Monday, January 31, 2011

Scientific American Magazine: Looking at the Wrong Solution for Obesity

You could forgive the media for its often ignorant position concerning obesity and nutrition but when the same ignorance is displayed on a magazine that is oriented toward the scientific community and its adherents, one has to wonder to what extent does this ignorance steer people away from exploring the right questions and answers.

The recent issue (February 2011) of Scientific American takes a stab at the scientific view of obesity and offers a remedy. In the article "How to fix the obesity crisis" author David H. Freedman wonders why is it so hard to lose weight and keep it off if the way to do it is simply "consume fewer calories than you expand." The low-carb community will recognize this as the "calories -in/calories-out dogma that is questioned by a number of reputable researchers. yet he admits that not much of a dent has been made in dealing with the current epidemic. Freedman tells us that the best approach to solving the obesity epidemic would be "to build on reliable behavioral-psychology methods developed over 50 years and proved to work in hundreds of studies."

It is interesting that in recent years the behaviorists have zoomed in on another area of human failures  - obesity and ready to treat it as if it were merely a psychological/behavioral problem. The behaviors to be corrected are over eating and maintaining a sedentary lifestyle. Forget biochemistry, forget molecular biology, forget that we are organisms pushed and pulled, twisted and re-twisted with molecules, hormones, and various chemicals. No, we are nothing but a series of behavioral events being manipulated by the environment - on the outside - and therefore obesity can be remedied through behavioral therapy. But don't carbs cause insulin to behave in a certain way? What about the regulation of lipoproteins? Are they behavioral events in and of themselves? The behaviorists don't seem to care - we are an event in an outside world - the inner world does not matter. It is all about friends, economics, food shelves, predispositions, taste buds and so on.

Freedman points out that as early as the 1960s studies based on behaviorism recognized "some basic conditions" that link themselves to the success of losing weight and keeping it off - measure calories, exercise, make small changes, eat balanced meals, and lower fats. Is he confusing correlation and cause? What Freeman does not look into are the numerous studies that show this so-called link to be at the root of the current epidemic. The link is a lie; it is a myth that we have been inundated with. Counting  calories, replacing fats with carbs, and exercising have all come under attack in recent years. Unfortunately Freeman seems to be unaware of it. He wants to fortify that very wrong approach with behavioral modification in order to correct the shortcomings of approaches like Weight Watchers by tailoring it for individuals rather than take the traditional "one fits all" approach. Are we supposed to hire our own behaviorist to deal with our obesity issues in the same way that psychoanalysis has always operated one on one? It would seem so when reading this article.

For Freedman, it seems that only behaviorists can get us to do a better job of counting calories, be motivated to exercise, avoid fats and so on. That is, until the pharmaceutical companies find the solution. As he says, "someday biology will provide us with a pill that readjusts our metabolism so we burn more calories or resets our built-in cravings so we prefer broccoli to burgers."

It is obvious that Freedman is out of touch with recent developments in the low-carb scientific community. Perhaps, he chooses to ignore it but, in any case, the article diminishes the stature of Scientific American. To uphold a dogma that has failed us and say it only needs to be improved with a new twist puts the brakes on critical thinking and innovative research.

Freedman supports a point of view that has been a monumental failure for more than 40 years and it comes just when the new updated 2010 Dietary Guidelines for Americans comes out, once again, in favor of this misguided and wrong approach to obesity. The guidelines will continue to fuel this wrong approach and Freedman's solution will not help. The root cause is not understood. Knowing the cause is the first thing needed before one embarks on a remedy. This failure is given tacit approval by Scientific American magazine.

At the end of the article under the heading of "more to explore" Freedman cites the following works: B.F. Skinner, About Behaviorism, Vintage 1974; Michael F. Rozen and Mehmet C. Oz, You on a Diet: The Owner's Manual for Waist Management, Free Press, 2006; Nia S. Mitchell et al., Determining the Effectiveness of Take Off Pounds Sensibly (TOPS), published online; the National Institutes of Health website: obesityresearch.nih.gov.  That says it all.

Monday, January 24, 2011

Nutritional Stupidity - it is everywhere, especially in the news.

Here we go again - I opened the morning paper and there she was - again. A media darling, she is  British Columbia's go-to dietitian when advice is needed. She is up-beat, charming and so on but .... woefully ignorant or misinformed about nutrition. She is a spokesperson for the "lie" that I mentioned in previous posts. A few days ago I posted my rant about how she upholds the misguided mantra that carbs cause no harm - not even diabetes.

Today Patricia's little sidebar nutritional advice in the Vancouver Sun newspaper counsels us that we should consume healthy fats and reduce intake of bad fats. Because we should consume the fats that "nourishes cells, provides key nutrients and helps our heart instead of the kind that adds unwarranted weight or clogs arteries." Notice how she uses the same word that has been used for more than 40 years to illustrate and paint or draw a picture in your mind about what "bad" things saturated fat do - "it clogs arteries." She then babbles on about oatmeal, whole grain toast, whole grains blah blah blah ....

The newspaper is the worst place to learn about fats and these little sidebar tidbits that passes itself as sound advice is relentless in its recital of 40 years of dietary nonsense. Patricia, here's an inconvenient truth for you: beef fat is 45% unsaturated; chicken skin is 70% unsaturated; butter is 30% unsaturated; lard is 60% unsaturated. They rank right up there with your beloved olive oil.

Here's a bit of history taken from Gary Taubes' research - by the early 1960s there were two competing hypotheses that needed to be tested. The American Heart Association had, by 1961, sided with Ancel Keys' view that fat/cholesterol were at the root of heart disease. The other hypothesis was the view that high levels of triglycerides were at the root of heart disease as well. It was already established  that triglycerides are raised by the consumption of carbohydrates. The research was dominated by those who held to Keys' hypothesis; not surprising considering the difficulties of measuring triglycerides (with a paucity of facilities to do so) as opposed to measuring total cholesterol.

Meanwhile, with advances in technology, research uncovered that there are a number of different types of lipoproteins: VLDL, LDL, HDL, and chylomicrons; from this came the classification of metabolic lipoprotein disorders - low fat diets could remedy high LDL and low carb diets could rectify abnormally high triglycerides. Soon HDL was able to be measured in large populations and it confirmed studies conducted in the 1950s - that when HDL is high, triglycerides are low and vice versa. This meant that triglycerides and HDL are more important factors or markers for heart disease than total cholesterol. It was obvious that a low-carb diet would be beneficial if one did not want to have a cardiac event. Raising HDL would seem to be a better way than to lower LDL or total cholesterol - but there was too much money invested in Keys' hypothesis.

January 17, 1977 was when the studies on HDL, which were so promising in terms of offering salvation against heart disease, came three days after the U.S.A. government announced the publication of the Dietary Goals for the United States in which it promoted a low-fat , high carb diet for all Americans based on Keys' fraudulent research and a lack of further evidence. Like lemmings, the rest of the world followed.

There were critics that railed against Keys' position, rightly so, but George McGovern and his committee  could not wait any longer - he had to show the American people that the government was going to do something/anything. Politics ran over science. Replace fats with carbs was the order of the day. What had been discovered about HDL was ignored but problems arose.

The researchers were faced with a dilemma. Replacing fats with carbs would increase triglycerides. But this would also decrease HDL - the good cholesterol; so, replace fats with polyunsaturated fats was the decision. But these industrial oils were suspected of being carcinogenic. So reducing fat became the advice. By 1980 any discussions of the effect of carbs on HDL were silenced - the advice now was to raise HDL through exercise and losing weight. The way to lose weight was by implementing the low-fat, high carb diets.

Then a way out of the dilemma appeared when it was discovered that there was a way to lower LDL while at the same time raise HDL. And this could happen without adding more carbs or fat to the diet - monounsaturated fats such as olive oil with its oleic acid content was the answer. Monounsaturated fats were neutral. Saturated fats raise both LDL and HDL; carbs lower HDL but also lowers LDL. monounsaturated fats raise HDL and lowers LDL. The Mediterranean diet was "in" but they could not figure out if it was because of a rise in HDL or a decrease in LDL that benefits could be acquired.

But here's the stinker - let Gary Taubes finish it off:

     "The observation that monounsaturated fats both lower LDL cholesterol and raise HDL also came with an ironic twist; the principal fat in red meat, eggs, and bacon is not saturated fat, but the very same monounsaturated fat as in olive oil. The implications are almost impossible to believe after three decades of public-health recommendations suggesting that any red meat consumed should be at least lean, with any excess of fat removed.
     Consider a porterhouse steak with a quarter-inch layer of fat. After broiling, this steak will reduce to almost equal parts fat and protein. Fifty-one percent of the fat is monounsaturated, of which 90 percent is oleic acid. Saturated fat constitutes 45 percent of the total fat, but a third of that is stearic acid, which will increase HDL cholesterol while having no effect on LDL (stearic acid is metabolized in the body to oleic acid, according to Grundy's research). The remaining 4 percent of the fat is polyunsaturated, which lowers LDL cholesterol  but has no meaningful effect on HDL. In sum, perhaps as much as 70 percent of the fat content of a porterhouse steak will improve the relative levels of LDL and HDL cholesterol, compared with what they would be  if carbohydrates such as bread, potatoes, or pasta were consumed. The remaining 30 percent will raise LDL cholesterol but will also raise HDL cholesterol and will have an insignificant effect, if any, on the ratio of total cholesterol to HDL. All of this suggests that eating a porterhouse steak in lieu of bread or potatoes would actually reduce heart-disease risk, although virtually no nutritional authority will say so publicly. The same is true for lard and bacon." (Good Calories, Bad Calories, pp. 168-169).

Sunday, January 23, 2011

What's in a Myth? Stupidity.

Recently I opened my morning paper (Vancouver Sun, Saturday, January 22, 2011) and was jolted out of my seat when my eyes glanced at the title of a article: "Hands off my statins (and please pass the steak)." The article simply underscores the stupidity of mainstream thinking when it assumes that (saturated) fat leads to cholesterol which, in turn leads to a heart attack. This myth is so saturated (pardon the pun) in our mindset that we actually believe it - it has become mainstream dogma. The result can lead one to embrace a stupid way of living.

Andrew Brown, the author, admits to taking a statin, knowingly that he may be "imperiling" his health because of various possible side effects. On the advice of his doctor, because he had "raised cholesterol" and a family history of heart disease, Brown readily buys into the belief that a pill is the answer to avoiding future cardiac events - as he says, " I believe in it .... I'm more inclined to welcome wonder drugs with enthusiasm than to be skeptical ... I listen to the good it can do and tune out the stuff about side-effects." He also readily admits that "I'm temperamentally inclined to trust the latest products of the pharmaceutical laboratory."

 Is this what the modern world has come to to be? Yes, this is indeed the world that pharmaceutical companies are trying to create. Have you noticed the advertisements these days? Pills are offered for everything. Perhaps it is a noble idea; after all, we wear glasses to see better (if needed), we use binoculars to see distance, scientists use microscopes to overcome the limitations of our eyesight. But Mr. Brown says that he has been on statins because it  is "massively more convenient for me to have this backup that somehow mops up some of the fats in my diet." This is a better option than "to enforce on myself the strictures of an unpalatable low-fat diet." Brown goes on to say that "I love my food. I enjoy a varied diet that does contain cheese, cream, red meat, and butter." What???

He seems to want to eat the "low-carb" way - yet he is very afraid of its outcome. I could just see Dr. Atkins turning in his grave as if experiencing a bad dream. It sort of reminds me how often doctors allow their patients to lose weight on the low-carb diet while at the same time warning them of long-term consequences. That fat results in "cardiac events" is the prevailing myth. But in this case Mr. Brown is deprived of worry - he's got the statin; the future looks bright. Why fear heart attacks? The statin is preventive medicine. There is no mention in the article that he has a weight problem and he does admit that "I haven't, to my knowledge, had any cardiac events."

Is it possible that Mr. Brown has made this up? Could he be trying to bait the readers to write in and offer their opinions on the matter - certainly the article raises more than just health issues. It raises ethical questions regarding the artificiality of the modern world - he may take statins but others take botox. Are pills the answer? Is it as smart as putting on a helmet when riding a bike -that seems to make sense; parents watching their kids my not dispute that. But the comparison is not similar. Riding a bike does pose its risks. Eating fat does not - at least not in an absolute way.

The causal link between fat and heart disease goes back to the work of Ancel Keys and his diet-heart hypothesis. Dr. Jonny Bowden (in his book Living Low Carb) summarized the history of this notion this way: " Keys concluded that cholesterol is a cause of heart disease, saturated fat causes a rise in cholesterol, and therefore saturated fat causes heart disease. Key's seven-country study became the basis for dietary policy for more than three decades, indirectly birthed the fat phobia of the 80s, and indirectly spawned an entire bureaucracy devoted to lowering cholesterol (the National Cholesterol Education Program) and also to producing some of the most profitable pharmaceutical drugs in history."

 The diet-heart hypothesis has been discredited - but the media and the majority of doctors still uphold the dogma. Why? Because they refuse to look at the history and scientific studies from that point onwards and even going backwards to uncover its threads - it has been ignored. Why? Too many careers are at stake. For doctors and the media and the drug companies and governments to suddenly turn around and say "yes, we were wrong, we take it back" amounts to career suicide and a questioning of the integrity that is demanded of our health care practitioners. Litigation would be the order of the day. For more than 40 years we have been presented with a lie- the one believed by Andrew Brown and his doctor. The scientific studies and books that are currently being published suggest that it has all been a big fat lie as Gary Taubes has boldly been asserting since his 2002 article in the New York Times. The current position of the low-carb community is this: fats (saturated & monounsaturated) are good; avoid polyunsaturated types - they are inflammatory; refined carbs are bad - avoid grains and sugar/fructose.

The way that Andrew wishes to eat - loaded on fats - is good. For millions of years of our evolution, fat has been the preferred dietary staple, supported by plants. Our bodies never evolved to eat out of a box, or a package. My advice to Andrew - throw away your pills, eat two steaks a day (with eggs), drink water, eat organ meats, once or twice a week; eat some veggies (a few berries); enjoy the sun. That's it. Oh yes, I forgot - tell your doctor to take a hike.

Friday, January 21, 2011

Defining Low-Carb

The concept of  "low-carb" should be easy to understand but there have been times when researchers have missed the point. We have seen instances where the clinical trials held 100 grams of carb/day as "low-carb."Of course, the results are not what they should be when such a diet is compared to the Standard American Diet in these studies. The low-carb way of eating means that fat is being consumed in the place of carbs. Hospitals and doctors, who are currently treating children for seizures using the "low-carb" approach, are generally worried about the long-term results. The seizures go away but they worry about what looms on the horizon for these kids. They worry that the price for success in one therapeutic outcome will exact a price somewhere else on the horizon. After the seizures are gone along come the heart problems - that is what they think.

The low-carb community consists of those who are trying to promote the view that, since the 1970s, the American Standard Diet, supported by multinational corporations, health agencies, and governments, has impacted the health and well-being of countless people in a negative way - the results are the diseases of civilization - obesity, heart disease, diabetes, cancer, and a host of others. Researchers are scared of experimenting with very low-carb intake; researchers, eliminating seizures through the low-carb diet, are afraid of the long term effects; doctors, who have long noted that low-carb diets reduce tumors, are afraid to support it in public. Mainstream society seems to think fat is bad and to be avoided; the low-carb community has an opposite view - it is not fat that is the problem, it is the carbs - the foods that are not in tune with our evolutionary journey.

The idea of eating fat in place of carbs is the universal maxim of the low carb lifestyle, often referred to as "paleo." The differences between the two are minimal -paleo avoids dairy because the "caveman" didn't drink it. They have to be understood within a context. To illustrate this, I've gathered (in no special order) a number of low-carb advocates from my blog list and see how they are similar and different in their presentations of what constitutes a low-carb diet or a low-carb way of life.

Some blogs lay it out in detail and some don't, but the gist of what low carb is actually does clarify itself. Robb Wolf starts off his blog by saying that the "Paleo diet" is "effective for fat loss and halting or preventing a number of degenerative diseases." The building blocks of the Paleo meals are meat, fowl, and fish -wild and grass fed; fruits and veggies in season and "healthy fats such as nuts, seeds, avocado, olive oil, and coconut oil." Operating under the shadow of his mentor, Loren Cordain, animal fat is not mentioned here. Elsewhere he suggests lean meat.

At the blog of Dr. Art Ayers (Cooling Inflammation), the emphasis is on the contrast - what not to eat. These are starches, simple sugars, and high fructose corn syrup. He says the focus of our diet ought to be "meats, fish. eggs, and leafy vegetables." Trans-fat are a no-no but probiotics are good as well as saturated fats - in fact he says that "saturated fats are healthy and reduce the peroxidation of omega-3 fatty acids at sites of local inflammation." He seems to emphsize that "saturated fats should be the major source of dietary calories."

Over at the PaNu blog of Dr. Kurt Harris we find a 12 step solution that will "remove the neolithic agents of disease in an efficient and practical manner." The steps are to be followed in the order as they are set out - you get healthier the further you go along this path: 1) get rid of sugar - fruit juices, sport drinks - and foods that contain flour; 2) eat proper fats -animal, coconut oil, and whole cream; 3) get rid of gluten grains - limit grains like corn and rice; 4) get rid of "grain and seed derived oils" - those are "cooking oils" that should be replaced with coconut oil, butter, animal fats, or ghee; 5) eat meat from ruminants & include eggs and some fish; 6) get sun & supplements for Vitamin D; 7) two or three meals a day is all you need; 8) adjust the omega 6 and omega 3 ratio; 9) exercise using resistance and interval training instead of aerobics; 10) ease up on fruits because of fructose - emphasize berries; 11) get rid of legumes; you may want to avoid dairy, if allergic or concerned with casein - stick to butter and cream. He is not concerned about numbers but says that Paleo should range along this ratio: 5-35% carbs, 10-35% protein, 50-80% fat. This depends if you are dieting or maintaining your weight. One point he makes is that the issue is not fat vs. carbs but "neolithic agents of disease versus everything else."

These views are succinctly summarized by Mark Sisson (Mark's Daily Apple) where, on his blog, he says the following: "Focus on quality sources of protein (all forms of meat, fowl, fish), lots of colorful vegetables, some select fruits (mostly berries), and healthy fats (nuts, avocados, olive oil)..... Eliminate grains, sugars, trans - and hydrogenated fats from your diet."

From Richard Nikoley's Free the Animal blog we get a five-point summary: one should eat "real foods" and by that he means meat, fowl, fish, natural fats from animals, coconuts, and olives; veggies, fruits, and nuts. He points out that one should remove grain, sugar, and vegetable oils from one's diet, supplement with omega 3 fats, and engage in intermittent fasting; get sunshine, supplement it with Vitamin D, and do short intense exercises.

From this we can come away with some universal maxims: eat animal fat, tropical oils (coconut/palm) & avoid industrial oils (vegetable -canola, safflower etc...); get rid of all carbs (starch/sugars) except for some nuts, some vegetables & minimal fruits; get into the sun, supplement with Vitamin D; exercise briefly but intensely. The bottom line is to eat like the human race has done for millions of years or  at least the last 200, 000 years, since our last migration out of Africa. We did not evolve to eat synthesized, processed, boxed, packaged, wrapped, and canned foods.

Thursday, January 20, 2011

Another Low-Carb Blog?

Here we go - another low carb blog. Why? Because I'm fed up with the misinformation, incomplete facts, distortions, & misinterpretations I see and read in the media about diet, nutrition, obesity, & diabetes on a daily basis. It has become an irresponsible and unethical sport.  People are victimized, the science is shoddy, policy-makers are hoodwinked, corporations run a scam, physicians are confused, and the health of nations have never been worse. This is just one more blog to poke, prod, prick, and mock the so-called authorities of health and nutrition who have fed us lies, deceit, and terror and, in doing so, have inflicted suffering and death to countless folks.

Recently in the Vancouver Sun newspaper's Health section  (Monday Jan. 17, 2011) SportMedBC's Dietitian Patricia Chuey offered her food and nutrition insights in order to help the readers achieve their sport and well-being goals.

The first thing she wanted to get across was that she was debunking the idea that carbs make you fat - she was adamant they they don't. To quote her - "Too many calories from any food will cause your body to produce and store excess fat." What have we seen in the last few decades, Patricia? A decrease in fat consumption (low-fat yogurt, low-fat milk, low-fat this and low-fat that) with the added carbs. And what has happened, Patricia? An epidemic of obesity and diabetes.

Oh yes, she also debunks the idea that carbs cause diabetes. What? In her own words: "Sugar and other carbohydrates do not cause diabetes. However, an excess of refined, low-fibre high sugar carbs can negatively impact blood sugar control." So Patricia, can't you link the dots?

What does Patricia want us to do with carbs? She wants us to pick "quality" carbs and make changes such as switching to whole wheat in place of white bread; whole wheat pasta should replace white pasta. Hey Patricia, a carb is a carb and a carb in the bloodstream is glucose. Don't call it "blood sugar" -  it isn't. It is glucose. Sugar is in the pantry or on a teaspoon. Excess insulin is at the heart of diabetes (type two - the recent epidemic type). Insulin provides escort service for glucose and fills the cells with it until the day those cells put up a resistance - like "not in my backyard." The overload of glucose draws an excess of insulin. Then you are in trouble. The insulin scrapes the endothelial cell linings of arterial walls and leads to further damage - clots, blockages and so on. Soon you crave more carbs and the vicious cycle becomes permanent. At some time the pancreas crashes, like an overused computer. Then you need insulin as in Type One.

Chuey believes that "diabetes is a complex condition with many genetic and environmental contributors." So Patricia, why do the good doctors offer us insulin as a remedy? Which is stupid anyway - just remove carbs from the diet - hey, it's free. And they are not tweaking our genes or sending us to sunny Florida as a cure. But maybe you think they should.

Well Patricia, let's give Dr. Andrew Weil the final word. In commenting on Gary Taubes' book Good Calories, Bad Calories on Larry King Live (Oct. 19, 2007) he says that the book is full of big ideas, such that "there is absolutely no scientific evidence for the belief that fat is the driver of obesity.... its (sic) carbohydrate which is central to this process ... in which insulin is a central player ... that overeating and under activity are not causes of obesity." (transcript from Alan L. Watson, Cereal Killer: The Unintended Consequences of the Low Fat Diet).