, these foods contribute to the development of heart disease. Vegetarianism and veganism are hardly mainstream, but the lipid hypothesis is quite well-accepted. If you’re a blogger who wants to weaken the rationale for veganism, at some point you’ll probably be tempted to take on the lipid hypothesis. Colpo and Minger have done that, as have most other apologists for saturated fat consumption.

Cholesterol denialism and anti-veganism tend to go hand in hand.

Upon a first encounter with their pro-cholesterol arguments, one might take pity on the denialists. As I have shown you in the Primitive Nutrition Series, many lines of evidence developed through over a hundred years of research have firmly established the validity of the lipid hypothesis. The task of overturning it at this point might remind one of the punishment chosen by the gods for Sisyphus, who was condemned for eternity to repeatedly roll a boulder up a steep hill, only to have it roll back down once he neared the top.  The endless wasting of effort on an impossible task would be a miserable fate, and make no mistake, overturning the lipid hypothesis looks to be nearly impossible, yet this is the path the deniers have chosen.  So why do they do it? Are they as miserable as Sisyphus?

While the objective of legitimately undermining and replacing the lipid hypothesis may be a nearly impossible task, especially for individuals who lack the appropriate education, I doubt the confusionists feel like Sisyphus because I don’t think they are really trying to win this battle. If they were, they would head off to school, gain some legitimacy, and wage their campaign within the science community. But they don’t because they have goals that don’t require all that dedication and integrity. They want to find an audience, grow it, and sell books to them, and these goals have nothing to do with science. Anthony Colpo already has his book for sale.

Denise Minger will soon have hers, too.  For an entrepreneur in the diet book business, it isn’t necessary to be accurate, rigorous, or responsible.  All you have to do is cater to your audience, and this is fundamentally a marketing task.

And as a marketing strategy, a self-aggrandizing one-sided battle with the scientific mainstream is pretty smart. First, the actual experts in the mainstream are unlikely to fight back. Why should they engage in public mud-wrestling with someone who has only demonstrated an ability to win fans on the web when they have real and pressing work to do?  Because the people who actually know the science on cholesterol don’t engage the fringe bloggers, the bloggers can declare themselves experts to their hearts’ content. There hasn’t been much risk of public embarrassment for them. At least, not until now. Moreover, the health authorities have a common disadvantage with the vegans. They are asking people to give up or cut back on foods they like, and who wants to give up things they like? If you want to reach the status of internet diet guru, you might have an easier time of it by differentiating yourself in the marketplace by giving contrarian advice and by telling people what they want to hear. 

To make this strategy effective, it’s best to never show a hint of modesty or doubt despite your lack of appropriate training.  Just use a lot of references and people will think you know your stuff.  It’s easy these days to find references that seem to support practically anything, and hardly anyone will actually bother to read them to see if you understood them. Also, a guru wannabe should ignore the environmental or ethical considerations of food choices. If vegans raise these issues, reflexively mock them. Because cholesterol denialism is mostly a marketing effort, you may find the tactics of political campaigns to be helpful. Pretend you and your audience are gifted with unusually fine critical thinking skills. You and they are too smart to listen to the mainstream experts. Smart people do their own thinking on PhD-level medical research. That makes them independent. Also, find anti-government buttons to push. The people in government are entirely animated by a desire to control you, including those nerds at the NIH. Demagogue your opponents while you’re at it, too. They’re idiots, haha! Lastly, make use of focused and repeated messaging. It really helps to have everyone on your team reciting the same talking points.

T Colin Campbell has had these techniques used against him.  He is cast as a villain who should be shut up.  The classy individual who wrote this has a book to sell as well.  I have received hostility like this now, too, which puts me in some good company…

With both Dr Campbell, who Mr Colpo says is lying to sell books, something Colpo would never do, …

And with Ancel Keys, who was shamelessly biased.  Colpo is not at all biased. This is a rare quality among humans.

Denise Minger seems to think it is necessary to mockingly include photos of vegans in her blogs who have absolutely nothing to do with whatever topic she is discussing.  We need good guys and bad guys to create a story line.  We need people to laugh at.  This is how this fresh new critical thinker among the confusionists has decided she should present her ideas.

A key technique for the demagogue is focused messaging, and the confusionists are great at it.  This reminds me of Steven Colbert’s word “wikiality”.  Colbert noticed that on Wikipedia, the truth could be made into whatever people wanted it to be if enough people agreed on it, even if the new “truth” was factually false.  Wikiality need not be confined to Wikipedia.

Here’s an example of how wikiality works in the confusionist subculture. This was pointed out to me by a good friend who won’t let me give him credit. This website is promoting the so-called “wise traditions” of the Weston A Price Foundation.  Apparently, a brochure of theirs gives us what appears to be a solid journal reference to shoot down the myth that vegetarianism is healthy.  The truth, they say, is that both vegetarian men and women have higher all-cause mortality than their omnivorous counterparts.  Hazard ratios and a journal citation make this appear to be an unbiased and rigorously proven fact. The Weston Price people have just proven that meat helps you to live longer. Eating meat is wise indeed!

But let’s look at that reference. The study the Weston Price people chose actually found that vegetarians have a lower death rate from ischemic heart disease.

Look at the tables for overall mortality in the study and you will see that the standardized mortality ratios were actually lower for both vegetarian men and women.  The lower this number is, the fewer deaths occurred compared to the number of deaths that were expected.  The study authors say, “these results give further support to the belief that vegetarians have a lower risk of dying from ischemic heart disease than other persons.” How can this be explained?

Maybe the vegetarians were just more health-conscious. That makes sense.  After all, they were so health-conscious, they stopped eating meat! Agree with me or not, but really, is it possible the Weston Price people somehow innocently misunderstood the conclusion of this paper?  Get real. Their work is what I call propaganda.

This very same text from the Weston A Price Foundation is repeated all over the internet. Every one of these results has this same false information. It’s not based on any truth in the real world, but online, it is now wikiality.

The deniers don’t need to be logically consistent. In his same blog ridiculing me, this individual also attacked Don Matesz.

Matesz expressed support for my video series so he had this coming to him.

This individual criticized him on the grounds that he studied and practices Chinese medicine.  This isn’t science-based, he says, so it’s not good enough for him.  He says the only alternative medicine practitioner he likes is someone named Chris Kresser, whose name he fails to spell correctly.  How rich is this?  He approves of an alternative medicine practitioner because he rejects the lipid hypothesis, a product of several generations of scientific research by scientists from around the world, yet he casts himself as a defender of science. These guys don’t experience cognitive dissonance, it seems.

Go to Kresser’s website and you will see that he is sharing a video that he believes debunks what he calls the saturated fat myth.  You see at the top of my slide the video he likes, called “Big Fat Lies”.  It is a video perpetuating the untruth that a scientist named Ancel Keys tossed out original data to make a fraudulent case against saturated fat, a lie I exposed in The Primitive Nutrition Series.

Yet Keys is the one who is called a liar by these people.  Let’s take a moment to see how the use of this one false claim has been used by the cholesterol deniers. This clip comes from a movie promoting cholesterol denialism. I don’t recall Jimmy Moore calling this one propaganda.

Low carb patriarch Robert Atkins asserted that Keys cherry-picked data.  He thought the Seven Countries Study was published in the 1950s, but it wasn’t.  Dr Atkins was totally misinformed about what the Seven Countries Study was. But we should consider Keys the liar.

Wikiality is on display on Wikipedia as well.  Whoever wrote this had no clue what the Seven Countries Study was, either, yet they think they can educate you about it.

Johnny Bowden is all mixed up as well.  He thinks he has more integrity than this great scientist.

Kurt Harris tells us Keys’ work was criminal.  He says this even though he obviously never bothered to investigate the matter for himself. Harris’s libel seems closer to real criminality than does Keys’ investigation to me.

 Here’s another MD who says Keys was more interested in pursuing an agenda rather than the truth. This man didn’t know what he was talking about either.

Of course, I’ve shown you how sloppy Mark Sisson’s been on this one.

Chris Masterjohn didn’t mind repeating this smear against Keys.

Which this blogger spread further.

This veterinarian thinks Keys was shown to be a charlatan.

Internet entrepreneur Joe Mercola doesn’t have a clue about any of this, either.  He thinks the Seven Countries Study should have been called the 22 Countries Study.  He must be comparing notes with Mark Sisson.

Also confused is Donald Miller, the star of my Confusionist Mind video. 

Gary Taubes twists this data as well to suit his ends.

Even this textbook buys in on this gross distortion of history.

To just briefly repeat myself and show you why all these confusionists are wrong, at the time Keys compared those countries, he had not yet determined that it was the saturated fat found in animal foods that elevated cholesterol, rather than all dietary fats.  He eventually realized unsaturated fats did not do this. He changed his mind, so I don’t see evidence here of a man with an agenda.

He was very careful not to get ahead of the science in his recommendations, only encouraging the reasonable substitution of certain fats until more definitive research was conducted.

The development of Keys’ ideas is described here.  This historical context is essential to understand how and why saturated fat was ultimately singled out as a problematic dietary factor.

As I said in my other videos, the paper criticizing Keys’ comparison of six countries in 1953, the same one all those confusionists are using to smear him, found there were other food categories that correlated to heart disease more strongly than fat, in particular, animal protein.

In 1978, using the same data as Keys, Jeremiah Stamler found reason to suspect animal-sourced foods as well. Somehow all those confusionists think it’s just fine to bash away at Keys for his imagined distortions, while not a single one reports the rest of the story. They don’t tell us that animal protein and saturated fat correlated best with heart disease.

To the rescue has come Denise Minger, who used her blog to announce that the confusionists have been wrong about Keys all along.  Minger says she was “inspired” to do this blog post correcting these distortions about Ancel Keys and his alleged abuse of data by my videos, but doesn’t really give me credit for my work.  She is content to leave her readers with the impression she is sharing the fruits of her own research. She even takes a little potshot at me by saying I glossed over something of importance in my videos.  Someone reading this who had not seen my videos might assume I had bought in on these lies about Keys, just like all the others.

Here you can see I uploaded the video with my observations on December 1, 2011.

On December 17, Minger makes it clear she is learning about this big lie from my videos. “I watched part of the Plant Positive guy’s first video on Ancel Keys, and he’s actually kind of right,” she says.

Yet five days later on December 22 she says she is about to reveal the truth about Keys because she has so much integrity, she is willing to bust a myth regardless of whose ox is gored.  She is claiming to be a truth-teller, even as she misrepresents this research as her own.  This is the standard for integrity in the confusionist echo chamber.

I’ll address Minger further in later videos. But before I do, I want to talk a bit more about cholesterol, since that is the big theme of this batch of videos

TPNS 68-71: Waking to Realities

Primitive Nutrition 68:
Waking to Realities, Part I

You might think I am here to say animal foods are not good for you.  I am not.  If you are going hungry, any source of calories and nutrients is good for you.  But if you have a choice they are probably not optimal for you over the long term. And if you care about our modern challenges, they are not right for us, as a community.

All the meaty low-carb, Paleo, fad diets being peddled seem to me to be an unfortunate distraction from some basic and pressing facts.  When you snap out of your Paleo fantasy, there will be some inescapably realities you will probably eventually have to face along with the rest of us.

The Harvard School of Public Health and the World Economic Forum have released their best assessment of the staggering burden of diabetes and other non-communicable diseases threatening our future finances.

Over the next two decades the world economy will be dealt a $47 trillion hit from these diseases.  Most of these diseases are effected by nutrition to some extent, particularly heart disease and diabetes. 

According to the International Diabetes Federation, by the year 2030, 1 in 10 adults is expected to be diabetic. These non-communicable diseases won't just effect the richest nations.

Developing countries will see more and more productive years in the lives of their people wasted due to these epidemics as well.  This is not just a financial disaster, but a human tragedy.

Central to this problem is the global epidemic of obesity.  The Lancet has looked at this issue recently, and their findings are grim.

Here you see trends in childhood obesity among selected industrialized nations.  Clearly we are failing our children, especially in the United States.  Everyone in public health is aware of these discouraging trends.  There is also broad agreement over why they are happening.  People are more sedentary yet food is more abundant. Some of the increases in non-communicable diseases are simply a result of longer life spans.  But trends in childhood diabetes and obesity as you see here are clearly a result of changing diets.  What is so wrong with modern diets?  How are they different now?

This remarkable map is from 1941.  Notice the legend to the left.  The darkest regions here represent populations that obtained only 30 to 40 percent of their calories from cereals and potatoes.  The more lightly shaded areas consumed between 60 and 90 percent of their calories from these fantastic high-carb foods.

This is how cereal and potato consumption broke down by population.  Look at the heavy concentration of people in the 80 to 90 percent range.  This is nearly two-thirds of the world population.  Until very recently, the world ate very high-carb diets from mostly wholesome sources, and there was no obesity epidemic.

The world collectively became richer since then, allowing people to afford to eat foods frequently that used to be eaten only occasionally.  Here you can see it was understood back in 1969 that as incomes rise, so does the consumption of animal products.  Along the left, the graph shows increasing gross national product.  Along the bottom is the percentage of total calories a food group represents.  The most obvious loser as wealth increases is in the white section in the middle, starchy carbohydrates, At the bottom of the wealth spectrum they represent about 70% of calories.  Other losers with wealth are vegetable proteins and vegetable fats.  Those that increase with wealth are animal fats, processed fats, meats, and sugars.  That's a disastrous combination for human health, and the trends have continued like this since then.

This graph picks up where the last one left off in 1969.  You are looking at the percentage of calories derived from cereals separated by year and by the category of country - developing, industrialized, and transition.  Developing countries ate the most cereals, but they are predicted to lower their consumption of them into the future.  Industrialized countries ate the least and that it is not expected to change.

Compare that to past and expected trends of meat and dairy consumption.  Compare the second line from the top, the developing countries, to the second line from the bottom, industrialized countries. In particular, compare the value for meat in developing countries in 1964 through 1966 with the value for meat in industrialized countries anticipated for 2030.  That's nearly a tenfold difference.

Here's a visual for these trends in meat consumption starting in 1995.

You can see world meat consumption is increasing far faster than world population.

Here is how meat consumption currently varies now by region.  The developed world and North America are along the bottom.  It's hard to believe these regions are actually expected to dramatically increase their meat consumption from these already gluttonous levels.

Many self-styled diet experts want you to believe wheat consumption is the problem, but wheat is eaten far less now than in the past.  This decline was noted all the way back in 1929.

There is no question that meat is eaten more now, though.

We've gotten so extreme we are starting to see ads on tv for gout.  This guy is carrying around a symbolic bottle of uric acid.

Gout used to be associated with the rich.  Now enough people have it that it pays to advertise drugs for it on television.

Gout, of course, is associated with high red meat consumption.  Are you such an amazingly well-adapted Paleo meat eater that you can never experience gout?

I doubt it, considering that even Tyrannosaurus rex suffered from it, thanks to its meaty, purine-rich diet.

Meanwhile, we're eating far fewer fruits and vegetables than we need.

The result for us Americans is a chart that looks like this.  Joel Fuhrman has categorized our food consumption the right way to show how low our standards have become.  By far the biggest share of calories is taken up by unhealthy processed foods, followed by animal products.  Unrefined plant foods and whole grains, the pillars of good health, combine to total only 12 and a half percent.

This leaves out the changing nature of the meat we eat.  I find this table to be remarkable.  Here you see the nutritional characteristics of broiler chickens dating all the way back to 1870.  These birds have been progressively bred and raised to deliver dramatically more fat and calories.  The chickens people eat now are nothing like they used to be.

As I showed you in the previous section, China is caught up in this global nutrition transition.  The world's most populous country is now consuming more protein and much more fat as a percentage of total calories.  These changes between 1989 and 2004 are modest compared to what we expect to see.

Rice consumption has remained flat.

And as you know by now, wheat consumption there will decline.

But all major categories of animal foods are expected to skyrocket.

The price for this is their health.  Look how steep these trend lines have been for diabetes and glucose intolerance.

Obesity and metabolic syndrome are dramatically rising as well.

There is a country that is an even more dramatic example of the nutrition transition than China, though.  I'll tell you about it in Part II.

Primitive Nutrition 69:
Waking to Realities, Part II

Let's return to the Lancet to see how dire the consequences of the nutrition transition can be for a country. 

This chart looks at the prevalence of obesity, defined as a BMI over 30, among women in a variety of countries.  At the bottom you see two Pacific Island nations, Samoa and Tonga, with Tonga experiencing an astonishing obesity rate of 70%.  What is happening in the South Pacific?

The traditional diet among Pacific Islanders used to include exceptionally healthy complex carbs like taro root, yams, breadfruit, and bananas.  These were considered by them to be the real food and they formed the foundation of their diet.

This diet was uniformly very low in fat and high in fiber-rich carbs. 

Their nutritious traditional foods have now taken a back seat to the worst foods of industrialized society, such as refined carbs, dairy, sweets and fried foods.  Meat, fish, and seafood were treated as only condiments once upon a time, but not any more.

Now they import fatty meats and junk carbs, displacing their traditional foods,

And the price they pay for this is epidemic obesity and cardiovascular disease.  You can be sure they think these saturated-fat-laden animal foods taste good to them.  You can also be sure these foods are ruining their health.

Let's look at the other end of this chart.  Ethiopia has hardly any obesity.  You can be sure there are important reasons for this beyond diet preference.  Ethiopia has historically had poor food security, for example.

However, their traditional diet is worth a mention.  Traditionally people there ate very little in the way of animal foods, saving those for special occasions.

Grains were their staple foods.

The Lancet series included the observation that there is a linkage between the issues of obesity and environmental degradation.

At a certain level, this should be common sense.  This is not how our food is produced today.

A hundred years ago our pig farms looked like this.

Now they look more like this.

And our poultry comes from places like this.

And this.

This is because civilization looks like this now.  The quaint family farms of our imaginations are not going to make much of a contribution to the overall food supply in the modern world. 

Modern appetites require that enormous numbers of animals pass through the food system.  Just look at how many animals were in the US alone in 2001.  10 to the sixth is one million.  This has serious environmental costs.

Industrialized livestock and fish production has put us at risk for superbugs that are resistant to antibiotics.

This drug was pulled from the poultry industry once it was realized that it promoted the development of superbugs.  The drug is no longer used this way, but the superbugs it created persist.

We are overfishing our oceans so severely that the global collapse of our major fisheries is projected for mid century.

Agriculture is the largest user of our increasingly scarce fresh water resources. Water shortages will put our global food security at risk.

The growth in livestock production required by all that future meat-eating is a big problem for our water needs.  Climate change will increasingly threaten the animal-sourced foods sector.

The awful drought this summer in Texas may have given us a glimpse into the future of cattle production.

The fact is meat production is an incredibly inefficient use of water resources.  Beef is estimated here to require 86 times as much water as potatoes to produce.

The wastefulness of animal-sourced foods is a hard truth that most environmentalists have not yet faced.  This inherent inefficiency is very easy to understand.  The conversion of food into tissue and work is energetically inefficient in all animals.  Plants are far more energetically efficient than animals.  More and more energy is lost as layers of animals are added to the food chain.  This is why so few animals are carnivorous.  The top of a very big food chain is therefore a vulnerable and unstable perch on which to sit.  We’d be smart to come down from there.

The extreme inefficiency of animal food production becomes clear when we calculate the number of calories that can be extracted from a given amount of land by different agricultural strategies.  Oats produce more than 25 times the calories per acre as beef.

Wheat is comparable to oats in its calorie yield per acre.

And potatoes are way out in front of both of them. 

As efficient as these crops are, bananas absolutely blow them away. 

Notice at the bottom of this chart all the protein soybeans produce per acre.

Soybeans produce twice as much protein per acre as any other crop and up to 15 times the protein per acre as meat.  These facts have such important implications for the quality of our future, and yet fad diet promoters demonize all these foods - fruit, grains, potatoes, and beans - and advocate that you eat more meat instead.  These are the retrograde voices in the food world.  Their heads are buried in the sand.  They offer no real solutions.

But what about grass-fed beef? you may ask.  Surely that is environmentally responsible, right?  This myth will be exposed in Part III.

Primitive Nutrition 70:
Waking to Realities, Part III

Some people believe they are getting around the environmental costs of meat-eating by selecting grass fed beef.  I'm not sure why they believe this. 

If you are concerned about land use or greenhouse gases, the regular feedlot system is much better.

Just think about it.  Giving an animal growth promotants like hormones and antibiotics makes it more efficient at converting *its food into muscle and fat mass that will eventually be food for the meat-eater.  Therefore it needs less resources and less time to develop all that meat, milk, and fat.  This is a major argument in favor of the use of these artificial methods.  How is it better for the environment to eat an animal that requires more land and more resources to produce the same number of calories?

Look at the table to the left.  The second to last line shows you how much more mass feedlot beef produces per animal.  On the right you see how this translates into land use.  Organic grass fed beef is a disaster for land use.  More land means more ecosystems destroyed and more wild animals like coyote killed as a part of wildlife damage management, as it is euphemistically called.

Grass fed requires three times more land and produces 60% more greenhouse gases.  That doesn't sound like a solution to our environmental challenges to me.  There are real solutions out there, and they are not expensive, feel-good ways to basically just keep doing the same old things.

One proposed solution for satisfying humans’ meat cravings is the growing of artificial meats.  That would certainly make a dent in greenhouse gas emissions and land use.  Those vertical black bars are for beef.  The red is for cultured meat.  Check out the difference in land use in particular, which is the second category from the right.  You need to look really closely to see the size of cultured meat's footprint.

Scientists understand the current appetite for meat is unsustainable using traditional methods.  That's why they're experimenting with such extreme measures as synthesizing meat from feces.  Compared to what we're doing now, it's really not that crazy an idea.

But what about those health challenges from non-communicable diseases?  Can we take pills to compensate for our meat- and fat-laden diets?  Unfortunately, a really smart person can talk himself into taking many dozens of supplements in an effort to maintain good health.  But nutrition doesn't work this way.

There are many thousands of chemicals in foods that interact synergistically with each other.  Supplements can't do for you what truly healthful foods can.  Going overboard with supplements is not a solution.

The solution, of course, is a whole food plant-based diet.  It's clear it is environmentally better, but how much could it help our health?  The World Health Organization estimates an increase in our fruit and vegetable consumption to quite modest levels could seriously reduce the global burden of heart disease and cancer.

Adopting a vegetarian diet could even more sharply reduce disease.  When you see a study reach a conclusion like this, realize that most of these vegetarians are probably not eating a particularly healthy diet.  They are only eliminating meat to get these benefits.  This doesn’t tell us much about the rest of their diets.

By returning to our historical plant-based, high-carb diets, we could bring down those terrible trend lines projected for non-communicable diseases.  The people who dismiss The China Study don't want you to spend too long pondering findings like what you see here.  Colin Campbell and his associates found that rural Chinese men eating low-fat plant-based diets had less than one sixteenth of the rate of deaths from coronary artery disease as American men.  I don't understand how anyone can ignore a statistic like that.  Campbell seems radical when he asks us to make the big changes in lifestyle this information implies, but that's only because of our cultural bias.  These rural Chinese did not see themselves as radical.  Their diets were quite normal to them.

Campbell's views are just the logical extension of mainstream nutrition science.  The National Institutes of Health know plant foods can fight these diseases through their thousands of phytochemicals.

These chemicals aren't completely understood today.  We just know they seem to be among our best weapons against these diseases over the long term.

At this point it seems the only reasonable strategy to take advantage of the ability of phytochemicals to fight disease is to actually eat plant foods.  Supplements may never catch up to the real thing.

A great way to fight modern health challenges may be to go back to the future, as this author puts it, and rediscover all that plants can do for us.

There are some big obstacles standing in the way of a cultural shift back to plant-based diets. This is the Primitive Nutrition Series, so let's stick with that perspective to consider these obstacles.  First, you may have heard of the thrifty gene hypothesis.  The basis of this idea is that genes that enabled efficient fat storage were advantageous for animals that might have faced occasional food scarcity.  These genes are a mismatch for us today because most of us never experience serious food scarcity.  That makes sense and it may well be true.  Imagining the challenges of the past, you could also imagine an evolved preference for high calorie foods like fats and concentrated sugars that could supply the extra energy required for that fat storage.

These preferences might play out in a way that resembles addiction.  This study showed that in obese rats, extended access to normal human junk foods like bacon, sausage, and cake created such powerfully compulsive eating behavior that even electrical shocks could not deter them from eating more.

Monkeys have been shown to crave high-fat foods in response to emotional stress.  Does that ring any bells?

Brain scans of humans reveal responses to food that suggest addiction, and this is not a phenomenon limited to the obese. 

Then there are individual biological variations that effect our food choices.  For some the same signals that compel us to have a sweet tooth may also increase the likelihood of alcoholism.

Some of us are so-called supertasters, experiencing most flavors more intensely.

These people are less likely to eat fatty and sugary foods, which is great, but they also may avoid healthy vegetables, too, resulting in a greater risk of disease.

As you know by now, as people become wealthier they tend to eat more meat. This may be because meat is unfortunately associated with social power. Primitive impulses may explain the desire of some of us to climb the food chain.

These researchers found people actually tasted the same foods differently based on whether they believed it was made from real meat or not, and this correlated to their cultural beliefs.

There have been other experiments showing how easily influenced people can be by the ways foods are named or how they are described to them.  If you're sure you need meat because it tastes good, it may just be in your head.

It's been shown that children can be warmed up to vegetables that they otherwise might not have chosen to eat simply through repeated exposure.  If children can be transitioned to healthy foods, so can you.

This program showed that when children take part in gardening, not only are they more likely to eat more vegetables themselves, their parents are, too.  I've had trouble finding similar programs to the one described here that instead expose children to the nitty gritty of the production of meat products.  I doubt we'll see that anytime soon.

Do you remember that amazing comment by Uffe Ravnskov about a diet that actually reversed heart disease?  Here is a man with an MD and a PhD who rejects such a promising approach, one that could prolong life and save money at the same time.  He just can't emotionally accept the idea of giving up fatty foods in favor of fruits and vegetables.  He suggests eating unhealthy, addictive foods would be be better for one's inner sense of peace.  Inner peace?

Would he say the mice that withstood electric shocks to eat bacon and cake had greater inner peace?  Just because someone has an education doesn't change the fact that he or she has primitive impulses.  These rats may have seemed addicted to these terrible foods, but they didn't know any better.  They couldn't concoct flimsy rationalizations for their unhealthy choices like Ravnskov could.  All low carb promoters are subject to all the same innate tendencies as the rest of us.  They may find it impossible to critically reassess their beliefs, even if they hadn't staked their careers on these absurd diets.

It has been persuasively argued that humans have evolved a capacity for self-deception.

Robert Trivers has a lot of interesting things to say about this, including this nugget about academics, who seem especially good at self-deception.  Do you think low carb promoters do not deceive themselves?  Do you think we should trust their research findings?  I'll show you why you should stay skeptical in Part IV.

Primitive Nutrition 71:
Waking to Realities, Part IV

If you try hard enough, you’ll probably always be able to find intellectual support for terrible diet choices.  There are many media voices who, unlike Colin Campbell, are only too happy to tell you what you want to hear.  Their claims may seem well-supported by research.  But not all research is created equal.  Fortunately, someone has given us tools to distinguish the good from the bad.

Even without an awareness of the instinctive and unhelpful cravings humans - including smart humans - have for fat, meat, salt, and sugar, we would have good reason to be skeptical of much of the nutrition research we see.  In 2005 John Ionnidis made the shocking claim that most findings in peer-reviewed journals are false.  His arguments are very well reasoned, and I think they apply nicely to nutrition research.

Here are my favorites of the ideas he presents.  First, the probability that a research finding is true depends on the prior probability of it being true.  When you see a study contradicting the consensus view on an important topic, like the study I showed you that claimed that saturated fats aren’t associated with heart disease, odds are the study is flawed.  Extraordinary claims require extraordinary evidence.  For anyone to seriously reconsider whether saturated fats associate with heart disease, that study would have had to have been of a very high quality.  Instead, it had numerous flaws. 

Next, the smaller the study, the less likely it is to be true.  Nutrition studies often have very few participants.  Small studies lack statistical power.  Think of the pro-Paleo study that had full data for only six people.  No one should make much of that one.  The next of Ionnidis’s ideas I’d like to mention is huge.  The greater the flexibility the researchers have in both the design of their study and how they measure outcomes, the less likely the findings are to be true.  I have shown you in The Best Low Carb Research videos how their studies are usually designed to have unhealthy control diets.  Therefore, those studies were poorly designed and used definitions that were too flexible.

Those studies may have called a control diet low fat or low glycemic index, but they were still bad diets so they couldn’t really tell us anything.  I've shown you how much they try to distract you from their repeated failures to lower LDL cholesterol. That’s an example of the use of oddly selective outcomes.  Another great example of that is the study I showed you that said a Paleo diet was more satiating per calorie than a Mediterranean-style diet in patients with ischemic heart disease.  That sounds like a pretty weak result because it is.  You have a right to be suspicious of all studies with signs of tampering or claims of victory on oddly narrow grounds. 

Next, the greater the financial interest and prejudice in a field, the less you can trust research findings. Nutrition studies fit this one to a T.  If a study is funded by a non-neutral organization, that matters.  If the researcher has staked his career on a fad diet, that matters.  Don't forget the Upton Sinclair quote: "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"  Pretty much all the studies in my The Best Low Carb Research videos fail this rule of thumb.  The last one of Ionnidis's insights I’d like you to think about now is that the hotter the scientific field is, the less likely the findings about it are to be true.  It seems every week a study related to diet makes the news.  As long as there is a fat, unhealthy public looking for a quick fix, nutrition research will continue to be a hot field generating lots of dubious claims.

Knowing all this, it makes sense that Ben Goldacre and colleagues found that most health claims appearing in the reporting you read in the news are based on shaky science and are therefore more likely to just confuse people rather than help them.  That’s especially true of dietary advice.

There are a other reasons to question the scientific claims you read, but you get the idea.

With 2 and a half million articles being published in 25,000 journals, they can't all be winners.  I think if you take the time to read lots of nutrition studies as I have, you'll find that those that say meat and saturated fat are good for you have more red flags, are less frequently cited by other researchers, and are more often authored by individuals who are less-widely-respected in their fields than those that find great results for plant foods.  In other words, they are on the fringe.

I am going to reuse this slide here because I think it expresses an idea that is important for people casually reading about nutrition to understand.  Many controlled trial studies are focused on people who are metabolically broken.  Metabolic dysfunction receives lots of attention because that's where the big money is.  Diabetes and obesity, as I've shown you, cause huge economic losses.  Drug companies pour a lot of money into these problems because they stand to make a lot of money if they find pharmaceutical therapies that help. 

Just do a search on typical terms related to metabolic dysfunction.

You'll probably notice that much of the science out there is attempting to define good diet starting with bad health.  

That's why Stephen Phinney's old study of cyclists stands out so much from the other low carb research.  If there is only one study in the literature arguing a particular diet is good for fitness, there is a high likelihood that represents a fringe idea.  Low carb researchers usually stick to the diabetic and the obese because only the desperate and confused would fall for such ridiculous dietary advice. Frequent exceptions to this observation are the studies focusing on sports nutrition, but just like Phinney’s article, those seldom consider long term health issues.

There are other serious obstacles to a shift to a food culture that addresses our real modern challenges.  Some of us frequently have to eat in restaurants, and those restaurants usually sell foods that appeal to our primitive impulses.  They want to draw you into their restaurant, and then they want you to part with your money.  Appealing to your primitive instincts is an effective way to get you to do that.  Why else would we see meals so loaded with calories, fat, meat and salt?  These meals are the very definition of calorie-dense and nutrient-poor, and unfortunately they make up about 35% of the calories Americans consume.

What hope does the average person have of eating healthfully in a restaurant when professional dietitians can't even estimate the calories in the foods they serve with reasonable accuracy?

And then there is the way our government subsidizes food.  Unhealthy foods have hidden costs at the front end when you buy, with artificially lowered prices thanks to subsidies, and at the back end, when they cause you to require medical care or compromise your productivity.  Those costs, not to mention the environmental costs, aren’t on the price tag when you buy butter or meat, but they will be paid by someone nonetheless.

If you are really interested in how evolution informs your food choices, think about this.

Early man's most fundamental adaptation was adaptability and versatility.  Those who survived and passed on their genes were those who were best adapted to their situation in their time.  Do you think they deluded themselves back then trying to recreate idealized diets from their distant past?  No, they used their intelligence and ingenuity to find the right food solutions for them in their world at that moment.  We must do the same now.  Our world today is different than theirs.  It's time to use our big brains to adapt again.

If we look to our historic roots, we should recognize how short-sighted and destructive we can be.

We humans have a historic tendency to destroy ecosystems in pursuit of meat.

If we open our eyes, we will see we have the opportunity to eat the healthiest, most humane, most responsible diet in human history, if only we would be smart enough to recognize it.

We should do our part to create a food culture that helps all of us to be healthy because ultimately, we will all pay the price one way or another if we don't.

What I'm advocating isn't radical.  I think a great place to start our new adaptation is the Harvard School of Public Health's Healthy Eating Plate, which is based on good science.

If you implement this, you won't be too far from what I think is best.  I would disagree that oils have a special place in the diet.

As Joel Fuhrman points out, they are essentially empty calories.

I would also follow their line of reasoning about calcium just a little further.  If you are eating a healthy plant-based diet with lots of greens and beans to get your required calcium, you probably don't have to concern yourself with the other purported benefits of milk regarding high blood pressure and colon cancer.  Plant foods are arguably much better for those issues.  They also lack the unwanted baggage of dairy.  So I don’t see the rationale for dairy consumption.

And I would choose the vegetarian proteins they name instead of meats for all the reasons I laid out at length in the Protein Choices section.  I don’t need unhealthy baggage along with my protein, either.  I’ll take some extra nutrition to prevent disease, though.

One can use all the arguments I've presented, whether based on nutrition, evolution, environment, or cost, to dramatically cut back on your meat consumption and still stay well inside the mainstream.  But can I make an argument based on all that that will compel you to go completely vegan?

Probably not.  Ultimately going vegan is about your own conscience.  What kind of life do you think these animals deserve to live?

For me, knowing that I don't need their bodies to be healthy, I cannot justify hurting them.

You could hope drugs will one day fix our broken metabolisms.

Or that genetically modified organisms will solve world hunger.

Or that geoengineering will fix climate change.  Maybe all these will help us.

But before placing all your hopes in these, my suggestion would be to follow this old saying first.

When you are in a hole, stop digging.

I'm not trying to sell you on a fantasy or a fad. This is the world as it is.  Engage these realities.  Be more responsible.  Be more aware.  Be healthier.

Be more compassionate.  Whole food veganism is the single best response I know to all these problems.  It can make the world a better place for us and them.

If a top competitive athlete doesn't need to exploit these animals...

And if a top fitness pro doesn’t need to exploit them, then I don't, either.  That's why I made the choice to go vegan.

I would rather let these animals be.  Where nutrition ends, that's where ethics begin.

TPNS 66-67: Animal Food Odds and Ends

Primitive Nutrition 66:
Animal Food Odds and Ends, Part I

There seems to be a belief among many that there must be a diet out there that perfectly supplies every last nutrient.  I consider this belief to be a byproduct of the design fallacy.  Only a perfect and coherent organism would require a perfect and coherent diet.  Yet our evolution should make it plain that we did not arise out of perfect and consistent circumstances.  Abandoning the expectation of finding a perfect diet might be liberating.  I have no requirement for a perfect diet.  I only want the best possible diet for my priorities. 

My nutrional requirements, like yours, all arise from biochemistry.  How those requirements are met is of secondary importance to me.  If I need to supplement B12, for example, what is the downside to that?  I'm not going to abandon a diet that provides perhaps thousands of important nutrients just because of one that it lacks.  A whole food vegan diet supplies me with the greatest nutrient density possible.  With that as my caveat, I'm going to run through a few of the claims you might read to support the belief in a requirement for animal-sourced foods.

First up, the omega-3 fatty acids that supposedly make fish and grass-fed beef so good for you.  Even the website for American Grass Fed Beef makes it clear that these fatty acids are not produced by animals.  Instead, they get into the animals through the plants they eat.

These fatty acids are in such low concentrations in grass fed beef it is not a significant source for them.

And yet people are willing to spend a lot more money for the perceived health benefits of grass fed.  Plant sources of omega-3s are inexpensive.

The meat industry is finding that the nutritional value of beef is enhanced by the addition of flaxseed flour.  It seems more efficient to me just to eat the flax seed directly.

Fish can't make omega-3's, either.  They get theirs from microalgae. Here you see these algae are fed to farm-raised fish to make them more nutritious.  Fish also get these fats from eating other fish.

Because of the over-exploitation of our fisheries, it is increasingly recognized that feeding fish to fish to feed to us doesn't make as much sense as it used to.  Soy is being fed to fish instead now.  Once again, why not just eat the soy directly?

It is a fact that no animal naturally produces omega-3 fatty acids.  Animals are being genetically modified now so that they can.  This is hardly primitive nutrition.

Omega-3s are one of those nutrients that are caught up in evolutionary speculation.  Here it is hypothesized that they explain why fish must have have been a key component in the human diet, as though fish were the only place to find them.  Maybe that is what happened, but I'm not sure why that matters for our diets today.

That article set off a debate.  The gentleman disagrees.

And it went back and forth a bit.  These interpretations of evolution strike me as speculative and not particularly useful for planning your diet.

In any case, there are more modern concerns with seafood.  Mercury is a potent neurotoxicant.

It is responsible for a loss of intelligence in our children.  The consumption of contaminated fish is the primary mode of exposure for us.

Environmental pollution is probably why the consumption of crustaceans and canned tuna were significantly associated with undersized babies in this study.

As for the omega-3's themselves, when they are sourced from seafood, they are associated with the development of diabetes.  From plant-based sources they are not.

A huge review of the literature on omega-3's found little benefit for total mortality, cardiovascular events, or cancer, so this is not much of a reason to eat fish or grass fed beef.

To the extent that they might help for reducing heart disease, plant-based sources seem just as good.

Often opinions are expressed based on articles like this.  Humans cannot convert their alpha linolenic acid to EPA and DHA.

But this doesn't seem to be such a problem for vegans.

You may have noticed a previous slide said that background omega-6 fatty acid consumption has little effect on the benefits of omega-3's.  This undercuts a big issue among the Paleo people.  There is supposed to be a proper ratio for these fats that we used to achieve but no longer do.

I'll just run through a few slides here to show you this is not a view that is universally shared.  These authors find it quite oversimplifies our understanding of fats and distracts from where our focus should be.

This researcher finds the idea has little value and is not supported by observations in humans.

This researcher concurs.

The UK Food Standards Agency has concluded this ratio is not a useful concept.

Here's a strange one.  Loren Cordain says the information on arachidonic acid is equivocal, which a charitable way to put it.  He wants you to think his diet, loaded with arachidonic acid, is good for you.

I wonder why he thinks the National Cancer Institute wants you to know what foods have the most if you are monitoring your risk factors.  You see chicken is on top.

There has been research into trying to lower arachidonic acid concentrations in chickens.  I guess Cordain would disapprove of these efforts.

The arachidonic acid you eat definitely affects the arachidonic acid in your blood.

Cordain seems so interested in helping people with autoimmune disease.  He should spread the word that lowering arachidonic acid in the diet helps people with rheumatoid arthritis.

More arachidonic acid in the diet makes you more vulnerable to ulcerative colitis, an autoimmune disease.

This was recently affirmed in a cohort study.

Your body does need some arachidonic acid, but you can make it without eating it.  Vegetarians moms have no problem with this.

On a side note, vegan and vegetarian moms-to-be can have very healthy pregnancies with a little planning.  I have a few more odds and ends for you in Part II.

Primitive Nutrition 67:
Animal Food Odds and Ends, Part II

I'll run through just a few more of these minor nutritional concerns now before I start wrapping up.

You have no doubt heard that trans fats are bad for you.  You may not have heard that animal foods have them naturally.  One of them, conjugated linoleic acid is often touted as a selling point for grass fed beef and milk.  Mark Sisson wants you to know grass fed dairy has a lot more than conventional dairy.

I wonder why this is supposed to be good.  CLA doesn't help your cholesterol, so that must not be why.

In fact, CLA is bad for your lipids, just like industrial trans fats.

CLA won't help you lose weight, either.

Same finding here.

These researchers were surprised to see CLA causes insulin insensitivity and raises blood glucose and cholesterol concentrations.

The reason some animal food promoters thought CLA might be good for you is because they saw some studies in animals and jumped to conclusions about what CLA does for people.

It turns out it is not good for people and is therefore not recommended for supplementation.

Here's an issue that is often overlooked.    A natural fatty acid called phytanic acid is more present in grass fed animals and their milk because of the chlorophyll they consume.  It makes its way into dairy fats people eat.

Dairy fat consumption determines blood concentration.  Vegans have way less in their blood.  They are better off for it.

Phytanic acid has gotten more attention recently because it is suspected of contributing to cancer development.  These researchers say it is a significant risk factor.

The lack of dairy consumption in vegans and some vegetarians doesn't seem to be a problem for their bones.

This is the most recent study I’ve seen on this issue.

Here's an issue I hadn't heard much about.  Natural toxins in plants that humans don't eat can get into us through the animals that do eat them.

This is considered to be a severe problem by these authors.  Some milk has been shown to contain this toxicant.

The best-known such toxicant in history is white snakeroot, which caused a condition called milk sickness.  In the 19th century it killed up to 50% of the people in some parts of the United States.  One of the victims was President Lincoln's mother.

For those who insist on searching for a magic nutrient that will end veganism, I'll just say that humans manage to do well on lots of different diets.  The health problems caused by diet, through deficiencies, imbalances, and overconsumption, are well-established at this point.  We're better off focusing on the issues that are clearly harming human health rather than searching for an "X-Factor" silver bullet to protect our fragile belief systems.

The exaggerated and imaginary nutritional concerns harped upon to discourage plant based diets are mostly just distractions from some very important issues.  In the last section of the Primitive Nutrition Series, I will try to show you what the big issues are. Some are quite distressing, but if we face them, they also give us the chance to do something truly positive.

TPNS 62-65: China Studies

Primitive Nutrition 62:
China Studies, Part I

This may be the most controversial book about nutrition to appear in the last decade.  Yet it's not a diet book.  It doesn't give irresponsible advice.  It doesn't ask you to sacrifice your long-term health so you can drop a few pounds.  To the contrary, its whole focus is on improving long-term health.  What's more, it's written by someone who actually had a career in nutrition science.  Yet T Colin Campbell's  book, The China Study, might fairly be called radical, especially in a cultural sense.  It was not enough for Campbell to just say the healthiest foods are whole plant foods.  He went much further than that.  He said animal-sourced foods are big culprits in causing chronic disease.  Unlike what you'll see in the writings of other nutrition professionals, he does not make a virtue of moderation.  For Campbell, there is no middle ground.  Whole plant foods are where you'll find proper nutrition, period.  I can understand why that message would be hard to swallow for a lot of people.  He's asking a lot of us.

That's beside the point, however.  What interests me is whether or not he is right.  Being radical doesn't make you wrong.  Having researched these issues, I've concluded that his views are basically correct.  Now I'm sure it's no surprise to you at his point that I'd say that.  So rather than offering a T Colin Campbell puff-piece in this section, I'll engage his critics and take their charges seriously.  Campbell has really put himself out there with an uncompromising and unusual opinion, so if he's wrong, his critics should have no problem exposing his mistakes.

Search "The China Study" and you'll see his critics are many.  They appear soon after the usual sites you might expect for a prominent book: a Wiki page, the author's page, some shopping options.  Then look down a bit to the last three here, if you can make them out. The link third from the bottom, called "The China Study: Fact or Fallacy," is a critique created by Denise Minger.  The title doesn't make any sense, but I won't digress.  I wasn't all that interested in her take on this book and I originally didn't plan on including her in these videos.  Her posts about the China Study are pretty long and she is mostly just disputing the way numbers were crunched.  I don't have the expertise nor the interest to properly fact-check her analysis of it.   What pushed me to include her was that last search result you see on this slide.  Science-Based Medicine is a very useful and interesting site for anyone concerned about health matters, and it's most famous blogger, Steven Novella, is someone I admire a lot.

So you will understand my disappointment at this headline.  That Science-Based Medicine would be one of the sites bashing this book really disappoints me.  I want them to be better than this.  I'll show you what I mean.  The author of their article, Dr Harriet Hall,  says a new analysis of The China Study does not support Campbell's vegetarian ideology.  This has the ring of a news bulletin, as if the proper authorities have finally weighed in.   That's not the case.  This is about Denise Minger's blog.  This raises some questions for me.  A new analysis? Is it better than the original analysis?  How has Harriet Hall determined that?  Bear in mind this new analysis was not published in a peer-reviewed journal.  It was just a blog posting on a raw foodist’s personal site.

Does Dr Hall regularly read the raw food blogs?  Is there a reason she is confident in Minger's competence to analyze the copious data from the China Study?  Is she sure Ms Minger can produce a plausible, fair, and responsible interpretation of it?  Getting into the content, she faults Campbell for failing to tell us that in his data, wheat is strongly correlated with heart disease, but animal food is not.  This is what Minger says and apparently she is in full agreement with her.  Why is she so quick to accept this assertion?  I wonder what special skeptical tools she is using to assess all this.

After all, the nutrition transition is an important topic in  public health these days, and China is one of the countries experiencing it the most.  Their diets are changing fast, as are their rates of obesity and diet-related disease.

Is it their increased fruit consumption that is causing their problems?  Can grains be blamed even though they are being consumed less by all income groups in recent years? 

The trend in China is away from wheat consumption and toward greater meat consumption.  These trends are associated with increasing disease.  What could Minger have said to make Dr Hall ignore these basic facts?

Other studies showing similar conclusions about food and cancer to Campbell's were published before his.  Is she similarly suspicious of those?

If someone looks at The China Study with some skepticism, I can understand that.  After all, most published research findings are suspect, as I'll discuss in my Waking to Realities section.  However, one's degree of skepticism should be proportional to the claims being made and who is making the claims.  The China Study shouldn't stand out as such a lightening rod from this perspective. There is plenty of evidence to support his ideas beyond his own research.  You can take or leave his conclusions, but let's first put The China Study in context.  What have other researchers had to say about diet and health in recent years?

Here is a major recent study of a large cohort in China that compared the effect on mortality rates of vegetable-rich, fruit-rich and meat-rich diets.  The conclusion states,

"In general, a fruit-rich diet was related to lower mortality, whereas a meat-rich diet appeared to increase the probability of death."

Here, a population based study of Chinese women found a link between animal proteins and saturated fats with breast cancer.

Here is a study that showed major health advantages for Chinese vegetarians, including lower BMI and blood pressure and better cholesterol numbers.  These advantages were bigger the longer someone was vegetarian.

The World Cancer Research Fund and the American Institute for Cancer Research examined the effects of various dietary factors on specific cancers.

They created a very clear chart to represent their assessments. You should have a look at it.  If you do, Campbell's ideas don't seem so radical.

The funny thing about the uproar over his book is that when a committed meat eater hears a result he or she doesn’t like from a modern, professional work like The China Study, you can be sure they will protest that correlation does not equal causation, yet if Denis Minger says wheat causes heart disease or Loren Cordain says that populations a hundred thousand years ago were free of chronic disease, they just accept it without question.  Whole wheat is associated with lower rates of cancer. 

It is also associated with lower rates of heart disease.  Why deny this?  And how are you going to do a population based study on people who died tens of thousands of years before civilization?  Some people have breathtaking double standards.

I'd like to point out that on the topic of carbs, Campbell seems rather mainstream.

Like virtually all health professionals, Campbell is not a promoter of refined carbohydrates. 

Harriet Hall calls herself The SkepDoc and she has been active in the skeptical community.   Unfortunately, just calling yourself a skeptic isn't enough to make you one.  Skeptics know they have their own biases, and they know they have to at least try to account for them.  Dr Hall had already made her biases concerning nutrition clear.

She had quite a skeptical take on the diet former president Bill Clinton adopted to achieve his dramatic weight loss.  She dismissed the work of the three doctors who informed his change in lifestyle.

In reference to Colin Campbell she dismisses his amazing assertion that over a period of years some provinces in China didn't report a single heart attack in anyone under 64 even though their populations were in the tens of thousands.  "That doesn't tell us anything," she says.  Thanks for the serious analysis, Doc.

She considers the connection between saturated fat and heart disease to be debunked by Gary Taubes.  Taubes used lots of references, she says, so I guess in her mind that means he's right.

You can find a far more informed and skeptical take on Gary Taubes than hers if you visit the website of the excellent low carb blogger, CarbSane.  You can see she has kept herself busy trying to fact check Gary Taubes and his book, Good Calories, Bad Calories. 

This blog recently debunked Taubes's core beliefs.  Dr Hall should check it out.

This thorough critique of Taubes by an obesity specialist should be on her reading list as well.  Why assume the science writer Taubes understands obesity better than a top obesity researcher, doctor?  Because you want to believe him?  Because he used a lot of footnotes?

Amazingly, she even references the International Network of Cholesterol Skeptics in her critique.

Her language reveals that she, like Uffe Ravnskov, may have hedonic barriers that prevent her from taking a clear-eyed look at nutrition.  She assumes Clinton's diet was a difficult lifestyle adjustment.  Has she tried it?  Did she skeptically research this?  She also thinks one must renounce avocados to meet the recommendations of these doctors for some reason. I'll get to that in a moment, but notice she indulges in some snarkiness with a rather personal parting shot at Bill Clinton at the end.  The Skepdoc is apparently not above pandering with this cheap non sequitur.

Where does she get the idea Bill Clinton can never again taste an avocado?  There is nothing about avocados in Dean Ornish's book about reversing heart disease, and he is one of the doctors she takes to task.

If he changed his mind when he wrote The Spectrum in 2007, he has a funny way of showing it.  Maybe his multiple tips for eating avocados are only there to tempt and torment heart disease patients.

Another doctor she turns her skepticism toward is Caldwell Esselstyn, who only restricts avocados for cardiac patients with elevated lipid scores.

Dr Campbell himself is practically an avocado pusher, telling you to eat all you want.  Dr Hall should at a minimum offer a retraction of her avocado-based fib.

Dr Hall has used her critical thinking skills to address fears over vaccines and autism.  In doing so, she is a defender of good science.

The National Academy of Sciences would agree with her. Their expert Food and Nutrition Board might wonder, however, why she trusts Gary Taubes and The International Network of Cholesterol Skeptics so much more than them.

I hope Dr Hall takes a look around the internet and asks herself if The SkepDoc should be endorsing fringe movements so uncritically.

Having vented about Science-Based Medicine, in Part II I'll turn to Denise Minger.

Primitive Nutrition 63:
China Studies, Part II

The chapter in The China Study that is most controversial is a distillation of Campbell’s findings while coordinating the China-Cornell-Oxford Project.  It was a collaboration of many researchers that was funded by several institutions.  This was a large-scale effort.  It was not a case of one radical scientist left in isolation to cobble together suspect findings.

The raw data generated by this project is freely available.  Denise Minger's critique is based on her interpretation of that data.  You can download the data, play with it, and blog about it, too, if you don’t mind going to the effort.  You probably wouldn't be any less qualified to do this than Ms Minger was.

Who is Denise Minger? The last I checked, her website says she is 23, but really, she says, you should think of her as 35.  She is not a doctor or dietitian, much less an epidemiologist or a nutrition scientist, but she says she will get a degree in something like that one day so you should give her credit for that, too.  It is upon that scholarly foundation that she has been able to make weighty scientific pronouncements, like her statement that the new USDA guidelines are hogwash and that the lipid hypothesis is feeble and unproven.  Look deeply into that close-up photo of her left eye and you will know she is right.

She has an interesting background with regard to food issues.  I learned what I'm about to tell you about her from her interview on The Livin La Vida Low Carb podcast number 405.  At 7 she almost choked on a piece of steak, which convinced her to stop eating meat.  She says she then became a "die-hard vegetarian."  At 7.  "I started young," she says.  At the age of 11 she had been sick for about a year when she went to a naturopath who put her on an elimination diet, and then progressively reintroduced foods.  Guess what food made her sick right away?  Wheat.  "Ever since I have not eaten wheat and I have not even wanted to because of that," she says.

At 15 she noticed she was feeling unwell after eating soy, which she had been eating five times a day.  That's a lot of soy.  That's when she found a web site about the purported dangers of soy.  Can you guess which one?  Of course you can.  It was the Weston A Price Foundation web site.  "At the time I was in my vegan la-la land," she recounts.  I guess the Weston Price people are not in la-la land in her opinion.  She was so impressed with their soy bashing, she asked herself, "what else can they teach me?"  I guess the site is well-targeted at15-year-olds.  When she saw they promoted raw milk she thought, and I quote: "What!  No!  Back one, back one, back one!"  (she’s talking about her browser back button.)

Back to the quote. "I had to get out of there as fast as I could so I could wash my poor vegan eyes out to with water to cleanse them of the filth they spread."  "I think it planted a seed," she said.  This was at 15 years old, mind you.  Ms Minger is part of an annoying phenomenon for me: people who become vegans for purely emotional reasons without much knowledge about nutrition who then, after somehow getting into trouble, blame veganism for their problems.  Remember, she became vegetarian on her own at age 7.

After the WAPF site ruined soy for her she became a raw vegan at 15.  Eventually her raw diet lead to: "dental problems, anemia, B12 deficiency, a lot of problems".  She called her experience a disaster.  So at 16 or 17 she "woke up from the vegan dream."

I want to address Harriet Hall one more time now.  So Skepdoc Harriet Hall MD, do you hear anything in this that presses your skeptic buttons?  Do you see any potential for bias in all this?  Vegetarian at 7?   Visits to a naturopath? How do you feel about naturopaths, doc? What about raw veganism?  Do you think she might be a bit biased against wheat given her problems with it?  Does the WAPF promote good, skeptical science in your view?  Do you recommend raw milk to patients?  Dr Hall, how do you feel about low carb diets? 

Dr Hall, do you find it interesting that she has created a presentation called, "How to Win an Argument With a Vegetarian"?  Does this indicate any bias to you?  Here you see she finds the conspiracist mindset an easy fit.  She thinks she knows how to do epidemiology better than the professional epidemiologists, who certainly would not think to check for confounders in population data such as other lifestyle factors.  She is just really on top of things, I guess.  The last slide referencing Seventh Day Adventists is interesting as well.  It's a reference to members of the American Dietetic Association, the most prominent nutrition science organization, which has endorsed well-planned plant-based diets.  I guess Ms Minger has uncovered that they're in on a vegan conspiracy.

The video of her presentation that used these slides can be viewed here.  I tried to watch it all but I only made it this far.  If you can get through more you are a more patient person than me. 

I got her slides from Slideshare, which is hosting presentations from something called the Ancestral Health Symposium.  MInger gave her talk there.

As you can see, it was endorsed by Loren Cordain, who thinks evolutionary medicine needs a Woodstock.  Do oncology or endocrinology have Woodstocks, too?  Minger is just one of many jumping on the Paleo fad bandwagon.

By the way, check out their imaginary Groks to the left.  If you find photos of any individuals from Loren Cordain's favorite hunter-gatherer cultures that look anything like these two silhouettes, I would love to see them.

Personally I find the these two real hunter gatherers to be a lot more interesting than the imaginary models in their graphic.

So that's the background on Denise Minger as I see it.  Let's look at what she says about The China Study.  Read this paragraph and you'll see she feels Campbell should have reported associations between heart disease and non-rice grains.  By her reckoning, wheat, corn, barley, even fiber require investigation for causing heart disease.  Comments like this are where her amateur status becomes a problem.  She knows enough to point out that these are unadjusted correlations which may be totally meaningless without any context, but she doesn't know how unlikely it is these are real contributors to heart disease because she doesn't seem aware of the body of nutrition science beyond The China Study.

Here's another example of her bizarre interpretations.  She has capitalized her phrase Green Veggie Paradox in the bottom left paragraph, as if such a thing exists, in order to say that people who eat more green vegetables aren't protected from stomach cancer.  She offers a suggestion that there may be a geography issue at play, but she doesn't say what she has in mind.

Now if she were to know anything about Chinese food culture, she might realize that they consume a lot of their vegetables pickled.  This practice has been associated stomach cancer.  Chinese health officials who are not bothering to pander to low-carbers suggest the solution is to eat less pickled food and more fresh fruits and vegetables.  The article here also points out that urban Chinese eat double the meat they did 20 years ago, and this is considered a contributor to their health problems.

Look into gastric cancer and you will see that fruits and vegetables are associated with less stomach cancer, and meats with more. 

This recent study shows this as well.  Minger apparently is unaware of this.

Here's another challenge she levels at Campbell.  She accuses him of a major oversight when he fails to factor into his observations of colon cancer rates the effects of a parasitic infection called schistosomiasis.  Because that parasite is linked to colon cancer, her point is that fiber intake may not be explanatory for rates of colon cancer.   That’s an interesting charge since on his website, Campbell says they found an association between schistosomiasis and colon cancer.  So he says they found an association for this parasite but Minger says he didn't account for it.  Who are you going to believe?

Once again, these issues do not occur in a vacuum.  Here is another piece of research that found that schistosomiasis is associated with colon cancer.  Colon cancer is also associated with animal foods and high cholesterol.  Green vegetables appear protective.  All these may be true at the same time.  Is Minger complaining about his study, too?

Here's another study she can complain about.  Cereals, with all their fiber, were found to protect against colon cancer.

And if she still is buying into the views of the Weston Price Foundation, she should know that soy appears to be protective of colon cancer in this study of Chinese women.

Here's one more issue she raises before I move one.  She says blood glucose levels are linked to Western diseases, sort of like the way cholesterol is.  She doesn't seem to know why this may be.  As I have shown you at length by now, saturated fats harm glucose metabolism, as seen in this study.

This brings us back to diabetes and Neal Barnard's insights into the effect of saturated fat on insulin resistance.    Minger panders to the typical low-carb belief that healthy carbs cause chronically higher blood sugar, which is just not true.  I can provide you with plenty of references to show you saturated fat is the real problem.  This is one.

Here is another.

And another.

Saturated fats make blood sugar less manageable for type 1 diabetics as well.

High-carb, high-fiber diets actually improve insulin sensitivity and therefore help your body control blood sugar.

Replacing saturated fats with healthier foods improves glucose disposal.

This study says that the insoluble fiber in cereals, which are so vilified by the Paleo crowd, is most protective against diabetes.

I hope you can see why I haven't investigated her claims about The China Study further.  I just don't find her ideas to be very well-informed. 

Rather than spend more time on her view of the Colin Campbell's research, I think I can show you why she isn't an especially authoritative voice in nutrition research by looking at this blog post of hers.  This is where it gets nutty.  Grab some aspirin and meet me in Part III.

Primitive Nutrition 64:
China Studies, Part III

This part of the Primitive Nutrition Series may give you a headache.  Things are about to get really confusing and really wacky at the same time. The purpose of this portion of my presentation is to show you how studies can be abused in all sorts of ways so that they seem to be supportive of nonsensical beliefs.  I hope the message you take away from this is caveat emptor when reading studies and blogs about nutrition.

In her blog, Minger is bringing to our attention what she is calling a new China Study. 

This is the first source of confusion.  For one thing it’s nothing like Colin Campbell’s China Study, which I’ll explain in a moment.  Next, it’s one of three papers from the same authors.  All three are the products of their work with what  looks like a single big cohort of Chinese participants.  She is calling one a new China study and you’ll see Michael Eades is calling another a new China study.  I guess conformity is valued more than originality in the low carb echo chamber.

You know we're in for some weird, wild stuff when you read excerpts from the three publications.  "A vegetable-rich food pattern is related to obesity in China."  "The vegetable-rich food pattern was positively associated with metabolic syndrome."  "The vegetable-rich pattern was positively associated with weight gain."  You might wonder why they keep using this phrase, "vegetable-rich food pattern."  I'll show you what that's about later, but the direct answer for now seems to be simply to confuse you. 

We will be dealing with two of these studies now.  One is what I'll call the Minger China Study, which is the one on the right in blue about dietary pattern and weight change.  The other one was published earlier than the Minger China Study.  It is the one on the top left that is about obesity.  I'll call that the Eades China Study, because Michael Eades seized upon that one to push his fringe agenda.  I'll get to that one soon.

First Minger tells us she thinks her study is a gem.  The Minger China
Study says a vegetable-rich dietary pattern is associated with weight gain.  Before you learn anything beyond that, ask yourself what the chances are that a study saying such a thing is a gem.  I hope you're skeptical.  She says she is going to give us some background and to do this she will tell us about the Eades China Study.  She says that one reached a half-baked conclusion because, quote, "no one wants to think vegetables make people fat."  What is she saying?  That vegetables make you fat but fatty animal foods don't?   She then explains that her new China study was really about wheat even though the authors say it was about a "vegetable-rich" dietary pattern, not a "wheat-rich" pattern.  So the authors of her gem of a study couldn't even correctly choose the right word to use - vegetable or wheat – in the study title, according to her.

Here's the article she sends us to by that promoter of ketosis, Michael Eades.

Remember, Eades is writing about the one on the top left that says a vegetable-rich food pattern is related to obesity.

Pause the video and read this if you like.  His starting premise is to give you a way of refuting what he considers unsupported claims in nutrition he thinks you will often hear.  This is all perfectly ridiculous. Take the fourth and the last bullet points, for example.  "Fruits and vegetables don't make you fat."  And "Show me the study!", which I guess is what he wants you to say in response to an imaginary vegan inquisitor challenging your meaty diet.  This is his set-up.  He thinks he is about to show us that fruits and vegetables make you fat.  Good luck with that one, Dr Eades.

In the next paragraph he says this study is special because it comes from the company that publishes the journal Nature.  He seems to think there is a transitive property of prestige from flagship journals to their lesser journals.

If that's so, he'll have his mind blown to see that the Nature publishers also gave us these studies.  High fat promotes obesity.  The lowest weight gain was seen in people who changed to a diet containing fewer animal foods.  A vegan diet was associated with significantly greater weight loss.  Meat consumption is associated with obesity.  Those are some important findings, aren't they, Dr Eades?

Minger mentions someone at the bottom of this slide named Stephan Guyenet as the person who clarified that her China study was really a wheat study.

I won't talk about Stephan Guyenet much here.  Just bear in mind as I go through this that like Minger he saw Dr Eades blog about his China study, did not find fault with his analysis of it, and readily accepts that eating more vegetables in place of other foods does not have any bearing on whether you'll become obese or not.  Eating more low calorie, high water, high fiber vegetables will not protect you from being overweight.  That's his opinion.  Like Eades and Minger, he's a popular blogger with the Paleo and low carb believers.  As I explain these studies, ask yourself if any of these people seem to have any clue about what they actually show.

Mr Guyenet, Ms Minger and Dr Eades, please pause the video and take as long as you need to understand this slide.  Look at the serving sizes and calories. Bacon has 23 times the number of calories as spinach for the same serving size.  Dr Eades, how do the vegetables make up this huge difference in energy and somehow make you fat?  Mr Guyenet, is this basic fact not a way vegetables will protect you from being overweight?  Ms Minger, iff you think vegans are in la-la land, what would you say about the low carb apologists?  The reason no one wants to think that vegetables make you fat is because that is not plausible.

Vegetables have the highest ratio of nutrition to calories of all foods.  This unavoidable fact makes them an unlikely candidate to make you fat.  It could even be argued that celery delivers negative net calories.

When Minger calls the paper she is praising a "new China study," she may be trying to mislead you into believing it is somehow comparable to the huge project Campbell oversaw.

The Minger China Study had a lot fewer participants, and the data about their diets just came from their recollections submitted through questionnaires.

Campbell's study, however, was a whole different animal.  It was much bigger and covered a much more diverse population.  Questionnaires weren't enough.  He actually had blood and urine samples collected.  His workers even examined the food sold in the markets where his participants shopped.

Another difference is that the Minger and Eades China Studies are based on dietary patterns.  Here's what they look like.  What does this mean?  This is where that oddly repeated phrase "vegetable-rich pattern" comes from.  Unlike Campbell's big study, which looked at individual foods and categories of foods that you might think naturally belong together, like meats or dairy products,  this bunch of papers use dietary patterns they created and gave their own names.  That's why the apologists can't even agree if the Minger China Study is about wheat or vegetables.  It's actually about neither of those.  It's about these patterns.

Here you see the four patterns with which they started.  In addition to the vegetable-rich pattern, there are the traditional, sweet-tooth, and macho patterns.  Yes, we are supposed to take seriously a study of macho foods.

I don't have access to the content of the Eades China Study, but you can see that the vegetable-rich patterns from the other two studies are very similar.  I think I'm safe in assuming the first study used similar patterns to these, especially since the patterns had the same names.

The use of dietary patterns instead of naturally related foods and food groups is not totally without reason.  Using dietary patterns theoretically lets them see complex interactions between contrasting foods.  I'm not sure that's a very smart strategy, but we must accept that this is how these studies were done.  So if someone says one of these studies shows us that, "The more wheat you eat, the fatter you get," that suggestion is actually quite at odds with the way the study was designed and how the data were analyzed.  These studies were not meant to address specific foods.

This is important, but neither MInger nor Eades seem to understand that.

Then we need to think about how they used these patterns.  That's where the numbers come in, which they call factor loadings.  These researchers needed to somehow turn the foods named in their questionnaires into data they can play with.  Let's see what they did with the data their approach gave them.

Here's the explanation.

"Dietary patterns (main independent variables) were identified by factor analysis using the standard principal

component analysis method. Factors were rotated with an orthogonal (varimax) rotation to improve interpretability and minimise the correlation between the factors. The number of factors retained from each food classification method was determined by eigenvalue (greater than 1), scree plot, factor interpretability and the variance explained (greater than 5 %) by each factor. Labelling of the factors was primarily descriptive and based on our interpretation of the pattern structures.“

I'll stop there. 

You can pause and read the rest if you like.

If you don't understand it, I'll explain.  What you should realize is that people were not organized into cohorts, given a diet to follow, and then assessed for their compliance and results with that diet over time.  There were not separate groups of people with contrasting diets that would let us see what diet worked best.  Instead, they took every individual and measured their diets against every pattern, and then proportionally assigned them to different quartiles depending on how close their reported diets were to these patterns.  Still don't get it?  I don't blame you.  It's pretty convoluted. 

I'll try to make it simpler.  They are basing all this on the recollections of the participants only and then interpreting these recollections through these patterns they created.  Imagine what people would say if the raw data in the real China Study were left so open to interpretation and so dependent on memory and then measured so indirectly.  People would probably say, "garbage in, garbage out."  Yet the low-carb apologists think these studies are enlightening somehow.

Given all this, it seems Minger's use of the word "adherence" is a little misleading.  People were just doing what they normally do.  They weren't trying to adhere to anything.

Take a look at what exactly these patterns were that they used.  Here are two of them, the "traditional" and the "vegetable-rich."  Would you have guessed that the traditional pattern weighted fresh vegetables much more heavily than the vegetable-rich pattern?  Would you have guessed the vegetable-rich pattern included eggs but the traditional did not?  Would you have guessed the vegetable-rich pattern positively weighted milk and milk powder?  And notice the heavy emphasis upon pickled vegetables in the vegetable-rich group.   Understand the implications of this.  These patterns may have been truly representative of not a single person in the study.  The patterns are just their tools for crunching their data and nothing more, no matter what they name them.  How wacky is that?   To show you how misleading this can be, let's take the second-most heavily weighted factor in the traditional group, fresh vegetables.  You might think that means some people in the study were eating a lot of raw vegetables.  But you shouldn't assume that.

Raw vegetables aren't eaten very much there.  For one thing, Chinese medicine sees them as energetically depleting because they aren't warm.

A more compelling reason for the Chinese to avoid eating raw vegetables would be the practice of using "night soil" as fertilizer, which is raw and untreated human excrement and I'm not kidding.  You would cook or pickle your vegetables, too, if they were grown this way.  How they cooked them is important.  They used lots of oil, adding high amounts of empty calories in the form of fat.

The researchers can add whatever value they want to fresh vegetables, but if people aren't eating many raw, and they are frying the rest, they won't have the effect you might expect.  Also, the factor loadings are not necessarily based on the amount they eat directly.  They are based instead on the degree of variance for that factor.

Given all this, I hope you can see how disingenuous Minger is being.  She thinks this study can be used to say wheat causes what she calls "metabolic havoc."  She panders to the conspiracist mindset when she says she recommends reading the study fast before the capitalized "Powers That Be" hide it from you.  How silly! 

Here is the link for the study.  It's up now.  Ms Minger, if there are Powers That Be, it seems they can't take this down, or more likely, they just don't give a damn about it.

All this is just a prelude to showing you what total messes these blogs and studies are.  That's next in Part IV.

Primitive Nutrition 65:
China Studies, Part IV

Back to these mind-numbing studies and their kokamami patterns.

These are their descriptions of the four dietary patterns.  Notice there is a heck of a lot more information being provided for one than the other three.  The vegetable pattern on the bottom is the one generating their headlines, but that is not the one they show you in detail.  That's a big problem.  What we're left with is a detailed assessment of what they are calling the traditional pattern.  As I said, they just assigned people numerical values to weight their similarity to these patterns. 

They divided the data they got from this into quartiles, which run across the top from Q1 to Q4.  This allows for comparisons beyond just the simple patterns themselves.  Now we can compare based on what Minger calls adherence within a pattern, which really is just how close they happened to be to the pattern.  She is basing her argument on wheat because that is one of the big differentiators between the quartiles in this pattern.  But let's not forget what is going on here.  This is just the crunching of numbers from a big number soup.  There are not different groups of people, Q1 through Q4.  Rather, everyone is in every pattern and in every quartile.  That's where the factor loading comes in.

Look at the last paragraph here.  Participants were assigned pattern-specific factor scores.  We are looking at groupings of scores, not groupings of people.  This is tricky, isn't it?

Here's something else that's tricky.  In this study they reported energy as kilojoules.

In the previous study the energy was reported as kilocalories.  Why the needless complication?

But wait there's more!  To obscure matters further, the Eades China Study doesn't even use consistent weight measures, instead reporting some foods in local weight units called liang. 

By now maybe you are starting to think these studies were designed to be both impenetrable and useless.  I wouldn't disagree.  I don't think it's coincidental that a bunch of studies implying that vegetables make people fat are this weird.

For comparison, here is the sort of information generated by Campbell from his work in China. Here's a nice, clean comparison between Americans and rural Chinese at the time.  You see the Americans ate a lot more protein and fat, and a lot less fiber, iron, and vitamin C.  They were also much heavier and had much higher cholesterol.  I think that's refreshingly straightforward by comparison.

So back to our Minger China Study about weight change.  What she notices is that the biggest weight change in their graphs happens between the first and second quartiles in the traditional pattern.

Because there is a lot more wheat flour represented in the first quartile, 298 grams versus 40, she has decided that this is really all about wheat.  She isn't telling you about the line right below, though.  Look at the differences in whole grains and you'll see all that wheat flour was not from whole wheat.

That wheat flour was instead coming in the form of noodles and dumplings.  Once again we have a low carb apologist forgetting to tell you they are talking about refined junk carbs, stripped of nutrition, because it suits their agenda.  Who in the health business says you should eat refined grains instead of whole grains?

This is why all quartiles have pitifully low intakes of fiber.    Despite all that information for the traditional pattern, sugar is not listed.  Sugar intake is really important.  I can't believe that was a simple oversight.  Notice also that quartile 4 had the highest fruit and fresh vegetable consumption and was the only quartile in their whole mess that maintained body weight, which you can see in the graph all the way at the top left.  Locate Q4. Zero point zero. So Dr Eades, if I wanted to show you that fruits and vegetables don’t make you fat with a study, I could use this one.

This is despite more calories in that quartile than any other.  Q4 is at 10,207 kilojoules of food energy yet Q4 showed no weight change.  That seems a lot more interesting than any observation about noodle consumption, but Minger is not interested in that for some reason.  Also notice the so-called "vegetable-rich" pattern at the bottom represents 524 more calories in the 4th quartile compared to the first quartile.  None of the other patterns show such a big difference in food energy between quartiles.  I wonder if Minger understands that eating more calories or kilojoules is a better explanation for adding on the pounds than any wacky beliefs about wheat.  But she can't eat wheat herself, so that's where her mind automatically goes, I suppose.

Minger should know calories are a much more obvious explanation than wheat.  The Eades China Study tells us this.  For all their convoluted patterns and statistics, they came up with a plausible reason why vegetables might have some association with being overweight in China.  They eat their vegetables in stir-fries with a lot of oil.  Oil is just empty fat calories, so using a lot of it consistently might easily add up to weight gain.

Let's now take a closer look at that Eades China study and his thoughts on it.  On the left I have selected food components of the vegetable-rich pattern this study said were associated with obesity.  Get ready, here is another source of potential confusion for you.  In the Minger China study, the lowest quartile number, Q1, was the one that was closest to a pattern.  For this one, it's backwards, so here Q4 means this grouping is most like the pattern, such as the vegetable-rich pattern you see here.  At the right you see Eades' commentary.  He scoffs at the authors for saying the reason for increased weight gain in the highest quartile is from all the cooking oil.  Instead, he says it's the carbs that make you fat, to paraphrase.  No, he is not subtle. Yes, carbohydrate is a bit higher in quartile 4. 
But calories are higher, too, as is protein.  The protein comes in the form of more fish, milk, and eggs.

Another China Study!!!

The eggs caught the attention of the same authors in yet another China study.  They put out a later paper pointing out that in their Chinese participants, those eggs were associated with diabetes, as well as higher triglycerides and cholesterol.  I put the vegetable-rich pattern to the right to show you that eggs were a positively weighted factor in their scheme.  Eades didn't seem to notice that.

But here's the real kicker for Eades.  If you stop the video and read this, you will see he is under the mistaken belief that there were actually distinct groups of people in this study.  He is making it clear he is unaware this was a pattern-based study and not a cohort study.  He doesn't understand how they used their data, yet he judges the integrity of the researchers and the conclusions they drew.  One reason they might arrive at this conclusion is because they know it it is practically impossible for vegetables alone to make you fat.

This slide is so embarrassing, even for Eades!

Dr Eades might look at a few news items or recent studies if he wants to understand what is making the Chinese fatter these days.  The study he looked at will make more sense to him if he does.  The same people who are eating more vegetables are also eating more of everything else, including meat and junk food, because they have more money now.

The Chinese also develop diabetes more easily than Caucasians.  At the same BMI, they are in worse health.

You can't blame wheat for this, Ms Minger.  It's been going down while the meat has been going way up.

As I said, China is an example of a nation experiencing the nutrition transition.  Their diets have less fiber and more animal foods and fat now.

Here's one of the craziest quotes you will ever see from an MD. 

"It is obvious from the first two sentences of the quote right above what the bias of these researchers is: fruits and vegetables are good for you. And more of them is even better. Problem is that there really isn’t any definitive research showing this, although it is widely believed."

We are to believe the good doctor has scoured the medical literature for studies showing that fruits and vegetables are good for you and has come up empty-handed.  Only someone with diet books to sell would say something so absurd.

Here are two pictures of Dr Eades.  The one on the left is from his website.  It's how he wants you to imagine him.  The picture to the right is a little more recent.  There are some differences, of course, but the one that jumps out to me is the orange tint he has on the left.  This reminds me of a recent study...

Did you see this one, Dr Eades?  People look healthier when they have skin coloration suggestive of vegetable consumption.

I find it interesting that Dr Eades would choose a photo of himself for his site that gives him that healthy vegetable-eating glow. There is a way to have a healthier appearance without Photoshop.  The Onion knows what this doctor does not.

Steve Hoyer has it right.  Maybe he should write half a dozen diet books, too.

Despite all these videos, I know I've let some pet issues for the primitive nutrition believers slip through the cracks.  I'll try to catch some of them next.

TPNS 58-61: Ketosis Is Natural. Natural Is Good.

Primitive Nutrition 58:
Ketosis Is Natural. Natural Is Good. Part I

So far in my examination of low-carb diets I've shown you that they are nutritionally deficient, metabolically damaging, and unlikely to produce weight loss, if only because fats are so calorically dense.  For the low-carbers, the solution to this last problem is ketosis.  For them, this special metabolic state is the ultimate goal of their diets.  They imagine it will effortlessly melt away all the fat they've accumulated from their prior unhealthy eating behavior.

Low carbers' zeal for ketosis has lead some to make a questionable claim which I'd like to ponder in this section.  Michael Eades presents it here in his blog explaining ketosis.  Of course, like many other primitive fad diet promoters, he wants you to start from the assumption that the activity pictured to the left somehow represents man's true nature and the way he has historically obtained food.  I don't see any women in that photo, which should give you a clue that this isn't the whole story.

According to The Economist, among the hunter gatherers who provide the Paleo model, "men usually bring fewer calories than women, and have a tiresome tendency to prefer catching big and infrequent prey so they can show off."  Eades is tapping into the same old macho vanity that has worked so well in marketing Paleo.

If you'd like to see what a group spear hunt really looks like in live action, watch this video.  Somehow the artist who created Dr Eades picture forgot to include all the blood.  Having read a bit about how intelligent and social elephants are, I find this unappealing to say the least.  If you watch it, see if you can imagine Michael Eades participating in such a hunt. 

But back to ketosis, despite his acknowledgement that ketogenic diets create a state quite a lot like starvation, he considers ketosis to be the normal human metabolism.  This seems to me to be a bizarre opinion, but he isn't the only one who says this.

This is a man with a proper education in nutrition who believes ketosis is the preferred human metabolic state.  He has a site called Ketotic.org.  He wants you in full gloom, avoiding sweetness in general and even limiting vegetables.  How can someone come to believe this?  Is ketosis natural?  Of course it it, just like starvation and death are natural.  But is it healthy, normal and desirable?  That is the subject of this section.

If you don't understand what a ketogenic diet is, I suggest you pause the video and read through this short description.  Ketogenic diets are designed to deprive the body of the carbs it needs for normal metabolism.  The diet has to be extreme to break the normal mechanism your body uses to burn fuel and to induce a dramatic elevation in the number of ketone bodies present in your bloodstream.

One of these ketone bodies is acetone, so someone in ketosis has breath that smells like nail polish remover.

These ketone bodies are acidic, which is why when you read the research conducted by the low carb gurus they supplement with sodium and other minerals.  Without this addition, the blood may become dangerously acidic.

I don't know of any other diets that require broths.  Low carbers try to make a virtue of this but it is clear this is only to minimize the adverse consequences of such an extreme diet.

The Atkins website runs down the problems attendant to this distorted diet without their supplementation ritual.

These diets are seen as mimicking the effects of starvation.

Ketogenic diets are used therapeutically today to control the seizures of epileptic children.  They have been used this way for many decades.  Fasting had long been known to be an effective method of seizure control.  In the 1920s a doctor named Wilder recognized how metabolically similar a ketogenic diet was to fasting.

It was this similarity that gave him the idea to use this extreme diet as a tool for managing seizures. 

It is not clear whether it is the reduction in blood sugar or the ketone bodies themselves that reduce seizures.

It is from observations of children subjected to such diets that most of the effects of the long term use of these diets are understood.  Here, for example, we see that these diets are damaging to the bones of these children.  This is only one hazard of this supposedly natural and normal diet.

Imagine little children having high cholesterol or kidney stones.  That doesn't sound natural to me.

Here is a list of the potential problems kids on these diets face.  I think if a similar list could be compiled for vegan diets the low carbers would find it quite damning, but somehow they still like ketogenic diets.

Despite the potential these diets offer for the treatment of epileptics, these numerous health hazards have hampered research into them.

If ketogenic diets are so natural and good, why do children abandon them at the earliest opportunity?  Why do they not prefer high-fat foods when they are back on normal diets?  Are these kids resisting their basic nature for some reason?  Are they under the spell of Ancel Keys, too?

Eades acknowledges the similarity between ketogenic diets and starvation, but starvation is not the only circumstance in which ketosis takes place.  Ketosis also takes place during uncontrolled diabetes and chronic alcoholism. 

Also producing ketosis are anorexia nervosa, prolonged vomiting, and several gastrointestinal diseases.  Of course, these all are unique in their own ways, but these associations should provoke a little skepticism of these diets.

As I said, the number of ketone bodies in the blood is dramatically escalated in ketosis, which are otherwise kept at very low levels by the intelligent systems of your body.  You know you're in ketosis when you have ketone bodies in your urine.

This is why low carbers buy a product called ketostix.  Diabetics use these to test their urine for ketone bodies.  If they have them in their urine, it means their insulin is too low and blood sugar too high, and this is a serious problem.  But for fad dieters, they want these ketone bodies in their urine.  This brings up another question for those who think ketosis is so normal.  Why should a person need to test their urine to see if they are in the preferred metabolic state?  Shouldn't it be easy to keep your body in ketosis if it's preferable?

Ketosis is rather delicate, actually.  Even sugar alcohols and the fillers in artificial sweeteners can provide enough carbs to knock you out of ketosis.  Why should the body be so resistant to it's preferred state?

There are a lot of things you can eat that will stop this supposedly preferred metabolic state, including most amino acids and even the fraction of fats which can be turned into glucose in humans.

Eades also wants you to believe ketosis is somehow efficient for your organs. He says the heart is 28 percent more efficient when it is fueled by ketones.  He says this even as he admits that glucose is still required by the brain.  I think it makes some sense that under conditions of starvation, it might be good for the heart to operate more efficiently.  Does this mean the rest of the organs operate more efficiently on ketones, too?  Is he saying this was a metabolic adaptation originating specifically in man during the Paleolithic?  Look for the answers to these questions and you'll see just how far off Eades' Paleologic is.

We're going to get back to basics in Part II.

Primitive Nutrition 59:
Ketosis Is Natural. Natural Is Good. Part II

Michael Eades says the heart runs more efficiently when fueled by ketone bodies.  So then ketosis makes your other organs, and indeed your whole body, more efficient, right?

To answer this, let's first look at the issue of efficiency generally before we look at specific organs.  Ketosis is the result of the breakdown of the normal cycle of chemical reactions most organisms, including us, use to convert nutrients into energy.  Your body needs some carbohydrate for this set of reactions, called the Krebs cycle, in order to extract all the energy available from fatty acids.

This is why it is often said that fat burns on the flame of carbohydrate.  Ketosis, therefore, is inherently inefficient.  Not only is less energy extracted from fat than normal, the energy available in excess ketone bodies is wasted in the urine.

Ketone bodies themselves are low in energy.  ATP is the elemental source of energy for all processes in your body.  Glucose produces 36 ATP.  Calorie-dense fat produces 146 ATP.  Ketone bodies, however, only yield 22 ATP.  This demonstrates the slouching approach to health of the low carbers at the most fundamental level.  Do they think we have evolved to store energy so well only to later waste it?  What do they think the purpose of body fat is?

Fat is there to provide energy to make survival possible in times of food scarcity.  A man carrying an extra 30 lbs of fat has a whopping 130,000 calories to burn when food is unavailable.  Think of this in terms of evolution and I hope you'll agree it's quite amazing that our bodies can do this so well.  We've evolved to be efficient machines, and this is one example of that. 

Consider that even without ketosis, fat metabolism is less efficient than carbohydrate metabolism because it requires more oxygen.    Moreover, it is hardly efficient to carry around a bunch of fat you don't need all the time. 

Fat is also less versatile than carbs.  Your body can turn glucose into fat, but it can't convert most fat into glucose. 

Lastly, ketosis wastes a lot of water, which can hardly be called efficient.  Looked at from the perspective of efficiency, fat is clearly a fallback fuel for use in hard times. Your body uses carbs much more efficiently.  Yet your body stores fat because it is just so good at keeping you from dying of starvation.  And that is because it holds lots of calories.  It would not have provided your ancestors any advantage to waste those calories.  So why say ketosis is natural?

Glucose is clearly the preferred energy source.  All human cells can use it.  Does that seem to be an overly broad statement?

We can take it further.  Glucose is the principal energy source for all living cells.  Can Michael Eades say the same about ketone bodies?

Remember Eades' statement that ketones are the preferred energy source for the heart?  What about the rest of your body?

Well, he said that ketones can't totally replace glucose as a fuel for the brain.  He should have said that except under extreme conditions glucose is nearly the only source. 

Your brain actually uses glucose disproportionately to the rest of your body, burning 25% of your glucose.

Our brains' greediness for glucose is far beyond what is seen in all other mammals.

Your brain only uses ketone bodies as a back-up power source. It has no minimum requirement for them.  They can even cause your brain to work less efficiently.

What about your muscles?  They're an interesting case.  Your muscles store carbs in the form of glycogen.  Your muscles are so stingy with glycogen, they won't share it with the rest of your body.

They keep their glycogen separate from your blood glucose regulation system.

If you engage in exercise and thereby become a more efficient machine, your muscles become better at storing glycogen to fuel them. Ketosis, on the other hand, requires the depletion of glycogen from the body.  This raises a question for those who think your body prefers ketosis.  Are they saying that as you become more physically fit and strong, you are also becoming increasingly metabolically broken? 

At this point you know that ketogenic diets are not adequate for athletes.  This is reason enough to conclude ketosis is not the preferred metabolic state.

So we know that your brain and muscles prefer glucose rather than ketone bodies from fatty acids.  Let's add to that list your red blood cells, which cannot use ketone bodies or fatty acids at all.  Without glucose they'll die, and without red blood cells, you’ll die.

Let's reconsider the heart while we're looking at different organs.  During normal metabolism your heart does not prefer ketone bodies.  Instead, it uses fatty acids.  Eades doesn't mention this.

In pondering Eades' statement that carb restriction was the norm for most of our existence as upright walking beings, with starvation being the normal metabolism, I find myself asking lots of questions.  Homo developed big, energy-expensive brains on a starvation metabolism?  Why would we hyper develop this uniquely glucose dependent organ in a glucose-poor environment?

Why do we seem so uniquely adapted to consuming starch?

I got to wondering, since it seems so improbable that ketosis is the normal metabolism for us, could it be the normal metabolism for any animals?  After all, Eades wants us to essentially be carnivores.  So are carnivores normally in a state of ketosis?

The answer is in Part III.

Primitive Nutrition 60:
Ketosis Is Natural. Natural Is Good. Part III

At the end of Part II I was wondering if any animals at all stay in ketosis under normal conditions.  It seems to me that carnivores are the world’s top low carbers so let's investigate them first.

Carnivores don't have much use for dietary glucose.  They are so dependent on animal protein they can't synthesize some amino acids the way we can.  So they must be in ketosis then, right?

Nope.  Carnivores need glucose.  They just make their glucose from the protein they consume.

Therefore, they consume protein not to satisfy an especially high protein requirement so much as they consume extra protein to satisfy their requirement for carbs, which are made during gluconeogenesis.

Here you see our minimum protein requirement is put in the range of 6 to 8% of calories.  Cats need at least 14 to 20%, yet their protein turnover is actually slower than in other mammals.  The extra protein is for making glucose.  Therefore, cats on low carb diets cannot enter ketosis if given adequate protein.  If a cat is in ketosis, it's either because it's diabetic or in prolonged starvation.

A protein-based diet enables cats to supply a steady stream of glucose to their tissues.

It's a good thing for them this glucose is supplied so steadily.  They have insignificant liver glycogen reserves to supply glucose in between meals.

This is why a carnivore like the mink is so poorly adapted to food deprivation.  It is quickly forced to break down its own body proteins to produce glucose.

What about that most low-carb, high-fat of carnivores, the polar bear.  Surely they are the one species that is normally in ketosis.  After all, they show a greater preference for fat than protein.  Could they really be running more on glucose than ketone bodies on such a fatty diet?

Polar bears are unique, but not because they are in ketosis.  They are actually using all that fat to manage their body water.  Because it can be hard to get enough water to drink in the Arctic, they don't want to eat excess protein because, as you will recall from my Protein Choices videos, the digestion of excess protein requires lots of extra water to eliminate all that urea.

When polar bears are starving, they actually begin to produce more glucose.  Unlike other mammals, they resist ketosis even during a fast.  They seem to be capable of turning their fat into glucose, something we can't do to a significant degree.

Notice the paragraph to the left.  If we look at ketosis as the back-up metabolism after normal carbohydrate metabolism breaks down, what is the back-up to ketosis?  There isn't one.  Even during terminal starvation, their bodies will make glucose right up until the end.

Polar bears in captivity are not fed a diet like they would consume in the wild.  They are actually fed fruits and vegetables.  But this isn’t their natural diet!  Surely this is a form of animal abuse, right?

Actually, polar bears in captivity live considerably longer.  But shouldn't an evolutionarily novel diet destroy their health?  This is yet another example of how Paleologic is no substitute for experiment and observation.

If there ever were an observed human culture that normally experienced ketosis, it would have to be the Eskimos.  They have eaten as close to an all-animal-flesh, polar-bear-like diet as any humans ever have.  Perhaps they will be an example of Dr Eades' normal metabolism.  Knowing now that polar bears are so resistant to ketosis, you might be doubtful, of this.  Your doubt is justified.  Eskimos don't normally develop ketosis.

This was studied all the way back in 1928.  Eskimos showed no ketosis at all on their traditional diet and during starvation became only mildly ketotic.

Even after his famous year-long meat diet experiment, everyone's favorite low-carber Vilhjalmur Stefansson did not experience ketosis.  His gluconeogenesis cranked up to make up for his carb deficiency.

Explorers who encountered Eskimos nearly 100 years ago remarked that they ate outrageous amounts of meat.  20 pounds of meat in a day!  Low carb didn't promote satiety for the Eskimos, did it?

Eskimos ate all that meat to turn their protein into glucose, which sounds like what carnivores do.  Eskimos were known to have unusually large livers, and this was speculated to be due to an adaptation to create more glucose from protein than other humans.

All that glucose probably kept them warm.  The present day practice of consuming sugar to stay warm goes back a long way.  Here in 1915 explorers in the Antarctic found sugar to be a necessity to tolerate the cold. 

Sugary beverages are advised for use today to warm up hypothermia victims.  Sugar would have been useful in any cold ice age landscape Dr Eades might be imagining, even if it was produced from protein.

Evolution helps us look at this from another angle.  An understanding of the utility of high levels of blood glucose in extreme cold has lead this doctor to suggest Type 1 diabetes is the result of an adaptation to cold.  Extra glucose would have prevented the formation of ice crystals in the blood.

In fact, Type 1 diabetes does have a pattern of occurrence that links it to cold weather.  Evolution seems to say that cold weather requires more glucose in humans and other animals, not less.

It seems to me this is the fatal flaw of the rationale for ketogenic diets that cheerleaders like Stephen Phinney like to employ.  The cold weather adaptation argument is not only ahistorical, it is metabolically backwards.

What about ketosis in naturally high-carb-eating mammals?  What can we learn about ketogenic diets from them?  That's where I start in Part IV.

Primitive Nutrition 61:
Ketosis Is Natural. Natural Is Good. Part IV

Let's look at ketosis in mammals at the other end of the carb spectrum.  If Eades says our normal metabolism is ketosis, and if ketosis is the result of carbohydrate restriction, then our primate relatives, which are frugivores who do not restrict their carbs, must then be resistant to ketosis by this logic.  In other words, in Eades’ mind we are natural ketotic low carbers, so ketosis must be really unnatural for primates because they eat so many carbs.  But this is not the case.  Primates experience ketosis a lot like us.

In the context of other species, even though we don’t enter or stay in ketosis easily, we are still on the end of the spectrum of animals that more easily enter ketosis right along with fruit-eating monkeys.  On the other end of the spectrum are dogs, which have much more obvious adaptations to meat eating such as teeth built for tearing rather than grinding. Dogs resist ketosis.  Farther still along this continuum would be polar bears.  Considering ketosis in other species, it seems very unlikely that we would normally be ketotic low carbers.

We're like primates in another way that wrecks the ketosis-is-normal argument.  You probably also know there are awful consequences to not consuming adequate vitamin C, namely scurvy.  Not only are we next to fruit-eating primates in the area of ketosis, we are next to them with our need for vitamin C as well.  Most mammals can synthesize their own vitamin C but primates like us can't.

A very good hypothesis to explain this is that we, like the other primates, consumed vitamin C from fruit regularly enough that our pre-homo ancestors did not need the ability to synthesize it. This created what amounts to a nutritional addiction.  We need to get our vitamin C fix somehow.

Here's another evolution-based argument for carbs and fruit.  It is also believed that our color perception developed from our ancestors' fruit-based diet.  Advanced color vision helped them to be discerning fruit-eaters.

Low carbers may say that Eskimos received enough vitamin C to prevent scurvy in the uncooked animal tissues they ate.  Cooking these meats would destroy that vitamin C, though, and we know that cooking goes back minimally around 400,000 years, which includes periods that were warmer than today.  This is before the beginnings of anatomically modern humans.  This timeline argues against the idea that our vitamin C requirement originated with the eating of uncooked meat.  The consumption of plenty of vitamin C from fruit long before that makes a lot more sense as an explanation.

I've noticed that low carb apologist and cholesterol denier Uffe Ravnskov thinks we need higher amounts of vitamin C than what is currently recommended by most institutions.  Just enough to prevent scurvy isn’t good enough for him.

I can't say I disagree.  I just wonder how he and Michael Eades would see us getting high levels of vitamin C on a natural low carb, ketogenic diet...

Especially during the times in our history when our ancestors lived in warm climates.  Here is a text from 1900 written by a US Army surgeon who noted that inhabitants of hot climates found meats and fats distasteful, preferring mostly vegetarian food.  Is Eades saying that it is more natural for humans to live in areas that are brutally cold?  Where does he think most people live?

It seems the human species concentrates more in warm places rather than cold places.

From an evolutionary perspective, it's clear the basic problem with Eades' thinking is that the capability to enter ketosis is not a uniquely human capability.  It seems almost all mammals can do it to some extent, regardless of their natural diet.  Therefore, ketosis metabolism must pre-date the first humans.

I would suggest another proof that ketosis is not normal is the issue of pregnancy, yet the Ketotic.org guy goes there in this blog.  Without coming out and saying it directly, he tries to give the impression by presenting a handful of animal studies that ketogenic diets are appropriate for pregnancy.  This man is advising women to eat a lot of saturated fat and keep carbs low during pregnancy. 

This is quite irresponsible.  Even Eades, while he says ketosis is the normal human state, won't condone this fanaticism.  I'm not sure how he reconciles his belief in the normalcy of ketosis with how damaging ketosis is to a fetus, but at least he draws a line somewhere.

This guy, though, sarcastically mocks the lack of human studies of low carb diets during pregnancy.  The studies he does cite don't help him make his case very well.  The first is about glycemic load which is a non sequitur here.

He doesn't tell us he's referring to a study using a product called the "Solo GI Bar." The manufacturer of these snack bars supplied the researchers with all the bars they needed.  The other low-GI foods in the study were whole grains, fruits, vegetables, nuts and legumes.  Does he really think these researchers would approve of using this paper to promote ketogenic diets during pregnancy?  That’s quite a stretch!

He says the second study he references tells us pregnant women do better with carbs kept down to 40 to 45% of calories.

He neglects to mention the women in the study had diabetes, which seems an important detail to leave out.  Their carbohydrate metabolism was already broken.  Do you see why I am showing you all these studies?  I need you to see how trustworthy these people are.

Here are some facts the Ketotic.org guy won't tell you.  Ketone bodies are likely to induce birth defects.

This is why groups assisting women to have successful pregnancies want them to test their urine.  They want them to make sure they aren't in ketosis.

For a while Robert Atkins himself recommended his awful diet to pregnant women.

He eventually learned that his diet could damage a fetus.  He then changed his mind.

If we are talking pregnancy, once again, we can look for clues in evolution that show us what proper nutrition looks like.  Fruit-eating primates start to become ketotic during times of fruit scarcity.  Females vary their fertility so that they are more likely to conceive when there is plenty of fruit around.

We don't have to consider evolution to know that ketosis is not desirable, though.  As I stated earlier, we know that children suffer ill-effects from these diets, including slowed growth, kidney stones and fractures.

We also have animal studies that show they can derange metabolism toward more accumulation of visceral fat.

And that they interfere with the hormones insulin and leptin.

Ketogenic diets also produce some of the very worst known risk factors for heart disease, which correlate with the degree of ketosis.

Top obesity researchers have found ketogenic diets have no benefit over other weight-loss diets.  To the extent they seem to work, it is believed this is simply due to the lower caloric intake most people consume on them.  Here's one reference for that.

And here's another.

Comparing a ketogenic diet to a less extreme low-carb diet, the ketogenic diet is not better for weight loss.  A ketogenic diet is, however, worse for cholesterol, inflammation, and emotional well-being.

And low-carb diets themselves are hard on emotional well-being.

Put it all together and you can see why a fad diet promoter needs to appeal to your inner disordered eater with language like this.  "On a low-carb diet you can feast and starve all at the same time."  This is the lazy, confused, magical thinking of low-carb in a single sentence.  Gullible diet chasers desperate for a quick and easy fix at any long-term cost, exit here.  All others proceed to a sustainable and healthy approach based on whole plant foods.

I have plenty more of Michael Eades in the next section of the Primitive Nutrition Series.  What can we learn from diet in China?  And just how ridiculous can Michael Eades get?  This may give you a headache, folks.  You have been warned.