TPNS 55-57: Stephen Phinney, Native Americans, and Low Carb Fitness

Primitive Nutrition 55:
Stephen Phinney, Native Americans, and Low Carb Fitness, Part I

In my short time studying the low carb view of nutrition, the most interesting person I learned about is Stephen Phinney.

He has extensive experience and great professional credentials so he should know what he's talking about, and if you read his journal articles you'll see he is no lightweight.

He has a longstanding professional and personal investment in the low carb idea, as you'll see.  If you've built your career as a low-carb scholar and researcher, it might be difficult to eventually realize that low carb never was a very good idea.  I see no indication he has reached that point yet, so I’ll try to help him come around in these videos.

For now, he is still putting into writing wacky beliefs such as implying that a minority of people can tolerate beans, whole grains, or vegetables without packing on the pounds.  Perhaps he’s thinking of magic beans with more calories per gram than fat.

I'll only be examining two articles of his.  This is one.  It’s an interview in which he extols the virtues of pemmican, a dense mixture of meat and fat eaten by the Plains Indians.

We’ll start with this paper though.  This is a scholarly article he wrote to present ketogenic diets as compatible with athletic fitness. This is the paper most often referenced online to prove that you can be an athlete and perform well on an extreme low carb diet.  There is practically nothing in the medical literature that makes this argument beside this paper, so it’s become somewhat of a stand-by for the low-carbers.  To create some context, let's first consider the concept of low-carb athletic performance.

Realize the basic objective of low carb dieting is to control insulin.  Low-carbers are forever at war with their body fat.  They think that since insulin promotes fat storage, if you keep your insulin down, you won't store fat.  I've already talked about why in real life it doesn't quite play out this way over time in my Low Carb, High Fad section.  Low carb and high saturated fat diets cause a multifaceted dysregulation of metabolism, which might even cause epigenetic defects in later generations.  But for the moment, the point is their own stated objective is to suppress insulin.

From an athlete's perspective, I don't see why this would be desirable.  The athletes I know don't struggle with weight loss.  They are usually more interested in becoming stronger.  Suppressing your insulin won't help with that.  I trust the friendly folks at Steroid.com know what they are talking about when they say insulin is one of the most powerful anabolic, or muscle-building, agents.

It is because of carbohydrate's effect on insulin that carbs are considered essential to increase strength.  Low carb diets have been shown to reduce one's capacity for muscle building, and this is probably why.

Even the promoters of low carb say it is not good for building muscle.

Insulin is not the only hormone we should consider.  This study looked at the free testosterone to cortisol ratio, a possible biomarker of overtraining, in two diets, one in a normal carbohydrate range and another in the low carbohydrate range.  The free testosterone to cortisol ratio plunged in the low carb group, likely indicating an impaired capacity for recovery from training.

Why take an unhelpful approach even further until you’re in ketosis?  Ketone body production was found to directly relate to perceived exhaustion in this study.

This study found the same thing.

The carbs in recovery drinks have been shown to reduce the inflammation response after a workout and to prevent damage to your DNA.

Food and Agriculture Organization of the United Nations

These are some of the reasons major health organizations say when you're an athlete, you need more carbs than ordinary people, not less.

Athletes looking at low carb research need to keep in mind a strikingly consistent fact.  Those low-carb-friendly studies were generally carried out on individuals with impaired glucose regulation, excess body fat, or other metabolic problems.  Low carb is all about easy fat loss for the sedentary.  This is why I think it is such a slouching, gloomy approach to health.

Should easy fat loss appeal to an athlete?  Should an athlete desire inefficiency in the function of his or her body?  Wouldn't you rather consider your body to be an amazingly efficient machine that deserves only the best and cleanest-burning fuel?

Against this backdrop, Phinney has a big challenge if he wants to convince the typical athlete that he or she should give up carbs. In his attempt to persuade you, Phinney gets off to a terrible start.  His first argument, unreferenced, is that our ancestors had limited access to carbs.  Somehow the isolated population dispersals into the arctic dictated how all humans on the planet developed.  I have shown you at length that this revision of history doesn't make any sense.  Dr Phinney needs to brush up on his evolutionary history and population genetics.  That this Paleo-truthiness made it in to their scholarly journal should be an embarrassment for Nutrition & Metabolism.

Look at the editorial board of this online journal and you will see it includes Phinney along with the usual cast of low-carb apologists.

Nutrition & Metabolism has a neutral sounding name but don't be fooled.  It is a product of the Nutrition and Metabolism Society, a low-carb advocacy organization.   When you visit their site to learn more about saturated fats, they will offer you an article by none other than conspiracy-minded cardiac surgeon Donald Miller.  The low-carb echo chamber now has a scholarly journal to give it an imprimatur of academic gravitas.  I doubt a top-tier mainstream scholarly journal would have published Phinney's article.

I won't go through the research he presents as the foundation of what he oddly calls carbohydrate supremacy, which is I guess his way of saying modern sports nutrition.  Unlike the cholesterol confusionists, he doesn't even try to discredit any of this science. 

I will note that in his review of history, Phinney predictably relies on the Stefansson meat-diet study.  I've already shown you why that study is nothing to crow over. 

After this section Phinney's primary material is drawn from two studies he conducted, one published in 1980 and the other in 1983. 

It's a little odd that he would write an article in 2004 that relies on these old papers so heavily.

In the first one, he subjected obese volunteers to prolonged ketosis in order to see if they were capable of moderate physical exertion in that condition.  He found they performed their best after a period of adaptation.  This is his main point regarding low carb fitness.  All other research into low-carb and ketogenic diets and exercise did not allow for a sufficient period of adaptation.

You can see even way back in 1980 he was relying on good old Stefansson and his meat-diet study.  His focus was different back then, though.  I think this is really interesting.  He was not interested then in ketogenic diets as a way of providing sufficient calories for long-term sustainability.  He said they had little clinical relevance to the treatment of obesity.  Back then he called the diet in his study a protein-supplemented fast, or PSF.

And that was certainly more accurate than calling it a diet.  These people only consumed 500 to 750 calories a day with supplements. As you know, supplements are necessary for low carbers to avoid serious deficiencies and are therefore used in all their studies.

Sometime since that study, Phinney decided those protein supplemented fasts should instead be called ketogenic diets.  Fast forward to 2011 and he doesn't tell you some were eating as little as 500 calories a day when he says, "In case you're wondering, while on the ketogenic diet, they had lost, on average 25 pounds."  Now that you've seen what they really ate, do you think he is reporting honestly here?

Here are their weight loss statistics.

In that rock-bottom range of calorie restriction, his participants were able to drop their cholesterol.  There is no mention of LDL, but give him a break, this was 1980.

Athletes, take note.  Ketosis absolutely cratered their insulin production.

At the end of their six weeks, with the doldrums of keto-adaptation well behind them, the people in the study did improve their performance, but Phinney doesn't make too much of this.  Dropping that much weight will certainly make an obese person perform better.

In that 2004 article, Phinney goes on to recount another study.  That one used subjects who were not only not obese, they were athletes.  This is interesting, and it's next in Part II.

Primitive Nutrition 56:
Stephen Phinney, Native Americans, and Low Carb Fitness, Part II

After his study on severely calorie-restricted overweight people, Phinney then conducted another study, here recounted 21 years later.  This one was more interesting.  He took well-trained cyclists and fed them enough to maintain their weight.  Once again, serious supplementation was deemed necessary.

Two papers came out of this study.  One result stood out for Loren Cordain here, and I agree with him completely.  After only four weeks on a ketogenic, extremely high-fat diet, these athletes saw their cholesterol rise from 159 to 208.  Imagine that.  In less than a month they went from having excellent cholesterol levels on what were likely very healthy high-carb diets all the way into what we conservatively would call a borderline high level today.  Imagine if they stayed with that diet how high their numbers might have gone.  Again, these were athletes, and this happened in only four weeks.  This is why every other low carb, meat based study conducted by low carb promoters creates a serious energy deficit.  At maintenance levels of calories, low carb diets are flat out dangerous.  Phinney amazingly says in the abstract that serum lipids were not pathologically elevated.  This is charitable of him to say the least.

The diet fed the cyclists was based on Phinney's recreation of an Eskimo diet.  To simulate the consumption of brackish water and caribou blood, they received the usually battery of low-carb supplements.  This is just the use of Paleologic to rationalize and repackage a nutritionally deficient diet.  Bear in mind his choice of an Eskimo model for later.

Also note that a diet free of carbohydrate is not historically accurate if you are reproducing an Eskimo diet.  Not only did they eat berries for carbs, but their practice of eating meat in its raw form gave them the glycogen stored in the muscles of the animals they ate.  Glycogen is a carbohydrate.

This is the second paper this study produced.  Glycogen in their muscles dropped like a stone.  Nevertheless, the cyclists did adapt to ketosis to the point that they performed almost as well as they did at the beginning of the study.  It's a very interesting result.  The human body really is amazing. 

So what are the lessons Phinney would like us to take from this study?  First, there is adaptation after that difficult induction period into a ketogenic diet.  For me, this raises a question.  Did the cyclists need a similar period of adaptation when they went back to eating carbs?   I think I'm safe in assuming they didn't, and this should tell you which diet is healthier for humans.  One observation in this study, often glossed over by low carbers, is that while in ketosis they did not match their sprinting performance on normal diets.

Because of this, Phinney is conservative in his written conclusions.  He says if you are using a ketogenic diet therapeutically, and I would question whether it's therapeutic for most uses, you don't need to stop exercising.  But athletes, understand this next point.  Your explosive strength will be handicapped on this diet.  This is probably a serious drawback for most sports.  Phinney says this factor would strongly discourage its use in competition.  So why do it at all?

One last note about this paper.  Cholesterol is not mentioned in his recounting of the 1983 study.  Do you think this was an innocent oversight?

Here is the other article I'd like to comment upon.  This one is an interview with Phinney.  He has a particular interest in the Plains Indians and their use of pemmican.

If you don't know what pemmican is you can pause the video and read how it was made. Basically it is dried meat and hot fat mixed together in a bag to provide a transportable source of calories in nutrient-poor environments.  Pemmican literally means "he makes grease."  Low carbers like Phinney evidently think grease is health food.

Because pemmican was a potential calorie-dense food source, the US military attempted to use it as a ration for troops.  It might have made sense to use it for personnel in the Arctic but it was abandoned because it was known that men did not thrive on it.  Put this in historical context and it is quite damning. The military had unsophisticated food preservation methods by our standards back then along with a great need for foods that could be easily and safely shipped, stored, and carried.  I doubt they gave up on this effort easily.  It must have been found seriously lacking as a source of nutrition.  This is the food Phinney finds so intriguing.

Here are some excerpts from this interview.  He is caught up in the reputed height of the Plains Indians and he thinks their diets were responsible for them being tall.  It is clearly assumed by him that being tall is healthy, and is a good measure of overall health.

I'm not sure why he believes this.  Greater height tends to associate with shorter life span.

Here is a graph from a study of height and longevity using data from baseball players.  Age is along the vertical-axis and height runs along the bottom.  There is a clear trend toward shorter lifespan with increasing height.

It's also an odd choice for someone who believes so much in the Eskimo diet, which is nutritionally quite similar to pemmican.  You'll recall from my Eskimo videos that they were notably short people.  They did not benefit from longer life as a result, though.

If you need the reminder, you can see they were considered short and fat, to put it bluntly.  As I have said previously, these are good traits if you live in extreme cold.

Here is another reference to their short height and short lives if you need it.

And another.

In the first paragraph here Phinney is interested in the Cheyenne tribe for their height.

He thinks they were eating practically no carbs and up to 80% fat.  Why he thinks this I have no idea.  As this author points out, those who think the Cheyenne ate only flesh are wrong.  They ate plenty of healthy carbs.  He points out that their diet was like those of the other Plains Indians, with a wide variety of plant foods to go with their meat.

For what it's worth, there are differing accounts of which tribes were tallest.  Here the Sioux are said to be taller than the Blackfeet.

This author extols the Sioux for their great height and fine appearance.

This author says the Blackfeet were among the tallest, though.

What did the Blackfoot Indians eat?  Here is an old text from 1905 which tells us the Plains Indians ate a lot of underground storage organs like potatoes.  Vegetables were so important to the Blackfoot they chose their routes of travel based on their availability.

They did eat a lot of meat, but also a lot of vegetables and berries.

What about the Sioux?  Rocky Mountain tribes ate a very large proportion of their food from root vegetables, according to this old source.  The Sioux are mentioned as particularly big consumers of a type of turnip, along with corn and meat.

Yet Phinney inexplicably believes they ate no dietary fiber.  He doesn't seem to have done enough research on this.  He says the same about the Inuit.  Is he right?

The Inuit did eat some fiber.  They just got it from a far less appetizing source, the contents of animals' digestive tracts.

Here is a magazine article from 1919 that gives you further evidence of Eskimos eating half-digested moss.  It was understood at the time this practice was employed to relieve constipation.

It doesn't look like Phinney was so concerned with duplicating the Inuit diet that he fed his cyclists reindeer intestinal contents like moss.

I invite Phinney to have a look at this book.  Eskimos did eat plant foods when they could get them.  Not included here are some less-than-ideal plant foods they ate in times of desperation.  Berries were highly prized, however.

Some Eskimos would go to considerable effort to ensure a year-round supply of them.

Writers in 1922 were trying to correct the perception that the Eskimos did not consume plant foods.  The message still hasn't reached Dr Phinney.

If you think this talk of fiber is leading to a slightly awkward subject for me to discuss, you are right.  I will discuss bowel health in Part III.

Primitive Nutrition 57:
Stephen Phinney, Native Americans, and Low Carb Fitness, Part III

I left you with Dr Phinney making some dubious historical claims about how much fiber was in Eskimo and Plains Indian diets.

In that interview, Phinney explained why you don't need fiber to have healthy bowel movements.  I have to say, it is pretty crazy to read comments like this coming from a doctor.  Anyway, this argument is based on Eskimos and Sioux being in ketosis.  I will show you in my Ketosis is Natural section next that this is absolutely not true.  Phinney has made the mistake of assuming here without actually researching this.  The Sioux would not have been ketotic, either, with their consumption of turnips and corn.  Phinney then walks straight into trouble saying that the Eskimos must have had easy bowel movements because they would have needed to be quick about their business out in the cold.

Once again, it seems he didn't research this.  Here is an often referenced article by low carbers written by a doctor who cared for the Inuit early in the twentieth century.  He said constipation was in fact common.  He said the cold weather added to the problem for them.

There don't seem to be many old references to constipation among the Eskimo beyond this one so I must conclude that their practice of eating partially pre-digested caribou food worked adequately if not well.  I can nevertheless show you how a relatively comparable culture with high meat consumption fared with respect to bowel health.

This paper is an examination of the Innu culture by Peter Armitage.  I have seen this document used to describe the Inuit online but this is a mistake.

The Innu and the Inuit are distinct cultures.  Some Inuit do, however, live near the Innu.  In these cold conditions they are obligated to subsist on animal-based foods due to the lack of vegetation around them...

Meaning their diet was and is high in meat and very low in carbohydrates.  Like the Inuit these are hunter gatherers who have a created a culture over the generations which has allowed them to maintain a stable population despite extreme cold.

This paper is well-known because of this section, in which Armitage tells us about a mythical spirit among the Innu called the Fart Man.  You might think the fact that they have such a legend is merely an odd quirk of their culture, but actually the Fart Man is very important in their belief system.  He is able to punish people for misdeeds with constipation so severe as to be fatal.  To the right you can see a mythic legend retold that makes clear the Fart Man was considered the most powerful of Innu spirits because of his power to constipate.  I think it is safe to say from this that constipation was a serious concern for these people, and I also think it is safe to say this was a result of their diet.

Phinney says he is going back to basic principles when he suggests we only need fiber so we have proper bowel movements.  He also says low carb diets provide adequate short chain fatty acids for intestinal health.  Neither of these beliefs are true.  Fiber promotes bowel health, which in turn promotes overall health in ways that are only recently coming into focus.

Moreover, low carb diets have been specifically criticized for not providing adequate short chain fatty acids to avoid bowel disorders.

In this interview Phinney is asked about the incidence of stroke among the Eskimos.  His response is to question if the Eskimos being referenced were truly pure low carb.  This is a common tactic for the low carbers.  Any historically documented health problems with extreme low-carb cultures were caused because they were not extreme enough in their diets.  You know you are dealing with a radical when he immediately suspects phantom carbs and overlooks the obvious. 

The extremely high levels of omega-3 fatty acids they consumed made the Eskimos very susceptible to blood loss.  Here is your explanation for their strokes, Dr Phinney.  No phantom carbs necessary.

To close out, let's circle back to the Plains Indians.

I am fortunate enough to own this old book featuring the photography of Edward Curtis.

Curtis set out over a hundred years ago to document the indigenous cultures and people he feared would soon disappear.  His pictures are mesmerizing.

One cannot look at them without pondering how much different their lives must have been from ours today.

Life in a challenging environment...

meant a life filled with hardship.

The people in the photos are fascinating...

and I would say beautiful.

But looking at these photos does not suggest to me their lifestyle would match our values today.

Although I respect these people, I would not trade places with them.

I'm sure this guy could hold his own living that life. 

I am not like this guy.

One of the photos stood out to me.  This lovely young mother and her child look especially healthy.  She is a Hopi Indian.  What did they eat?

The Hopi were practically vegetarian. 
This young woman came from an agricultural society that relied heavily on healthy carbs.  They let hardly a plant go to waste.

Curtis's photos suggest these were very healthy people for their day.

They seemed to have done a little better than merely survive.

Here they are preparing their grains.

When the Spanish encountered the Hopi, they were amazed at their physical fitness.

The Hopi even produce an Olympic medal winner for the United States in 1908, Lewis Tewanima.

And he was a true Hopi starch-eater.

Maybe Dr Phinney could take some inspiration from these people for his future work.

Phinney and the other low-carbers want you to believe you should be in an extreme metabolic state called ketosis.  I'll take that on directly in the next section.

TPNS 52-54: The Best Low Carb Research (Money Can Buy)

Primitive Nutrition 52:
The Best Low Carb Research (Money Can Buy), Part I

So far I've tried to show you how little sense low carb diets make by looking at basic metabolism, evolutionary history, and dozens of human and animal studies.  You may have your doubts about my views, though, because you've heard of studies showing that low carb can be good for you.  Therefore, in this section I'll take a look at some of those studies.  I selected these because I thought they were the best the low carbers had, most of them created by their top experts.  These studies are surprisingly easy to pull apart.  Let me show you how.

All internet meat promoters are familiar with the first and perhaps the most interesting low carb study.  An arctic explorer named Vilhjalmur Stefansson became convinced of the superiority of an all-flesh diet after years of interaction with Eskimos.

As you can see in this article from Time Magazine from 1930, he and his partner Karsten Anderson consented to be observed by doctors for over a year as they ate an all-flesh diet.  I use the word "flesh" in the interest of accuracy.  You'll see why soon.  Stefansson had some radical beliefs about nutrition.  "Eating vegetables and fruits is just like a form of religion," he said. 

Here's the study their year of flesh-eating produced.  You will notice that it was funded in part by the Institute of American Meat Packers.  This is where I get the second half of the title of this section.  I set out only to find the best low carb studies.  But over time I couldn't help but notice that a pattern emerged.  The funding for many of these studies came from organizations with a financial interest in meat.  Go figure.

Search for diet studies funded by these special interest groups and you will see this pattern for yourself.  I'm not complaining.  I know this is how the world works.  But we should factor this into our interpretations when we read these studies.

A recent report found that the American meat industry is funding pro-low-carb studies in Sweden now, just as they did in 1929 with Stefansson.  Until I see a study funded by the meat industry telling us meat can be unhealthy I will consider their studies suspect on this basis alone.  But this is far from the only interesting feature of this old experiment.  Let's look at the details.

We are told that the resolutely meaty Stefansson had required occasional catharsis for moderate constipation before the experiment but we are not informed of the chosen remedy, which I'll guess was probably castor oil.  Maybe if he had a better attitude toward vegetables he wouldn't have needed catharsis.  For all the muscles he ate, his own muscles were called soft and flabby.  The experiment began with more meat and less fat than he cared for, resulting in nausea and diarrhea followed by what must have been a very uncomfortable ten days without a bowel movement. 

He quickly had another bout of digestive drama which required more tinkering with the fat to meat ratio.  He had more trouble again within a month due to eating spoiled meat, experiencing abdominal pain, nausea, and vomiting, although he fared better than a friend who ate with him.

His partner Karsten Anderson came down with pneumonia at the end of the all-flesh diet experiment.  For his recovery he didn't mess around, taking in plenty of carbs.  Both before and after the experiment he freely chose a mixed diet.

Anderson had the usual loss of appetite on his flesh diet which is to be recognized as sign of good health according to low carbers.

During the experiment both men were sedentary.

This separate paper from this experiment is very interesting.  Low carbers, take note.  After a year on an all-flesh diet, with presumably only carbs in the form of muscle glycogen in meat, both men showed impaired glucose tolerance.  Anderson actually had glycosuria.

If you don't know what that is, it's sugar in the urine, which is a serious problem normally associated with untreated diabetes.

Just as interesting, after going back to a mixed diet their sugar metabolism normalized.  Carbs cured them!

The top line shows you Anderson’s blood sugar after the all-flesh diet and the bottom shows the improvement he experienced once back on carbs. 

Look at the effects of this diet on these men. The acidity of their urine multiplied by two or three times.  This is also something seen in diabetics.  I'm thinking most low-carbers aren't aware of these findings.  If they were they wouldn't keep referring to this experiment.

It's not at all surprising that their high-saturated fat diet caused insulin resistance.  This can happen in mice even without weight gain.

Glucose intolerance was also observed in the sort of low carbers who inspired Stefansson as well.  In 1936, it was written that Eskimos have higher blood sugar than other people as a rule, and were considered glucose intolerant.

An amazing 44% of young Eskimos ages 15 to 29 indicated glucose intolerance in 1968.  Maybe Neal Barnard is on to something.

Despite this unusual and alarming result, the meat-industry-sponsored researchers reported no ill-effects.

After the Stefansson study was published, a doctor named Newburgh at the University of Michigan took exception to the message this study sent.  He quibbled with their descriptive title, "all-meat diet."  This is why I have used the phrase "all-flesh diet."  As we saw from Stefansson's distress at the beginning of the study, the diet was not so much high in meat but high in animal fat.  Newburgh said this was the only way their so-called "all-meat diet" could be made to work.  In his research he found kidney damage resulted from a diet of 32% lean meat.  You may recall from the Protein Choices section that 32% protein is in line with Paleo recommendations.

He found bias in the reporting of the researchers who conducted the all-flesh experiment, who said that in a prior study of 142 Eskimos, renal damage was rare.  Newburgh corrected them, pointing out that the study actually found that 14.5% had some form of kidney disease.  Even back then, it was clear to someone this study wreaked of bias.

Let's look at more recent studies.  This analysis of 21 epidemiological studies declared that there is no evidence that dietary saturated fat is associated with heart disease, as though there had been no other evidence worth considering from the last hundred years beyond these 21 studies. 

This was greeted as a vindication of saturated fat by the low carbers, who seemed to think the medical world would just accept this conclusion without skepticism.

As you might expect, these researchers had funding sources that might strain their capacity for objectivity.  Ronald Krauss, for example, has received funding from the National Dairy Council, the National Cattleman's Beef Association, and the Atkins Foundation.

Krauss only wants you to consume 35 to 40 percent of your calories from carbs, far below the recommendations of most experts.  You can see he, like many others, has uncritically accepted the belief that Eskimos are models of health eating their traditional blubbery diets.  You know more about that now than this expert does.  He also does not shy away from his relationship with the Dairy Council.

This study caused a fuss when it was released and was quickly discredited.

Jeremiah Stamler, the famous cardiologist, was disturbed by it.  He found it had numerous technical flaws, which you can read in this article.  If you do, it will be clear to you that at the age of 90, Stamler was still on his game.

Letters of complaint were sent to the publishing journal.  One concern was that the authors did not distinguish between carbohydrates of different quality.  That's a common low-carb sleight of hand that was caught this time by these letter writers.

If you replace saturated fats with junky refined carbs, heart disease will be a bigger problem.  Replace saturated fats with healthy carbs and heart health will improve.

There is no contradiction in this.  Researchers are perfectly able to see both junky carbs and saturated fat as unhealthy at the same time.

One of the authors of this controversial study knows the difference.  He said that a singular focus on saturated fat was unhelpful because I guess he thinks people will inevitably just replace them with bad carbs.  This is an interesting statement coming from the author of a study that focused singularly on saturated fat in order to contradict most previous research on the subject.  Remember, the study said there is no significant evidence linking saturated fat with heart disease.  How is this not misleading?

In fairness, these researchers did address what the saturated fat might be replaced by in a separate article, but this one has gone unnoticed by the low carbers.  Here they only distinguished between different types of fat, though.  I'm always amazed at professional health researchers who find the differences in fats to be extremely important, but make no mention of the differences in carbs.  Read this and you might put all carbs in the same category, from quinoa to candy canes.

You'll see this isn't the only low-carb-friendly study to hope you don't know the difference.  More studies are ahead in Part II.

Primitive Nutrition 53:
The Best Low Carb Research (Money Can Buy), Part II

Of all the low carb studies I’ve seen, this is the one I found to be the most perplexing.  Before I saw it I thought there would never be a study showing that atherosclerosis can be healed on a low-carb diet. I thought, until the low carbers produce a study of their own like Dean Ornish’s, documenting a regression of heart disease, there really isn’t much to debate when it comes to diet and heart health.  But here it was, a low-carb study showing a reversal of atherosclerosis.  This looks like a serious two-year-long study with real results.  Had I been wrong about nutrition all along?  Could a diet high in saturated fat actually make our arteries healthier? I came to believe a nutrient dense vegan diet is the best we can do, and that a meat-based low-carb approach is a disaster, through what I believed was a rational and skeptical process. 

But if I am a true skeptic, I am obligated to discard that belief in veganism’s superiority, as much as I love veganism, if it is shown to be wrong.  Would this be the study that would finally puncture my convictions? An early warning flag was raised for me because the funders of this one included the Atkins foundation.  It bears repeating: I sought out the best low carb studies.  I did not try to find the ones with questionable funding sources.  It just happened this way.  The funding doesn’t discredit their findings automatically.  Maybe the Atkins people had finally found a way to make their approach withstand scrutiny.  What did they come up with? This study compared three diets: low fat, Mediterranean, and low carb.  All the diets seemed to turn back atherosclerosis for these people.  Maybe these were fair-minded researchers.  Somehow the Mediterranean diet was the one that was highest in fiber, which should tell you all you need to know about the quality of carbs consumed on the low fat diet. But still, the walls of the arteries of the low carb group seemed to heal, just in like the other groups.  What happened here?

This same group of researchers published a study comparing the same people while on these same three diets in a paper published earlier on the topic of weight loss.  This prior paper got some interesting feedback, as some strange things were noticed in that one, too.  Some people gained weight despite reporting serious reductions in their calories.  The diets were not really reflective of the names they were given.  The low fat group didn't actually reduce their fat intake.  They just were not low fat.  Dean Ornish noticed the strangest quirk.  The Atkins diet group was instructed to choose vegetarian sources of fat and protein.  He asks the right question: Why were they told to do this?  Are the Atkins people advocates for vegetarianism now?

Here you see it for yourself.  ”Participants were counseled to choose vegetarian sources.”  Is this approach typical for low carbers? 

The lead authors responded to these comments.  They said the low fiber intakes were due to the lowered amount of calories they ate.  This, they said, is obvious, although I'm not sure why.  Unless these obese people had been super health-conscious vegans, which I would submit is impossible, I think it would be very easy to increase their fiber and decrease their calories at the same time.  They didn't really answer Ornish's question about vegetarian proteins other than to say that the Atkins diet they used was based on an Atkins book.   The low carbers were reported to be consuming only about 1250 calories, which is really low.  This is another problem.  The researchers were, in fact, leveraging the power of calorie restriction more for low-carb to help it look better.

Here's something the letter writers didn't notice.  I hope you can follow me on this one.  This is the breakdown of the patient population.  The patients were categorized by how thick their artery walls were.  The thicker they were, the more atherosclerosis they had.  There were big differences between these groups, with the highest tertile really standing out as having the most plaque.  Look how the groups were put together.  The low carb group had the lowest fraction in the lowest tertile, only 20%.  They also had the highest proportion in the highest tertile.  Even though the low carbers made up only 26% of the study population, they had 32% of the group with the most arterial plaque.  The low carbers started out with more plaque than the other groups.  This is important.

People with the thickest artery walls respond the fastest to healthy lifestyle changes.  It's sort of like how an obese person can lose more weight faster than someone who is just a little overweight.  I will never win a weight loss contest because I don’t have much fat.  It works the same way for atherosclerotic plaque.  If you are judging by the amount of plaque you regress, then having more people with the thickest plaque concentrated in the low carb group will skew the results.

The people studied in these papers also had a mean BMI of over 30, which is technically obese.  Cutting these people down to under 1300 calories a day is bound to make a big difference.  There is no way they got to be obese eating so few calories.  This was yet another study of calorie restriction, not low carb.  Look at calorie restriction in low-carb this way.  Saturated fat hurts your arteries.  If you eat less of it, there is less of it in you where it can hurt you.  Even if you are still eating a high proportion of saturated fat, reducing the total amount you eat will still give your body a chance to heal itself at least a little bit.

I'll remind you that our potato guy, although he didn't have his artery walls measured, did see big improvements in other tests without drastically cutting calories.  I think we can conclude from this study that to make low carb appear to make you healthier, you have to cut back severely on calories.

Dean Ornish also regressed heart disease, but his patients were consuming almost 600 calories more per day than people were in this Atkins-funded study.  I'd think getting to eat those extra calories would make a diet a lot easier to stick with over the long term.  Also, Ornish's study did not look at artery wall thickness only.  He also looked at cardiac events, and that's what counts.

You would think that a reduction in the thickness of artery walls will always translate into a reduction in cardiovascular risk, but that isn’t necessarily true.  It is clear that a regression or halting of atherosclerosis by itself does not reduce cardiovascular events when drugs are involved. 

This leads to the next point.  Ornish did not put his experimental group on cholesterol-lowering drugs.

The Atkins study did.  26% were on such drugs, and another 31% were on blood pressure medication.

It's quite possible the atherosclerosis in these people regressed as a result of their lowered blood pressure, both from the drugs and the weight loss.  This could be an important factor in this study.

While measurements of artery walls are surely valuable, other measurements are more important.  Here aortic valve calcification is seen as more important than such measurements...

And this calcification is strongly related to LDL bad cholesterol.  The authors don't tell us what happened to their LDL.  You know why.  LDL is the Achilles heel of low carb.  You can bet they would have told us if it improved.

Based on all these issues – inaccurately named dietary interventions, questions about the accuracy of the reporting of calories, vegetarian sources of protein for the low carbers, aggressive calorie restriction, confounding medications, non-random distribution of the patient population, and a lack of disclosure about LDL – this study cannot be the one to tell us low carb can be made more heart-friendly.  Scratch its surface a bit and this very impressive-looking study just turns out to more of the same old low-carb chicanery.

Our next study is brought to us by top low carb researcher Eric Westman.  Here he is telling us that in his study, he happened to find that an extreme ketogenic diet was better than a low-glycemic index diet for glycemic control in diabetics.  We've seen already that ketogenic diets are probably harmful to blood sugar regulation, and we've seen how other low carbers only want to compare their diets to junk-carb-based diets, so this one looks to be different and promising.

What's more, Westman said in 2007 that he takes no funding from the National Cattleman's Beef Association.  Maybe he's even free of special interest influence.

Or maybe not.  A year later you can see he did receive compensation from this group for speaking and consulting.  This is the same year that he created the study we're examining.

This study, you might guess, was funded by Atkins.  He assures us that the Atkins people had no influence over this study.  That's hard to believe since he is Atkins people.  Here you see he participated in a low-carb podcast to promote his new Atkins diet book.

Do some searching on Google and you'll see that Westman has a great relationship with Atkins, who have funded numerous studies of his. 

This study has the usual dead giveaways of low-carb bias.  No mention of LDL cholesterol.  No mention of fiber consumption.  No mention of sugar intake.  From this, I’ll assume LDL went up for the low carbers, and that the carbs in the low-GI group included plenty of junk.

But there is a more interesting and subtle sign of bias in the subjects they used in the study.  First, look at those BMI's.  All are over 37. That is far into obese territory.  Do these people represent you well?  If not, maybe this study can’t tell you much about what is best for you.  More interesting, and I must say, highly unusual, is the nonrandom assignment of participants by race.  The low-glycemic group had a significantly greater proportion of African Americans.  They also have a higher percentage of women.

African American women are not the same as caucasian women.  They tend to gain more weight on the same number of calories.  Moreover, they may be more susceptible to insulin resistance and diabetes.  Remember, this is a study of glycemic control in diabetics, so this tendency for differences in blood sugar regulation is important here.  Why weren't these subjects properly randomized?  This is pretty sly, don't you think?  These Atkins people know all the tricks.

What exactly was the low-GI diet they used?  We are told it was based on what Westman calls a lay-press book.

This is the author of that book.  His name is Rick Gallop.  He is not a fan of the Atkins diet. Maybe comments like this inspired Westman's study, giving him a little bit of payback.  He wants us to keep our calories and fats low, especially saturated fat.  This is very mainstream and responsible advice.

Amazingly, we can see at the bottom that the obese people in the  low-GI group did not lower their fat intake by even a single percentage point on the diet that was supposedly based on Mr Gallop’s book. They actually ate fewer carbs than before. It seems to me this study is pretty useless as a representation of Gallop's ideas.

The first paragraph is good for a laugh.  Westman says there was no difference between the two groups in terms of adverse effects.  Then look at the symptoms.  I see the low-carb group as worse off in every way but back pain.  Really?  Back pain?  Dr Westman is really working hard in this one to make Atkins look good.  No wonder they keep funding him.

Look at that list of adverse effects and you will know what conclusions I draw from this.  Under controlled conditions and administered by a top low-carb promoter, a ketogenic diet will induce headache and constipation in more than half of people, with large percentages also experiencing diarrhea and insomnia.  It was, however, better for glycemic control than an unhealthy diet they just made up and called low GI.  That is not what I would call a success.

Stay tuned for Part III, where I'll show you what the top low-carb all-stars have created when they put their heads together.  Nothing but the best of low-carb for you in the Primitive Nutrition Series.

Primitive Nutrition 54:
The Best Low Carb Research (Money Can Buy), Part III

Now for the first of two studies conducted by some familiar names to low carbers.  I'll call these guys the Low Carb All Stars.  The names I recognize here are Jeff Volek, Stephen Phinney and Richard Feinman.  I'll focus on Phinney separately in the next section because he’s so interesting to me.

Maybe, just maybe, Volek and Phinney have a possible bias toward low carb. 

You can see Volek, like Westman, has been a reliable long-term partner for the Atkins people.  That’s no problem, of course, but it’s just good to bear in mind.

By now I hope you know the drill. I'm not even going to bother to read the text.  Let's just look at the data.  Here's an accounting of what the two groups ate.  The low carb group is CRD and the low fat group is LFD.  The participants were obese here, too, with BMI's well over 30.  We might assume from this that these people were not eating the best diets coming in to the study, and indeed, they entered eating only 13 and 16 grams of fiber daily, as you see in the last line.  The low fat group only managed to add one extra gram of fiber to that pitiful amount on the diet the All-Stars devised for them.

To put that in perspective, this is the nutrition data for a cup of lentils.  You would get 16 grams of fiber from only 230 calories. That means this one serving would represent nearly all the fiber they ate in a day.  Can you imagine how many advanced degrees these guys must have between them?

You'd think they'd know enough about nutrition to at least have their low fat diet meet the minimum recommended intake of fruits and vegetables.  For their participants, the CDC would say they would have needed 1.5 cups of fruit and 2.5 cups of vegetables.

I picked some standard produce items to fulfill that amount and I wound up with 36 grams of fiber, or more than twice what the all-stars gave them.  They should have eaten more fiber with the rest of their diet, including whole grains and beans.  Instead, it is clear that most of their carbs were junky carbs.  They fed them this way to guarantee that their low carb diet would look good by comparison.  They think you'll assume a carb is a carb is a carb, and stop thinking there.

In this study they want you to be impressed with the effects each diet had on triglycerides...

as well as lipoprotein particle size, which they broke down in detail.  In my Anything but LDL section I already explained the possible shortcomings of these biomarkers.  Look at this table, with all it's thoroughness, and ask yourself if these guys really don't know any better about fiber.  Amidst all their numbers, the one line that matters the most is the LDL score, and it went up despite the 800 fewer calories the low carbers were eating per day.  Once again, low carb is much, much worse than an all-potato diet. Don't let this blizzard of numbers distract you from that.

These guys should know that low fat diets don't necessarily promote the small, dense LDL particles they are so concerned about.

And remember that fasting can improve the lipoprotein subclasses as well.  With such a reduction in calories, you would expect that these biomarkers would improve a bit regardless of the diet.  Once again, a calorie restriction study is masquerading as a low carb study.

Plant foods can improve these lipoprotein subclasses, but there is a catch.  You'll need to eat more than 17 grams of fiber per day.

I'll make even faster work of this one from the Low Carb All-Stars.  It's an analysis of different low carb studies.  Here you see the studies listed which they picked to bolster their low-carb beliefs.  I think you can assume the low fat diets in these studies were not based on fresh, high fiber, whole plant foods.  Nevertheless, compare the two basic diet approaches for LDL.  Low fat dropped it by quite a lot in some cases.  In the low carb studies, no studies showed an improvement in LDL despite very low calorie intake.  None.  They managed to break even in two.  Once again, a very poor showing given the importance of LDL.

This is a consistent pattern for low carb.

Children put on ketogenic diets experience the same thing.

Unfortunately some of these kids have elevated LDL bad cholesterol for years after stopping these diets.  Some of these children actually had total cholesterol over 200.  Pause this and read that last paragraph.  It's really clear what these diets do to your cholesterol unless you are severely restricting calories.

Plant-based diets, however, can dramatically lower LDL.  This is the biggest problem for the low carbers.  Almost any diet that a health professional might recommend looks better by comparison.

Stephen Phinney was an author in each of the two studies, but I think he warrants videos all his own.  He's up next in the Primitive Nutrition Series.

TPNS 49-51: Better Than Low Carb

Primitive Nutrition 49:
Better than Low Carb, Part I

Could there be a faster and better way to achieve your best health than low carb?  Of course there is.  Whole plant foods are the healthiest foods of them all.  Yet if you read the arguments of the low carbers you would think they will somehow harm your health.

For example, Stephen Phinney wants you to think you can't handle eating fruit without getting fat.

Primitive nutritionist Kurt Harris thinks fruit is just like a candy bar. I guess in his mind, fruits are packed tight with tons of calories, unlike animal fat, I guess.  He's also afraid of fructose.  Fear of fructose is a common theme in this crowd.  Fructose will make you fat, they say. Of course, this thinking relies on a Paleo-yarn and ignores basic facts.

If fruit makes you fat, how do you explain this guy?  This is Doug Graham and he's probably eaten more fruit than anyone else over the last thirty years.  He is not fat.

This guy doesn't look fat to me, either.  This is Mike Arnstein.  He runs a site called TheFruitarian.com.  If fructose really does make you fat we're going to need to look under every stone to explain why these guys aren't fat.

Maybe it's the phytochemicals in fruit.  It could be the anti-obesity effects of the liminoids in the citrus they eat.

Or the anti-obesity effects of the resveratrol in the grapes and berries they eat.

Another candidate might be the quercetin in their cranberries.

And don't forget anthocyanins or ursolic acid, either.  Those are in berries, too.

Maybe these magic chemicals are why, in spite of the fructose, fruit intake is associated with lower body fat.

In this interventional trial, only fruit consumption was shown to lower BMI.  But what about the fructose?  I thought fruits were candy bars!

The low carbers have seen headlines like this.  Fructose can cause insulin resistance.  The researchers make a connection to high-fructose corn syrup in this article.  Not fruit.  Fruit is not high-fructose corn syrup.

The sweetener industry didn't like this one, and I must say, they have a point.  The rats in this study consumed a staggering 67% of their calories in the form of refined fructose.  That seems a little extreme.

Look at other such studies and they are similar.  In this one from 1987 fructose was at 66% of calories.

It’s time for some context.  Here's a table showing the fructose content of various foods.  Look at the whole foods highest in fructose and you will see that if you ate raisins, and only raisins and nothing but raisins, your diet would still only be 37% fructose.  We are way short of the levels of fructose used in these studies.  I feel a responsibility to say this, though:  Please, folks, do not fall for the all-raisin fad diet no matter what you see online.  Thank you.

Now high fructose diets are not the only diets used to trigger insulin resistance in lab animals.  High fat diets are also used.  Here rats were given a diet that was 60% fat.  That really is a lot.

You can look up the specific chow formulas they used.  60% fat is the standard for these studies.  Also, low carb apologists, note that although this formula includes sucrose, there was a whole lot less of it than in the low fat formula, and the low fat formula did not cause insulin resistance.  But still, isn't 60% a bit unfair?  That's so much fat!

Actually, for low carbers, that's not enough fat.  This is their usual criticism of studies of low carb.  Low carb needs to be so high fat to make them happy, it needs to be ketogenic.  Here you see low carb promoter Stephen Phinney wants your fat intake over 80% of calories.

He probably wouldn't be impressed by Weston Price Foundation founder Sally Fallon, who thinks her 70% fat diet is a model of healthy eating.  Pause the video and read that breakfast if you want to see how extreme she is.

Fallon says her high fat diet is actually good for weight loss.

If you eat saturated fat you will lose body fat, she says. 

The low carb world is a strange place.  They do some hard thinking to find a way around the calorie-density problem inherent in fat.  They argue there is such thing as a metabolic advantage to low carb diets that overcomes the caloric density of animal fats.  Here you see Michael Eades thinks you need to go low carb all the way up to ketosis to experience that metabolic advantage.

He found support for this belief from Richard Feinman, who argues that there is an important advantage to getting your glucose inefficiently from protein.

Inefficiency is at the core of the low car idea. Here he is trying to show you the degrees of inefficiency in different metabolic pathways.  For him, the more inefficient, the better.  Does that sound like a smart strategy for health to you?

Have a look at this and see how hard they try to overcome the calorie problem.  Easy there, Einstein!  No need to strain yourself.

The CDC has already worked out a way to lose weight that's a lot simpler and more effective.  It's called energy density and it's not a hard concept. They recommend that instead of bogging down your body with unhealthy, calorie-dense and nutrient-poor foods like bacon, you eat nutrient-rich and low-calorie foods like fruit.  You may ask, why do I like this energy density strategy better than the metabolic advantage?

Well, it's just a much bigger effect.  Here you have a list of candy bars, I mean fruits, and their calories.  Look at the fruits listed in a one cup portion size.  Blackberries have 75 calories.  Cherries 85.  Grapes are way up at 115.  How would that compare to a cup of butter?  I hope you're sitting down.

With the same portion size you get 1628 calories!  And look at that inflammation factor.  That's a big disadvantage for metabolic advantage to overcome.

Look at the inefficiency they think is so important.  27% isn't enough to make up the difference between highly-saturated fats like butter and healthy carbs like grapes.  In real life, the magic thinking of metabolic advantage is just never going to be taken seriously.  Low carb foods will always be more energy dense than fruits and vegetables.  This is explained very simply.

Here are some fruits and vegetables and their water content.  Grapefruit and broccoli are 91% water.  A cucumber is 96% water. 

By comparison, look at the water in meats.  It's way less.  Dr Feinman, water has no calories.  Fruits have a lot more water.  They also have no fat bogging you down at 9 calories per gram.  That's the bigger metabolic advantage, don't you think?

By the way, since this video series is called Primitive Nutrition, remember that the meat eaters argue that the extra calories from meat allowed the development of big brains.  Yet they also say meat will help you lose weight.  They try to have it both ways, not because it makes sense, but because their truthiness actually seems to be convince some people.

Here is the whole story on energy density visualized.  The graphs plot energy density against water, fat and fiber, from left to right.  Water and fiber have no calories. Fat has the most calories of any macronutrient.  The relationships are pretty clear.  The fiber graph on the right is especially clear.  This plays out in people in the ways you might predict.  I’ll have some evidence in Part II.

Primitive Nutrition 50:
Better than Low Carb, Part II

Do you think that if you eat more energy-dense foods, you’ll end up eating more total calories? Not such a hard question, is it? This carefully controlled study examined the effect of high fat consumption on total calories and the results are what you'd expect.  People voluntarily ate more calories eating fatty foods.

In this study, participants were given meals of different macronutrient composition but were not informed of those differences.  Here again, without anything to interfere with their choices, they ate more calories on high-fat food.

It has also been demonstrated that a high fat diet is less thermogenic than a high carbohydrate diet.  High fat causes less passive release of heat, so it is less likely to lead to weight loss.

This study found this result as well.

Then there is the question of what your body does with excess calories.  Does it matter whether they come from fat or carbs?  As we see in this study, it does seem to matter.  When people overate on carbs, the calories were less likely to turn into body fat.  Their bodies seemed to burn through calories a little faster in response to the overfeeding. Dietary fat was more likely to turn into body fat.

How do we explain this?  It seems the creation of new fatty acids from carbs is not your body's first choice when given excess carbs.  When your body senses you have eaten too many carbs, it increases the rate at which it burns through them. 

Put all these issues together and you'll see why the old claim that somehow a high-fat diet won't make you fat doesn't impress a lot of obesity researchers.  The best that can be said for a low carb metabolic advantage is that low carb might cause you to lose your appetite. 

When reading studies comparing diets we should bear in mind the glycemic index.  The glycemic index is essential for understanding the differing health effects of different carbs.  Low GI carbs don't cause wide variations in blood glucose.  They keep blood sugar in check and that is usually better for us.  You'll see in my The Best Low Carb Research videos that low carb promoters don't like to compare their diets to healthy high-fiber, low-GI diets.

Have a look at this list of candy bars, I mean fruits.  None are high on the glycemic index.

If fearing carbs or fructose keeps you from eating fruit, you'll be missing out on some great health benefits.  Fruits are associated with healthier arteries.

They might keep you from getting certain cancers.

They even seem to lessen the buildup of toxic mercury in our bodies.

Unlike low carb diets, high fruit diets are associated with greater longevity in this study...

And in this study.

Even diabetics can enjoy fruit.

High fiber diets in general are a better strategy for diabetics than low carb.

And so are healthy vegetarian diets.

Do you feel like nutrition news points you in every direction at once?  Do you feel there is so much confusion in nutrition that there can't be any way to figure out what is best?  If you feel this way then you are right where the fad diet promoters want you.  Actually, the nutrition research out there is easy to understand and is remarkably consistent.  How's this possible?

How could it be possible that a so-called Twinkie diet could dramatically improve cholesterol and promote weight loss ....

In the same world as an all potato diet doing the same? 

And a low carb study doing the same as well?  Well there are two factors that sort it all out.  The first is calorie restriction.  This low carb study, put together by an all-star cast of low carb promoters, limited energy intake to only 1500 calories.  The payoff was a 14% drop in cholesterol and a 10% drop in weight over about 84 days.

The Twinkie guy ate a little more.  He allowed himself 1800 calories and he dropped his bad cholesterol 20% and his weight 13% in 60 or 70 days, it's hard to say from the article.  Here it says two months.

But the article started saying 10 weeks.  Regardless, the bottom line is he did better than low carb in less time and he was eating Twinkies.  That's pretty embarrassing for low carb, isn't it?

In only 60 days the potato guy dropped 10%  of his weight

And his bad cholesterol dropped an amazing 41%.  He must have been really restricting calories, right?

Not exactly.  He started consuming only 1600, still more than the all-star low carber study.  But in week three he bumped his calories to 2200, way more than the other two diets.  What happened to the power of calorie restriction?  Well the other way to understand these seemingly contradictory studies is through plant foods.  The potato guy ate all plant foods, with all the dietary fiber that would include.

The Twinkie guy didn't limit himself to junk food only.  He took supplements and ate some vegetables, too.  Those are pretty important additions the potato guy didn't have to make.  Plant foods made a difference for the Twinkie guy for sure.

The low carb all-stars know about the power of fiber and whole plant foods, too. That's why they made their comparison high carb diet pitifully low in fiber.  Participants who started out with metabolic syndrome, meaning they had horrible diets to begin with, added on average only about one gram of fiber per day for their study compared to their normal bad diet.  Fiber in these diet studies is a pretty good indicator of the quality of the carbs the participants eat.  These low carb guys are afraid of carbs with fiber.  They only want to compare low carb diets to refined junk carbs.  Also, you can see they made sure the high carb group had plenty of saturated fat to mess them up a bit more.

And unlike the potato guy, the low carb group had an increase in LDL bad cholesterol.  This is after 12 weeks on only 1500 calories!  Yes, low carb is far worse than either a high-twinkie diet or an all-potato diet, yet they want you to think it's healthy.  Are you really going to fall for this?

So what are some better alternatives to low carb?  That's in Part III.

Primitive Nutrition 51:
Better than Low Carb, Part III

Before I show you a strategy that really is better than low carb...

I want to go back to the idea of calorie restriction.  In the Arthur De Vany video I talked about how calorie restriction has been shown to extend life in lab animals.

While it may not be clear whether it extends lifespan in humans, it does seem to offer some benefits.  Here, periodic fasting improved cholesterol scores and increased insulin sensitivity.  If you are overweight or have some bad metabolic scores, simply restricting your calories will probably improve your numbers, even if you restrict calories by fasting, using a twinkie diet, or doing low carb.

But restricting calories can turn you into a yo-yo dieter, and I’ve shown you already that weight cycling is unhealthy.  Also, it is apparent from animal experimentation that periodic calorie restriction can cause depression.  We need a better way than this.

There have been efforts to devise a low carb diet that is truly healthy.  The great nutrition researcher David Jenkins compared a low carb plant-based diet to a vegetarian diet that did include milk and eggs in a four week study of people with high cholesterol. Importantly, he limited the calories in both groups to what he calculated to be 60% of their requirements.  The plant-based low carb diet was more successful at improving lipids than the lacto-ovo vegetarian diet.  Jenkins probably could have predicted this outcome.  He has done other important research on the beneficial effects of plant foods on cholesterol.

Here was another effort to make a reasonably healthy low carb diet.  These researchers created a ketogenic diet that replaced saturated fats with unsaturated fats.  In their comparison, the unsaturated fat-based diet showed better results, especially concerning insulin sensitivity.  Saturated fats seem to have a special ability to damage insulin sensitivity, which sets us up to learn about a strategy that is truly better than low-carb.

We should understand that high carb diets have important advantages over high fat diets.  Epidemiological data indicate unrefined grains and legumes are associated with better overall health and lower weight.

High-carb cultures of the past didn't have our problems with diabetes.  Here you can see how rare diabetes was in Japan, for example.

Data like those caught the attention of Dr Neal Barnard.  Barnard concluded that it was the trend toward increasing saturated fat consumption that was driving the global rise in diabetes.  His review of the literature prompted him to do something that might seem unwise. 

He conducted a study with diabetics to compare the effects of two diets.  One was a diet based on guidelines from the American Diabetes Association.

The other was a vegan diet that was unrestricted in the amount of carbs participants could consume.  The ADA diet, on the other hand, was designed to create a caloric deficit.  So which was the more powerful of our two powerful factors in nutrition, calorie restriction or whole plant foods?

The plant-based, high carb approach was better from every angle. Like the all-potato diet, calorie restriction isn't necessary to get good results if the diet is high-carb, low-fat, whole food, and plant-based. 

High-carb diets are not usually recommended for diabetics.  They usually are told to limit their carbs to control their blood sugar.  Was it irresponsible of Dr Barnard to even try this?

Not at all.  Of course, his team monitored the participants carefully.  He also had conducted prior research that indicated he was on the right track. Dr Barnard thought this might work because he was familiar with the history of diabetes, including that article about diabetes in Japan…

and past studies that showed how high-carb, plant-based diets can help diabetics.

Although not many have noticed, low-fat, high-carb diets had been used successfully in diabetics all the way back in the 1920s.

How might a low-fat diet help diabetics?  Barnard took interest in research like this that indicated that fatty acids within muscle cells interfered with the function of mitochondria…

resulting in insulin resistance.  This could be induced by a high fat diet.

Mitochondria are the organelles inside cells that generate the energy that powers everything in your body.

They are fascinating from an evolutionary perspective.  Read this and you’ll see our cells are kluges, too.

There has been some debate recently regarding the exact relationship between mitochondrial dysfunction and insulin resistance.

It’s not clear how all this works

Researchers keep trying to understand what is happening.

But the basic story isn't changing.

The connections between high-fat diets, fat accumulation in cells, insulin resistance, and mitochondrial dysfunction has been affirmed by numerous studies.

Saturated fats seem uniquely responsible for clogging cells. 

And therefore they are the culprits impairing your mitochondria and starting the development insulin resistance.  This is probably why that experimental ketogenic diet using unsaturated fats was so much better for insulin resistance. The question that remains is how, exactly, do saturated fats cause this damage?

Researchers seem to be making progress in answering this question.

I think for the average person like me, the details don't really matter.  It's enough to know that saturated fats seem to be highly disruptive to cell metabolism.

And individuals eating plant-based diets free of saturated fats, otherwise known as vegans, seem to have less clogging of muscle cells by fat and consequently better glucose metabolism.

Other research has supported the use of plant-based nutrition in diabetics. 

Fortunately, Barnard's research participants found plant-based diets to be as palatable as the standard diabetic diet. If we step back and look at plant-based diets more broadly, there appears to be a lot of research to recommend them.

I'm old enough to remember Biosphere 2.

The diet consumed by participants in that study was essentially high-carb, low-fat and plant-based, and it produced results that would make any low-carb researcher envious.

Healthy low-fat diets almost always compare well to high-fat diets.  They are better for heart health in a number of ways.  Blood flow is improved.

Blood vessels are made healthier.

And lipids improve. 

These studies undermine the usual low-carber beliefs, like carbs make you fat, or some people have broken their metabolism and just can’t handle carbs anymore.  Those beliefs are just wrong.

Now, if you are a low-carber, you may still not be convinced. Maybe you are thinking you've got great studies to support your approach.  If that’s what you think, I made the next section just for you.

TPNS 47-48: Low Carb, High Fad

Primitive Nutrition 47:
Low Carb, High Fad, Part I

The phrase low carb usually really means Low Carb High Fat.  It is nearly a consensus position in the low carb world that low carb high protein is not sustainable.  The objective in low carb high fat diets is to attain an unusual metabolic state called ketosis, in which the body's carbohydrate stores, in the form of glycogen, are depleted.  Consequently, acidic ketone bodies are created from stored fat, and they partially replace glucose as a fuel for your cells.

Ketogenic diets, or diets that induce ketosis, have been used since the 1920s to control intractable epileptic seizures in children.  It is from this therapeutic use that much of our understanding of these diets comes.  High fat diets have many of the same problems as high protein diets.  By limiting the consumption of healthy plant based foods they limit the intake of important nutrients.  While not saying so explicitly, low carb promoters acknowledge the nutritional inadequacy of these diets because they demand the use of multivitamins and other supplements. 

As we review some of the primitive nutrition logic that underlies low carb diets these days, remember that this aspect of the diet is quite necessarily modern.  Our ancestors did not have bottles of pills and powders.

Vitamin supplements are not a substitute for food.  Whereas plant foods have well-recognized disease fighting powers, the evidence for the benefits of vitamin supplements is a mixed bag.

Some actually can be harmful.

You won't find a well-designed study showing ill-effects from eating whole *plant foods, but vitamins have had a *bad run recently.

Multivitamins have recently been linked to breast cancer, for example.

And here they were found to just be mostly a waste of money.

Extracts of fruits and vegetables probably won't do you much good, either.  You have to actually eat these healthy foods, which would necessarily displace the low carb foods in your diet.

The fact is you just can't create a nutritious diet from vitamin supplements, at least not yet.  This is the conclusion I draw from the proven inadequacy of elemental diets.  Elemental diets are purified, easily-assimilated, supposedly complete nutrition formulas given to patients who cannot digest normal food.

Despite their increasing sophistication, deficiencies still result from them.  Generally they are used as little as possible, and this is one reason why. 

Dietary antioxidants make important contributions to health.  Beef USA will tell you that you should get them from food, not pills.  They'll also tell you fruits and vegetables are the best food sources of antioxidants.

Atkins himself knew that in his diet, you had no choice but to take supplements to have a chance of obtaining adequate nutrition. 

You might think this fact would be a problem for the Atkins people.  Far from it.  It creates an opportunity for them to sell supplements to the gullible people following their extreme diet.

Why would someone consider such a deficient diet?  It seems serious nutritional inadequacy is a pretty major flaw for a diet to have.  The research must say there are some really great benefits to low carb, high fat to overcome this, right?  I’ll show you lots of research into low carb soon and let you be the judge of that.

Low carbers imagine the body's metabolism is fragile, and easily broken by even the healthiest high-carb foods.  Somehow we are to believe that only some people can tolerate starches, for example, even though all the world’s population centers have historically eaten diets dominated by them. 

I have a hard time understanding how this type of reasoning makes it past the laugh test.  Here are some high carb Indians from around 1910.  Do they look overweight to you?

Here are some Fakirs from around the same time.  What about them?  What do you think they ate?  Now maybe they appear undernourished to you.  But the point is, carbs did not make them fat.  I found these pictures randomly, but you can easily go on Google Books and find many more old photos of people from high-carb cultures.  Good luck finding someone who looks fat.

Poor people in pretty much every society used to eat primarily starch-based diets.  Poverty has not been associated with obesity until recent times.  Of course, diet is only one factor in explaining this, but I would think the idea that carbs make you fat would be hard to accept for any rational person with a sense of food history.

On the other hand, low carbers tell us that somehow liberal amounts of fats, meats and oils can somehow promote weight loss.  It's hard to figure.

Who doesn't know that fats are the most calorie-dense macronutrient?  It seems this fact creates some difficult math to overcome for low carb promoters.  I'll talk about this more in the next section, but for now, let's look at the research out there for low carb diets. 

First, let's start with the basics.  It is the consensus view of obesity researchers that the most important factor for weight loss is creating a calorie deficit.  You need to use up more energy than you eat, simple as that.  The particular diet you use doesn't matter much as long as you create a calorie deficit.  If you need to lose weight and you do so successfully, you will be probably be at least a little bit better off regardless of your strategy.  Here, for example, no advantage was found for a high-protein diet.

No particular macronutrient balance was seen to have an advantage in this one, too. 

Have you ever noticed that people doing low carb diets can't stay with them very long?  They seem to fall off the wagon a lot more than vegans do.  This slide might give us an explanation for all that.  To stay on a diet you need willpower.  But to have willpower you need glucose.  Low carb aims to keep your glucose low, so you probably won't have much of a chance of sticking with it very well.  How ironic!

Adequate levels of blood glucose will also keep you from craving fatty, unhealthy, high-calorie foods, too.  If you are more likely to crave high calorie foods, you will probably have a harder time achieving and maintaining your optimum weight.  A dietary approach that endeavors to give you low blood sugar doesn’t seem like a great strategy for having a healthy long term relationship with food. 

As I said, you would think there must be some really great research out there that makes low carb look good.  The most important fact you need to understand about the favorable low carb studies is that all of them are short term.  Even a year- or two- year-long study is too short to show all the harmful effects of a diet.  The harm associated with high saturated fat consumption can take decades to build.  A short study won't show that. But make no mistake, there is a lot of research that suggests these diets are harmful over the long term. If you're a low carber, as I go through these studies, I'd like you to ask yourself: If all this negative research were about vegan diets instead of high fat animal food diets, wouldn't it make you question the safety of vegan diets?

High-fat diets are associated with brain aging...

and cognitive decline.  This study saw heart impairment as well.  There is also a lot of reason to worry about what these diets will do to your heart.  I'll show you what I mean in the Part II.

Primitive Nutrition 48:
Low Carb, High Fad, Part II

Let’s see what low carb can mean to your heart.

High fat diets are shown to be harmful to cardiovascular health in numerous animal studies.  Here in baboons, for example, a high-fat, high-cholesterol diet was shown to damage the ability of cells within arteries to the point they can't replicate.  This is called cellular senescence and it is a known cause of inflammation and aging.

High fat diets are known to hurt human arteries as well.  The health of the endothelial lining of the arteries is assessed through the measurement of flow mediated dilation.  Here in a comparison of different diets, only a diet high in saturated fats harmed this function.

Flow mediated dilation was also a problem in this low carb study.

In this one, low carb caused damage to heart metabolic function suggesting it could raise the risk of heart failure.

And in this one it hardened arteries.

We can also look at traditional measurements of heart health to see problems.  In this comparison of diets, only the high-fat diet increased LDL cholesterol.  This is a running theme for high fat diets.

In this year long study a high fat diet raised LDL and worsened a lot of other measurements, too.  Uffe Ravnskov should note the mention of fibrinogen.

The most famous low-carber, Dr Atkins had significant atherosclerosis at the end of his life.

With their lack of plant foods, low carb diets increase the chance of damage to your digestive system as well.

But the most concerning studies link low carb diets to an increased death rate.  This one really raised hackles among low carbers.  Diets based on animal foods and lacking in healthy carbs were associated with higher all-cause mortality.  Every conceivable objection has been raised.  They weren't really hard core low carbers, or they didn't eat the right animal foods, or the people in the study had bad memories, but really, those arguments are pretty weak, especially since there are other studies that have shown the same thing.

This study of Swedish women found higher mortality on low carb, too.

And so did this study of elderly Swedish men.  Think about how long it would take to complete a study that shows the effects of diet on mortality and you'll know why epidemiological studies like Ancel Keys' Seven Countries Study were and are necessary.  You can’t take people and put them in controlled lab conditions for decades. There will probably never be a perfect study assessing diet and mortality for this reason.  Low carbers will always have a way of dismissing a study if they want to.  That doesn't mean they are right.

High fat diets also seem to scramble our metabolism.  We can see metabolic dysfunction in people with normal metabolism but who are at risk of diabetes after only one meal.

And we can see in primates that a maternal high-fat diet causes metabolic dysfunction in offspring.

And here you see something similar in rodents.

And here, too.

There has been a lot of research into the effects of a high-fat diet on rodents.  Do your own search on "high fat diet" and "mouse" or "rat" and you'll see how much bad news is out there.  With lab animals, researchers can examine what a fatty diet can do in great detail. It seems no one is asking whether a fatty diet is harmful but rather how it is harmful.  This one got low carbers upset but you can see this is a very sophisticated study.  Impaired glucose-sensing was observed in these mice.

Here rats were fatter and more insulin resistant and generally more dysfunctional with higher fat consumption.

Here resistance to growth hormone was induced.

In this one a high fat diet reduced the activity of a gene controlling a key enzyme, setting the stage for dysfunction.

Here a high-fat diet caused insulin resistance and lessened fat-burning.

A high fat diet caused intestinal inflammation in these mice.

These rats were so damaged by a high-fat diet that when they went back to normal food, they gained more fat than they otherwise would have without actually eating more calories.  If it works the same way in humans, it's easy to imagine how a low carb fatty diet sets the stage for yo-yo weight-loss and gain, or weight cycling as it is properly named.

Weight cycling is likely harmful to both your physical and mental health.  It seems more efficient to skip the fad diets and adopt a healthy and sustainable lifestyle based on the best modern science.

I think you are getting the point, but here is just one more rodent study.  I like this article because it tells you why all these studies are done.  I doubt these studies are being funded to prove low carb is bad or fat is bad, and they are certainly not to figure out the best way to feed mice.  No, these are to develop new drugs to combat obesity.  Obesity represents a serious and growing public health concern, as well as an opportunity to create profitable therapies.  This researcher does acknowledge there might be a healthier solution than drugs.  He says a healthy diet is a noble thing to strive for.  After seeing all this research, it seems to me it's much more than that.  I'd say it's the only option if you want to have real and lasting good health.

If that is what you want for yourself, I'll show a you a better way to achieve that than low carb in the next video.

TPNS 46: The Gloomiest Diet

Primitive Nutrition 46:
The Gloomiest Diet

The Garden of Eden is the most utopian condition for humanity we can imagine.  All kinds of life coexist in this painting without stress or conflict.  It seems a fruit has been found to be appealing.  This is how we think of paradise.

It seems when people acquire the means, they like to try to create their own rendition of paradise.

And the results can be spectacular.

When we want a special vacation in a place that feels like paradise, we go places like here.

Or here.

That are home to people we imagine look like her.

Or her.  Tell me, guys. Which do you prefer?  This.

Or this?  Not quite as pleasant to look at, is it?

Here, I'll try to make it up to you.

A woman's beauty has long been likened to sweet fruit.  Fruit evokes the warm and inviting places it comes from, and our attraction to sweetness is deeply ingrained.

We love sweetness before we are even born.  If amniotic fluid is sweetened, a fetus will swallow more of it.

Sweet carbohydrates induce a rapid calming in crying newborns.

Adults are no different. Facial reactions to sweetness in adults are much like those seen in newborns.

Primates react to sweetness just like newborns, too.

Our closest relatives eat diets dominated by fruit whenever they are abundant.

Our hominid ancestors are believed to have maintained those preferences.

All food energy comes from the sun.  It first takes the form of sugar through photosynthesis. Sugar is here called the universal food and energy source of most living things.  Herbivores get their sugar through plants, and carnivores get theirs by digesting other animals.

Sugar is sensed at a very deep level.

...  in particular for special types of sweet compounds, the ones we like the most, sucrose and glucose and fructose, the monosaccharide and disaccharide sweeteners, there are extra pathways, extra mechanisms that let us taste something like that as being sweet.

And these are, as we reported in this recent paper, sugar transporters and special ion channels, potassium ion channels, that respond to the metabolic state of the organism or the metabolic state of the taste cell.

And remarkably enough, these same things you'll find in other parts of your body, in the gut, in the stomach, small intestine and in the endocrine cells in the pancreas.

... you can actually train mice and rats to tell if they've gotten something sweet in their stomach or in their small intestine.

So you can bypass their taste buds in the oral cavity and directly put sugar into the stomach or small intestine, and those animals can be trained to know that that's something good and something positive, and they will seek more of that stimulus.

We have multiple pathways in our bodies to sense when we consume it.

Sweet fruit has long been prized by humans. 

But throughout history most humans have gotten their sugar in the form of starches, even if that required eating the inner bark of trees.  It has only been when humans had minimal access to carbohydrate that they have resorted to high fat diets.

Our long time dependence on starches is reflected in our genes.  We have probably been subjected to strong selective pressures to thrive on starches, differentiating us from other primates.

Yet low carbohydrate diet promoters want you to crave a diet that would be forced upon you in a place like this.  Does this look like paradise to you?  Just looking at this photo gives me seasonal affective disorder.  This guy looks like he could use a vacation.

Would you rather be here than Hawaii?  Where do you think you would last longer?  If you lived here, you would need to bundle up like this little boy just to survive.  You would need warm air against your skin.  You’d me making a little tropical bubble for yourself.

Even the Labrador Inuit would gather berries by the barrel and store them so they wouldn't have to do without them through the winter.  What few carbs they could find, they went to a lot of trouble to utilize.

What about these Plains Indians?  Can there be any doubt that life was hard for them living in such unforgiving places through all seasons?  Would you trade places with them?

Whereas a carbohydrate-based diet is immediately attractive

A low carbohydrate diet seems just a bit lacking in aesthetic appeal.

It's amazing to me that people think we should avoid sweet fruit.  We are not carnivores.

Yet even some carnivores are sweet tasters.

Humans have wide variations in their sensitivity to tastes associated with meat.

Yet misguided fad diet promoters want you to think your pancreas can't handle eating fruit.  Denying ourselves the healthiest sweet foods is somehow supposed to be a strategy for lifetime maintenance.  To me it sounds like a lifetime battle with your very nature.

This is rationalized through evolution by people who don't understand evolution.  Fad diet authors focus on places humans managed to inhabit through technological adaptations, and ignore the places our ancestors originated and thrived.  Humans survive everywhere, so how does this logic tell us anything?  What responsible health authority would tell you to avoid oranges because it's cold outside?  You're inside where it's warm, aren't you?

In the next video, we’ll get better acquainted with gloomy low carb, high fat diets.