Your comments and questions are welcome.
Posted on March 9th, 2008 by Jay Wortman
Please feel free to ask questions or post comments about the documentary film, “My Big Fat Diet”, or anything you see on this site or its links. I will endeavour to reply to all posts.
169 Responses to “Your comments and questions are welcome.”
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Were any dietitians consulted in preparing this diet?
It doesn’t seem like there have been any nutrition professionals consulted in preparing the protocol for the study. MDs do not receive sufficient training in nutritional science.
Dr. Jay’s Reply:
Thank you for you comment.
Your observation that MDs generally do not get adequate training in nutrition is something I would agree with. I think my profession, in embracing the pharmaceutical approach to disease management, has allowed the very important issue of nutrition to be side-lined. As physicians, we are taught to examine the research that guides our practice to ensure it is done to high standards. The double-blind randomized controlled trial is considered to be the gold standard with which drugs and other interventions must be evaluated. In deferring to other professionals in the area of nutrition, we assume that they conform to the same standards. In reality, it appears that they do not. Gary Taubes’ excellent book, “Good calories, Bad calories†details the areas in which nutritional science has been deficient and how the consequences of this can be found in the modern epidemics of obesity and related conditions.
Were there any dieticians on my research team?
No. However, we did have Dr. Eric Westman from Duke University who has done a number of studies on low-carb diet and who does have a dietician on his team. The diet he used for his recent research was very comparable to the one we used. We also had Dr. Mary Vernon, who has had years of experience designing low-carb diets for her diabetic and metabolic syndrome patients and successfully managing these conditions. We had Dr. Steve Phinney who is an internist with a PhD in nutritional biochemistry from MIT who has been doing research in this area for over 30 years. We also involved Dr. Abby Bloch who has a PhD in nutritional science and who has been a contributor to the standard textbook of nutrition used in American universities.
With this kind of expertise in place, I don’t think that the fact there was no dietician involved would constitute a significant deficiency.
At the end of the day, regardless of who was on the team, the most important question is whether the intervention delivered a beneficial result. Although we haven’t completed a final analysis, from our interim analysis, I am happy to report, it appears that it did.
In the past I have lost over 50lbs using a low card diet.
I was 40 at the time.
Now I am 48 with high blood pressure (around 155 over 110) I am on diovan. I would like to go on another low card diet. Any suggestions on how I should start this diet and what I should be aware of ? I weigh 285 now and would like to go down to 200 .I am 5′11″ tall
Do you have a diet plan that I can use?
looking forward to hearing from you
Dr. Jay’s Reply:
Thanks for your comment.
Your story highlights an issue that is common to most diets including low-carb – how to maintain long term compliance?
It is something my colleagues and I have been discussing. I think it depends on the fat portion of your diet. While you are losing weight on a low-carb diet, your appetite drops because you are burning off your stored fat. At some point your weight loss will plateau and you will need to replace those internally stored calories with additional calories from the food you are eating. Most people have been counseled to avoid fat and if you are trying to avoid carbs, too, that leaves protein. The problem is that if you increase protein beyond a certain point it will make you feel ill. If you start to increase your carb intake you run the risk of getting on that slippery slope of cravings and eventual weight regain.
So, that leaves fat. It does make some sense that since you are replacing an internal energy source in the form of fat, you might consider adding fat to your diet. The question then is what kind of fat. In the literature so far it appears that additional saturated fat is not a problem as long as the carbs are kept low. Perhaps the best type of fats, though, are the mono-unsaturates like olive oil. A big proportion of human fat is mono-unsaturated.
As to offering you specific guidance on your own diet plans, I am not comfortable doing that here as it comes too close to practicing medicine over the net. Until I and my colleagues get around to writing a book of our own, I think the best low-carb diet resource out there is still an Atkins book.
I hope this helps.
thanks
Hi Dr. Wortman,
A reader notified me of your site via my blog, and I’m glad she did. I think you’re doing vital work, and I want to congratulate you on persevering and getting your study going!
I’m a low-carber myself, and have a particular interest in traditional diets, especially of our native population here in Canada. I’m fascinated by Stefansson’s experiences working and living with traditional Inuit in the early 1900’s (reading “My Life With The Eskimo now) and his subsequent Bellvue study (the year-long, all meat diet he undertook with his colleague).
As a writer and independent filmmaker, I hope to undertake a study of my own, albeit informal! The answer to so many of our current health “crises” seems so simple, yet meets with such vehement opposition that I just can’t wrap my head around it. People like you (and Taubes, Dr. Vernon, etc) help get the word out to the public that there are easier, natural ways to health that require little more than altering the composition of our diets. My goal is to do the same, however I can.
I’ll be reading your site with interest, and am looking forward to the CBC doc tomorrow night! Thanks for all your hard work.
Tracy
Dr. Jay’s Reply:
My good friend Dr. Phinney was the first one to tell me about Stefansson. I have read accounts of his work with the Inuit and the Bellevue experiment. It is a fascinating story. Phinney figured out very early on that the conventional wisdom that low-carb led to poor exercise tolerance was wrong by studying the diaries of arctic explorers. He then did his PhD at MIT by putting bicycle racers in a metabolic ward and feeding them a diet of protein and fat modeled on the Inuit diet. He demonstrated that exercise tolerance did drop but that if you stuck with the diet, it returned to baseline levels. He coined the term “keto-adaptation” to explain the process of adjusting to a low-carb diet. Phinney and I compare notes on our personal feats of endurance that we are convinced are possible only because we burn fat and ketones in our muscles rather than glucose. He rides his bike great distances on the California roads while I ski like a maniac, non-stop down Peak-to-Creek at Whistler.
Glad to see you reference Gary Taubes new book, Good Calories, Bad Calories — Challenging the Conventional Wisdom on Diet, Weight Control, and Disease. I found the book provided an excellent overview of the history of nutritional “science” — amazing what we accept as self-evident. For those who like a good “who-dunnit” with a little conspiracy theory tossed in, this is as close to a page-turner as we’re likely to see on the subject of diet and nutrition.
As a writer for Science magazine, Taubes has meticulously documented the research in his book, with over 110 pages of notes and references in the bibliography. It will be interesting to see which academic naysayers will dump on your program in the name of science, given that you too threaten the conventional wisdom and established “experts” on the subject. I hope you are ready to fight back and issue the challenge: “Prove your own damn science”.
Best of luck.
Dr. Jay’s Reply:
Good to hear you are a Taubes fan. I highly recommend his book and I have also been telling people it is a “whodunnit”. Great minds …
Dr. Wortman,
I agree with the low standard of nutritional information from Universities. We expect useful, UNBIASED information from our learning institutes.
While attending the University of Manitoba, I was amazed at the nutritional ignorance or rather the fear of literally “going against the Grain” of the Canada Food Guide. I mean how can anyone expect First Nations people to go from wild plants and high protein and fat to high starches and sugars within less than half of a century. (Middle Eastern countries spent thousands of years adapting to heavy grain diets.)
Also, I have read research correlating alcoholism with low levels of protein and fish oils, that might also contribute to First Nations problems of alcoholism and drug abuse.
When some old, tough-as-nails labourer insists that part of his health is from wild berries and say, apple cider vinegar, I tend to pay attention. On the other side of the coin, when a Phd in Nutrition, who has a mouth full of bad teeth and has to struggle up 3 flights of stairs and claims, “There is no junk food.”, I question that authority. When an RD insists that they must serve ice-cream, processed cereals and pastries at a camp for diabetic children, I have to ask where did they get their funding.
Even a cardiologist, whom I was sent to visit explained that he learned “nothing about nutrition from medical school” and had to learn nutrition on his own.
Food for thought.
Keep up the good work.
–Doug Setter
Dr. Jay’s Reply:
Thanks for you comment.
There is some interesting research out there that may tie carbohydrate consumption to addiction in some people. It appears that the same parts of the brain are involved. There was a recent study that showed that overweight women self-medicated with sugar to elevate their mood. I know that when I first started restricting carbs I experienced something akin to drug withdrawal. It took some will power to get through it but the cravings do die down. I think cold turkey is the best approach for that (no pun intended).
Congratulations on the success of your study and bringing hope to Aboriginals. I hope a similar study can be launched in the general population in Canada using meat without the fat carved off, all the eggs you want, vegetables and fruit and the elimination of sugar and junk food. Doctors and dieticians, in general, shun the words “red meat and saturated fat”. They would not approve this diet. You being a doctor, can perhaps change this perception by what you have shown. This change in diet will save millions in health care. Best of luck in your continuing success.
Dr. Jay’s Reply:
Thank you for your supportive comment.
Dr. Wortman,
I look forward to seeing the documentary. Thank you for allowing us to follow your important research in the area of traditional diets and the low carb approach to disease control/management!
My question relates to the area of liver disease. Some of the statistics show that as much as 100% of the population who are obese and who are diabetic also have fatty liver disease. Can you comment on the the percentage of prevalence in the Alert Bay population?
There are very few published studies that detail the long term effects of diet on liver disease at this point in time. Did you look at this area of your patients’ health and if so, did it change during the duration of the diet?
I am hoping to hear that low carb diets not only help diabetic patients to experience remission of the disease but also help to reverse fatty liver congestion. Any information you can give me in this area would be appreciated.
I currently follow a low carb diet.
Dr. Jay’s Reply:
Thanks for your query.
Non-alcoholic fatty liver disease (NAFLD) and Nonalcoholic steatohepatitis (NASH) are the liver manifestations associated with metabolic syndrome (which some people call “pre-diabetesâ€). In our study, if people had high liver enzymes indicating a compromised liver we excluded them.
In other studies which looked specifically at NAFLD and low-carb diet (there are two of them, I believe) there was an improvement in liver function associated with carb restriction. One of the studies, in which my colleague Eric Westman was a co-author, actual liver biopsies were done to document the improvements in liver health as a result of the low-carb diet.
I am sorry I don’t have the references handy as I am traveling at the moment but if you did a pubmed search you should be able to find them.
Hello, I have a couple of questions about your diet.
I am currently trying to follow the “Zone” diet. It proscribes a 40-30-30 carbohydrate-protein-fat caloric ratio. I am getting my carbohydrates primarily from fruits and vegetables, and my fats from olive oil, nuts, and peanuts. I don’t eat dairy.
Anyway, the questions. I’m wondering about your personal opinion of these–if it is backed up by literature that’s great, but I understand that in some cases there might not be enough studies to provide an “official” answer one way or the other.
1) What are your thoughts on the caloric breakdown of the Zone diet? 40% of intake from carbs is lower than a normal American diet, but it sounds like it’s much higher than that of the diets of the people in your study.
2) Were people allowed to eat fruits? Do you eat fruits? Do you feel fruits are an acceptable source of carbohydrates? Do you have a preference of berries versus oranges, or some fruits over others?
3) What about non-liquid milk dairy products, such as cheese and cottage cheese? Do you allow yourself intake of these items?
4) Is it correct to estimate that caloric intake on this diet (and your diet) comes primarily from fats? Do you feel, personally, that it is better to get fat intake from nuts and nut butters, olive oil and coconut oil, fatty meats, or is fat from butter and dairy products OK in your book?
Dr. Jay’s reply:
Good questions. Here are my thoughts:
1) From the published literature it appears that benefits accrue as carb content drops. In the OMNI-Heart study, they replaced a little bit of carb with fat or protein and found a benefit with both, a bit more with protein vs fat. I also think that if you shift the glycemic value downward you will get a benefit. This is what Walter Willett’s idea about glycemic load addresses. Glycemic load is a multiple of glycemic index and amount of carb so to get your GL down you can shift to lower carbs with lower glycemic value. I think this is similar to what you are doing with the Zone.
2) In our study diet we didn’t include fruits. We advised people that if they were going to start eating fruits they should stick to berries, partly because they were a traditional food and partly because berries tend to be lower in natural sugar content than other fruits. When I indulge in fruit, I stick to berries. I think the darker ones are the best because they tend to be low in sugar and full of other good things like resveratrol.
3) We allowed cheese in the study because there is little lactose in most cheeses (the hard cheeses are the best) and they are a good source of calcium, fat and protein. I avoid cottage cheese as it has a little more carb.
4) Once you have stopped losing weight on a low-carb diet, you need to replace your internal fat calories by adding fat to your diet. The oil in nuts is okay but it comes with some carb so you have to be careful not to overindulge. Oils that are high in omega-6 should be avoided which means most of them except olive oil and canola oil. I eat fatty meats and dairy fats like cream, cheese and butter because the literature I have seen suggests that these are not detrimental if you keep the carbs low. Having said that, I cannot say whether or not the level of carb you are eating is low enough. If you are eating these types of saturated fats you might want to check your cholesterol to make sure it is okay.
Hi Dr Jay. My story is similar to yours. I’m a white male, age 57, 6′1″ tall. By age 52 my weight had climbed to 215 lbs, waist measured 40″, fasting blood sugar was 145 or higher, and blood pressure had climbed to 155/95. My doctor wanted me on Metformin for diabetes, Vytorin for Cholestorol, and a Beta Blocker for blood pressure.
I declined all the medications and decided to try a dietary approach. I got Atkin’s book and carbs to try to immediately reduce blood sugar. My results, like yours, found impressive gains in all the target areas. Within a year my weight had dropped and stabilized to 160 lbs, my waist is now 32″, my blood sugar is rock stable at around 100 at any time it is measured, and my last blood pressure check was 98/63 – all without medication.
I was inspired by Steffansson’s story about 3 years ago and decided to give a little more radical all meat diet a try. For over 2 1/2 years now I’ve eaten nothing but uncooked or lightly cooked (rare) grass-fed beef, pork, or bision. It is amazing but I feel better than I’ve ever felt before and show no signs of any deficiencies. When I started, I was told that meat would not supply critical vitamines like “C” and was to low in calcium. None of the predicted deficiencies has materalized.
I also find that I’m rarely sick any more, even though those around me often suffer from colds and flu symptoms. I also suffered from weekly debilitating migraine headaches since I was a teenager, and since converting to an all meat diet these have gone away completely.
I’ll be following your reasearch with great interest,
Lex
Dr. Jay’s Reply:
Thanks for sharing your story.
You know, if you told me about your all-meat diet six years ago, I would have said you were crazy. Now that I have been exposed to the scientific literature in this area, including the study where Stefansson and his colleague ate nothing but meat for a year, I am not surprised by your account of improved health from this way of eating. I’m not recommending this to anyone but I no longer think it is necessarily an unhealthy way to eat. One of the things that led to the challenge to Stefansson was the belief that we need to have significant sources of vitamins that are available mainly from fruits and vegetables. It turned out that by completely eliminating carbs, Stefansson’s need for these vitamins dropped and he remained healthy. There are similar stories of European arctic explorers dying of scurvy while their Inuit companions remained healthy. It appears to have been because the Europeans were eating carbs while the Inuit were not.
Your diet would be considered a little extreme for most people but good for you for pushing the envelop and good luck with it.
Dr. Jay
I am Type 2 controlled on insulin daily. I am very active, running 40 -50 km per week. I weigh 165 lbs I am 6 ft.
I was diagnosed 4 yrs ago. My question to you would be On this diet… ” How do I achieve energy levels adequate for my lifestyle without having serious lows”. I do not need to loose weight, I need to have better A1C’s and lower blood cholesterol levels which are not high at all but need to be better than normal.
I do not take lipitor anymore, it makes me feel bad and I am better off since discontinuing 6 weeks ago.
I appreciate your taking the time to write back.
Yours truly,
Yves
Dr. Jay’s Reply:
Thanks for your query, Yves. I cannot give you medical advice on the management of your diabetes. However, from what you have told me, ie that you are fairly recently diagnosed, not overweight and are exercising a lot, I am a little surprised that you require insulin. The more insulin you take the higher the risk of hypoglycemic episodes so it is a good idea to try to reduce the need for insulin. Reducing carbs does this. Stamina should not be affected by reducing carbs after a period of initial adaptation (see other post on this). I would recommend Dr. Richard K Bernstein’s website (see links) for more information on how to manage diabetes using a very low carb diet approach.
Congrats on study and this site. I’m a type 2 diabetic looking for alternatives to deal with this condition, so your ideas are very interesting. I need to try something, as I’m drifting up in weight because I’m just so weary of the struggle, I have little willpower, and yet I want to control or reduce my weight and sugars. I live to eat and enjoy all foods, love those carbs, all of them. Of course, I feel hungry all the time. I know drugs are not the answer. In a cautious manner, I’m going to adapt my diet to greatly reduce the carbs I love so much. Thanks for your good work. It’s hard to get the message out to we t2ds, as we are very shy and don’t talk to each other or about our diabetes. We have learned to feel shame for our “lifestyle” disease.
Dr. Jay’s Reply:
I would recommend the book, “Atkins Diabetes Revolution”. It was co-authored by Dr. Mary Vernon and Jacqueline Eberstein. It is an excellent guide on how to use low-carb dieting in the management of type 2 diabetes. I also recommend the links I have posted here.
It is a lifestyle disease but nothing to be ashamed of. We tend to buy into the current model that being overweight is the result of “gluttony and sloth” when, in fact, it is more likely due to a disturbance of our metabolism caused by excess consumption of carbohydrates. Have a look at Gary Taubes’ lecture link to learn more about this.
You have mentioned that exercise tolerance temporarily dropped in one study with the bicycle racers and that others went through temporary sugar withdrawals/cravings. I’m wondering if there is a range of time we can expect these side affects to last? Three days, two weeks, a month or longer?
Is it possible that this diet can eleviate arthritic aches? (I wake up stiff in the morning and have trouble opening faucets and door knobs,etc but within 1/2 hour I’m okay unless I sit still for a period of time.)
Also, are tomatoes considered an acceptable vegetable or do you have them in the fruit list? I just finished looking in my fridge and pantry and now I can certainly see why I feel the way I do!
Dr. Jay’s Reply:
I believe Phinney’s study was 2 weeks duration. It appears that keto-adaptation occurs within that time frame, some people would be faster in adjusting than others. Earlier experiments in this area were terminated before people had time to adapt, hence the belief that carbs were necessary for stamina.
For me the cravings were intense for a couple of weeks and began tapering off over the following months. I think if you can get past the intense early period it quickly becomes more manageable. One of my tricks was to eat a little treat every evening before bedtime. It started with diet Jello with a little cream (how pathetic is that!) and then I developed my own low-carb ice cream recipe and that was my reward for fighting off the cravings every day.
I have heard lots of anecdotal reports of improvements in arthritic symptoms when carbs are restricted. I have not seen a study on this but, based on all the stories I hear, I think one is warranted.
I love tomatoes but they are more of a fruit than a vegetable so I don’t over-indulge. I also make a great tomato sauce that can be used in small quantities. I usually eat a small tomato with my eggs in the morning.
Dear Dr. Wortman
I would like to commend you for taking the time to raise First Nation nutrition awareness.
I am First Nation, 37 years old, and I was once 245 lbs. I am now down to 165 lbs. I know exactly what it feels like to feel “heavy” and “sick”, and being told by my doctor that I will need to take high blood pressure medication forever, and I have a high chance of being diabetic, and so on. Being First Nation, I simply accepted it all as “fact” and that that was how my cards were dealt.
I decided “hog wash”, and wanted to change but where would I start? I went on a journey of self-discovery 5 years ago.
Change did not happen overnight. I became aware of calories, fats, energy (joules), fitness, exercise, natural supplements and better living. I cut back nearly completely on junk foods, fast foods, heavy fat foods, learned about what is healthy, what isn’t, ate more balanced diets, and I began doing lots of cardio and working out. I refused to do another desk job and got a job that keeps me active physically and mentally. I completely quit coffee, alcohol, dairy products, and chose to eat foods that were “living” and not “dead” being laced with chemicals and preservatives.
I have to say that I have done very well. I have never been in better physical shape, ever. I feel stronger, more energetic and I’m told that I look great. I can’t help but feel “sorry” for everyone when I go home for visits and seeing how obese everyone is, how kids I grew up with have died because of diabetes and other fat related illnesses.
There was one extra surprise benefit. My mental/emotional state has changed dramatically. I no longer get long bouts of depression, anxiety and panic attacks any more.
I’ve recently read about a study that links the cumulative effects of chemicals in our bodies that can cause mental/emotional imbalances. The chemicals can include alcohol, caffeine, salt, sugar, preservatives, hormones, antibiotics, and many others that are added to foods. Such additives can cause chemical imbalances that could lead to depression, drug/alcohol addiction, anxiety, irrational thoughts such as suicide and other mental problems. This makes sense being that our ancestors never came in to contact with such dietary additives making us even more prone/susceptible to mental problems today.
I believe that our new “diet” is what is possibly the main source for most of the ills of First Nations people, but no one has really done any research (to my knowledge) to link diet to the emotional/mental well-being of First Nations. My own return to a more “traditional” diet and active lifestyle has personally helped me, and I could see it helping others.
It’s about time this happens.
Les
Dr. Jay’s Reply:
Thanks for sharing your story and congratulations on your achievements.
I agree that there is a big relationship between mental health and diet. If you watch “My Big Fat Diet”, you will see that this is one of the things that people comment on in Alert Bay, that there was a noticeable improvement in mood in that community. I think it is an area that deserves more research.
Breakfast is my favourite meal of the day-, full of carbohydrates-cereal, toast, pancakes, porridge etc. I am just wondering what you eat for breakfast? You can only eat so many eggs.
Any good breakfast ideas?
Laura
Dr. Jay’s Reply:
Thanks for your query.
I used to eat a big pile of waffles with fruit and yoghurt drizzled with maple syrup. Delicious, but in hindsight, that’s probably what pushed me over the edge into full-blown diabetes.
Now I eat a lot of eggs (the ones with omega-3). I have them over-easy with lots of salt and pepper and a dash of cayenne or in omelets and frittatas with cheese and a little onion. I usually include a small tomato on the side smothered in Hellman’s mayo. If I’m skiing I’ll also have a little piece of steak otherwise it’s usually bacon, the thick farmer’s type. All this chased with a mug of hot breakfast tea. And you know what – I don’t miss the waffles one bit. Ditto the toast and hash browns.
I just heard about your research on CBC radio this afternoon and look forward to watching the documentary tonight.
Having been a healthy, very active vegetarian for 17 years, I am proud to say that complex carbohydrates are my best friends. I eat very little simple sugars and carbs and very little dairy (preferring goat milk products to cow), I consume a lot of beans and legumes, and I prefer my fruits and veggies whole and raw.
I recognize that the research you are conducting is specifically dealing with a population that traditionally ate a diet containing few to none of the carbohydrates of the Canadian diet. However, I get a bit nervous when research results like yours, obtained from a specific population, is misunderstood and/or misused by the general population as the ultimate answer and quick fix to their diet and health woes. Although the low carb diet may work for some, it may not work for everyone because we are all different because of our genetics, our lifestyle, our willingness to change more than just our diet, etc.
So, my question is: do you see a role for complex carbs, such as brown rice, beans and legumes, or ancient grains, in the diets of both low-carb aboriginal and non-aboriginal people in the long term? Is it something that you think could be successfully incorporated into the diet of the people of Alert Bay eventually?
Thank you very much!
Dr. Jay’s Reply:
Thank you for you comments.
I think the quantity of carbohydrate one can tolerate is probably genetically determined at both the individual and populations levels. Would a low-carb diet work for non-native populations? I once asked my colleague, Dr. Steve Phinney, that question. He said that he had treated over 3000 patients in his clinic at UCDavis and didn’t find any ethnic variation in response to a low-carb diet.
As to unrefined complex carbs, yes they are better than the refined versions. If one ate only these types of carbs (plus protein and fat, of course) from an early age, I would venture that the likelihood of developing obesity and diabetes would be greatly reduced. And, if you did develop these conditions, reverting to unrefined complex carbs would, I think, improve things. However, the research on low-carb diets suggest to me that the most effective therapy once problems develop would actually be carb restriction. For the people in the study, I expect some of them will start introducing complex carbs. If they do, my advice will be to watch what happens and if any of the problems start to return, to back off again. In my own case, the lower I go with the carb content of my diet, the better I feel.
I am so very interested and wanting to do the diet. Where do I get oolichan grease? I need all the details for this diet so I can begin asap. Can you forward me all I need to know,what I should buy,etc? Can you send me it in an email please and thank you.
Dr. Jay’s Reply:
Unfortunately, the protocol for the study diet is not generally available since it was designed to be used in a specific medically supervised research setting. I am often asked to provide a diet plan to people and, since I and my colleagues have not written a book (yet), I usually recommend the Atkins diet. The first phase of Atkins, the induction phase, resembles the diet we used in our study. My friend, Jacqueline Eberstein, who was Dr. Atkins nurse for 30 years tells me that he kept some people on induction indefinitely. If you think of the Inuit, they, too, ate virtually no carbs over their whole lifetimes so this is not unheard of.
I think oolichan grease is a remarkably healthy fat and would be good for people other than the coastal First Nations who currently eat it. Unfortunately, it is not commercially available. The fishery itself is dwindling and the amount of grease produced probably doesn’t entirely meet the demands of First Nations people who still use it. In the absence of this wonderful food, you might consider adding things like butter, olive oil and canola oil to your diet instead. An omega-3 supplement is also a good thing if you aren’t eating a lot of cold water fish.
If you are taking any medications to control blood sugar or blood pressure you need to consult your doctor before starting carbohydrate restriction. Also, if you have any serious illness like unstable heart disease, cancer or liver or kidney failure, you should see your doctor before making a big dietary change.
Dr. Wortman,
I was very much interested in hearing about your research on CBC 1’s “The Current.” My dietary choices are very limited due to celiac and multiple food allergies so it is good to hear that some of my favourite indulgences–whole milk products and butter–might actually be better for me than the low fat alternatives which I’ve all but abandoned.
I do have a few questions–
I was wondering whether it is the type of fat that you are recommending that is key here. Wild salmon is high in omega 3s and vitamin D and I imagine oolichon grease would be as well. I’ve read that wild game and grass fed beef contains more omega 3s than does typical supermarket meat (although I’m not certain how significant the differences are). My question, then, is would eating a diet in omega 6 fatty acids have the same health benefits as the diet you’ve studied?
It also occurred to me that the fat to carbohydrate ratio was not the only major change in the diet—-the traditional Inuit diet is high in vitamin D (which is all the more important in a northern climate). The role of vitamin D in regulating immune function isn’t well understood, but it seems to me that it is a ‘hot topic’ in medicine right now. Some autoimmune conditions like allergies and multiple sclerosis are much more prevalent in northern climes (possibly because of a lack of sunshine in winter months.) It could be the case that diabetes is also more prevalent in Canada than, say, in southern California?
Lisa
Dr. Jay’s Reply:
Omega-3 and -6 are polyunsaturated fatty acids (PUFA) and are also known as essential fatty acids (EFA) since we must get them from our diet. There is a lot of interest in omega-3 because of its association with things like reduced risk of cardiovascular disease. There is some interesting literature on how omega-3 supplements are therapeutic for a range of mental health problems. Omega-3 is a big component of brain tissue, hence the idea that fish is brain food. While omega-6 is also an EFA, it turns out that the ratio of 3 to 6 is important and that if 6 is too high relative to 3, this can lead to health problems. They both compete for same enzyme pathways and if there is too much 6, it overwhelms 3. Omega-6 is the precursor to some powerful immune system molecules like the leukotrienes. What this means that too much omega-6 can be pro-inflammatory. Rather than a balance of 3 vs 6 in the range of 1:1 or 1:2, most people are getting excess 6 in the range of 1:20 or 1:30. The source of the excess omega-6 is the commodity vegetable oils like soyabean oil, corn oil, etc. I advise people to use only olive oil or canola oil. You also have to watch the labels on prepared foods as they tend to use the cheap commodity oils, as well.
In the case of oolichan grease, we found that it was mostly monounsaturated like olive oil and that it actually had a very low omega-3 content. In the supermarket, meat from grass fed animals will be higher in omega-3 and those that are corn fed will be higher in omega-6.
I think an omega-3 supplement is a good idea if you aren’t eating a lot of cold water fish. In term of fats as an energy source, the ones I eat are olive oil, canola oil, dairy fats and animal and marine fats.
Would this diet be suitable for someone with VERY high total cholesterol, low triglycerides, no diabetes. Yes, aboriginal. Yes, omnivore.
Dr. Jay’s Reply:
The typical cholesterol pattern found in metabolic syndrome (some people call this pre-diabetes) and type 2 diabetes is characterized by high LDL (the bad cholesterol), low HDL (the good cholesterol) and high triglycerides. Within the LDL, there would be more of the small, dense athrogenic subfractions. When someone with this pattern goes on a very low carb diet what usually happens is that there HDL goes up, their triglycerides go down and their LDL may rise a little, stay the same or go down a little. The sub-fractions of the LDL would shift away from the athrogenic type to a more healthy type. The ratio of total cholesterol to HDL is usually greatly improved due to the rise in HDL. The drop in triglycerides is a fairly reliable indicator of how much carb-restriction the person is actually doing. Dr. Vernon has case reports of patients with very high triglycerides getting them back into the normal range through carb restriction.
In your case, I don’t know the answer to your question. If you already have low-triglycerides you are probably not over-eating a lot of bad carbs (correct me if I’m wrong). As to total cholesterol being high, it would depend on which component was causing this, LDL or HDL, what measures would be effective in managing that problem.
I do eat carbs, but only whole grain and unprocessed. Life long. I eat and cook the old way. But I am always told to eat little meat, no butter, no eggs, etc by physicians who are pop eyed at my TC.
Don’t know quite what would bring my cholesterol level down. Although I qualify as FH, I don’t have any xanthomas etc. And then there’s my high, really high, hdl.
Statins nearly killed me, while the chorus was “never heard of (whatever side effect I was experiencing). Stay on or you’ll get cardiovascular disease”.
I took myself off, but am still kind of worried about a TC of 14 or so.
Dr. Jay’s Reply:
I know of a couple of people with familial hypercholesterolemia who were able to achieve good control through very low-carb dieting. I think you would want to do it under medical supervision, though, and the problem you are likely to encounter is that most doctors don’t have training in how to manage carbohydrate restriction. My colleagues and I are working on that.
Congratulations on your work and please keep it up.
I have had diabetes for about 10 years and have been overweight for a good portion of my life. Most recently I have gone on a low carb, low fat, low sugar diet (commercial and Dr. supervised). The results are much like those experienced in the documentary “My Big Fat Diet”, an excellent documentary, by-the-way.
I am completely off my medication for diabetes. I am also all my hyper-tension medication except for 1/2 of a diuretic pill and I expect to come off that as well. I have lost 40 pounds in 2 months and approximately 6 inches around the apple.
I am noticing low energy and have been on a K-Lite supplement with a multiple vitamin. Some days I also experience anger/rage which concerns me but apparently is not uncommon. Do you have any information on that?
Otherwise I was veryencouraged with your research and would like to learn more and will watch your site.
Dr. Jay’s Reply:
Since your diet is medically supervised, I am reluctant to meddle. I am somewhat concerned, though, when I see low-carb and low-fat together. This suggests to me that you may be eating too much protein in order to get sufficient calories. When people eat too much protein, they don’t feel too well. I am tempted to think your feelings of rage might be related to this. You might also ask your doctor if he would recommend a magnesium supplement. In my experience, by the time someone had developed diabetes they probably have a magnesium deficiency, also. Since virtually all of our magnesium is intracellular, a blood test won’t detect it. Usually it makes itself known when you develop leg cramps at night. If your doctor checks your reflexes and finds them to be hyper, that would nail the diagnosis. The remedy is a slow release magnesium pill, like SlowMag. For whatever reason it is hard to find in Canada. I get mine at Costco in the US. The have a good knock-off called Mag64.
The program was EXCELLENT! I hope this show becomes accessible through the Internet so people from other countries can see it. I know there any many Americans, Brits and Australians who would love to see the documentary.
Congratulations, Dr. Wortman for having big enough kahunas to take on this project. Hopefully the ball will continue to keep rolling and we can start heading in a direction as a nation to overcome the epidemic of obesity that has resulting from the Canada food guide, the Canadian Diabetes Association and the Canadian Heart Association recommendations.
Oh yeah, I am living proof that this stuff works. I have lost 93 lbs as well as all of my meds for hypertension on a low carb, high fat diet. I currently eat a diet where I get 70 – 80% of my calories from fat. I feel great, I look great and I am healthy. This is not a diet, it has become a lifestyle choice.
Pass the butter and cream, I need to make a sauce for my fatty steak!
Dr. Jay’s Reply:
I am glad you enjoyed the documentary. Thanks for adding your interesting experiences and observations to the debate.
Hi, Glad to see someone is finally paying attention. About 4 years ago my blood sugar was outof control. Had been taking metformin for several years and it worked for a while but then my level went up and doctor doubled the dose. No effect. I went to book store and bought Dr. Atkins book on the diabetic revolution. Started the diet and within a week my level was normal and I stopped medication. I stilll watch my diet and get an a1c test every 3 months and it has always been in the 6 range, but now if I want I can eat anyting and it has little effect on my blood sugar level. My doctor is pleased with my results but has never asked what I’m doing. Keep up the good work. I know there is a lot of resistance to this method. I believe it is mainly from the drug company funded organizations. Oddly enough on one of the blood minitoring device (test strips) web site they say that the Atkins diet will work but that our doctors won’t agree with it. They just love giving us all those pills.
Dr. Jay’s Reply:
Thanks for your comments. I am glad my friends’, Dr. Vernon and Jacqueline Eberstein, book, Atkins Diabetes Revolution, was helpful to you.
I watched the program tonight and as a diabetic I am very interested in this approach.
I have tried Weight Watchers, and just trying to watch my calories, etc., but nothing has been sustainable. In order to maintain my weight loss, I had to exercise strenuously one hour every day, and restrict my calories so much that I was feeling deprived. When my weight was down, my sugar was great, but my weight has been creeping back up and so has my sugar.
Are there any fruits and vegetables that are not allowed on this diet? What about cheese and nuts?
I have not read any Atkins information yet – will the Atkins plan reflect the diet that was followed by those in Alert Bay?
Thanks,
April
Dr. Jay’s Reply:
See my response to Tachour’s post above on the Atkins diet. You should have a look at “Atkins Diabetes Revolution” by Vernon and Eberstein.
In the study diet, we stayed away from root vegetables as they tend to be higher in starch and sugar content while we encouraged the cruciferous vegetables like broccoli and cauliflower and all the salad vegetables, of course. Nuts are good food but you have to eat them only sparingly if you are avoiding carbs. I generally recommend zero nuts for awhile at the beginning.
Greetings from Calgary!
I loved the show and I think you did an amazing job at bringing this information to the table, so to speak!
Although, I hear everyone pushing the “Atkins” diet! I was hoping you would be willing to have a look at Suzanne Somers Eating plan as it is very comparable and had different medical documentation. I know it sounds funny that Suzanne Somers would have such a book, but she speaks the same way about the plan as you do and I quite enjoy the eating~ I just can’t seem to find anyone with more backround or a professional opinion about her stuff.
Respectfully,
Chuck
Dr. Jay’s Reply:
I am not that familiar with her diet. One of the reasons why a low-carb diet is successful is that the reduction in carbs leads to a significant drop in the insulin your pancreas produces. One of the functions of insulin is to store fat and to keep it stored so your cells can burn off the glucose resulting from the digestion of all those carbs. Too much glucose is not good so your body sidelines fat burning while it deals with the glucose first. Dropping your carb intake reduces the supply of glucose and lowers insulin. If you can get your insulin below the threshold where it tends to keep fat stored in your fat tissue, then the fat is released and can be burned. When this happens you have an increase in energy and you will experience a decreased appetite. In a nutshell, that is the secret of the success of low-carb (for a much more complete explanation, read Gary Taubes’ excellent book, “Good calories, Bad calories”). If Somers’ diet gets the initial carb content low enough, it would work in a similar way. However, from what I gather, it would seem that there are still significant amounts of carb allowed as fruit.
I think the bottom line with any diet is whether it works for you and whether you can stick with it.
Dr Jay…. Just finished watching the documentary “My Big Fat Diet”. I must say it has perked my interest… I am a mother of 4 who was told I had diabetes when I was pregnant with my last child…I took medication till just lately and have also developed high blood pressure, I have been taking diet pills on and off for years…I take merdia as it has shown the best results but I am finding it to difficult to pay for them much longer… I am extremmly overweight…I stand 5 6′ and weigh about 370lbs…actually I am not sure on the weight as I cant find a scale that goes over 300 lbs but at last weigh in at a local center that uses a special commerical scale I was about 350… I have also had my stomach stapled (gastroplasty) for the weight loss and it has not happened the way I wanted it….
I was wondering about meal planning? and a sample diet plan? I would like to try it out and see what the results would be….please let me know…thanks Darlene
Dr. Jay’s Reply:
As you may have seen from other replies, I generally recommend the Atkins books. I find their meal plans and recipes tend to be the best guide to low-carb eating currently available. We didn’t offer specific meal plans in our study; we just provided a list of the foods that could be eaten. In the documentary you would have seen how people gathered for meals and how they shared recipes and techniques. This created a supportive environment that helped people make the adjustment to a new way of eating.
I am concerned that you have already had gastric bypass and still cannot get your weight down. A bariatric surgeon friend tells me that he has seen this occur when his patients drink sugar-laden beverages. You might think about what you are drinking in terms of carbohydrate content. This would include anything from pop to smoothies to fruit juice, even milk, as it contains lactose. All these drinks contain significant calories in the form of carbohydrate.
Dear Doctor:
I happened to see your comment regarding your choice of Canola oil and was somewhat surprised as Canola is the least of healthy fats. I just wondered if you were familiar with Sally Fallon and Mary Enig PhD and the Weston A Price Foundation? They have a huge body of scientific facts on good fats at http://www.westonaprice.org and thought to let you know of them as I believe it would add another great dimension to your work.
Respectfully,
Maria Atwood
Dr. Jay’s Reply:
My recommendation of canola is based on the fatty acid composition of this oil and the fact that it is fairly low in omega-6 (see posts above re the problems of too much omega-6). I have heard objections to canola suggesting that it is suspect because of possible GMO content or because of the refining process. If you have these concerns, I would suggest falling back on olive oil and butter.
I am familiar with Weston Price and find his work fascinating.
I find the whole concept quite interesting. I am a heavy woman – currently on a campaign here in Nanaimo to lose 100 pounds in 12 months and raising money for a school and Haven Society by doing so. I am keeping track of my progress and failures at http://singleparentbootcamp.blogspot.com. As someone who quite heavy I have, like most other people, tried numerous times to lose weight. What I have discovered is that, pretty much, anyone can lose weight doing any kind of diet. Physically weight loss is possible. Where it becomes difficult is with the mental game – with continuing to eat one’s chosen method. It becomes challenging due to either boredom, self-sabotage, and particularly the feeling that one is “denying” one’s self something. Certainly this time around I am choosing to view weightloss much as I viewed quitting drinking – a gift that I am giving to myself. “I am not punishing myself by eating this way, I am celebrating the radiant gloriousness that is me.” Hey, so far it’s working!
In a diet that is restrictive to certain food groups, as low-carb (or low-fat) eating certainly is, I wonder about the long term possibilities of success. Is this something that can be sustained by the majority of people for a substantial period of time? And sustained in a healthy manner? I have done low-carb dieting and had fabulous success with it – it’s, like, magic!, but then failed to maintain it for more than a few months.
I find the public documentation of this effort in Alert Bay quite compelling and am delighted that both you and the residents there were willing to both undertake this and share the results with us.
Kyla
Dr. Jay’s Reply:
Thanks for your comments. What you are doing is admirable, like the people in the documentary who shared their innermost thoughts and feelings and who were willing to make their struggle public to benefit others.
As to long-term compliance, I have been eating this way for over 5 years and, for me, there is simply no question about going back. I think with low carb, the ability to stick with it over the long haul has a lot to do with the fat component of your diet. Once your weight plateaus and you need to increase your calorie intake, if you increase protein or carb, rather than fat, you risk falling off the diet and regaining the weight. If you eat fat, and the right mix of fat, you should be able to go indefinitely. Olive oil, canola oil, dairy and animal and marine fats are good. You need to avoid the other oils that contain too much omega-6. An omega-3 supplement is a good idea if you aren’t eating a lot of cold water fish.
Good luck with your weight loss.
I’ve recently become aware of the possible positive effects of using duck fat in my cooking. We’ve always loved duck but have carefully rendered the meat completely and until recently have thrown away the fat. I’ve read that it might be a factor in the French Paradox (we call it the French Pair’ O’ Ducks). I wonder if maybe it might be a reasonable substitute for the oolichan grease?
Dr. Jay’s Reply,
Although I don’t know what kind of fatty acid mix you get in duck fat, I would not be surprised to find that it was a healthy fat. In my travels, I have been discovering that indigenous people around the world valued certain sources of fat. Here it was oolichan grease, up north they render the fat from moose and bear, in Labrador it was caribou fat, on the prairies is was buffalo fat to make pemican, among the Australian aborigines it was emu fat and among the Inuit it was whale fat. And these are just the ones where I have had a chance to personally observe or to hear first hand accounts. I think, in the modern setting where we tend to see everything through the lens of the current low-fat dogma, we overlook this important phenomenon or perhaps underestimate its significance. It appears to me that these ancient practices validate what I believe to be the secret to sustaining a low-carb diet over the long haul – getting the right fats and making them the central source of energy in your diet. Enjoy your duck grease!
I have done the Atkins diet many times without losing weight and I felt bad.. no energy… tired… very bad breath.. headaches… ketosticks would be the darkest purple.
I would eat lots of cheese, chicken wings, steaks and lots of mayo and some days add 3 cups of romaine lettuce… with diet 7up and water…
What am I doing wrong, and when you mention things like bacon… it has carbs (sugar..glucose…corn syrup..) in it …???
I would appreciate any and all comments/answers.
Dr. Jay’s Reply:
Thanks for your query. Some people report adverse effects when they significantly reduce carbs. One of the first things that comes to mind in your case is salt. When you stop eating carbs your kidneys will release sodium into your urine. If you are not getting adequate salt in your diet you will experience the symptoms of sodium depletion. One of my colleagues recommends drinking a cup of bouillon twice a day to replace electrolytes when on low-carb. Since we are taught that salt is bad for blood pressure (and it likely is if you are eating a lot of carbs) many people try to limit salt intake and if you continue this as you restrict carbs you can develop symptoms like the ones you describe. Constipation is another symptom related to salt depletion. The bad breath is because you are exhaling ketones. I recommend a little sugar-free gum to offset that slightly annoying problem. It should eventually get better as time passes. I wouldn’t hesitate to eat lots of salad veggies and to be liberal with the olive oil. Mayo is okay as long as it is made with olive or canola oil.
Dear Dr. Wortman,
I would love your thoughts on this: about six months ago, a relative of mine had a heart attack where one of his arteries was completely blocked. The doctors report showed that his trycleride levels were high, which i’ve learned is largely caused by an excess of carbs, something which his diet was indeed high in. Since his heart attack, she has been taking the following medications (one daily), on the request of her doctor:
Cardicor 2.5MG
Tritace 1.25MG
Plavix 75MG
Nu Seals Aspirin 75MG
Lipitor 40MG (Nightly)
The person in question exercises frequently and eats what he believes is a good diet, as do most people who have been mislead for years, namely a diet low in aminal foods and fat, but high in carbs and processed fats. I desperately want to help this person on the road to better health. I don’t want him to take any unnecessary medications. I think that a diet high in good fats and low in carbs would be ideal, and may even allow the person to forgo his medications, but since i am not a doctor, i am unsure as to advise him to change his diet and give up his meds. Do you have any thoughts on this, or do you know of anyone who has had a heart attack that successfully switched to a diet high in fat and low in carbs?
Lastly, do you yourself eat the fat of animal protein. For instance, do you eat the fat that tends to run along the edges of a steak?
Look forward to hearing from you,
Peter
Dr. Jay’s Reply:
Thanks for your query and I appreciate your desire to help your relative. As I am sure you can appreciate, I am very reluctant to get involved in the medical management of someone who is in the care of another physician nor can I practice medicine over the net. Whatever your relative decides to do should be done under the supervision of their doctor.
Having said that, I do think that cardiovascular disease is part of a disease continuum that includes obesity, metabolic syndrome and diabetes. And, it is evident that all these conditions improve with carbohydrate restriction. In the documentary, one of the subjects had had a heart attack prior to enrolling in the study and he did quite well. His cardiologist decided he needed bypass surgery while he was on the study diet but didn’t discourage him from continuing to restrict carbs. After the surgery he attributed his rapid recovery to his improved health on the diet and he is so happy with his results, including improved cholesterol, that he is committed to continuing eating this way indefinitely.
were there any vitamins such as b12 or any other vitamins given to the participants of this venture?
Dr. Jay’s Reply:
In the study, we provided a multi-vitamin to participants. As it turned out, I don’t think most people actually took them.
I hope the program will be on YouTube, or available for online viewing at CBC.ca. I don’t have tv.
About fat yes every culture ate fat. A couple not mentioned: schmalz (East European and Jewish, chicken fat), and last not least, the Scots with deep friend Mars bars. Kidding. But northern Scots and Brits did/do have heir fried bread, or bread spread with rendered fat or from the bacon grease pot at the back of the cabin’s cookstove.
But if fat is so good, why is it that Americans of African descent who have such high cholesterol would like to continue to eat that country southern diet that is swimming in fat?
Memories of bear grease on my chin long ago.
Dr. Jay’s Reply:
I don’t know what is planned in terms of making the documentary available beyond broadcast. When I find out, I will post a notice here. You should also bookmark Mary Bissell’s website (Mystique Films, on my links here) as she will be working on this.
The thing about dietary fat and cholesterol; it seems to hinge on how much carb you eat with the fat. In the example you mention, those African Americans who love to eat that southern country high fat diet are also including a lot of sugar and starch. The current research tells us that that is a bad combination and their obesity and diabetes rates are evidence of that. I think our Scottish friends, dipping their fried bread in the bacon grease might eventually have similar problems, maybe manifested more as cardiovascular disease. If they were to drop the carbs, I think their high fat diets would be a lot healthier without the need to reduce the fat or the saturated fat. This is the part that gets everyone annoyed at me, as the conventional wisdom is that you need to cut down on fat and saturated fats, especially.
Great program last night. Look forward to the book!
I have a question. My son is on a diet for Candida (Stomach yeast bloom), and he eats very close to your diet, except that he eats a lot brown rice. The point of the diet is to eliminate the sugars that the yeast live on, but he is concerned about having grains as a complementary protein. Is there an alternative other than Cauliflower (He gets upset stomach from it)?
Also, I suffer from Gout, and I find the the recent research from UBC on sugar’s role in bringing on gout attack very interesting. Over the past month, I have noticed the correlation. I suspect if I was to try your diet, that I could eat more beef and chicken and not experience the gout with the sugar eliminated.
Dr. Jay’s Reply:
I am not familiar with “stomach yeast bloom” but I do know that diabetics can be more susceptible to candida infection since they tend to have more glucose in their system, if not well controlled. It would follow, then, that a diet that lowers glucose levels would be beneficial in reducing the problem of candida, even in a non-diabetic. So, if your son’s candida problem is better on a low-carb diet, this would not surprise me. On the other hand, brown rice is still a high-carb food, although not as high glycemic as the more refined products. It may be that his eating pattern is more low GI than low-carb. I think there are definitely benefits in moving down the glycemic scale when you do eat carbs. As to something other than cauliflower, I eat all kinds of veggies, as long as they aren’t too high in starch or sugar content. A good resource to check on this is on the Atkins website. Go there and search “carb counter”. Look at the “net carb” values to determine how much digestible carb a particular food contains.
With respect to gout, as I understand it, when you initially reduce carbs the presence of ketones inhibits the excretion of uric acid in the kidney so there would be a theoretical risk of gout with low-carb. It appears, however, that the kidney adjusts to ketosis as you progress on your low-carb diet as ketone excretion diminishes while blood ketone levels remain elevated. As the kidney adjusts to stop excreting ketones, the inhibition of uric acid excretion would stop, as well. This is probably why I haven’t seen any reports of gout in the many published low-carb diet studies. Some critics point out that gout is associated with the consumption of purine containing foods, the same types of foods that you can eat while doing low-carb, basically animal and marine sources of protein. They overlook the fact that the diet doesn’t significantly increase the absolute amount of protein that is eaten, although it appears higher as a proportion, because carbs have been reduced. I suspect that sugar will turn out to have a bigger role in the etiology of gout than purines, but that is just my opinion for now.
I think you’ve talked me into trying it. But please; stop talking about maple syrup and waffles and French toast.
)
Dr. Jay’s Reply:
I know – I haven’t had maple syrup in over 5 years and my wife is from rural Quebec! She loves my low-carb maple walnut ice cream, though. I’ll post the recipe.
Dr. Jay
Thanks for your comments…Everyone around me is concerned about my health and weight. I have a few questions about the veggie thing…where do tomatoes fit into the whole scheme of things, cucumbers, cheeses…things like mustard, cranberry sauce…if made from fresh berries. I will look into the Atkins book that I have and how will this effect hyernias that I have developed in my stomach region….
Thanks Darlene
Dr. Jay’s Reply:
Tomatoes are okay but you should eat them in moderation. Cukes and other green veggies are okay, too. Cheeses are okay except for the processed cheeses. The hard cheeses are the best. Look on the labels of condiments to see what is the carb content. On a very low carb diet you would be aiming for less than 30 gm per day. You subtract the fibre from the total carbs to come up with the number you need to consider. Also look at the serving size. For instance, ketchup will list the amount of carb in 1 Tbsp (it is usually 5 or 6 gms). That is high given the small serving size. Most ketchup has added sugar, about 1 tsp of sugar for every tablespoon of ketchup. My son likes it so we get sugar-free ketchup from the US. My wife orders it on the web and it is delivered by courier. I digress. I am not sure what a low carb diet would do to your hernias. If you are experiencing gastric reflux (heartburn), however, there are lots of reports of this problem going away when carbs are restricted. There have been two recent studies that confirm this, as well. In Alert Bay, a number of people told me that they had stopped taking medication for heartburn after they got on the study diet.
hello
I got saw your documentary yesterday it was very interesting. I am 20 years, weigh 150 pounds – I have gained over 25 pounds in the last year from stress and snacking throughout the day without a eating a proper meal. I have tried to regulate my constant eating – try to bring fruits and vegetable but its not working for me. I would like to lose the 25 pounds and maintain it.
How long should this diet last and where can I find recipes that are reliable and stay true to low carb diet.
Your diet include: Vegetables, Meat, Eggs, Cream
No sugar, bread, rice, potatoes, milk, pasta
What about ? Oatmeal, Lentils, Tofu, Nuts, Dry fruits, Olive oil, ketchup and salad dressing.
I would like to start over the weekends so I can get used to it. please advise
Dr. Jay’s Reply:
The study diet was a low-carbohydrate diet modeled on the traditional diet of the Namgis people. For everyone else, I am currently recommending the Atkins diet and, particularly the “induction” phase of Atkins. This resembles the study diet. It should be easy to find an Atkins book as there were about 25 million of them sold over the years. This works best if you don’t think of it as a temporary measure just to lose weight but as a permanent change in the way you eat.
The whole concept is based on reducing foods that contain starch and sugar. Of the foods you mention: oatmeal, lentils, dry fruits (and fresh fruit, too) and ketchup would be a no-no. They all contain too much carbohydrate. Tofu and nuts are healthy foods but they do have some carbs and you would avoid them at the beginning. Olive oil is good and I recommend you use it to make your own salad dressings. I like to mix it with a little Hellmans mayo, salt and coarse pepper, a splash of white wine vinegar and a few drops of balsamic vinegar plus a pinch of Equal. I never get tired of this dressing and it is easy to whip up and very low in carbs. Eat lots of greens and cruciferous vegetables but avoid root veggies. Eat all the meat, chicken and seafood you want. Dairy fats like cheese, butter and cream are good. So are eggs. But, as I say, get an Atkins book to guide you. I also recommend the Atkins recipe books. You can also check out http://www.Atkins.com and the other links I have here. Most of the low-carb forums have recipes. Good luck.
Hi Dr. Jay: I am 38 years old and have been diagnosed with polycystic ovarian syndrome. It has gone untreated for quite a while as I have had these symptoms since I was a young teenager. Concurrently, I also have polycystic kidneys and hypothyroidism and I seem to be insulin resistant, something which seems to go hand-in-hand with PCOS. I am currently about 90 pounds overweight, something that the PCOS seems to facilitate, despite obsessive efforts (diet and exercise) to the contrary. I am very aware that losing weight is a key factor in controlling PCOS but that in turn makes it very difficult to do so. I have recently been hearing that a low-carb diet might finally be the answer but my personal physician is very against the idea. I am not yet on any form of medication such as antiandrogens or birth control pills, which have been discussed with my doctor but not yet started. Can you please comment on this situation?
I missed your original airing of the documentary but plan on watching it on Saturday when it airs again.
Dr. Jay’s Reply:
I hate to come between you and your doctor. I am sorry he/she does not approve of low-carb dieting but I don’t find fault with him/her. It is an emerging area in terms of acceptance by the mainstream. Most physicians struggle to keep up with the scientific literature over a broad range of illnesses. They rely a lot on Continuting Medical Education (CME) programs to update them. There are no regular CME programs that devote any time to teaching the science of low-carb nor do they provide guidelines that physicians can use to manage their patients this way. In fact, the major authoritative sources that physicians rely on for guidance are emphatically opposed to low-carb diets. Under these circumstances, I am amazed that any of my physician colleagues are supportive at all. That may change, though, with the inclusion of low-carb diets in the most recent guidelines published by the American Diabetes Association. This has opened the door to the development of a clinical practice guideline for physicians, something some of my colleagues have already started to work on. The thaw will be slow, however, so I am going to stick my neck out and give you some information you may want to take to your doctor.
There is a school of thought that PCOS is a gynecological manifestation of metabolic syndrome. PCOS usually goes hand in hand with the other signs of metabolic syndrome like obesity, high cholesterol, hypertension and, as you say, insulin resistance. Metabolic syndrome and type 2 diabetes are part of a disease continuum that usually begins with overweight and obesity and then progresses along as the other conditions develop. Most people won’t argue when I say that type 2 diabetes is an intolerance to carbohydrates, however, although I find the evidence compelling, not everyone agrees with the concept that metabolic syndrome might also be a manifestation of carbohydrate intolerance. The evidence that convinces me is the fact that every feature of metabolic syndrome heads towards normal when you eliminate carbs from the diet (Jeff Volek and Richard Feinman wrote a paper on this in Nutrition and Metabolism – see link). All that to say that your PCOS may be amenable to low-carb diet therapy. In my study, one of the women who had PCOS began to get better after a couple of months and some weight loss. My colleague Dr. Mary Vernon (see link) also has told me of cases in her practice where PCOS has responded to low-carb. I hope you can gain the support of you doctor to try this diet for your PCOS.
Should a person go on a traditional diet depending on their heritage? I have been on low carb diet for years and never did get down to a desirable weight. I am in my range but not close enough to the bottom or middle of my range to feel or look my best. I was 118 before and after children, then developed hypothyroid and have been 130-140 ever since. On a low carb-natural foods diet, I do feel fine and my meds were reduced but never eliminated. I never lost much weight besides the initial 4-5 lb loss, which eventually, I regained while still ON the diet.
I am Danish, English, French, and Choctaw. What would be my “traditional” diet?
Dr. Jay’s Reply:
Sorry to hear you haven’t been able to get down to your desired weight. Thyroid is one of the first things to consider when everything that should work, doesn’t. I would wonder in your case whether you are getting enough thyroid hormone replacement. The next thing I would look at is whether some carbs are sneaking into your diet. I don’t think you need to focus so much on what might be a traditional diet for your particular ethnic mix. My colleagues tell me that carbohydrate restriction is effective for weight loss across the racial and ethnic spectrum.
Dr. Jay, you are my new hero. I gather from your story that in deciding to tilt at this particular windmill, you didn’t realize what you were getting into. So bravo for having persevered! To have obtained Health Canada funding to support a low-carb diet is an accomplishment in itself, but in terms of the implications for thousands of Canadians, Aboriginal and non-Aboriginal, it takes my breath away.
I do have one question. I was saddened to see on the documentary that one of Art Dick’s daughters had to go off the diet because of gallstones and acid reflux. She is such a sweet young woman, but I’m afraid she needs your diet to save her life. Was that the decision made because the diet is “controversial� From what I’ve read on Dr. Eades’s Protein Power website, and the experience of a number of people who frequent the Low-Carber Forums (http://forum.lowcarber.org/), a low-carb diet can prevent or reverse both conditions.
I’ve returned to a low-carb diet after five years of stupidly ignoring my increasing weight and the inevitability that I would develop diabetes. Fortunately, I have also figured out that wheat makes my knees hurt, so a return to my bad old ways is less likely. I’m also older and wiser.
I was prompted to write to you when I read your comments in the online edition of The Globe and Mail challenging the conventional nutritional wisdom of Leslie Beck. Thank you for that.
Dietitcians need to be challenged at every turn (there’s a “fact” sheet on the Dietitians of Canada website that warns of heart disease, high blood pressure, osteoporosis, gout, kidney stones, and constipation if you follow a low carb diet).
Dr. Jay’s Reply:
Thanks for the supportive comments. Both of Art’s daughters are lovely people and I was disappointed we weren’t able to do more to help them. You are right about gastric reflux, by the way. Most people report a resolution of their heartburn when they do low-carb. In the study, several people said they were able to discontinue their GERD medications.
Leslie Beck and I don’t always see eye to eye, as you know. It is one of my guilty pleasures to post comments when the Globe and Mail runs her columns or other items that unquestioningly promote the status quo. Sometimes I meet really nice people that way, but I also take my lumps, too.
It sounds like you are plugged into some good websites and low-carb forums. And it also sounds like you are on the right track. Good luck with it all.
Hi,
I am a type 1 diabetic…I did try the induction phase of the Atkins diet for about 2 weeks (this was about a month ago) and I was amazed at how quickly I had to reduce my Insulin doses (basal insulin was reduced by 1/3 and I took almost no bolus insulin at all before meals. My blood sugar was pleasantly stable as well (for a change).
For some reason I stopped, but I’m going to start again today. (Chicken Ceasar Salad here I come). My question has more to do with the effect of reduced insulin. Am I correct in assuming that as I lower my total daily (or perhaps weekly) insulin dose, the amount of fat stored must also be reduced, or is the relationship more complex than that?
Also, if you happen to know anywhere one could go in Calgary with experience in Low Carb for Type 1 diabetes management, would you mind sharing the information?
Thanks,
Jason.
Dr. Jay’s Reply:
Although my experience with low-carb is with type 2 diabetes, what you describe does make sense. Perhaps the leading authority on the use of low-carb to manage type 1 diabetes is Dr. Richard K Bernstein (no connection to the Bernstein weight loss clinics here). He has type 1 diabetes himself and runs a clinic in New York where he takes patients from all over the world and gets them sorted out on a very low-carb diet. He’s a long way from Calgary, unfortunately, but you can check out his website for more info (see link).
Hi Dr. Jay,
Since I am in the US, I have not been able to see the documentary. I have, however, read as much information I could find, watched the YouTube clips and listened to your radio interview.
Great work!
I have managed to cure my own hypertension (from 149/95 down to 101/62) with a low carb diet and have lost 37 pounds so far. During the last month, as an experiment, I began following the traditional diet of the Tokelau atoll natives even though I am a pasty white chick with Irish, Norwegian, and Polish ancestry. This was inspired by reading “Good Calories Bad Calories” by Gary Taubes and the works of the Weston Price Foundation. I feel fantastic!
I believe there are a variety of “pre-contact” diets that will work wonders for people, not because there is anything magical to them, but because they all have a common factor…the lack of refined carbohydrates and starches. Returning to an ancestral way of eating may provide more of a benefit because of easier to find local low carb foods, and the spiritual component of connecting with the past may add an extra advantage.
I sincerely hope more First People and other indigenous peoples can shake the sickness and disease introduced by a high carbohydrate diet and more work like yours comes to the public’s attention. I will be spreading the word through my forum postings and on my blog.
Thank you!
Linda (aka Wifezilla)
P.S. Please tell me this is coming out on DVD some day?
Dr. Jay’s Reply:
I agree that Gary’s book provides excellent insight into the world of nutritional science and how we got into such a fix. I think he’ll be a little surprised when I tell him you started the Tokelau diet after reading it, though.
I don’t know when the documentary will be available in the US. Mary Bissell, the producer, tells me she has had some discussions with American broadcasters. The CBC has been very happy with the response and, as you can see, are already planning a re-broadcast. Perhaps if you, and your fellow bloggers, start pestering the networks down there, they might get interested in airing it. She may also make the DVD available commercially. If that happens, I’ll post a note here. You should also watch the Mystique Films website (see link).
Love your handle, by the way.
Dr. Wortman,
Thanks for the speedy response to my previous query. I have two more questions for you, which i’d love your thoughts on. Firstly, what advice would you give to a person who frequently complains of having feelings of heaviness, tiredness, and cramping in their legs? Secondly, what are your thoughts on the paleo diet, consisting of lean meat, fruit, veg, nuts and seeds, in comparison to the strict low-carb diet you follow? For instance, do you think that the greater quantity of fruit, nuts and seeds allowed on the paleo diet offers more health advantages that a strict low-carb diet rich in fat?
Really look forward to hearing from you. Keep up the great work!
Peter
Dr. Jay’s Reply:
The symptoms you describe, if you are restricting carbohydrates, could be the result of electrolyte imbalances. When you cut the carbs your kidney excretes salt and you need to make sure you are getting enough to avoid sodium depletion. Another possibility is a magnesium deficiency which cannot be diagnosed by a blood test as most of our magnesium is intracellular. If your doctor detected hyper-reflexia, that would suggest magnesium deficiency. One of my colleagues recommends drinking a cup of bouillon twice a day to replenish electrolytes and, if the leg cramps don’t resolve, to take a slow-release magnesium supplement like SlowMag or Mag64 (the Costco knock-off that seems to be available only in the US).
The so-called “Paleo” diet is based on the idea that our paleolithic era ancestors ate lean meat, nuts, seeds, etc. I’m not so sure. The indigenous populations I have worked with all valued animal and marine fats and used them for the bulk of their calories. Have a look at the Jared Diamond article I have in the links section: “Worst Mistake …”.
Hi again,
I went to his site and checked out some of the chapters of his book. I’m amazed that I’ve never heard of this guy…I’m going to grab that book for sure. Thanks for your advice, and thanks for the caveat re: Bernstein Weight clinics, I would have probably assumed they were the same thing.
Jason.
Dr. Jay’s Reply:
Dr. Richard Bernstein is a fine person, he’s about 73 years old, still practicing and sharp as a tack.
Dr. Jay,
Further to our discussion on the Globe & Mail website, you mentioned toxic levels of protein in the Wisconsin study. What level of protein would be toxic and what are the principal effects of exessive protein? I take some protein powder supplements after workouts and sometimes in lieu of dinner working late in the office. How would I know when I am nearing undesirable levels of protein? Do I measure in calories per day, percent calories per day?
I appreciate your critique of the Wisconsim study I mentioned. It is difficult for a lay person to make sense of all the conflicting data.
Murray
Dr. Jay’s Reply:
I have read your many on-line comments on various Globe and Mail health stories and you do very well for a “lay person”. My good friend Dr. Steve Phinney tells me that eating more than 200 g/day of protein will make you feel “lousy”. The Inuit actually had a word for this because in the spring, when the sea ice was unstable and they couldn’t get fish or sea mammals, they would eat arctic hare. At that time of the year the rabbits were quite lean and the Inuit figured out that after a few days they would feel sick. The Inuit would normally get most of their calories from fat.
I think this is why some people cannot sustain a low-carb diet over the long haul. When they are losing weight they are getting a significant amount of their calories from stored fat. When weight loss plateaus, if they are afraid to eat fat, as most of us are, they will try to make up those calories by increasing protein. This makes them feel ill and they are likely to give up. If they get those calories from carbs, they risk falling off the diet and regaining the weight. So, the logical course of action is to replace those stored fat calories with dietary fat calories.
Great Job
I’m 65 and have been on Atkins for nine years. I lost 85 pounds in 4.5 months (39% body fat) and never looked back. There is no doubt in my mind that I would have hit the 400 lb mark. I just couldn’t stop eating! I was totally addicted to carbs.
The greatest thing about being on Atkins is that you aren’t even allowed to be hungry. Before Atkins, I was hungry all the time.
This is the only nine years in my life that I haven’t even had a cold or the flu. I have never felt so good.
I know everyone wonders about the “long term” effects of this diet. But ask yourself this question. How long would I have been around weighing 400 lbs?
I have never felt as good as I have the last nine years.
Thanks Again
Mike Scott
Dr. Jay’s Reply:
Thanks for sharing your amazing story. We need some long-term studies to validate this kind of experience so that low-carb dieting can be accepted by the mainstream.
I just wanted to stop by and thank you.
Although I’ve ‘done’ Atkins since the 70s, the recent spin control of the low fat believers even had me, a true low carber, wondering.
Unfortunately, my blood pressure got out of control, and four years ago I was diagnosed with hypertrophic cardiomyopathy, my ejection was 25%. Dire.
I first was put on DASH diet. Didn’t lose weight, but bp dropped… too low. So, it was suggested Weight Watchers. I was also borderline diabetic and the crazed hunger and fuzzy-headedness was too much for me. Not to mention I gained weight.
Finally, last May, at 301 pounds I met a Dr (not going to say who, but you can contact me for details) who told me to go on Atkins to save my life.
That day I did exactly that. I’ve since lost 115 pounds. I am no longer borderline diabetic and I’ve just had my results from my echo (drumroll please):
“Negligible”
I can barely believe it. I went from not being able to put on shoes without getting winded, coughing all night (ended up as CHF), to working full time, full of energy and ready to continue eating this way all the time.
The fabulous doctor, a nephrologist, said to me when I thanked him: You’ve done the easy work–losing–now stay on low carb to stay alive.
Goal weights, I remind myself, are not finish lines.
Thank you again, Dr Jay. I look forward to the rebroadcast.
Dr. Jay’s Reply:
Wow! That’s an amazing story. Good for you and your nephrologist! The funny thing is that there are doctors out there hiding in the woodwork who have figured this out and are actually quietly helping their patients with a low-carb approach. I run into them from time to time. Wouldn’t it be great if we could get them together and pulling in the same direction? That might make a difference.
Dr. Wortman,
With regards to my previous post regarding to having the following feelings in my legs–heaviness, cramping and tiredness, i discovered that my problem is not a magnesium deficiency or a deficiency of sodium, but a consequence of having varicose veins, pointed out to me by a friend. I’m sure the low-carb diet will be helpful in terms of this condition, because if i understand correctly, fat increases the amount of water in cells which improves circulation.
Lastly, just a quick question. Do you eat the fat that tends to run along the outside edge of steak?
Peter
Dr. Jay’s Reply:
I don’t know about your idea that fat leads to improved circulation. A colleague, Jeff Volek at the University of Connecticut, has demonstrated that restricting carbohydrates can improve blood vessel function. It can also lower blood pressure, something I discovered myself and hear about from a lot of other people. I wish I could tell you that low-carb cures varicose veins, too, but that might be a bit of a stretch.
Yes, I do eat the fat that surrounds the steak.
Hi dr. jay
I am wondering if you would advise someone to use this food plan if they had had one episode of gall bladder attack and now have a tube into it and it drains into a bag. i too am awaiting surgery for a year now and have had no more symptoms. The Dr who treated me thought i caused the problem by exchanging some of the flour in my bread (homemade) with ground nuts. i have been trying for one year to lose so I could have less risk during the surgery with no success. I took all white things out of my diet (when I eat white flour I get real dopey and sleepy)
Do you think this plan but with less fat would still help me lose. How do you feel about veggies like zucchini and turnips, cukes. I am an emotional eater and don’t think I eat a lot of fast foods but am static at 340 lbs. If a person eats too much protien does it turn to sugar in your system? if so how much is enough?
I am caucasian but was taught to cook by my mother in law who was native so learned all the cheap stuff that keeps well. We lived out in the toolies. Thanks for your response.
Dr. Jay’s Reply:
Sorry to hear of your gall bladder problems. In the study we didn’t include a young woman because she had had an acute attack and was waiting for surgery. After you have developed gall stones, high fat intake can trigger an attack because fat in the diet causes the gall bladder to contract to squirt bile into your intestine to help with the digestion of the fat. This can cause a stone to block the duct which causes a lot of pain and makes you feel quite ill. If you eat a very low carb diet without increasing your fat intake you should not have a problem. Once you have stopped losing weight, however, you will need to increase your fat intake and this may be when a problem could develop. Or not, it’s hard to predict. Some people think that going on a low-carb diet will help resolve the gall stones. I can’t say that I know one way or the other. If you were really disciplined and ate the so-called good carbs instead of fat you might be able to prevent a further attack. Either way, you shouldn’t be increasing your protein beyond 200 g/day as it will make you feel ill.
I generally stay away from root veggies but eat zucchini, cucumbers, salad veggies, broccoli, cauliflower, etc. Good luck with it all.
I apologise if this has already been asked and answered. I found it impossible to read all the questions and answers.
My partner and I have been following Suzanne Somer’s low carb diet with considerable success but have reached a plateau. After seeing the program MBFD I feel we can improve on our diet.
My son recently began a ‘Paleolithic Diet’, found on ‘Wikepedia’ which appears to be very similar to your program. This program, however, warns agains nitrites and sulphites in prepared foods such as bacon, ham and sausage.
How do you feel about these additives and do you consider it safe to eat these somewhat prepared foods in order to add fat to our diet?
Dr. Jay’s Reply:
Someone did ask about the Suzanne Somers’ diet. I am not that familiar with it but my impression is that it allows more carbs, especially fruit, so it wouldn’t be as low in carbs as Atkins or what we did in the study.
The issue of cured meats always comes up when discussing this type of diet and probably more so when I tell everyone that I eat bacon with my eggs in the morning. Here’s my take on sulfites and nitrites: sulfites were used to keep all kinds of food fresh, including vegetables, and had generally regarded as safe (GRAS) status with the FDA until the mid-80’s. This was re-evaluated because it was becoming apparent that a small number of people were allergic to sulfites. It is now used much less and people who have allergies are more aware, so the number of severe allergic reactions to sulfite containing foods is relatively low. It is still found in products like baked goods, beer, wine, etc. but should show up on the label. So, if you are not allergic to sulfites, you don’t need to worry about this additive. Now, to nitrites, which are found in things like bacon, hot dogs and cured meats, the concern is that nitrites added to keep the meat safe from harmful bacterial growth will turn into nitrosamines which are considered carcinogenic. In reviewing the literature on this, I don’t find a clear answer. One interesting thing you do find is that most of the nitrites we get come from all those green healthy veggies we are supposed to eat. Those who think that nitrites are bad for you suggest that the ones in the veggies tend not to get converted to nitrosamines because they travel in the company of vitamins. There was a study that seemed to show that nitrites might actually protect you from damage to the heart muscle during a heart attack. This would be because nitrites also get converted to nitrous oxide, something that causes the blood vessels to relax and improves blood flow. Bottom line: while I don’t find a clear answer in the scientific literature, I guess I vote with my fork, as I do like to eat a little bacon for breakfast. If you aren’t comfortable with nitrites, there are now more products out there, including bacon, that advertise that they are nitrite-free.
Dr. Jay,
I am a 5 ft 7 inch Caucasian Canadian, retired, and 66 years old this month. Genetically I am 68.75% European, 25% Middle Eastern, and 6.25% Native American. I have always been physically active. I run and work with weights. Ten years ago I began to have weight, cholesterol, and blood pressure problems. The problem culminated in 2002-2003. My weight was up to 220 pounds. Also during this time and reaching a peak in 2003 was the occurrence of severe leg pain when walking. I walked stooped over, and slow, like a very old man. My family doctor warned me about getting the cholesterol under control.
I did some research on weight and diet. Studied the Atkins and Zone diets, but also started looking at some new research available on leptin. I found the book “Mastering Leptin” by Byron Richards and begin applying the principles to my diet. I also incorporated some of The Zone ideas of at least reducing poor carbohydrate intake. The main idea of the Leptin diet is to NOT EAT BETWEEN MEALS. Richards suggests leaving 3.5 to 4 hour between meals with nothing to kick up body insulin levels between these meal times. I found that eating breakfast at the beginning of the day and dinner in the late afternoon was best for me. It took me a good part of a week to start feeling really great with the new eating habits. Within a month my legs started feeling really good, and it was easy to jog and move around. My weight dropped from 180 to around 120 and cholesterol levels and blood pressure have been good since the Fall of 2003. I eat meat, carbohydrates, and occasional deserts with no problems. I try to keep processed foods to a minimum, but don’t avoid them completely.
I was wondering if you did any comparison studies with 1) absolutely eliminating food between meals with 2) the elimination of most carbohydrates.
Some of the things that I read about Dr Atkins’ cardiovascular condition after his death didn’t sound too good to me.
I would be interested in your comments about Leptin and perhaps some of your readers might be interesting in looking at the Richards book.
Dr. Jay’s Reply:
The body has complex internal signaling systems designed to keep us in a state of energy equilibrium. Things like leptin and grehlin are being investigated now as they are part of the regulatory mechanisms that control appetite. I tend to take more of a macro view. I know from my own experience, clinical observations and from the research literature that, when someone stops eating carbohydrates, their appetite drops dramatically. While I am sure leptin and grehlin and other factors are in play to make this happen, I am more concerned that the result is that stored fat is burned and the person feels better. I make the analogy to a television set. If you want to change the channel to watch a Sopranos re-run, you push the button on the remote and get the desired result. Sure, it would be neat to know all about the electronic circuits and infrared signals, etc, that made it all happen but you don’t need to, as long as you get to watch Tony and his pals. With low-carb dieting, the fact that it works so well will be better understood as more work is done in this area, to be sure (we already have a good book on the subject, Gary Taubes’ “Good calories, Bad calories”, by the way). I read the developments on leptin and the other factors with interest but also a nagging worry that the main impetus for this research is to find a “magic-bullet” drug that will let people continue to eat a crappy diet and still lose weight.
From what you have told me, your dietary approach does reduce carbs and/or increase the quality of the carbs you eat and you have lengthened the intervals between meals, and, most importantly, it seems to be working well for you. I think you should stick with it.
Hi again Dr.Jay,
Thanks for your response. I was wondering if you will be doing any more studies. My children are desendants of a reserve here in the Interior and the people there are concerned about the rise in the incidence of diabetes. My granddaughter has develped it at the age of 13 and is finding it hard to control. Do you think low carb would be good for her or is it different with this type of the disease, ie in children?
My Dr. was very skeptical but he is skinny….thanks again.
Dr. Jay’s Reply:
Type 2 diabetes has become a very serious problem in many First Nations communities. When I trained in medicine it was unheard of in children but now it has become relatively common. This is a tragic situation. In the case of your granddaughter, if she has type 1 diabetes (so-called juvenile diabetes) she will need to take insulin injections regardless of what she eats. If she ate fewer carbs her insulin requirements would go down. The expert on this is Dr. Richard K Bernstein (not the Bernstein weight loss clinic doctor) who has type 1 diabetes himself and has developed a very low-carb approach for the management of type 1 diabetes. You can learn more by clicking on his name in my links section. If your granddaughter has type 2 diabetes, I would encourage you to try lowering her carbohydrate intake. A good book that can guide you is, “Atkins Diabetes Revolution” by Vernon and Eberstein. Perhaps, if you gave it to your doctor, he might be more inclined to consider this approach.
As far as further research goes, I am currently not planning anything beyond completing the data collection in Alert Bay. The people there have indicated that they want to continue the diet beyond the 12 month research period so I may start a study to follow them over the long term. I would like to do more in other communities so we’ll see what happens in terms of whether I get the opportunity to pursue this or not.
Dr. Jay,
I was wondering if any of the study participants developed gall bladder attacks during the study, like some people do when they have rapid weight loss and if not, why not?
Dr. Jay’s Reply:
One study participant, who had a prior history of gallstones, had a gall bladder attack while on the study diet but continued with the diet. Another, also with a prior history, dropped out and we were not clear whether it was because of a gall bladder attack or for some other reason.
When it comes to rapid weight loss and gall bladder attacks, it has been well documented that this can be a problem with very low fat diets or very low calorie diets (which will, by necessity, be low in fat). I think it is less of a problem with low carb diets which allow fat, as ours did. Here’s why. In the very low calorie or low fat diets, it has been documented that participants (mostly women) will actually develop gall stones while on the diet. We know that gall stones tend to develop when the gall bladder is not active. Fat in the diet activates the gall bladder. It has also been shown that women who skip breakfast and therefore fast for longer periods overnight are more prone to gall stones. The mechanism is the same, ie that the gall bladder is inactive allowing sludge and then stones to form. Then, if that person does eat a fatty meal, they are at risk of an acute attack which occurs when the gall bladder becomes active and expels a stone which gets stuck in the bile duct. So, on a low-carb diet which allows fat, if you don’t already have gall stones, it is highly unlikely you will develop them. If you do have gall stones, unless you increase your fat intake, you shouldn’t be at any greater risk of a gall bladder attack than if you weren’t dieting. In our study diet, fat was not restricted. However, as people lose weight on this type of diet, they burn internal fat which has no effect on the gall bladder. Once their weight loss plateaus, they would then increase dietary fat consumption and may increase the risk of a gall bladder attack. Or not. Weight loss is beneficial for a range of conditions including gall bladder disease so the gains from the weight loss may offset the risk of a gall bladder attack. I certainly haven’t seen gall bladder attacks reported in the published low-carb studies.
Any recommendations on what would be ok to drink, other than water?
Dr. Jay’s Reply:
Water is good. I also like tea. Ideally, you want to keep your caffeine intake down, so non-caffeinated teas are better. If you have a coffee habit, a cup or two is okay but don’t put sugar or too much milk in it. If you miss sweet beverages, an occasional diet soft drink isn’t going to upset the apple cart. There was some research getting media attention lately which suggested a link between diet soda and obesity. I don’t know how that would work, frankly. I met a young man recently after I gave a lecture who told me he had just shed 20 lbs just by switching from regular soda to diet soda. A glass of wine will have about a gram of carb per ounce, so use in moderation. On the other hand, distilled spirits don’t have any carb, unless you mix them with something sweet. Anyway, when in doubt, there is always water.
Hi Jay,
Watched the program again tonight. What is the long term plan for people on a diet such as this? Do you think this way of eating will become a life long habit?
Also, as a follow up question about my son and his diagnosis of candida infection – how are diabetics normally treated for this?
He is trying a naturopathic approach by eliminating sugar from his diet, and the naturopathic diagnosis implicates antibotics as the cause. This makes it seem that cutting sugar from the diet is the only solution – as he has not had much support from the traditional medical community for this condition.
You are the first person I have heard say that diabetics get candida.
Great show. Thanks.
Dr. Jay’s Reply:
In Alert Bay, the diet subjects indicated strongly that they wanted to continue eating this way beyond the point when the study ended. I am hoping to be in a position to continue to help them do that.
I am not that familiar with the concept of whole body candida infection although I am aware that many alternative practitioners diagnose this condition. In the case of diabetics, I have seen females who tend to get vaginal yeast infections more often which I think is a function of the higher sugar levels which the yeast like. The treatments were the usual ones, creams mainly, just applied more frequently. Antibiotic use can be implicated as a cause of candida infection as it can upset the natural equilibrium of organisms that colonize our bodies and allow the yeast to overgrow. Anything that normalizes blood sugar should help, I would think.
Dear Dr. Jay
After reading Taubes’ GCBC I’ve really lowered my intake of sugar and refined carbs. I have lost about 8lbs without any hardship at all. My weight is now in the normal BMI range. I’ve noticed that my weak spots, bread and beer, are losing their appeal and I don’t crave them like I did the first couple of weeks.
I’ve been eating lots of eggs and sausage or bacon for breakfast and I feel full for hours afterward. Is there cause for concern regarding the frying? I’ve heard that when fat reaches high temperatures it is harmful. Is it?
Also, is there any way to get more attention for GCBCalories. I heard about it on Quirks and Quarks. I’ve been recommending all of my clients to read it and then lend it to a friend. Keep up the good work!
Dr. Jay’s Reply:
If poly-unsaturated vegetable oils are used in the frying, they can become oxidized, which is not good. I would expect, however, that your bacon is providing its own fat when fried and you wouldn’t be adding vegetable oil. The only vegetable oil that is good for frying is olive oil because of its high mono-unsaturate content. Even canola, which I recommend for other things (like salad dressings) because of its low omega-6, should not be used for frying because it still has enough omega-3 PUFA to become problematic at high temperatures.
I agree that Gary Taubes’ book, “Good calories, Bad calories”, should be widely read. I have given away a lot of copies and promote it whenever I can.
Hi Dr. Wortman: Was wondering if people would be willing to share good recipes that follow this meal plan? I saw your program on Saturday evening and very much enjoyed it. It is clear that mainstream is still very skeptical about the diet’s success and long-term health benefits. I’ve been following the basic rules now for 3 days and have lost 1 pound already. One amazing thing I noticed is my appetite dropped and my heartburn disappeared. I also noticed I felt full very quickly upon eating. So, that’s a thumb’s up in my book. Thank you again for bringing this way of eating to public attention. I’ve been sharing your website with other women who have PCOS. You might have your revolution yet!
Dr. Jay’s Reply:
I have posted some of my favourite low-carb recipes on the site. I will continue to update them as I discover more new dishes. I would also encourage others to post their favourite recipes, too.
Dr. Jay,
Saw the show the other night. EXCELLENT!
Have read all the comments.
Congrats on this. I hope it is my answer.
I will spare you my profile/history and get to my??
Exercise and portions?
No one seems to mention these aspects
Can you please comment.
Also I am assuming that cream means whipping cream. What about 10%, 18%? sour cream?
Avacados??
You mentioned that you use Equal? I have always avoided sugar substitutes as I have avoided margarine. Please comment.
How does splenda fit in?
Thanks a million for this ..am off to get the Atkins and Taubes books
Andrea
Dr. Jay’s Reply:
When you drop the carbs, your appetite goes away. For this reason we don’t get into counting calories or worrying about portion size. There are some good studies that show it is the carbs in the diet that seem to drive excess eating. Most of the recent research on low-carb has used this approach and people get better weight loss than others who eat a reduced calorie diet that includes carbs.
Exercise is good. I believe that people who are overweight, especially if they are starting to develop insulin resistance or diabetes, have low energy levels. They just don’t want to get up of the sofa and go jogging. I tell people not to worry about exercise until they get their diet sorted out. What usually happens is that once they get carbs down to a very low level, they experience a surge of energy and feel like becoming more active. In the study, people spontaneously became more active.
Cream means whipping cream. I like sour cream, too, and avocados.
As far as the artificial sweeteners go, I don’t fear them but it is a good idea to limit them. I think it boils down to personal preference in terms of which one you should use. Personally, when I eat Splenda I feel kind of like I have eaten sugar so I tend to use Equal or Twin.
Hi Dr. Wortman
I wanted to thank you for bringing this issue to peoples attention.
I am 38 year old First Nation of Ojibwa descent. I was once 245 lbs. I managed to trim down to 165 lbs. During my “education” and “research” on learning how to improve my life, I stumbled upon one facet that I was surprised no one has really done any thorough research on (that I’m aware of).
I read a book that suggests that the introduction of hormones, pesticides, antibiotics, heavy salt, sugar, caffeine, alcohol, lactose and a multitude of other chemicals can have a cumulative effect on a body. I began to wonder how this is affecting First Nations people whose ancestors were never exposed to this as much as we are now. I am wondering how much of this can be linked to higher tendencies to depression, suicide, emotional/mental imbalances, anxiety, panic attacks, and more. This book made a link of cummulative effects of chemicals in the body/brain to a persons mental well-being.
When I ballooned to 245 lbs, I was on high blood pressure pills and was told I’d have to take them for the rest of my life. I was also told I’m prone to heart disease and stroke. I was convinced it was all because I was First Nation, and that I had no choice in that so I accepted it…for now.
Over the course of 5 years I began to do research on my own. I began cardio and weight training. I ditched coffee, alcohol, sugar, dairy products, focussed on eating low fat and living foods. I stopped junk food almost completely, and I ditched my desk job for a physically demanding job.
I am no longer on any medication whatsoever. I am more muscular, stronger and in far better shape than I’ve ever been in my entire life, and my mental/emotional state has returned to “normal”. Whenever I go home for visits everyone says “Wow! Have you ever changed!” and no one can believe it’s really me. I begin to feel bad for my childhood friends who used to be so cute and sweet have ballooned beyond the point of recognition, and some have already died due to complications of diabetes, heart attack and stroke.
I really wish someone would do a study on chemical cumulative effects on First Nations peoples especially when it comes to the emotional/mental effects. Many First Nations that I talk to always seem to have one thing in common; depression, anxiety/panic attacks and suicidal thoughts. I can see why First Nations are now prone to alcohol/drugs to cope with those feelings. But that’s just adding fuel to the fire.
Les Bruce – Vancouver
Dr. Jay’s Reply:
No doubt all the things you mention are contributing to the health problems of First Nations people. I do think, however, that the big change in diet over a very short time is the greatest contributor of all. One of the things we noticed in the Alert Bay study was the big improvement in mood and outlook of the people in the study. For some, it was a dramatic change for the better. It is an area that deserves more research.
I have a question about the HgbA1c tests. I am a Type 2 Diabetic and my last test results were .98. My doctor tells me that I will never be able to get my results any lower without insulin. I do not want to go on insulin, I am overweight enough. I need to lose 60 lbs. I am considering following the Atkins (Phase 1) for 3 months to see if I can lower these results. I also have high blood pressure (which is controlled by meds) and the doctor thinks I probably have PCOS, although I have never been tested for this condition. My doctor wants me to have another HgbA1C test in 3 months and then if the results are not down, he wants me to take insulin. Do you think when I follow Atkins for 3 months, my test results will be down significantly? And, does exercise play a big part in this also? I am willing to keep close records while I am following this plan ie: blood glucose monitoring, weight, exercise, and keep a journal of everything eaten etc.
Thank you
Judi – New Brunswick
Dr. Jay’s Reply:
I can pretty much guarantee that if you go on Atkins induction, your blood sugar will drop to normal values within a couple of days. If you stick with the diet, your HgA1c will be normal after 3 months. If you are on meds for blood sugar or blood pressure you will need to reduce them or get off them entirely very quickly or your sugar or blood pressure will go too low. I recommend “Atkins Diabetes Revolution” as a guide. It is best done under the supervision of your doctor, of course. PCOS seems to resolve fairly quickly on a low-carb diet, as well.
Hi folks,
I have been living a low carb for five lifestyle for 5 years, I lost 100lbs in the first year and have slowly gained back about 70 lbs. I do not miss high carb food.
I use keto-sticks and will be in a moderate state of ketosis for about one month and then the rating drops. I then go off the diet for one or two days and ketosis kicks in again. But it does not result in weight loss.
I have a hypothyroid condition and have been treated for it for six years.
My GP is not very informed about a low carb lifestyle so is not much help so I am looking for an MD in the Vancouver area that knows about low carb and hypothyroidism.
I think that I’d make a good case study as I have had blood work done regularly for the last six years. By the way it is always good in terms of cholesterol, etc. I am continually amazed by this considering the amount of natural fat that I eat.
Can anyone give me advice about what I may be doing wrong? Sometimes it is like my body has just gotten used to the diet and has shut down the weight loss processes, maybe by simply using the incoming fat and protein to create energy.
Thoughts, advice, suggestions?
Tommy O
Dr. Jay’s Reply:
Here’s the thing about ketosis. When you start low-carb, your liver starts producing ketones for your brain to use in place of glucose. Your muscles also burn ketones at first until they adjust to burning fat. Your kidneys leak ketones and testing for it in your urine with the keto-sticks is a good way to know if you have lowered the carbs far enough to cause ketogenesis. Now, what a lot of people seem to overlook is that, since ketones are a source of energy that is being wasted as it leaks out of the kidneys, the body eventually wises up and stops letting them leave via the urine. If you are sticking to the diet and you find that the keto-sticks are not showing positive readings anymore, it is likely that you are still making and burning ketones at the same rate but you are just not leaking them anymore. In your case, by going off the diet when this happens you are contributing to weight re-gain. Going off and on is not a good idea as, for some reason, many people find it harder to lose the weight when they resume after being off.
Hypothyroid can be a reason for stalled weight loss so it is important to make sure you are getting enough thyroid replacement therapy. Unfortunately I don’t know of a good MD who is experienced in low-carb and thyroid management in Vancouver.
I am not surprised that your cholesterol readings are good while you eat lots of fat. The research has shown this to be the norm if you are significantly reducing carbs.
Dr. Wortman,
Sorry to bother you once again. I have another question if you could be as generous with your time. Here goes: I like adding sea salt to my food, and i notice you advocate the consumption of salt, especially when adhering to a very low-carb diet. Could the addition of salt impact potassium levels, especially seeing as fruit consumption is not recommended on your diet? I’ve heard that potassium deficiency can cause a number of symptoms similar to those of both magensium and/or sodium deficiency, such as faintess and fatigue.
Best,
Peter
Dr. Jay’s Reply:
I like sea salt for its flavour. It also contains some potassium and trace minerals. When you lose sodium as a result of carb restriction, the body compensates by shifting other electrolytes like potassium and magnesium (to a certain extent). You wouldn’t need to take a potassium supplement to correct a potassium deficiency in this case, all you would need to do is get enough sodium and the potassium will equilibrate on its own. With magnesium, usually the problem is a sub-clinical magnesium deficiency which is unmasked by these electrolyte shifts which is why I recommend a slow-release magnesium supplement to those who show symptoms (usually muscle cramps and hyper-reflexia).
Hi Dr. Wortman
The show of your study rekindled my return to Atkins, thank you for that. I am scheduled to have my gallbladder removed soon. My concern is the processing of fat without the gallbladder.
I had pancreatitis in December which the doctors are unsure of the cause. In February I had gallstone like symptoms, but again the cause was unresolved. I was then referred to a surgeon who wants to remove my gallbladder. After reading the various forums about the after effects of the operation I am contemplating not having the procedure. It sounds like it becomes difficult to intake the proper amount of fat.
I am interested in your comments and any suggestions you would have. I hope the study is continuing well. Thank you for your reply.
Richard
Dr. Jay’s Reply:
I am sorry to hear of your gall bladder problems. A major contributor to gall stones is inactivity of the gall bladder due to inadequate fat intake. Once you have the stones, a big fatty meal can trigger an attack as the gall bladder will contract and a stone can become lodged in the bile duct. If someone with gall stones were to do Atkins, initially they wouldn’t need to increase their fat intake and there should be no increased risk of a gall bladder attack. During the time they were losing weight on a low-carb diet, they would be burning stored fat and this has no effect on the gall bladder. Once their weight loss plateaus, however, they should ideally start to increase the fat content of their diet. This may lead to a gall bladder attack or it may not. It is hard to predict. If someone has the surgery and then goes on the Atkins diet, they would have to be careful about adding fats after weight loss plateaus but should be able to do this by slowly increasing the amount of fat they eat and then backing off if they develop symptoms like bloating, gas and discomfort.
Hello Dr. Jay,
I just wanted to thank you for your good work. I did go on the Atkins style diet and lost 20 lbs. But my wife of 32 years who is a nurse was upset that I was eating too much fat. I as well did not understand the diet. Like many others I thought that it was high protein. But in your film, you put me straight that really it is a high fat diet. Realizing this has changed things around for me. I immediately went back on the diet but this time not with the negative attitude towards fat. And I have lost 5 lbs in the last 6 days. A lot of it was water that I think was kept in my system because of all the sugary stuff I ate that the body could not process well. I feel so much better now and I plan to keep going.
Thank you Dr. Jay and all the participants in the diet for setting me straight about fat being good rather than bad. I am back losing weight and feeling better every day.
Dr. Jay’s Reply:
The loss of water at the beginning is the result of two factors. You will burn off your stored glycogen in the first couple of days after restricting carbs and this releases water. This effect lasts only a short time. Secondly, while you are eating a high carb diet, your kidneys tend to retain salt. When you cut the carbs the salt is released into your urine and takes water with it. If you try to restrict salt while you are eating a low carb diet you may become salt depleted and experience symptoms of dehydration which can include headache, weakness, constipation and muscle cramps. My friend Dr. Phinney recommends people on a low-carb diet should drink a cup of bouillon twice a day to maintain adequate salt balance.
Thank you for the positive feedback and good luck with your new way of eating.
Hello Dr. Wortman,
Your show was excellent, I taped it for later reference.
I am 54 years old and have hypothyroidism, 5′ 10″ and 225lbs. I got encouraged by your show and started a low-carb diet just over a week ago. I eat less than 20 calories a day and so I expected to lose at least a few pounds by now. It did not happen and I may have metabolic resistance as described in Dr. Atkin’s book. Since hypothyroidism is not a rare disease, I am wondering if your study group had any such individual and if yes, what their progress was in losing weight. My keto-stick shows no loss of ketones and I am not losing weight. I also would like to know your opinion on the following:
1. Meat consumption promotes the production of uric acid which in turn, may contribute to arthritis. Is there any guide line to follow?
2. We are encouraged to eat lots of fibre to avoid colon cancer. Is there any research to show the incidence of colon cancer among low-carb dieters?
Thanks again for the show and your research!
Regards,
Steve
Dr. Jay’s Reply:
We didn’t have anyone in the study with thyroid disease. Hypothyroidism can get in the way of weight loss on a low-carb diet unless you are getting sufficient thyroid hormone replacement therapy. It is still odd that the very low-carb intake you describe did not trigger ketosis.
Meat and some other protein-rich foods lead to uric acid in your system which is excreted by the kidney. Excess uric acid over time is the cause of gout, a painful inflammation of the joints. When eating a low-carb diet, if done correctly, the protein intake usually increases only a little. However, at the beginning of the diet, the kidney excretes ketones which can inhibit the excretion of uric acid. This would, theoretically, increase the risk of gout until the kidney adjusts to ketosis and stops excreting the ketones. Although this may happen I have not seen it in any of the published literature on low-carb diets so far.
There was a recent meta-analysis of dietary fibre studies which could not demonstrate a benefit in terms of reducing the risk of colon cancer. There was a study done out of the BC Cancer Control Agency a few years back which looked at colon cancer among Chinese men and it found an increased risk with higher levels of carbohydrate consumption. We also know that the risk of colorectal cancer is higher among type 2 diabetics. Another recent study demonstrated that a low-carb diet significantly improved the symptoms of inflammatory bowel disease. All this to say that there appears to be no benefit from fibre but probably some harm associated with high carb consumption.
Dr. Wortman: I watched the program and was interested in one individual’s result of lowering his blood pressure because of being on your diet. I am 60, weigh 140 +/- lbs, cycle at least 50 k every other day, eat no red meat, nor dairy products, nor heavy starchy foods and yet my blood pressure and cholesterol are still elevated somewhat. I consume a lot of soy (soup cubes, soy drinks, cheese subs., marg. etc.) as well as consuming a lot of foods with flax/fiber (bread, waffles, dry cereal), 2-3 portions of fruit, 3 cups of veg. and 1 cup greens per day. I eat one ‘big meal’ per day and before 18:00 hrs. And when I bike I have calculated almost exactly how much to eat to counter what I expend/hour such that I weigh the same before/after and with no loss of energy. Still I have found getting close to 135 lbs to be hard.
Apart from a belief (backed up by Chinese research I found) that by and large blood pressure pills increase cholesterol, my cholesterol and blood pressure could be better. I have also tried most cholesterol-type meds except statins which I am resisting. Do have any suggestions?
Dr. Jay’s Reply:
Based on my own observations and a number of studies in good scientific journals, I think a low-carb diet is a good way to lower blood pressure and improve cholesterol. I have a 60 year old colleague who exercises a lot and eats a very healthy diet who tells me that the only way he can avoid being on two blood pressure medications is to severely restrict the carbs. The studies also show a benefit in cholesterol even when subjects increased their intake of fat, including saturated fat.
Dr. Wortman,
So far so good. These new eating habits are almost fun! Two things that I noticed almost immediately were firstly I actually feel full. I don’t remember feeling full for a very long time. Previously my husband would be moaning and groaning complaining that he ate too much, blah blah blah. Meanwhile I’m thinking I could go back for more. Not now, I feel full! Secondly, on all my many diets over the years, I have alway had to force myself to drink water. Now I’m thirsty. Every little while through the day I’m looking for water. Before I would have been looking for food. These are both very unusual changes for me. Is this commonly reported, particularly the thirst?
Dr. Jay’s Reply:
One of the nice things about cutting the carbs is that your appetite changes. You don’t get ravenously hungry anymore. I typically don’t feel hungry in the morning but eat a good breakfast anyway and then don’t get hungry until around 3:00 pm or later, even when I am skiing all day.
Have a look at all the posts here to get some information on salt needs when doing low-carb. Your thirst may be a sign that you need to get more salt into your diet. When you do low-carb you lose salt. A good way to replace it is to drink a cup of bouillon twice a day. Good luck with your new way of eating.
Hi again Dr. Jay,
I am pleased and amazed. Have been following the food plan (refuse to call it a diet) for 11 days now and have lost 10 lbs. I weigh on Sunday mornings and could barely believe my scale. I did not feel deprived at all, but had difficulty getting below 30 carbs a day so now i scout for the vegies with the lowest count. I was doing this a year ago and took some advice from my doc to go down to 800 calories a day. I stopped losing and caved in. So I have wasted a year. If I hadn’t seen your T.V. doc. i wouldn’t have tried again. So my thanks to you…
Yours,
Ellie
Dr. Jay’s Reply:
Good for you, Ellie. Please read through all the posts here to get more information on how to manage salt, which fats to eat, etc. Good luck with the new way of eating.
Hi Dr. Jay,
I watched with interest MBFD on CBC. I am a white female of 56 years. I admit that I have tried other ‘lifestyle’ plans to remove weight and only suceeded in adding more. I am on Crestor (no problems there) and have been concerned that I could be pre-diabetic as my weight has collected around my midsection.
I am not asking for a diagnosis or anything like that.
I have found that in the brief time that I have been using the food plan, I no longer have the big highs and lows of blood sugar and feel much better mentally. I do run on my treadmill every other day or try to jog as well – going to the gym to do a 1-1/2 hour weight program on alternate days.
My questions is were any of the participants on cholesterol lowering medication? and has there been any changes on that?
Sincerely Janet
Dr. Jay’s Reply:
I believe we had a couple of participants who were on a statin drug. I do not recall if they discontinued the statins or not; I would have to go back through the charts to find out. What I can tell you, though, is that the recent studies on low-carb diet have consistently shown improved lipid profiles among participants. I know people who have been able to discontinue their statins by following a low-carb diet. Some of them were unable to achieve normal cholesterol on the statins but were able to do that on low-carb without the statins.
Hello Dr. Jay, how important is fibre? It seems to me that fibre takes a minor role in low carb diets. By far are not the bulk of the meals fat and protein? As a matter of fact in traditional aboriginal diets were their diets literally devoid of any fibre for alot, if not most, of the year?
Dr. Jay’s Reply:
While I think fibre is highly over-rated, you can actually eat a lot of fibre on a low-carb diet. Fibre is not counted as a carb. I get a lot of fibre from the big salads I eat with dinner plus the other veggies like broccoli, cauliflower, etc. Some indigenous peoples ate zero fibre and maintained good health. The Inuit, for example. Also, the Masai in Africa. Most Canadian Aboriginal diets, however, appeared to include edible wild plants to some extent and from what I can gather, they would have added some fibre but little in the way of starch or sugar.
Why do I think fibre is over-rated? There was a big meta-analysis recently that pooled data from many studies on dietary fibre and they were unable to show a significant benefit.
Hi Dr Jay,
I have been trying the food plan for a week now & am pleasantly surprised with the stability of my energy level
No highs or lows. & feel better than before.
May I ask – the participants in your program- have they noticed a drop in their cholesterol?
Sincerely Janet
Dr. Jay’s Reply:
Yes, in the study we saw an improvement in cholesterol among participants. In our interim analysis there was a statistically significant increase in HDL (good cholesterol) and HDL/total cholesterol ratio while there was a decrease in triglycerides. There was a very small, statistically insignificant increase in LDL (bad cholesterol). We know from recent work by Forsythe and Volek in Connecticut that among people on low-carb diets, the LDL sub-fractions shift from the bad type to the good type, so even if there was no apparent improvement in LDL, I would assume that there would be an improvement in the sub-fractions (we weren’t set up to measure the sub-fractions in our study).
Dr. Wortman
Hello again. You mentioned that a major contributor to gall stones is the inactivity of the gall bladder due to inadequate fat intake. To me this sounds like the various low fat diets that I have been on over the years may be the cause of my current gall stone. Is this a safe assumption? In my case I don’t think it was a gall stone attack triggered by fat as I had not changed my food intake at the time. Is it possible that both my pancreatitis and gall stone attact could have been caused by high work stress? The reason for both my hospital visits were “unresolved” by the doctors involved. The doctors had told me that with the stone being 250mm (1 inch) that they did not think it block the bile duct. I believe that my gall bladder is being removed to eliminate a possible cause. Am I out to lunch?
Hope the study is going well
Thanks
Richard
Dr. Jay’s Reply:
There have been studies which have documented that people who start a low-fat diet without gallstones can actually develop them over a fairly short period of fat restriction. It is clear that low-fat intake which leads to stasis of the gall bladder is a major contributing factor in the development of gall stones.
As for stress, yes, I think that a lot of real physiological pathology can be attributed to life stress. I find that my shift to a low-carb diet greatly increased my ability to cope with stress and I found my threshold of irritability also dramatically improved. I speculate that this may be linked to the decrease in inflammatory markers that occurs when carbs are restricted. That high level of inflammation associated with metabolic syndrome and type 2 diabetes not only would make you feel irritable but probably also weakens your immune system function. I find that I rarely have any cold or flu symptoms now, for instance.
Hi Dr Jay,
After watching “My Big Fat Diet” I was motivated by your work and the people of Alert Bay. So, after a bit of research I started the Atkins Diet and lost 9 lbs in my first week. It’s great – the pounds are melting, yet amazingly, I’m not very hungry anymore and feel I full on half of what I used to eat. I also have more energy. It’s empowering to learn how insulin, glucose, and lipolysis affect our health. I’m a male heart-attack survivor and since going low-carb I’ve stopped taking my beta blocker and statin. However, I’m trying to find out how to safely get off aspirin after taking it daily for years. Apparently, it’s dangerous to suddenly stop aspirin therapy because there’s a risk of heart problems or strokes.
Interestingly, research reveals there’s only a mere 1% net health benefit in taking daily aspirin – versus a 1.8 % risk of possible side effects like: perforation of the digestive tract, ulcers, and bleeding in the brain. Clearly, the risks outweigh the supposed benefits. Furthermore, aspirin’s blood-thinning properties don’t work in 75% of the population. This is all depressing news if you’re on daily aspirin like me. Before doctors automatically commit heart patients to a lifetime of risky aspirin therapy, wouldn’t it be prudent to first verify if it will actually work for that patient?
It’s totally mad how the entire world became brain washed into believing that a low-carb diet is unhealthy – in reality, it’s exactly the opposite! I plan on staying low-carb forever. Watching “My Big Fat Diet” was an epiphany; many thanks for showing the path to a healthy dietary lifestyle.
Dr. Jay’s Reply:
Thanks for sharing your thoughts and experiences. You may be interested to know that some recent research on low-carb diets has shown that the markers of inflammation that we associate with cardiovascular risk go down significantly on this diet. Also, fibrinogen, which is a measure of the clotting tendency of the blood, also goes down. Good luck with the diet.
Dr. Jay,
I was wondering if you plan to do a similar study on the general population in Vancouver. Because if you do, I would like to be part of it. I am having such a hard time trying to lose some weight and I could use your guidance.
Thank you, Danielle
Dr. Jay’s Reply:
I would love to do a big study in the general population but it is unlikely that that will happen. My time at UBC has come to an end and I have returned to my regular position which offers only limited opportunities to pursue further research. If that changes and there is an opportunity to recruit subjects for a bigger dietary trial I will post a notice on this blog. In the meantime, have a look at the Dr. Atkins books. The most recent one, “Atkins Diabetes Revolution”, is good. I recommend it for people even if they don’t have diabetes.
Dr. Wortman,
This question and answer section is a great gift for people like me who are seeking to improve their lives through diet. I agree with your comment about the unimportance of fibre. For me, fibre causes bloating and seems to prevent proper digestion of protein. Anyways, the big problem i am having with making the transition to low-carb living relates to my mental state. I find that my ability to concentrate/think clearly is greatly impeded if i do not eat carbs. For instance, last night i felt a bit lightheaded and unable to think clearly and i ate a few peanut butter and honey sandwiches which provided great relief and improved clarity. This morning, i ate a high fat, low carb breakfast, but found myself unable to think clearly shortly after eating. Thus, i had to eat some carbs to pick up my concentration. I am using sea salt and taking magnesium. I drink lots of water. I am in my mid-20s. I am lean. But i seem not to be able to focus until i eat carbs. I can manage to go through a day of high fat and low-carb meals, but come evening time, i feel i need carbs to relax and improve mental clarity. Can you offer any suggestions? I know low-carb is the healthy route and i desperately want to make it my dietary approach.
Peter
Dr. Jay’s Reply:
I am sorry to hear you are having difficulty sticking to a low-carb diet. This is not uncommon. Many people find the initial cravings hard to overcome and cannot bring themselves to relinquish their high-carb comfort foods. The parts of the brain that are associated with pleasure and addiction appear to be involved suggesting that quitting carbs may resemble withdrawing from other addictive substances for some people while others seem to breeze through it without any cravings. In my opinion, if a person continues to alternate between low-carb and high-carb eating, their chance of getting beyond the initial cravings is not great. In terms of mental functioning, most people report an improvement in mental clarity after starting a low-carb diet. People in my study used language likening it to a “fog lifting”. I suspect if you could actually stick to low-carb eating for a period of time you might find the same effect. What you currently describe, however, eating high-fat/low-carb meals followed by high-carb snacks, doesn’t sound like a very healthy eating pattern at all.
Hello Dr. Jay, some more questions on fibre. How did the Masai or Inuit keep their bowels moving? With no fibre in their diet didn’t food just sit in their intestines and rot away? And wouldn’t their stools be painfully difficult to expel when they finally did move?
Dr. Jay’s Reply:
It is a common misconception that fibre is necessary for normal bowel function. The science on the benefits of fibre has been weak. A recent meta-analysis actually couldn’t demonstrate an overall benefit from dietary fibre. I haven’t asked any Inuit or Masai about how their bowels functioned on their traditional zero fibre diet but my bet is that it was fine. I am going to stick my neck out here and further suggest that the modern diet that is high in refined carbs may actually lead to abnormal bowel function and that the addition of fibre to that diet may mitigate this problem. Personally, I find that after adjusting to a low-carb diet, bowel function becomes very sensitive to carb intake.
Dr. Jay
Congradulations on a great body of work! — It’s only fitting, or is it ironic, that a Native American cure the ills of this world after all that has been done to him.
-Tom
Dr. Jay’s Reply:
Thanks for the supportive comment.
Dr. Jay
Contrary to the below writings, before Columbus, most Native Americans commonly lived to over 100 years of age and more often than not, they lived to 110 and 120 years of age and in perfect health.
This was told to me by Ted Archer, Nephew of Chief Joesph-Nez Pierce.
I wholly believe this to be an absolute and provable truth when looked at as an absolute fact of life as it is. This changes everything!
-Tom
“The Worst Mistake In The History Of The Human Race”
by Jared Diamond, Prof. UCLA School of Medicine
Discover-May 1987, pp. 64-66
“Life expectancy at birth in
the preagricultural community was about twenty-six years,” says Armelagos, “but in the
postagricultural community it was nineteen years. So these episodes of nutritional stress
and infectious disease were seriously affecting their ability to survive.”
http://www.nezperce.org/History/FrequentlyAskedQ.htm#how
Dr. Jay’s Reply:
I tend to agree that we have misconceptions about life-expectancy in those times. Having said that, a high infant mortality rate would account for a low life-expectancy at birth while still allowing for the fact that many people lived to a ripe old age. There was a large study of health status among native Americans in the southwest published in 1908 by Ales Hrdlicka, in which it was found that the numbers of very elderly people among the natives was much greater than among the surrounding white settlers.
Hello Dr. Jay – As my id says, I am a low carb convert. Although I have been eating moderate carb for the last few years, I took the plunge to very low carb last fall after hearing about Gary Taubes book. Since then, I have lost 20 lbs which is great. But I have been amazed at the health benefits of this way of eating. The one benefit that I would like to mention is about the liver. You had mentioned that you did not allow participants in your study who had NAFLD. This is very unfortunate as this has been the best improvement for me. My liver enzymes used to be very high and I have been taking Orso for the last few years with modest lowering results. After 3 months of very low carb (Atkins induction level), my liver enzymes have returned to completely normal.
What was the reason your study did not allow participants that had elevated liver enzymes?
Dr. Jay’s Reply:
Your observation is correct that a low-carb diet will reverse NAFLD. There have been two studies that I am aware of that have shown this. It appears that NAFLD is the hepatic manifestation of metabolic syndrome and like all the other elements of MetS, it, too, responds to carb restriction.
In our study, there probably were some people with NAFLD although it was not something we specifically looked for. The exclusion criteria was for liver enzymes high enough to suggest compromised liver function so people with moderately high enzymes were included.
Dr Jay
Were there any nuts involved in coast diets? Hazel nuts, pine nuts.
For your own purposes, check out coconut oil.
Ed the grocer (really)
Dr. Jay’s Reply:
I am not aware of any nuts in the traditional diet in this area. I am aware that coconut oil got a bad rap for its high content of saturated fat. It would appear that this was unwarranted and that the so-called “tropical oils” may actually be good for us. It’s not an area where I claim to be particularly knowledgeable so I will leave it at that.
I am wondering why items such as eggs, cheese, cream and nuts are allowed? It is my understanding that eggs (other than fish eggs), dairy products and nuts were not a part of the First Nation traditional diet or of any other traditional, pre-agricultural diet. As a long-time low-carber, I certainly understand how nuts and dairy add variety to the diet and also fat (most meat is pre-trimmed and hence too lean) — but I find that dairy and nuts are also common trigger foods and can cause weight loss stalls in people trying to reach ideal weights — not just “normal” weights, but to become lean. Also, eggs are a common allergen — although I do love the way they taste. Thoughts??
Dr. Jay’s Reply:
We did include foods that weren’t, strictly speaking, traditional as long as they conformed to the general macronutrient pattern of the traditional diet. This is why we allowed eggs, cream, cheese and vegetables like cauliflower and salad greens. We allowed a few nuts, as well. I haven’t observed that these foods are a cause of stalled weight loss and I eat a lot of them myself. I have omega-3 eggs for breakfast virtually every day, for instance, often mixing them with cream and cheese in little omelets.
Hi Dr Jay.
I am glad to see a health professional, especially an MD in the Vancouver area seriously looking at nutrition and diabetes. I am the parent of a young Type 1 diabetic and have read Dr. Richard Bernstein’s book, which has useful tips but is really written for adults, especially Type 2’s.
I would be very grateful for any information or referrals to dietitians or MD’s on the North Shore who would be able to help us safely adapt a reduced carb approach. I’ve been disappointed with the moral support and the acceptance of or resignation to abnormal blood sugars and A1Cs of most professionals.
Dr. Jay’s Reply:
I share your frustration that medical providers are not knowledgeable in administering a low-carb diet approach for their obese or diabetic patients. It is also troubling that we are resigned to abnormal blood sugars which are the consequence of an approach that encourages people to eat the foods they can no longer tolerate. I do hear from time to time of physicians who are supportive but they seem to be doing this quietly while keeping their heads down. I am unfortunately unable to direct you to anyone on the North Shore. I hope this will change over time.
Hi Dr, Jay,
Just stopping by to give you the results of my 1 month Tokelau diet experiment.
I have lost 5 pounds, my blood pressure is stable (consistent readings in the 101/62 range), I have lost 1/2 inch around my ribs, 1/2″ on my hips, and 1/2″ on my thighs.
I feel great and will continue basing my diet on mostly coconut (oil, meat and milk) while adding in poultry and beef. I will also test whether or not cheese is a reason for my previous stalls…but I am enjoying my success too much right now to start the test.
I can’t say enough good things about native diets. I have also researched the Celtic diet prior to the introduction of the potato and Scandinavian diets during the Viking era. I am also looking in to the diets of the Native Americans in Colorado, where I now live. Including your experience in Alert Bay, they all seem to have the same basic structure…a good reliable source of fat, adequate protein, with vegetables and starches playing a minor role…either being used more as a seasoning and thickener or as an emergency food source during famine.
No matter what your heritage is…go native! What type of native? This is the cool part…it depends on what food is easiest to get in your area and what your taste buds like the most. As long as healthy fat is your primary fuel source, it is hard to go wrong.
Dr. Jay’s Reply:
Congratulations on your progress. I will be seeing Gary Taubes next week and I will share your story with him. I have also found that every indigenous culture seemed to base their diet on a staple fat. Around here it was oolichan grease, among the Inuit it was whale fat, on the prairies it was buffalo pemmican, in the boreal forest it was moose fat, on the east coast it was caribou fat, and among the Australian aborigines it was emu fat. It’s a fascinating story to be sure.
Dr. Wortman
I would like to make one additional comment regarding the traditional indigenous diet and the traditional indigenous peoples longevity and health.
Prior to white mans arrival, almost everybody lived to be more than 100 years old and often 110 years old and more and everybody lived in near perfect health. Not just a few. — Everybody.
By the time we started recording, white mans horses and disease and war and guns had profoundly effected everyone.
The bones that they are finding are not 25 and 35 year old people with bones like 100 year old people because of a harsh, difficult living environment. These people are 100 year old and more. — They lived as perfectly and healthfully as all the rest of the creatures and plants and animals on this earth. — The perfection that we still see all around us.
This is the exact opposite of what white man teaches and believes and portrays to be the truth.
Traditionally, the entire world was the same, — before hybrid carbohydrates.
– One additional point please.
The native traditional peoples susceptibility to diabetes and alcoholism is not a weakness inherant in there genes and systems. Rather, it is because white man has been bombarding himself with these hybrid carbohydrates and sugars and alcohol for thousands of years and has built up a tolerance to them. Blacks face the same thing.
These hybrid carbohydrates and alcohol are like amphetamines and adrenaline in our bodies. They create an amplified intelligence and power and greed and self interest and self confidence. — Survival.
Adrenaline sharpens all of our senses by nature in a needed situation and then goes back to normal, like the deer in the forest. — Speed and amphetamines and these these powerful hybrid carbohydrates stay with us continually because we continue to ingest them. — For Thousands of Years!
Thank You
Tom Bunnell
Dr. Jay’s Reply:
See my earlier response on longevity. I think we tend to have a preconceived notion that the lives of people in primitive cultures were “nasty, brutal and short” when, in fact, these observations were made after those cultures had already been damaged by factors such as introduced diseases. There is an excellent recent book on this, “1491″ by Charles Mann. I think you would enjoy it.
Dr. Jay
It’s a common misconception that pure alcohol has no carbohydrates. Alcohol is in fact the highest form of sugar there is. — Like heroin is to opium, alcohol is to sugar. Both deadly substances.
I don’t know how many alcoholics have said to me they eat very little sugar and sweets. I guess so, they are eating tons of the purest form of sugar there is with there alcohol consumption. They don’t need to eat sugar, they are eating and addicted to sugar in it’s highest form, alcohol.
This as there diabetes sets in and there legs are being cut off from this dastardly disease, diabetes, caused by sugar, alcohol and carbohydrate consumption.
Dr. Jay’s Reply:
I have to disagree with you on this one. While we know that alcohol has been a scourge for many native people it is not because alcohol is a sugar. Although alcohol is made from sugar by the action of yeast, once that transformation has happened it becomes something quite different from sugar in terms of how it is metabolized in our bodies. It is handled exclusively by the liver where it can cause harm in the form of fatty liver disease, hepatitis and cirrhosis when taken in excess. Unlike sugar, it does not cause insulin to rise and may actually be somewhat beneficial to type 2 diabetics by improving insulin sensitivity. There is also evidence that moderate alcohol consumption reduces the risk of cardiovascular disease, increases good cholesterol and lowers blood pressure. Some forms of alcohol, like wine, contain other beneficial things like the powerful anti-oxidant, resveratrol. All this to say that, even though alcohol can cause harm, we can’t totally demonize it as it appears to also offer benefits if used in small amounts. The maximum recommended intake to achieve benefits while minimizing risk is estimated to be one drink per day for women and two drinks per day for men.
For people on a low-carb diet, who are relying on gluconeogenesis (the process where the liver converts protein to glucose) for their internal glucose needs, there may be another concern. Since alcohol tends to inhibit gluconeogenesis, excessive consumption may be doubly bad for them.
I should hasten to add that, if you are not currently using alcohol, this is not an argument to start. And for those who have had a problem with alcohol, I would certainly not recommend a return to drinking in the hopes that the benefits would outweigh the risks – they most likely would not.
Hello, Dr. Jay. Just wanted to say I’m thoroughly enjoying the comments by Tom Bunnell!
Dr. Jay’s Reply:
So am I.
Dr. Jay
I would bet my life that infant mortality was close to zero before white man came to this country, just like every other species.
William Randolph Hearst did an editorial on this about 1972 when his daughter was kidnapped and held captive by the SLA. I will try to find it. It points explicitly to the mentality and teachings we’re dealing with here. Thank You.
Dr. Jay’s Reply:
Sounds interesting. Let us know if you find it.
Dr. Jay
Thank you, yes it is very interesting.
I was living there at the time is how I happened upon this Editorial. I was working as an aid in adult corrections as a aid to a parole agent for adult males. We tried to help them. There were several Indian activists working there as aids at that time. Kieth Taylor and Archie Fire were Native Americans working with Native Americans and all races. We had Chicano’s and Blacks and Asians working there too.
Hearst sold the Los Angeles Herald-Examiner in 1986. The Los Angeles Public Library has on Microfilm the entire publication from it’s beginning in the late 1800’s I believe. It has not been digitized. For $5 they can send me a copy if I have the exact issue date and the title of the Editorial. I have the date and day, Sunday, within a few months in 1974, probably about June of 1974, give or take a few months.
He spoke explicitly of the Alaskan Native peoples receiving settlements and allotments from the government for there land use in the building of the Alaska Pipeline and the drilling and exploration on there land.
He was angered that they should receive this money, about $30,000 per person at the time or more and spoke vehemently against it. This is 1974
He said these people had nothing before the white man came here. He said they lived in the most terrible primitive extremes with no health and no medicine, with little food and no nothing.
They should be grateful Hearst said for white man coming here and bringing a great and abundant life and medicine and health to them, not charging them.
I think he was a little extra vehement because some blacks had kidnapped his granddaughter and were forcing him to feed the hungry with truck loads of food for ransom in San Francisco and Oakland and I think LA, so he lashed out against the American Indian because he couldn’t lash out against the blacks.
It shows the current mentality plainly. Of course the exact 100% opposite is the actual truth.
We need somebody to walk into that library in LA and locate this on the Microfilm. I wouldn’t expect it to take over a half an hour or so because we have enough information to get close. If it was digitized we could just type in a few key words but it’s not. I called them and talked to them. They gave me some phone numbers of research people in the area that will do it for a fee. I will contact them if I need too.
I will try my local library and see if they can contact the library and maybe get it. We will get it one way or another and post it here for everybody to read.
I believe that this discussion regarding the indigenous peoples diet and health and longevity and infant mortality is the key to understanding what has happened to all of us and what we can do about it.
We went from total perfection to total destruction.
Dr. Jay’s Reply:
From what you say of Hearst’s editorial, it sounds like it reflects an unfortunate line of thinking that is still around today in some quarters. I am not sure it is worth all the effort to find a copy, though. It won’t move us any closer to learning the truth about pre-Columbian times. I would encourage you to read “1491″ by Charles Mann. It does have a lot of good information that is more relevant to this pursuit.
Dr. Jay
I’m sure your right. To me it turns there whole world upside down with the reality that native people lived a life of pure health and longevity on a perfect earth the world over just like all of the other species on a perfect earth until the stimulated carbohydrate addicts with there greed altered and changed and destroyed everything.
This means Africa was a perfect land with a perfect people. Look at Africa today.
They being the powers that be, be it education or politics or science or business.
There world is turned upside down with this truth because this means everything we have done has taken away from the quality of life rather than having added to the quality of life like the major population believes to be true.
Every single thing we have done has been wrong and destructive and has taken away from the quality of life.
To this we could stop and attempt to turn this thing around.(for the children)
I believe that without a change in our diets away from sugar and starch and carbohydrates and we becoming non-stimulated, non-drugged people, none of this change is possible.
I realize this is a lot to ask and more than most people want to deal with but this perspective I believe to be pertinent to the recovery of our health.
You and your people have the unique ability to accomplish this. Nobody else has this power available to them or the desire or the intelligence to do so.
It’s only the truth!
I wish you well.
Dr. Jay
I owe you an apology here!
I forget sometimes that I am coming from a place that nobody else is coming from and this makes me very hard to understand and follow. A lot of people just throw up there arms and roll there eyes and call me a crackpot.
As frustrating and uncomfortable as this is I completely understand this. I would have thought the same thing had I not stumbled upon these bits and pieces of this puzzle that I have.
Some would call it a hypothesis. I call it a fact although it’s very hard to prove. It would in fact be an hypothesis or scenario though. I think it was a hypothesis that the world was not flat but rather that the world was round one time too so being an hypothesis doesn’t entirely blow this out of the water. It was probably an hypothesis that man could build an object and get on it and fly or make electricity at one time.
That said, my hypothesis is that these sugars and starches and carbohydrates and alcohol and caffeine are powerful man made drugs that stimulate the human mind like adrenaline and that they are what turned white man into this waring monster that takes over the whole world.
This coming from a white man. I am Scotch Irish and German and English and French. Bunnell is French from my dad and Perkins is English from my dads mothers side and Dodd is Scotch Irish from my grandfather on my mothers side and Hartman in German from my mothers mother. That’s 1/4, 1/4, 1/4, 1/8, 1/8.
I believe that my ancestors would be proud of what I’m doing and not consider what I’m doing a traitor.
I always knew something was wrong from early on. Even as a child I could see things. I, like every child in my generation was fed sugar and grains and starches and dairy and fruit from early on with almost every meal. Some of those with every meal starting sometime during and after my nursing years. I remember my mother putting Karo syrup and sugar water in babies bottles for my younger brothers Ron and Jeff, they are ten and eight years younger than me. I’m sure I was fed the same when mother would be gone a few hours and the baby sitter would sometimes care for me. Mother would leave the bottle with the sitter.
Something similar to this happened to almost everyone of us.
At a few months of age I was fed mashed potatoes and cake and ice cream, again like most everybody. We also ate a lot of meat with all of this.
Getting back to my realizing at an young age that sugar was a potent powerful drug. On a school field trip in the second or third grade we went to a large zoo in Tacoma, Washington, south of Seattle. Our whole class, about twenty or thirty of us kids and the teachers and several mothers. We went on a bus.
At the primate cages which we happened upon, these cages were large glass enclosures the size of a fairly large room with a few dozen or so monkeys with tails and of all ages from babies to old. They were hanging from trees and tires and moving all over the place and chattering and masturbating there brains out. Both males and females. The teachers and guides quickly moved us children on. As we left the area I looked at the monkeys and the floor and it was littered with wrappers and half eaten Twinkies and cup cakes smashed all over the floor with many of the monkeys with these crazed looks eating them as they mutually and singularly masturbate with these crazed looks in there eyes and looking off into space. They were totally insane.
I concluded at that moment that the sugar as well as the caging had caused this insanity. I didn’t know about the wheat flour being the exact same thing as sugar for another fifty years.
Just a couple of years ago I learned that wheat and corn and potatoes were the exact same thing as sugar.
The worlds insanity with the kings and rulers and there kingdoms in there pantaloons and wigs now made sense to me. Stimulated, greedy, self centered, heartless fools. They were all crazy.
The same rulers rule today.
Hybrid plants that were once only available to Royalty and the Rulers throughout the Kingdom became a commodity readily available to the whole world along with processed sugar and alcohol and caffeine as barters for trade and to live on. The cat was out of he box.
Sails and gunpowder and horses had been there earlier markings for many centuries while only the kings held these sugars.
Now with everybody eating sugar everything that has occurred the last 150 years has happened. Everything from Atom Bombs to electricity to gasoline power to telephones and space ships and computers and with no end in sight.
The rest of the takeover of the world has occurred and is occurring as we speak. Every natural resource has became a commodity for profit, including humans.
This greed and insanity is fueled by hybrid carbohydrates. Corn, wheat, potatoes and rice and sugar and alcohol. All of our fruits and vegetables are hybrid a thousand times for sugar.
That’s why I come down so hard on sugars and alcohol and caffeine and all of the other drugs. They have destroyed the earth and all of mankind and continue to do so.
That’s a lot more than just making us fat and giving us diabetes and heart disease.
Dr. Jay’s Reply:
No apology necessary.
Your views are not totally inconsistent with what lots of other people who have posted here have found vis a vis the power of carbohydrates (although, I would wager, that for most of them the penny didn’t drop because of masturbating monkeys!). People like me found that carbs were harmful when we eliminated them and discovered huge health benefits as a result. I also believe there is a mental health component to this. I assume you haven’t seen the documentary, “My Big Fat Diet”, yet but this is one of the things that comes through, that people were suddenly feeling much better and things like family dynamics were improving. I think that people who are in the throes of metabolic syndrome or type 2 diabetes feel crappy. I think they tend to be grouchy and irritable. I am not sure it is the cause of all the woes of the world but, in my opinion, the removal of dietary carbs brings such an improvement in one’s sense of well-being that there has to be something to this. I don’t dismiss your ideas out of hand.
Dr. Jay
Thank You. — I believe you people have rolled the snowball off from the mountain top in a way like nobody else could have done. It’s now just a matter of truth and application and logical understanding. Fortunately you have an abundance of all three. I applaud and commend you.
I’m going to guess that you had little understanding when you scratched this surface what you were about to encounter. It’s just remarkable that something of this magnitude could lay in waiting all these years.
Billions of peoples lives will be saved and billions of peoples health will be improved remarkably because of your interest and work.
When they hand you that Nobel Prize and you say that you just stumbled on to this. The rest of the story will be what you did with what you stumbled on to.
Congratulations again, I’m honored to be your guest.
Thank You
Tom Bunnell
Dr. Jay’s Reply:
Thank you for your kind words.
I’ve had type 2 diabetes for a couple of years. I’m taking metormin (and for high blood pressure – Altace and hydrochlorathiazide). I’ve lost weight and blood pressure is much more stable, has been for some time. However, I was also diagnosed with hypothyroidism (underactive thyroid) and now take synthroid. Blood test recently showed high levels of prolactin, low levels of fsh … is it common for your endocrine system to crash when diabetic?
Dr. Jay’s Reply:
While there are recognized endocrine failure syndromes associated with type 1 diabetes, I am not aware of similar entities associated with type 2. The recognized syndromes share a common autoimmune etiology and type 2 diabetes is not an autoimmune disease. On the other hand, since the endocrine system is highly complex and inter-linked it is tempting to think that something that damages one part of the system is going to have an impact on other parts, as well. That is speculation on my part, for now, as I don’t have the science to back it up.
Dr. Jay
One of the greatest misconceptions out there is this thyroid gland thing. About it being out of whack and needing to be elevated because the person is not getting enough of these hormones and that this is possibly the core cause of there weight loss problem or there lethargy or energy loss or depression, etc. etc. etc.
That’s not to say that a genuinely low (hypo) thyroid doesn’t exist and cause weight gain or weight retention or that it doesn’t cause mental problems. It definitely does. High thyroid or (hyper) thyroid also causes serious problems.
The question that has never been answered until right now at this moment is ‘what is the cause of our thyroid gland not functioning properly’. They once thought it was a lack of iodine, that’s one of the main reasons salt is mostly iodized. Until now the cause is completely unknown except by me and now you and your readers.
The cause is sugar and hybrid carbohydrates. Just like diabetes our thyroid and sugar clocks get all thrown out of whack.
If people when breaking there carbohydrate addictions like we are doing will wait long enough, this clock, like the sugar clock, will fall back into place where it belongs. It takes longer than the sugar clock but it will re-regulate when we stop bombarding it with carbohydrates.
The common consensus is that thyroid prescriptions if not prescribed in huge doses but rather small amounts are no more dangerous than a baby aspirin. — Nothing could be further from the truth.
Our thyroid gland regulates our whole body. Our sweat and our digestion and our heart rate, our mind, everything. This is no small potatoes.
Unless somebody is in the extremes of high thyroid or the extremes of low thyroid it’s impossible to tell what there thyroid levels should be because of the way levels vary from person to person. This leaves the door open to prescribe synthetic thyroid elevators that are thought to be nearly identical to our natural hormones and without any dangers in prescribing them.
It’s one of the biggest travesties out there. Everybody got caught up in this, and most still are. It has been handed out like candy for something like 80 years now. The Mayo Clinic’s founding partners were early pioneers in the field of thyroid studies and it’s treatment. It was one of their core programs from the very beginning.
You get a count of people that are prescribed this hormone replacement by there doctors since lets say 1940’s or so and you will find so many people that are using this stuff that it is staggering. Millions and millions and millions.
All through the 1940’s and 1950’s and 1960’s if you went to the doctor and you weren’t feeling well or you wanted to lose weight the first things they would do is prescribe amphetamines. The second thing they would prescribe would be levothyroxine to elevate your thyroid hormones. Usually both before they then prescribed sleeping pills and tranquilizers and all of the rest of the psychoactive drugs in an attempt to unravel the nightmare they had inadvertently begun. Many, many of these doctors and staff members themselves used amphetamines in this time period. It was common and thought to be OK, even good (see Dr. Atkins 1972 Diet Revolution to verify this). This is a mostly hidden fact with profound and far reaching implications and repercussions.
I acquired this information bit by bit when I first got Graves Disease (hyperthyroid) and almost died about 20 years ago and treated it at the Mayo Clinic in Rochester, Minnesota. I had lost over 100# and my heart went wild and I couldn’t do anything but lay for months and months I was so weak. I was sleeping under a freeway overpass bridge in Spokane, Washington while on my way back to Minnesota by freight train (to die, but I didn’t know that then) (I couldn’t work I was too weak) when I slowly walked to downtown Spokane to give blood so I could get something to eat. They wouldn’t take my blood and called an ambulance to take me to the hospital. My heart rate was something like 250 plus and wildly erratic. They asked me about my next of kin before they intravenously gave me (I can’t remember it’s name but the very well known famous for returning your heartbeat back to normal medicine) (digitalis). I slowly came back and then was treated later at the Mayo Clinic. Had I not went to sell my blood so I could get something to eat I would have never known and then died later from heart failure. We did the nuclear medicine radiation treatment to shrink up the thyroid gland like a prune and die and then I was supposed to take replacement thyroid for the rest of my life. Instead I was the one in a thousand that it takes out the bad part of the thyroid that is excreting too much hormone and leaves the good part alive. I took nothing for the first few years and then trying to treat my weight and depression they put me on a 100 MCG daily tablet. I quit it a few times throughout the years but they convinced me to keep taking it, again trying to treat my obesity and depression. I currently am taking the 100 MCG. I take nothing else and never have.
I know thyroid and I know it as a great a travesty as there is, the same as the sugar and carbohydrate travesty. Nothing is greater.
Dr. Jay’s Reply:
That is a remarkable story! I must say that you come by your opinions honestly. There was a a lot amphetamine produced during WWII as it was provided to the troops for use during battle. Similar drugs are still used by the military today (remember the US pilot who dropped the bomb on Canadian troops in Afghanistan). When WWII ended, the big stockpiles of amphetamine found their way into the mainstream and were widely used, mainly as diet medications. There are lots of examples of how certain medications were used liberally before we figured out that we were doing more harm than good. A recent example would be hormone replacement therapy.
Dr. Jay,
What dietary recommendations would The Bunnell Farm recocommend for someone who thinks they might have a problem with their thyroid? For instance, should certain foods be emphasised, while otheres minimised? I’ve often read that carbs are essential for supporting thyroid actions in that a lack of carbs supposedly disrupts the production of thyroid hormones.
Dr. Jay’s Reply:
Higher levels of T3 are associated with high-carb diets and lower levels are associated with low-carb diets. This doesn’t mean that a lack of carbs impairs T3 production. It is more likely, in my opinion, that a high-carb diet demands more T3 production just as it demands more insulin production although the mechanisms would be different. This may be another reason why high-carb is not good for you.
See my reply to the next comment. If the body needs to burn off glucose to get rid of it, it then makes sense that T3 would rise in the face of a high-carb diet to crank up the metabolic rate to get burn off the glucose more quickly. Maybe, just as running at a higher rate of output under these circumstances causes the pancreas to burn out and lose its ability to produce insulin, perhaps the same is true of the thyroid gland. Interesting to speculate.
Dr. Jay,
i read this report which caused me some concern. Are you familiar with this study. The theory does not make sense to me.
Murray Braithwaite
Resistance to insulin that precedes type 2 diabetes may stem from a “metabolic traffic jam” that blocks the body’s ability to switch between glucose and fat as energy sources, say researchers at Duke University Medical Center.
Normal blood glucose (sugar) control depends on insulin, a hormone that’s released after eating that stimulates sugar uptake in muscles and other parts of the body. Insulin resistance arises when the body no longer responds to insulin’s signals. It’s a serious condition that often accompanies obesity and increases risk of developing type 2 diabetes, a disease marked by dangerously high blood sugar levels. Scientists have been studying the disorder for years, but have not been able to agree upon its root cause.
But Debbie Muoio, an assistant professor of medicine in Duke’s Sarah W. Stedman Nutrition and Metabolism Center thinks she may have a pretty good idea. She and her colleagues trace the development of insulin resistance to overworked mitochondria – the tiny power plants inside each cell – that simply get worn down and worn out trying to burn excess fat.
The study appears in the current issue of Cell Metabolism.
Normally, the body switches fuel sources during the day, says Muoio, a phenomenon known as “metabolic flexibility.”
“For example, overnight and during periods of fasting or exercise, muscles and other organs in the body burn fat as fuel. That’s because there is usually more fat available at that time. But during the day, and especially after a meal, mitochondria switch to glucose,” she says. This makes sense, because food makes more glucose available and healthy individuals increase glucose use when it’s on hand. But there’s the hitch: If the diet is consistently too rich in fat and calories, the switchover does not occur. The mitochondria just keep working harder and harder to burn all the fat, and the effort eventually fails.
This is what leads to a “metabolic traffic jam,” – a mitochondrial gridlock where fat accumulates and blocks the use, or metabolism, of glucose. Muoio believes that chronically stressed mitochondria send out a distress signal that prevents insulin from doing its job, allowing sugar to build up in the blood.
“We think this is what leads to insulin resistance,” says Muoio, who acknowledges that the idea is not entirely new. “The first seeds of this hypothesis were actually planted fifty years ago, but it died out because researchers lacked the investigative tools to prove it.”
Now, they have them. Muoio’s team used a mass spectrometer to identify mitochondrial metabolites – by-products of fat-burning – that were found to be associated with obesity and the onset of insulin resistance.
They also developed cell and animal models that showed that when deprived of a fat-importing enzyme, mitochondria were protected and muscles continued to respond to insulin’s signals, suggesting that fat overload was indeed the culprit.
There is some good news in all of this, though, says Muoio. “There are two very easy ways to prevent insulin resistance: Exercise more – you’ll help mitochondria burn fat more effectively, or eat less fat in your diet. That’s always easier said than done, of course.”
Several other investigators from the Stedman Center contributed to the research, including lead author Timothy Koves, Robert Noland, Dorothy Slentz, Merrie Mosedale, Olga Ilkayeva, James Bain, Robert Stevens and Christopher Newgard. Additional co-authors include Gary Lopaschuk, John Ussher and Jason Dyck, from the University of Alberta. Lopaschuk and Dyck investment in a company interested in developing inhibitors to an enzyme central to the mitochondrial activity described in the study.
Source: Duke University Medical Center
Dr. Jay’s Reply:
Here’s what I think – the body partitions fuel. The muscle cells probably prefer fat for fuel but preferentially burn glucose because the body needs to get rid of it. Too much glucose is toxic to the cell. The cell eventually develops insulin resistance to defend against too much glucose. The tissues that are most vulnerable to diabetic complications, which we know occur when glucose levels are too high, are those that do not require insulin for glucose to enter the cells and are therefore not able to defend themselves by developing insulin resistance. When there is a lot of glucose available the body produces insulin to get it into the cells to be burned off. While this is happening, insulin also plays a major role in shifting fat into the adipocytes and keeping it there. When glucose supplies drop, insulin levels drop allowing fat to come out of the adipocytes to be burned as fuel. Insulin also drives the liver to convert excess glucose into fat to be stored in the adipocytes. All this excess fat production can lead to “ectopic” fat storage, ie fat appearing in places where it doesn’t belong. Ectopic fat is associated with various dysfunctions. In the liver, it is “non-alcoholic fatty liver disease” (NAFLD). Some colleagues are doing research on this right now that shows it is clearly related to the carb content of the diet, not the fat content. It appears that ectopic fat is also related to insulin resistance. To me the essential question is whether this argues for dietary fat restriction or dietary carb restriction. I think you know which side of that argument I support. In the research you cite, I would be really interested to see what happens to the signaling and insulin resistance if these mice were fed a low-carb. I bet it would all get better.
Dr. Jay
http://travel.nytimes.com/2008/04/06/travel/06hours.html?8dpc
These are the stimulants we are dealing with!
Hello, Dr. Jay. Rice, wheat, corn, potatoes. Millions upon millions of people depend upon these staples to survive each day. The oceans are already depleted of fish. There is no more game to hunt. Land is becoming scarcer and scarcer upon which to raise animals for food. These masses don’t have the privilege or the money to be able to go to a supermarket to buy their beef or chicken or pork. How can they realistically suddenly be expected to change to a low carb diet?
Dr. Jay’s Reply:
Obviously the change from a hunter-gatherer diet that was mostly protein and fat to an agrarian one of mostly carbohydrates was sufficiently advantageous to cause this to happen all around the globe. Jared Diamond describes how this shift made it possible to develop civilization as we know it since a farmer could produce and store more food than needed by his immediate family. This excess food production capacity allowed for the rise of other classes in society who could build structures, develop bureaucracies, raise armies, etc. etc. While all this is true, there may also have been a downside to this dietary shift. If you read the article by Diamond in my links section, you will find there is evidence that there were significant health consequences. I think Tom in the next comment hit the nail on the head in terms of your question. It is entirely possible that the earth could not sustain its current population on a hunter-gatherer type diet, that many people need to eat a high-carb diet because a diet of meat and fat is not sustainable in their circumstances. This is, as Tom says, a dilemma.
Tim, — If I’m allowed to answer.
They can’t! — This is the dilemma we face!
Dr. Jay,
I was able to take the time to read your story on this site. It is very authentic and compelling. I hope your journey continues to progress and motivate a lengthy and productive contribution to your family and public health. Everything you mention accords with my own experience.
My background is law. In the course of my careful study of legal reasoning and rhetoric, it struck me that most people develop emotional attachment to positions well in excess of the strength of any justification they can offer. Plainly the position served as some sort of cognitive crutch or shield for a deeper emotional need. This lead me to a Ph.D in legal reasoning, Nietzsche and Oliver Wendell Holmes. Applying the analytic skills I have acquired, it seems plain that the resistance we encounter over low-carb diet demonstrate that carbovorism is an addiction like many others, which gives rise to a deep emotional need to be defensive over the security of supply, including any moralistic, public health or scientific suggestion that carbohydrate indulgence is unhealthy or irresponsible. Read the comments to any article on diet and one sees near-religious fervour.
I therefore believe education without addressing the deeper emotional needs of carboholics will fail to move society off of its carbohydrate addiction–the deadly white powders of starch and sugar.
Concerning yesterday’s Globe column of Leslie Beck, I would suggest that restaurants be designated “safe ingestion sites” where carboholics would be permitted their indulgences, with counselling and medical supervision. Restaurants should be legally liable if the allow patrons to leave with blood sugar levels over a legal limit, just as we now hold them responsible for over-intoxicating people who leave and injure others by driving.
Dr. Jay’s Reply:
Interesting observation. You have articulated very well something I have noticed ever since I started on this tack. If you talk to people about reducing fat or protein, no problem. But talk about reducing carbs and the body language changes, blood pressure starts to rise, there is a sense of panic, emotions take over and logic and reason fly out the window. It reminds me of what it is like talking to an addict about taking away their drug. Fascinating. Much as I like your suggestion, I don’t foresee the police carrying glucometers anytime soon.
Dr. Jay,
I note a report today of research from Toronto General Hospital on the effect of lipids in the gut on brain signals to lower glucose production in the liver: “Upper intestinal lipids trigger a gut-brain-liver axis to regulate glucose production” as an advance on-line publication of the international science journal Nature.
The Physorg.com report concludes as follows: Working with rats, Dr. Lam and colleagues designed and performed a series of elegant experiments which showed for the first time that the lipids or fats which enter the small intestine trigger the afferent neuronal signal to the brain which then sends signals to the liver to lower glucose production and blood glucose levels in as little as fifteen minutes. No drop in levels occurred when nerves were cut or blocked between the gut and the brain or between the brain and the liver. The trigger to lower glucose was also disabled when rats were fed a high-fat diet for three days prior to the experiment, a finding which may suggest that those who eat a high fat diet lose this beneficial signaling pathway.
—
It seems to me this is of little concern where the diet is low-carb, since you want the liver producing blood sugar for the brain (as there is reduced flow of sugar from the gut in a low-carb diet). Nonetheless, this keeps me suspecting that the rate o fat ingestion in the upper small intestine is important and why I suspect that extruded fats may be less desirable (from a metabolic perspective) than fibre-bound fats, as in nuts and avocados, casein-encased fats in cheeses, or non-visible fats in meat, such as salmon. Concerning meat fat, it seems to me that animals not fed domestically cereal grains do not develop the extensive visible fat marbling. Rather, these animals have a greater proportion of polyunsaturated fats. Marine animals have visible fat, but again the quality of the fat seems different.
I do not raise these studies to be difficult. My only vested interest is to discern the most healthy strategies for living a long, vigourous and productive life with my family.
Cheers
Murray Braithwaite
Dr. Jay’s Reply:
Sorry for taking so long to reply. I have been attending conferences in Phoenix and Montreal.
I am not sure how to explain the results in this study. I do know that when the body is short of glucose from the diet, gluconeogenesis in the liver provides sufficient glucose to those tissues that must rely on glucose as their only fuel. The liver tends to do this by converting protein to glucose although it can also get some from fat but the efficiency is much lower. Why the ingestion of fats would cause the liver to reduce gluconeogenesis is puzzling. Most people would be eating enough carbs that the liver wouldn’t need to do this anyway. In most people, the liver is making fat (lipogenesis) from all the excess carbs.
By the same token, I don’t know that casein-encased fats are better than others. With carbs, the idea is that the more unrefined and fibre-bound the carb the better since there is a less sharp rise in glucose and a more muted insulin response. Since the metabolism of fats is much different, I don’t think the same principles would apply.
What is clear, is that excess omega-6 is a problem. The main source of omega-6 is vegetable oil. The only ones that aren’t too high are olive and canola.
Dr. Jay,
One last study to mention for today, I promise (lots on the web today). This one found that conjugated linoleic acid promotes the loss of fat from adipose tissue, but that leptin levels also fell and their was insulin resistance from the excess amount of fat building up in other cells (the metabolic rate apparently did not keep up with the rate of fat release from adipose, having been accelerating by CLA supplementation). This seems to accord with the Duke research on excessive fat choking the mitochondria.
This should not be a concern from a low-carb high-fat diet, since CLA levels in cheese and meat is modest (compared to supplement levels) and the rate of release one would expect would correlate with the metabolic rate.
From the report: Without leptin, fat loss occurs in mice eating a diet containing CLA, but the mice also become insulin resistant. When mice are fed CLA and given leptin, the same fat loss occurs but insulin resistance does not develop.
So though leptin is not essential to the fat loss, it has important protective effects to maintain insulin sensitivity, said Martha Belury, lead author of the study and associate professor of human nutrition at Ohio State University.
“Fat loss is not dependent on leptin but if we didn’t have leptin, CLA could have some short-term effects on insulin resistance,” Belury said.
The study appears in a recent issue of the Journal of Lipid Research.
CLA is an essential fatty acid found naturally in trace amounts primarily in beef, lamb and milk. Synthetic forms of CLA are marketed as supplements that help reduce body fat.
But continuing research shows that there are consequences associated with the loss of fat. Because fat in the body is energy, it has to go somewhere if it is not burned away by metabolism. When CLA is driving fat out of fat tissue, the fat tends to end up in the liver or in muscles. If that fat can’t be used, insulin resistance results. So Belury and colleagues are trying to find out precisely how CLA works to reduce body fat and how to prevent any associated side effects.
“You can reduce body fat, which is a good thing for a person trying to avoid diabetes. But if that body fat is lost too rapidly, the fat has to go somewhere else and in mice, it creates insulin resistance,” Belury said. Sometimes, insulin resistance can lead to Type 2 diabetes.
Dr. Jay’s Reply:
I don’t think anything ‘drives’ fat out of fat tissue. The way fatty acids cross the adipocyte membrane is by simple diffusion. Various hormones influence this by promoting or inhibiting the formation of triglycerides which cannot cross the membranes. If CLA promotes the release of fatty acids the net result would be higher serum levels and more available to be burned in the muscle cells. Whether this would lead to ectopic fat deposition and resulting cellular dysfunction, I don’t know. My friend Phinney recently published a paper showing that a gamma linoleic acid supplement will help prevent weight regain, so I expect there is something to this. On the other hand, he is currenlty doing some fascinating work on mice diets that is going to throw into question a lot of the existing research when it gets published.
Hello, Dr. Jay ! Have you heard of the 100-mile diet concept? I think it is a great idea—–supporting local farmers and not having our food travel great distances to get here (Vancouver). What is frustrating is that from a low-carb standpoint from fall through to spring basically the only veggies available are the starchy root ones—-beets, carrots, potatoes, etc .
Dr. Jay’s Reply:
I have heard of this and think it is a cool idea. I have a friend who is currently working on a tv series based on this so it is going to become even more popular, I suspect.
I think you should be able to get a lot of non-starchy veggies during winter in the Vancouver area because of all the greenhouses. On the other hand, Stefansson showed in 1928, in the famous Bellevue experiment, that you can live for a year eating nothing but meat and still be perfectly healthy.
Dr. Jay
Is it possible that alcohol is pure sugar and goes past the pancreas and goes directly into our blood and then to our brain? — I know we can shoot alcohol intravenously and get the exact same effects. — So it doesn’t cause high blood sugar but it causes a mountain of other things? I realise you spoke to the atrocious effects of alcohol earlier. I know too that alcohol is not considered to be a stimulant in the classic sense. Alcohol and power and greed and self confidence and more and war go hand in hand and always have (as in ‘Coming to the Americas’). That’s a fact (Vikings and otherwise), I know that. — The how’s we fight those wars is the question. — Build a bridge or build a printing press? Grow a garden. Could that be war! I know one thing. War and more and stimulants and power go hand in hand! I know too that power manifests itself in many ways according to the situation and environment at hand. Inverted power also expresses itself as gay and crazy and intellect and a lot of other things when it’s expressions are limited and diverted by our environment. — So it’s as apt to make us strong as it is to make us weak. — I can plainly see both. We feed the child milk and juice and the adult caffeine and alcohol. We feed the child caffeine too. — This whole big conglomeration is tied directly to sugar and starch and alcohol and carbohydrates and caffeine. Take them away and you have the bear, the wolf, the deer, the eagle, the fox. Even the fish, and the bug, and the tree and then man. Stimulated man. — Do it to rats and see what happens. — Psychologically, the mind.
Dr. Jay’s Reply:
Always interesting to read your comments, Tom.
Hello, Dr. Jay! Do you count carbs? Do you measure out even the low-carb foods you eat or do you simply not eat any higher carb foods and eat freely of the lower carb ones?
Dr. Jay’s Reply:
I have never been much of a carb counter. I just try to minimize the carbs and then eat pretty much all I want of the other foods. I do consciously try to get a lot of fat by liberally putting butter and olive oil on things, though.
Hi Dr. Jay
I have been on low carb since the show. I lost the first two weeks but have stayed the same for the next three. I have gall bladder trouble so have been careful about the fat. I also gave up diet pop and diet jello because in Atkins’ book he says not to eat aspartame. Can you tell me why Atkins is against it. I have gotten my carbs down to 20 per day. I really want to lose so i can have surgery. Thanks in advance. ellie
Dr. Jay’s Reply:
I think Dr. Atkins was against aspartame because it will cause a little insulin spike. For someone who is sensitive to the effects of insulin on the fat cells, this could be enough to slow down the release of fat and your ability to burn it off. I do consume products with aspartame but try to minimize them. It is not uncommon to hit a plateau as you follow the diet. The first thing to consider is whether some carbs are sneaking onto your plate. Secondly, a low level of thyroid hormone can slow down weight loss. And thirdly, you may still be losing fat but replacing it with muscle. In my experience this can go on for awhile. The way you would figure this out is if you find your clothes are fitting differently or your waist measurement is shrinking even though you aren’t shedding pounds. Many people who have developed insulin resistance will have wasted their own muscle tissue (this is why you see people who have large bellies and thin legs). When you cut the carbs you reverse the effects of insulin resistance and your body will want to build up the lost muscle at the same time as you are losing the fat. I would recommend sticking with it and possibly getting your thyroid checked.
Good luck.
Dr. Jay
Thank You!
I don’t know if you have seen this or not. (I hope these long links will post?)
This is an important and currently running Native American Documentary regarding indigenous peoples health and diabetes, shown on PBS Television throughout the United States and hopefully in Canada, it’s called: Unnatural Causes: Is Inequality Making Us Sick?
Seattle
http://www.kcts.org/search.asp?cx=005471459370339856894%3A_vbqbanscks&cof=FORID%3A11&q=Unnatural+Causes%3A+Is+Inequality+Making+Us+Sick%3F&sa=Go#431
North Dakota
http://www.pbs.org/modules/tvschedules/includes/programinfopopup.html?title_id=64648&display_feed=773&display_format=list_airdates&feeds=773,13429,13430&station=KFME&zipcode=58108-3240&transport=&provider=&channelsuppress=f&supersite=stations&program_title=Unnatural%20Causes:%20Is%20Inequality%20Making%20Us%20Sick?
USA National listings
http://www.pbs.org/stationfinder/stationfinder_relocalize.html
You can type this title into the search feature when you get there. — Unnatural Causes: Is Inequality Making Us Sick?
I don’t know how to find Canadian listings.
They touch several times on the cause and then leave it. The doctor who has spent something close to 50 years working with and studying diabetes with these people and still not knowing the cause, shocks me. — It’s wonderful that they are getting some of their water back and terrible that it was taken in the first place but I don’t believe that it is the cause of diabetes. — I believe the cause of diabetes is purely the results of the ingested foods and drinks we eat!– I’m going to watch it again, I missed it’s beginning the first time.
Thank You!
Dr. Jay’s Reply:
We get KCTS from Washington in Vancouver. I’ll watch for this. From your comments, I suspect it is about the Pima. I spoke once to someone who had worked with them extensively and asked if they had ever tried a return to a traditional diet. He said yes but that they couldn’t stick with it. This is also a common criticism of low-carb diets in general, that they do deliver benefits but people don’t stick with them. This is rubbish, of course. Some people stick with them for years and enjoy long-lasting benefits. I am one of those people. Because some people find it difficult to comply with a diet that delivers benefits is not a reason to abandon that approach. Where would we be if we accepted that attitude about smoking or other forms of substance abuse? The real issue is to figure out why people have difficulty complying and to address that. I suspect, in most cases, it is that the diet is not followed properly. Anyway, don’t get me started …
The high rate of Type 2 diabetes on Tohono O’odham Indian reservations in Southern Arizona is examined, including the role hopelessness may play in the disease. Also: how neighborhood environments may affect health.
Dr. Jay’s Reply:
The hormones associated with chronic stress are a factor in obesity. Cortisol, for instance, has been shown to increase fat deposition over oxidation. There is a chicken and egg conundrum here, as well. Does an inability to cope with stress lead to obesity or does obesity compromise one’s ability to cope with stress? Probably both are factors and, eventually, one is in a vicious cycle of obesity, stress and hopelessness. It was very apparent in my study that people felt they were being given hope. This is reflected in some of the comments in the documentary.
Dr. Jay
I just found this.
http://www.unnaturalcauses.org/
Hi Dr. Jay,
Re: Vegetable oils lower in omega-6 — avocado oil, macadamia nut oil and coconut oil are all lower in omega 6 than canola or olive oil. Olive oil has been consumed for centuries and its antixidant benefits go beyond the fact that it is high in monosaturated oil (omega9) and lower in Omega 6. Canola contains a whopping 23% omega 6 and I think people should avoid it if possible.
Re: Caffeine: Humans aren’t lab mice. Coffee and tea are more than cups of stimulants — that is an unfair, unscientific simplification. Coffee contains thiamine, magnesium and soluble fiber. Both coffee and tea are rich in antioxidants. Certain teas contain significant amounts of vitamin C ie sencha. Caffeine is an anti-inflammatory and coffee for example can ease headaches and stop an asthma attack in its tracks for some people. Note I say some people. Those who have adverse affects from caffeinated beverages should not consume them — but to demonize them for everyone is both unfair and totally unscientific. Don’t believe me? Do some research and be sure to analzye the way studies were conducted. Many of the studies purporting to show adverse affects from coffee or tea did not use coffee or tea at all — they used caffeine pills in water. This kind of study is flawed from the start as the magnesium and l-theanine respectively are part of the natural beverages that certainly would influence the effects of the caffeine. Caffeine increases circulation to the brain. Counterintuitively, it can also calm hyperactive children — it seems to have a reverse effect on them. In any event, there are hundreds of studies showing the numerous health benefits to delicious coffee and tea. To quote Benjamin Franklin who was reputed to drink 30 to 65 cups of coffee per day: — “Among the numerous luxuries of the table…coffee may be considered as one of the most valuable. It excites cheerfulness without intoxication; and the pleasing flow of spirits which it occasions…is never followed by sadness, languor or debility.”
Now I’m off for a double espresso — cheers!
Coffee and tea add pleasure to one’s low-carb diet and if one can tolerate them — enjoy!
Dr. Jay’s Reply:
Thank you for your thoughtful comments. I do enjoy my cup of tea, black with no sugar, thank you.
A day without coffee is like a day without sunshine! — The Inca High Priests considered it to be a link to paradise! — Benjamin Franklin like cocaine too! — Amphetamines have the same effect on children! — Bravo!
Dr. Jay
I am absolutely certain that the ‘addiction factor’ is the reason so many people reject or are unable to stay on the low carb traditional diet that we know is so healthy.
Your right, it’s like cigarettes. — For those of us that can break this addiction, although a difficult thing to do, we get over it and get better and all of the cravings leave and we feel much better for it.
The same thing with sugar and carbohydrates.
A lot of people can not break these addictions, sugar and starch and carbohydrate addiction or tobacco addiction. — I didn’t think I could ever get off from cigarettes but I did. It has been over ten years now since I quit. — I still have to fight my carbohydrate addiction. If I mess up and eat any of the wrong foods or get to feeling sorry for my self, bang, over I go.
If I stay 100% traditional, I feel great and have no problems and stay that way.
I get my strengths from knowing the validity of the traditional ways and how destructive everything else is.
The knowing that corn and potatoes have been destroyed also gives me strength. — Strength as well as sorrow.
The little ones make it all worthwhile.
Dr. Jay, I hope you have a moment to answer three quick questions. In Dr. Atkins Induction, I suspect a lot goes into food combinations,etc. I’m finding that I frequently have leftovers or can’t find certain products. There is so much emphasis on not cheating during these first 2 weeks. Is it allowable to exchange a dinner for a different day’s dinner or exchange a breakfast, etc? Also, when the menu calls for “endive”, are they refering to the bulb like Belgian Endive or the curly leaf lettuce like endive? And my last question, I have some chewable vitamin C on hand and it contains “sorbitol”. I’m not sure where sorbitol fits in as far as affecting insulin production. Can I chew on these without sabotaging my weight loss?
Dr. Jay’s Reply:
My apologies for the delay in responding – I have been traveling in the remote regions of New Zealand where internet access has been difficult.
During Atkins induction, the key thing is to eat very little carb. Substituting one meal for another is okay. Generally, when vegetables are allowed, they are the non-starchy version. I suspect the bulb of endive would contain more carb than the leafy type. All leafy vegetables are very low in carb while root vegetables tend to be higher and, in general, should be avoided. Sorbitol is a “sugar alcohol” which delivers some sweetness with fewer calories than sugar. It tends not to get absorbed in the intestine which leads to a laxative effect if you eat too much. It may be okay to eat a little bit of sugar alcohol while on a low-carb diet as long as you keep the quantities small. The amount in a chewable vitamin would be sufficiently small to not be a problem. Personally, I tend to avoid sugar alcohols as they make me feel like I’ve eaten real sugar, which is an unpleasant feeling now that I have been very low-carb for almost six years. I also think that if you find weight loss has stalled, elimination of all sources of sugar alcohol should be considered.
Dr. Jay
The addiction factor, as important as it is, doesn’t really answer the problem. The problem is most people refuse to believe that things like milk and beans and rice and flour and fruit and everything, are potent addictive drugs in the first place.– So how can one break an addiction that they don’t believe they have and that all those foods and drinks are not addictive drugs to start with. — There’s no way to win!
Dr. Jay’s Reply:
It’s true that most people find it incomprehensible that these so-called wholesome foods might actually cause problems. I also find that people get quite emotional at the thought of taking away their carbs, something that doesn’t occur when you suggest reducing fat or protein. I think there is something like an addiction at the root of this.
Dr. Jay
Somebody said don’t tell me that we have something like over six billion people addicted to hybrid and processed carbohydrates.
I said OK, I won’t tell you!
Dr. Jay,
I am a member of Fraser Valley Metis Association.
A year ago, my naturopath recommended to me the book “Nourishing Traditions” by Sally Fallon. It set me on the path to eating as our ancestors traditionally did (I had been a vegetarian for 12 years and after the birth of my child, my health began a steady and swift decline). It was only instinct that told me that as an aboriginal, eating a traditional diet that includes animal fat and avoids carbs is even more important to me. Your research fully supports the ideas in this book.
My question to you is, how can I arrange to have you come and give a presentation to our Metis community? Most of our elders suffer with diabetes. The impact of your study would certainly improve the quality of life.
Dr. Jay’s Reply:
I am happy to hear that you have found your way to a healthier diet. I do a lot of public speaking on this topic and will send you an e-mail to provide my coordinates. Having said that, it is often the case that I cannot find the time to meet every request. I think the documentary, in many ways, does a better job of communicating the ideas behind the diet and the benefits it delivers. Keep your eye on the Mystique Films site where the producers plan to start selling copies.
I read reports on two unrelated studies today that suggest something interesting. The first study observed that when people are stressed, the tend to eat more sugar-laden foods. Second, female mosquitos prepare for hibernation by switching from a diet of blood (protein and fat) to sugar (carbs)(the study looked at the role of insulin regulating genes.) Now here is the question–do stressed humans gravitate to sugar because it has drug-like properties, or because our bodies seek to gain fat in expectation of potential interruption of food (stress as a signal of upcoming hardship)? In favour of the former, most people seem to settle into a level of carb addiction that is an “attractor state” for their genes and environment/lifestyle. The addition of stress changes the environment and bumps them into a new attractor state, with a higher level of carb addiction. It will be interesting to see what other studies come along to help elucidate the causalities and teleonomics here.
Dr. Jay’s Reply:
Sorry for the delay in responding. I have been traveling in the remote parts of New Zealand where internet access has been difficult.
I think you are on the mark with your observations, as usual. In our hunter-gatherer past, stress would be a signal of uncertain food supply and would, therefore, shift us towards energy storage. The secretion of cortisol, for instance, is a hallmark of chronic stress and it leads to fattening. I have often noticed that when I travel, I am more inclined to eat frequently and larger amounts. I think that the brainstem interprets being away from familiar surroundings as a sign of uncertain food supply and wants the body to store energy in the form of fat. Carb addiction may be the result of too much reliance on carbs which causes the mitochondria to lose their capabilities to burn mostly fat and/or ketones. Dr. Phinney showed that “ketoadaptation” takes up to two weeks after one stops eating carbs. It is during this time that people may experience the intense carb cravings and other signs and symptoms akin to drug withdrawal. It is an interesting field of study.
I think the evolutionarily driven need to fatten up before winter is the reason carbs are addictive. They stimulate the same pathways in the brain that addictive drugs do but the carbs came first.
Dr. Jay’s Reply:
I struggle to figure out how an addiction could be an adaptive behaviour. I suspect we were compelled to eat carbs at times when we might want to fatten, as you suggest. However, I think that this adaptive behaviour becomes maladaptive when we shift to an environment where we are surrounded by carbs, and highly refined carbs, all the time. This overindulgence is probably what leads to the addiction. Just MHO.
I think it’s always hilarious when you see someone defending coffee and caffeine. Coffee raises insulin levels. It increases stress hormones like cortisol in the blood. Raises homocysteine levels. It is profoundly addictive with a particularly brutal withdrawal period that can last up to 2 months with fatigue and depression being some of the highlights. You enjoy it because it stimulates dopamine in your brain, similar to crack or amphetamines. It’s utterly toxic. Without it, you would pretty miserable for a couple months, so you rationalize your use by grabbing on to any study that shows a benefit, though most of the studies lately have been pretty negative. One doesn’t need a study if you look at the basics. It raises blood sugar, it potentiates stress, causes miscarriages and is likely the hardest addiction to break you will ever face. End of story.
Regarding all this carb restriction business, didn’t Weston Price find that almost all of the very healthiest peoples he encountered and studied in his travels so long ago consumed significant quantities of carbs, in addition to animal food and fats in their traditional diets? They ate starchy tubers, whole relatively unprocessed grains like oats, whole wheat and barley and corn as well as root vegetables. The very healthiest African tribe he encountered, the Dinkas, for example, with perfect teeth, bone structure, strength and endurance and no degenerative diseases, diet consisted of cereal grains and fish.
What Weston Price discovered was that none of these healthy peoples consumed refined carbs like flour or sugar and most did not use caffeine – a driver of high insulin levels and higher cortisol levels in the form of an extremely addictive substance with a profoundly affective and drawn out withdrawal period. This was what was missing not starchy carbs.
People point to the Inuit as an example of relatively healthy high protein/fat eaters with very low carb/starch intake – but even back in the day it was observed that these people looked much, much older than their age. Today they suffer from absurdly high rates of osteoporosis as well as devasatingly high rates of spondylolisthesis. Genetics? We are talking very high rates here.
The satiety index, a way of measuring length of satiety, found in fact that fat was the least satisfying component of the diet. The most satisying single food, by far, was the potato. There is also evidence that it was not the consumption of fish that led to the larger human brain, but tubers.
Seems to me the way to go is by restricting refined carbs and sugars – and that friend of some of the worst diets seen on the reservations and in other poor areas – the potent and pesticide laden coffee.
Dr. Jay’s Reply:
Thank you for arguing the counterpoint to much of what other posters have said. I think it is healthy to get both sides on the table. Although, I don’t agree with everything you say I think you have a right to your opinions. I think Weston Price has a lot to teach us but one should also look at Jared Diamond’s article in Discover Magazine published in 1987, “The Worst Mistake in the History of the Human Race” and his book that was recently re-released, “The Third Chimpanzee”, to get a perspective on the harms associated with a switch from a low carb hunter-gatherer diet to a high carb agrarian diet.
As to coffee, I have to admit that I was glad to shake that addiction when I quit many years ago. I find black tea to be just as good but far less addictive – no caffeine headache if I don’t start the day with a cup.
Dr. Jay,
In a previous reply you said, “There was a big meta-analysis recently that pooled data from many studies on dietary fibre and they were unable to show a significant benefit.”
I thought there were studies showing fiber reduces LDL and small LDL. Is that wrong? Also can you provide a citation for the meta-analysis cited above?
My system has been doing a lot better since reducing fiber, but my doc insists it’s good for me.
Thanks.
Dr. Jay’s Reply:
There was a Cochrane Collaboration report published in 2002 which showed no benefit from fibre for colorectal cancer (http://www.cochrane.org/reviews/en/ab003430.html). There was also a meta-analysis published in JAMA in 2005 by Park et al which came to the same conclusion. Also, in the American Journal of Clinical Nutrition in 2008, Barclay et al published a meta-analysis on the benefits of low-GI and low-GL diets which concluded that the risk of certain chronic diseases (heart disease, gall bladder disease, diabetes and breast cancer) decreased with this kind of diet. They make the following interesting observation: “The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression”. In other words, the big blood sugar rise you get after eating a lot of carbs is harmful and lowering the GI and/or adding fibre can mitigate that harm. Wouldn’t it make a lot more sense to just take the harmful carbs out of the diet to begin with? There is so much evidence accumulating to support this that eventually the dam will eventually have to burst. In the meantime, take comfort in knowing that you are on the right track.
Dr. Wortman,
You may remember me posting and mentioning that I was finding it difficult to adapt to a low-carb diet. Well, I’ve made the transition. For two weeks, I have been eating a low-carb high fat diet and feel fantastic. All the symptoms I complained to you about while trying to make the transition from a high carb diet have subsided. Thanks Dr.. Lastly, I saw a photo of you on Dr. Michael Eades web site, and I must say, you look very well. You and low carbs must be a perfect match.
Dr. Jay’s Reply:
I am glad to hear you are doing well on low-carb. I have been doing it for about six years now and would not consider going back to a high-carb diet for myself. Thanks for the compliment. I do think there is an anti-aging effect from this diet, probably due to significantly lower output of free radicals when you are burning fat vs carbs. Anyway, I plan to live forever or die in the attempt.
I would like to know if a dvd of the documentry will be
available.
Robert
Dr. Jay’s Reply:
I believe the producer, Mary Bissell, is planning to market a DVD. Keep an eye on her website for this: http://www.mystiquefilms.com.
Dr. Wortman
Well it has been 5 weeks since my gallbladder surgery. They had planned on the laparoscopic surgery to remove the organ but the surgen had to go with plan B with the open with a 9 inch cut. I was in the hospital for 6 days with 5 of that being on an epidural for pain relieve. After that I had 3 days of Percocet. Boy are they ever restrictive with those. After that I was taking a couple T3s every 4 hours reducing to 1 every 6 hours then as required. I was off the painkillers after a couple more weeks.
I have found that I have had none or very little of the symptons I was concerned with. It must have been that my gallbladder had not been working for quite some time. The surgeon said that this is possible.
Anyway I will be returning to work on Monday (12 May) and Transport Canada has reinstated my medical for my pilots license so all is good. It will be good to get some structure back in my life so as to return to proper eating on the Atkins plan.
Dr. Jay’s Reply:
I am glad to hear that it all worked out well for you.
I was reading the article with the work you are doing with the Namgis First Nation. I have not read all the comments but was wondering if you were aware as well that McGill University had a section that dealt with the study of the importance of traditional foods and First Nations and diabetes.
Dr. Jay’s Reply:
I am familiar with CINE at McGill which studies traditional foods. Dr. Harriett Kuhnlein from CINE is in the documentary voicing concerns about including saturated fat in the diet we used in Namgis.
Richard
Statin medications cause pancreatitis and gall bladder disease.
Just a heads up in case you were or are taking them.
http://www.spacedoc.net
Where on earth did you get this information:
“Today they suffer from absurdly high rates of osteoporosis as well as devasatingly high rates of spondylolisthesis. Genetics? We are talking very high rates here.”
Cite, please.
Dr Wortman,
I was struck by your statement, in telling your own story, that “although I obviously knew that these types of foods, starches and sugars, would raise my blood sugar, discontinuing them was not an accepted therapy for my condition”.
I believe low carbohydrate diet used to be accepted therapy – my uncle (in England) was diagnosed with type 2 diabetes in the late 1960’s, and was put onto a low-carbohydrate diet. In the 1970’s his diet was changed by his doctor to increase his carbohydrates and reduce his fats, that is, to a ‘balanced’ diet. He did stick to the new diet and keep his diabetes under control, but he once told me that he found it very difficult, because on the ‘balanced’ diet he had been hungry every day of his life. What I don’t understand is, why did the medical profession start to advise diabetics to eat carbohydrates ? It seems an awfully big change in accepted therapy, loaded with risks, requiring very strong justification.
The bottom line is, while I am full of admiration for your work, the way I see it, it should not actually be necessary.
PS I have been following Atkins for five years, losing 42 lbs in the first 9 months to get me to 6 ft 1 and 175 lbs at age 51. After feeling a bit strange for the first two weeks I have never felt hungry, and never counted a calorie or weighed a portion. My acid reflux immediately stopped, my energy levels rose, I really feel fitter than I have for 20 years, and I have absolutely no desire or craving to go back to my old bad diet. But I still meet people who tell me Atkins doesn’t work, or worse, that they have found for themselves that Atkins does work but they can’t be bothered to follow it!
Best Regards
Dr. Jay’s Reply:
Thanks for your thoughtful comment. You are right, of course, carb-restriction was at one time the standard treatment. The Osler textbook of medicine published in 1923 provides a very low-carb diet for the management of diabetes. I am told by older physicians that it worked well, too. When I was in medical school, our lecturer on diabetes began by telling us that the discovery of insulin set diabetes research back by 50 years. I think that says it all. When insulin was identified as the deficient hormone in diabetes and a method of administering a replacement was developed, everyone believed that diabetes was no longer a problem. We know differently now, of course. In subsequent years, the emergence of the fat-heart hypothesis further eroded any tendency to want to restrict carbs in the management of diabetes since you cannot demonize both dietary fat and carbs, one has to be the major source of calories if the other is to be avoided. This is why we find ourselves today in the weird position where the standard treatment of a dietary intolerance is to insist that those affected continue to eat lots of the foods they can no longer tolerate. Thankfully, we are beginning to see the development of a growing body of evidence that supports carb-restriction once again. Eventually the weight of the evidence will force a change in practice guidelines. The recent inclusion of a low-carb diet option for weight loss by the American Diabetes Association may be a harbinger of more to come. Let’s keep our fingers crossed!
Hi Dr. Jay,
Just to add another comment as well to your work with Namgis. I was also reading a recent article in The Economist about the vast changes as a result of the wealth in the Gulf. One of the fallouts includes that 1/5 of the Indigenous population of the Gulf now have diabetes as a result of change in diet and more sedentary lifestyle. This has led to the building of a state-of-the art diabetes centre in Abu Dhabi I believe. It would be interesting to do a comparison of their traditional diets to what you are doing as well or connect…just a thought.
Verna
Dr. Jay’s Reply:
It is true that middle eastern countries are now experiencing very high rates of metabolic syndrome and type 2 diabetes. There are some researchers in Kuwait who have published a couple of studies on low-carb diets but I don’t know how much interest there is in this topic generally there. I suspect the traditional diet was high in fat and low in refined starch and sugar like everywhere else and that dietary change is what is driving this problem there just as it has in the rest of the world. I would also bet that the big, shiny diabetes centre is all about pharmaceutical therapy and wouldn’t countenance a return to a traditional diet or low-carb approach.
Hi Dr. Jay,
Thought I’d share some of my recent lab work numbers for coffee/tea “addicts” such as myself who also follow a low-carb diet:
Insulin, serum: Less than 2 (Normal Range is Less than 17)
Cardio CRP: .2 (Low Risk Range is Less than 1)
Cortisol, Total Serum: 15 (Normal AM Range: 4-22)
Triglycerides 35 (Normal Range Less than 150)
HDL Cholesterol: 116mg (Normal Range Greater than 40)
LDL Cholesterol: 99 (Normal Range Less than 130)
The above tests along with others were done as part of a physical. The blood was drawn in a fasting state.
I reiterate that coffee/tea and theobromine found in cocoa may not be for everyone and certainly are not necessary for health. But they make life enjoyable to me and add variety to my very low-carb dietary regime and I believe my lab numbers speak for themselves. Where is the elevated insulin? Where is the elevated cortisol? Where is the negative impact on blood lipids? Nowhere.
If one wants to be as close to a purist as possible with respect to a hunter-gatherer type diet, then yes — ditch the coffee/tea/cocoa. But to be fair, you should also then ditch cheese, butter and cream and only eat seasonally and locally. However, I don’t see the point in making things unnessicarily more difficult unless there is a proven physical benefit. For me, the very dairy products I grew up with and adore are what cause me me stalls and fat gain despite being very low-carb. I love the taste of them but a little bit triggers the desire for more, more, more! I am a petite gal but can put down copious quantities of cheese, butter and cream — hence I have found I am better off just dropping all dairy. Yet I would never suggest that nobody should eat dairy products just because they do not agree with me.
By contrast, I can have an espresso shot and be satiated for hours. I do not require more, more, more coffee/tea to get some “buzz.” I do not require a “buzz “because I have boundless energy enough from following a high fat, very low-carb, moderate protein diet. Different strokes for different folks. If I am “addicted” to coffee/tea — so what? It hasn’t harmed my health and adds tremendous pleasure to my life plus makes it easier to stick to the low-carb regime. But again, different strokes for different folks. And, as for the purported “toxicity” of coffee/tea/cocoa — that makes me chuckle. My husband gets violently ill if he eats a single scallop. Does that make scallops “toxic” for everyone? Of course not. Anyway — I look forward to hearing what I’m sure may be very entertaining rebuttals.
Dr. Jay’s Reply:
There is truth in your observation of different strokes for different folks. I would add my own, that the proof of the pudding is in the eating (I know, terrible pun) which, in your case, is in the blood work, biometrics and your own sense of well-being.
Question regarding salt — you and other experts have indicated that we need to supplement with salt when we eat low-carb. While I understand some of the biochemical arguments for this, how about the anthropological arguments? Did our ancestors who lived off of wild game obtain salt in some way and did they not survive or thrive without it? Thanks.
Dr. Jay’s Reply:
Good question! While it is clear that adequate salt replacement is important to avoid the so-called side-effects of a modern low-carb diet, how that correlates with ancient peoples’ salt intake is less apparent. From what I have learned, it appears that the drippings from meat were preserved and that these would be one source of electrolyte replacement. Boiling them would concentrate the salt. When I talked with some Aborigine friends about their traditional diet, they told me fascinating stories of how they cooked kangaroo and emu so as to avoid losing any of the fat or juices. They would make a ventral incision, gut the animal, stitch the incision back together and then cook the animal in a pit with the skin still intact. The skin serves as a container for the drippings. Dr. Phinney determined that the Inuit carried carved stone cooking pots which would have been used for the same purpose when cooking meat (although they ate a lot of their food raw). I suspect that, just as fat was highly valued, salt would have been, too, among our ancestors.
Miigwetch Dr. Jay,
When you mentioned: “I would also bet that the big, shiny diabetes centre is all about pharmaceutical therapy and wouldn’t countenance a return to a traditional diet or low-carb approach”. Having people sick and living in fear is very profitable. I rented Michael Moore’s video, “Sicko” yesterday and had me thinking of the health care system in France where doctors are focused on their profession of keeping people healthy and reimbursed accordingly for their knowledge and work as opposed to trying to run a business for profit by treating the sick therefore needing a large enough target market. This is also pretty stressful for doctors having to ensure they have a big enough target market to bill for their practice as opposed to ensuring wellness. Raising diet awareness is a big form of health prevention and ensuring wellness as opposed to ensuring enough people are sick like a pharmaceutical business. Good for you!
Dr. Jay’s Reply:
I think my profession erred when we abandoned nutrition in favour of pharmaceutical interventions. A good example of this is found in the history of the management of diabetes. Prior to the discovery of insulin, doctors were trained to put their diabetic patients on a very low-carb diet which worked quite well. When insulin became available, however, everyone believed that the problem was going to be solved by simply injecting insulin without any need to worry about diet. We now know the folly of this, or some of us do, but it will take a lot of evidence to cause a change in direction. The problem is that, unless there is a big profit to be made at the end, it is hard to get the large studies funded. Nobody is going to get rich telling people to stop eating starch and sugar. On the other hand, there are large vested interests that are threatened by a large shift in diet. Atkins did well with his books and made money from his corporation that sold sugar-free products. Apparently, these endeavours actually subsidized his clinic which operated at a loss. I don’t blame individual physicians for the problems we see today. I think the failure lies with the large scientific and professional bodies that operate on a consensus-driven basis. This makes it very difficult to effect change when the new ideas are contrary to the consensus.
Sooo, I have been following this low carb thing for 2 months now and must really be doing something wrong.
In the first 2 weeks I lost 8-10 pounds….2 inches around my waist!
I was thrilled as I was able to get into some clothes that had been very tight.
I have read everything on your blog…tho’ there must be something I have missed. I have read “Good Calories Bad Calories” and Taubes NY Times article.
I am convinced of the benefits of this!
However, my weight has stayed the same since the initial loss….until today and now I am up 5 pounds! … my clothes are still fitting (but they may have stretched).
In the 2 months I have not had ANY bread, rice, pasta, sweets … (except for 2 cookies and a bowl of porridge). Typically this is what I eat … only whipping cream in my 2 cups of morning decaf coffee
2 eggs with spinach, cream, butter and sometimes a slice of tomato and sometimes 2 slices of back bacon and a spinkling of grated old cheese for breakfast.
Sometimes I skip breakfast and just have coffee and have a very early lunch as I am just not hungry.
lunch…a salad with green, cucumber, an egg, some bacon, 1/2 an avacado with oil and vinegar and a Tbsp. of Hellmans OR a can of tuna or salmon with greens, celery and onion and a good amount of Hellmans
dinner…. a steak, pork chop, beef patty, chicken thighs with skin with broccoli, asparagus, your faux potatoes and/or a salad with greens, tomato, cuc, oil and vinegar and a dollop of mayo.
I am never hungry and I rarely snack. In the 2 months my snacks have been a handful of raw almonds maybe 2X a week and I have had a stalk of celery 4X with peanut butter.
I have indulged in a drink or 2 about 2X a week…I’ll have a scotch with soda water and 2 glasses of dry white wine with dinner.
I am 58 years old, am still premenopausal, 5′7″ and wear a size 16 …185lbs.
What do you think?
Andrea
Dr. Jay’s Reply:
It looks like you are eating the right foods and I certainly don’t see too much carb sneaking onto your plate from what you have written. A couple of things to consider: thyroid production goes up when you eat a high-carb diet and comes down when you cut carbs (I believe this happens because an increase in metabolism driven by increased thyroid output would help the cells burn off the glucose that the body needs to get rid of when you are eating lots of carbs – just my opinion). When you are doing everything correctly and still not losing weight it may mean your thyroid levels are too low. This is something that can be easily checked by your doctor.
Another possibility is that you are “remodeling”, that is, that you are losing fat but are building muscle at the same time with a net zero loss in weight. This can happen when people with insulin resistance have wasted their muscles, the typical “apple on toothpicks” body type, where there is fat around the middle and the legs are thin. Correcting the metabolic problems by cutting carbs can result in a rebuilding of the wasted muscle even if you aren’t trying to build muscle through exercise. A third possibility is that you have hit a weight loss plateau for reasons that are unclear. In the last two instances, simply staying the course while taking care that you aren’t inadvertently eating carbs in some form should eventually get you back on track. We all reach a plateau at some point and I don’t know why. In my case, I would like to lose about another 10 lbs but I just can’t do it (my wife thinks I am already too thin). Even though I have more body fat than I would like, I take great comfort in knowing that my metabolic and inflammatory markers are excellent.
Hi AndreaK,
Here are some thoughts on your weight stall. You may have developed a sensitivity to dairy products which could cause you to retain water, masking further weight loss. I am not saying you have a classic dairy allergy, but perhaps just a sensitivity to it. I know I do and I grew up eating dairy but discovered it caused me to plateau despite eating very low carbs. It was difficult for me to believe this but I reluctantly tried omitting all dairy and the scale quickly resumed a downward trend. This was not merely the result of cutting calories because I purposely added calories to make up for the lost dairy calories. Try cutting out all dairy products or at least all dairy except for butter if you must have it. Best to go cold turkey and cut them all out though. Try this for 7 days and see if the scale number drops. Also, I find I can get away with unpasteurized sheep cheese but quickly bloat with cow dairy products. So experiment if you feel you need to eat dairy but you may feel much better without it. Nothing ventured nothing gained.
Since saturated fat is vital for health and metabolism — replace butter with organic virgin coconut oil. It contains naturally occurring MCT (med. chain triglycerides) and many — including myself — have found it absolutely kickstarts weight loss. It is delicious as a dressing or for curries etc. There are several brands available — I like the one from Tropical Traditions.
Also, while calories don’t count as much on low carb, they still count to some degree — especially for women. As you lower your weight, you should try slightly cutting calories. I do not mean go low calorie or slavishly count every calorie. I just mean to slightly, ever so slightly, reduce portions. For example, I used to eat 3 egg omelets with 3 turkey sausage links for a typical breakfast. Then I realized that I was just as satiated with 2 egg omelets and/or 2 turkey sausage links. I had just eaten more out of habit. Make sure you aren’t eating unlimited amounts simply because meat has practically zero carbs. Also, I grew up eating huge American size meat portions ie 12oz or more per serving and I am a short female! Now I realize that I can be just as satiated on 4-5 oz per meal so long as the cuts are sufficiently fatty.
Try incorporating unsweetened, organic oolong tea into your regime. Green tea — organic sencha — unsweetened is also good. Add a little cinnamon and powdered ginger but no sweetener. Use cayenne in your seasoning.
Do not use any artificial sweeteners — you may have a sensitivity to them.
Thyroid problems are endemic, especially amongst we gals and especially amongst us gals who are middle-aged plus. So definitely find a competent doc to check out your thyroid. I highly recommend 2 books on this topic: the classic by Broda Barnes MD “Hypothyroidism: The Unsuspected Illness” plus a new classic by the Dr. Mark Starr MD “Type 2 Hypothyroidism”.
Realize that food sensitivities are common and often go undiagnosed. That is why you need to omit certain common food allergens one by one and see if your weight begins to drop. Common culprits: nuts, eggs, dairy products, wine. I know these are low-carb staples but for some reason, they can cause stalls and are common allergens. Don’t waste money ofn dubious allergy tests or expensive close-minded allergists who only believe in the notoriously unreliable skin scratch testing — simply omit certain foods for 7 days and see how you feel. You know your body best. You can develop a sensitivity to anything you ingest or perhaps the molds (cheese and peanut butter for example are naturally moldy foods) which is causing water retention or affecting your metabolism.
Finally, walk for an hour a day — preferably first thing in the morning BEFORE breakfast. If one hour is too long, then start with 30 minutes. Up and at em for 15 minutes at a brisk clip then turn around and come home — reward yourself with a nice low-carb breakfast.
I’m sorry to be so longwinded and I hope what I’ve written can be useful to you. Best of luck and if you take it one day at a time and try not to get discouraged, I know you will succeed. Don’t let small setbacks throw you off course. Persistence is the horse that wins.
Dr. Jay,
I hope you will post something when Dr. Phinney comes out with the important results you mentioned above. I look forward to this.
I note an article was published in the American Journal of Clinical Nutrition by researchers at Guelph who found that caffeine consumption caused temporary insulin resistance. The participants who had caffeinated coffee (5mg/kg) an hour before or with breakfast and ate low glycemic cereal (75 grams of carbohydrates) had blood sugar levels increased by 250% compared to those who drank de-caffeinated coffee.
I have berries with breakfast and so I have now switched to de-caffeinated green tea and eat my chocolate later in the morning.
Dr. Jay’s Reply:
Caffeine is known to cause a temporary rise in blood sugar by briefly increasing insulin resistance and by causing a surge of adrenalin. While these seem to be undesirable effects, it also appears that coffee consumption is associated with a lower risk of type 2 diabetes. I know Dr. Atkins advised his patients to avoid caffeine because of the short term effects on blood sugar and insulin levels. For people who are very sensitive to the obesogenic effects of insulin, caffeine may impair weight loss on a low-carb diet. Personally, I like my breakfast tea even though it has some caffeine and this is probably why I still have about 5 lbs more subcutaneous fat than I would like.
I have been following the Atkin’s Diet for about four years now. It was a result of finding that the diet is the only one close to a First Nations diet that I could find that had something I could follow. Do you have a book or the handout that you were giving people that I might go to my doctor and use to work with?
Nanaskomon, (In Thankfulness in Cree)
Katryna Smith
Dr. Jay’s Reply:
Unfortunately, I don’t have anything in print yet. It is something that needs to get done. I have been thinking of a resource specifically for doctors, too, since we get zero training in this and nobody is providing continuing medical education on this approach, either. Now the the American Diabetes Association has included a low-carb diet as a valid option for weight loss, my physician colleagues will need to learn how to guide their patients who want to try it. Hopefully we will have a clinical practice guideline before too long.
I very much enjoyed your “Big Fat Diet” DVD. It reminded me of a diet two doctors in Winnipeg put me on in 1969. It did me so much good, I have stayed with it to this day (with some backsliding from time to time over the years).
Everytime I get into trouble with my health it’s usually because I have fallen off the “low carb wagon”. As soon as I get back on that diet my HQ (health quotient) goes way up. I believe that it is vested interests and institutional paralysis that is keeping the average person from benefitting from this diet.
Some researchers have said that type “0″ blood types are more susceptible to diabetes and alcoholism and that most native populations in the world are blood type “0″s. I am not native but my blood type is “0″ and so will continue to adhere to what has been called the “paleo” diet which is really just another name for a low carb diet.
I’ve been waiting for you a long time Dr. Wortman (almost 40 years). By now you must realize the extent of the forces that are marshalled against you and anyone else who dares to question the wisdom of the current medical paradigm. I know that you are on the right track. Don’t give up. There is reason for optimism. Eventually sanity will be restored to a badly failing “disease care system” and the health of your people and mine will be restored.
Dr. Jay’s Reply:
Thanks for sharing your experience and for your support. I agree that the weight of the evidence will eventually carry the day but it won’t happen without some scrapping. There are big vested interests that are threatened when people shift their eating habits and get off their drugs.
Dr. Jay
I equate these vested interests with tobacco and cigarette makers. — They genuinely believed that what they were (are) doing was right and good.
That’s hard to imagine but that’s how it is. — They would stand in front of god himself and profess their good intentions. — What he might respond with would also bring them to there knees!
Dr. Jay’s Reply:
Individuals are capable of self-delusion and may actually believe a harmful practice is good or are capable of perfidy where they know it’s not good but tell you otherwise. Corporations, on the other hand, are a different kind of entity. They exist for the sole purpose of enriching and protecting the interests of their shareholders. When anti-tobacco efforts were a threat to the bottom-line of the tobacco companies, they did everything they could to protect themselves. This is normal corporate behaviour. In fact, it is mandated by law. Henry Ford was once sued by his own shareholders for paying his assembly-line workers more than the minimum wage. When something like low-carb comes along, which threatens the bottom-line of food and pharmaceutical corporations, they will fight to protect their interests just as the tobacco industry did. Of the people who do this work, some will actually believe in what they are doing while, unfortunately, there appears to be no shortage of the perfidious type who do it in the full knowledge that it is wrong. I recall that memorable scene of a bunch of tobacco CEOs standing in front of a congressional committee and swearing that nicotine was not addictive. I fear we are up against the same kinds of adversaries when it comes to getting the crap out of our diet.
Dr. Jay
Your right, there are many who would actually enjoy causing pain and suffering and laugh all the way to the bank. — I forget about that sometimes.
Speed is famous for self centeredness and sadism and masochism.
I’m the guy that thinks that sugar and hybrid carbohydrates are speed.
Carbohydrates are like speed. — Those on top excel and those on the bottom degenerate.
Dr. Jay’s Reply:
I have observed significant improvements in mental health and well-being associated with restricting dietary carbs. It may have something to do with the anti-inflammatory effect of the diet. Being in a state of insulin resistance with high inflammatory markers has got to make you grouchy. Reversing those conditions on this diet should make you feel a lot better. Personally, I find that my irritability threshold is much higher – it takes a lot more to make me angry or upset and I am better at coping with stress. There may be other factors at play here as we also recommend avoidance of the high omega-6 vegetable oils, too, which should also reduce inflammation. Sugar and, especially fructose, also tend to promote inflammation and these are, of course, gone when you follow this diet. All in all, the anti-inflammatory effect of low-carb may be the key to a lot of the benefits you get from eating this way.
Dr. Jay. I have read Taubes’ GCBC and watched the lecture at Berkeley that you have on your external links. Thanks for that link!! I’m a massage therapist and every client I see gets referred to that book and video clip. God Bless the CBC!!
Dr. Jay’s Reply:
That’s great! I am also recommending Michael Pollan’s recent book, “In Defense of Food”, for those who need a quicker, lighter version of what is wrong with the way we currently eat. Gary’s book is still the definitive one in terms of understanding the history of nutritional science and why a low-carb diet should at least be considered a valid option, if not the preferred option.
Dr. Jay: Sorry, God bless you, too!
This blog gives me encouragement because the clinic I work in has a cardiac rehab program that follows the typical “dietary fat is the root of all evil” theory of heart disease. It drives me nuts! I’m a voice crying in the wilderness. If anyone who runs an enlightened clinic would like to rescue me from this I would be happy to send them my resume. Help!!
Fred Cory, RMT
Dr. Jay’ Reply:
Good luck with that. Hopefully, as the evidence continues to pile up, clinical guidelines will change accordingly. In the meantime, have a listen to this NPR item on saturated fat where Gary Taubes debates Dr. Ron Krause, a leading lipid researcher: http://www.npr.org/templates/story/story.php?storyId=15886898
Dr. Jay
I also feel far the better emotionally and sensitive with my ‘low-low carb’ lifestyle. Also my stress threshold is far better. — Peace and energy is what I have and all rolled into one! –It’s like a new lease on life for me! — I’m no longer running fast and living in a dream world and living with anticipation and discomfort all the time. — I’m right here, right now and it feels great!
http://www.metacafe.com/watch/625872/sensitivity_training/
Dr. Jay’s Reply:
As we have discussed in other posts, I really do think that there are mental health benefits unique to low-carb dieting. I think it is probably due to the significant anti-inflammatory effect of the diet.
BTW – I found the link quite funny although not related to the discussion.
Hi Jay: Watched the show and then I remembered you telling me about the diet. So after the show aired, I downloaded the PDF diet basics poster and put myself on the diet. So far to date, I have lost 31 pounds (weighed 211 and now 180). Although, I do not have diabetics-the rest of my family does (9 siblings and both parents). Blood sugar levels have been very low/normal levels. Told them about your project at the Atlantic Aboriginal Men’s health conference and the Atlantic Policy Congress of First Nation Chiefs has a yearly Health conference. Would you like to come out and present your finding?
Dr. Jay’s Reply:
Thanks for sharing your terrific results. I’ll be in touch by e-mail to respond to your invitation.
Dr. Jay
I think it’s hybrid carbohydrates.
Dr. Jay’s Reply:
It is tempting to blame carbs for everything but in this case the mice who ate a low-carb diet that was high in saturated fat had the problem with diabetes. Because they changed a lot of variables it is hard to figure out what might have caused the diabetes.
Dr. Jay
I actually do blame everything on carbs. — Just like I blame hemp rope and hemp sails and hemp smoke and Egyptian mythology for fostering most or all of the current religions and beliefs in this world. — An out of this world experience.
My hypothesis is that hybrid carbohydrates are potent, powerful, stimulant drugs, that have a profound effect on our human Psyche as well as our bodies and minds and our entire existence.
I also believe that caffeine is a major player in all this.
I won’t mention alcohol.
I fully realise that this sounds far fetched and ‘out there’. — This is the first time anybody has ever had an answer as to why man became the monster he became.
The Inca took hybrid maze to unimagined levels not entirely unlike the Egyptians did and as far as we can tell with no other likeness and difference and similarity while being continents and oceans apart and thousands of years ago in our existence.
Hybrid carbohydrates.
It’s no small wonder if I am correct, that our pancreas is so profoundly effected by all this sugar.
I appreciate your allowing me to have a voice. — This is priceless.
Maize!
Very interesting work Dr. Wortman. I’m a big fan of your American colleagues Dr. Phinney and Dr. Westman as well.
Can this type of diet be used for Type 1 Diabetics as well? It seems that blood sugar profiles would improve dramatically as there wouldn’t be the normal pronounced postprandial glycemic excursion seen with carbohydrate ingestion. However fat metabolism might not be as efficient due to the fact Type 1’s need to administer insulin with every meal. Can Type 1’s rely on fat metabolism or is this compromised even with smaller doses of basal/bolus insulin dosages seen with similar protocols? At what serum level does insulin inhibit fat metabolism/hormone sensitive lipase activity? Thanks for any information.
I have put in a purchase request for My Big Fat Diet at our local library system in Salt Lake City, Utah. I think many people will find this film and your work interesting. Keep up the good work.
Dr. Jay’s Reply:
Thanks for your kind comments.
I do think there is a role for low-carb in the management of type 1 diabetes. The expert in this area, however, is Dr. Richard K. Bernstein who has been practicing this approach with his patients (and himself) for decades. He has written extensively on the topic and I have included a link to his website in the links part of this blog, for your information.
Type 1 diabetics cannot gain weight without injecting sufficient insulin to facilitate excessive fat deposition. At the same time they must increase their insulin intake in lock-step with their carbohydrate consumption. This combination of increasing carb intake and increasing insulin injections can lead to weight gain in type 1 diabetics the same way that increasing carb intake and increasing endogenous insulin secretion in non-diabetics does. In some ways, what happens in type 1 diabetics proves the hypothesis that weight gain is dependent on carbs and the action of insulin. Without both, type 1 diabetics won’t gain weight.
What do u think about the benefits of juicing vegetables and fruits with each done seperatly and not constantly but mainly for breakfast
Dr. Jay’s Reply:
I am not in favour of juices. If they taste good it is because they have concentrated the sugar content of the fruit or vegetable. Carrot juice, for instance, would concentrate the naturally occurring fructose of the carrot. Obviously, this is true in spades for any type of fruit. Since the avoidance of sugar, natural or otherwise, is central to a very low carb diet, I would not recommend juices. Now, if you were to make juices from non-starchy veggies, like cauliflower, broccoli, zucchini, etc. I might be okay with that but then, of course, the question would be – why bother when you can just eat the veggie, smothered in butter, salt and pepper?
Hello Jay,
Relative to our family history, so far none of my siblings nor myself have been struck with the disease. So far.
I am wondering about the new theory of gastric bypass that claims to clear up the diabetic symptoms, lowers cholesterol, and overall good results that are coming from this surgery.
Hope your well
Delores (Bittman) Jones
Dr. Jay’s Reply:
Hi Cousin! I am glad our family’s genetic tendencies haven’t been a problem for you. Yes, there has been some impressive literature on the rapid improvements people get following bariatric surgery. A lot of research is being done to figure out exactly how this works. I think it is because, after the surgery the stomach capacity is so small that you cannot eat much in the way of carbs, that you have to give priority to protein and fats. This would mean, in effect, that post-surgery these people are on a forced low-carb diet. We know from lots of clinical experience now that people who are strictly compliant with a low-carb diet get similar results. I think potential bariatric surgery candidates should have a trial of strict low-carb first. If they could remain compliant, I would bet that surgery could be avoided in many cases. Just my humble opinion.
Dr. Jay
My family has a Metis background I myself am only about an 1/8 but after watching your program it left me with this hope I haven’t had in about 9 years or so…. my family has a very high amount of digestive diseases such as Crohns and colitis as well as heart disease, diabetes, as well as fibromyalgia and almost all of us on my mother’s side stuggle or have struggled with weight issues its pretty rampant throughout our whole family I myself have been treated for Crohns and fibromyalgia … I am sorry its all a really long sort of confusing story but I guess what I was asking was is there any way that the digestive issues stem from our native heritage? … I really admire your work I watched your documentary last night and I couldn’t believe how much sense it all made… you are offering a lot of hope to a lot of people … I just wanted to say thank you
Dr Jays Reply:
Thanks for sharing your story. I don’t know about fibromyalgia, but I do think those digestive problems are related to diet. I think that carbs, especially refined carbs like flour and sugar, can be irritating to the bowel. There was a study last year in Australia where they put people with inflammatory bowel disease on a low-carb diet and they got better. If you have weight problems, there is a high likelihood that this diet would help with that, too. Many of us have developed insulin resistance and recent research is showing that cutting carbs is the best way to treat problems related to insulin resistance. One of those problems is weight gain. Others include high blood pressure and cholesterol problems. I would encourage you to give this a try. Read everything on this site and you will have all the information you need to succeed. Be careful if you are taking medications for blood sugar or blood pressure.
Good luck!
Dr, Wortman if you haven’t read these books grab them.
Nutrition and Physical Degeneration by Weston a Price
Nourishing Traditions by Sally Fallon
Go to http://www.westonaprice.org
KEEP UP THE GOOD WORK THIS TYPE OF INFORMATION NEEDS TO GET OUT! if you have any questions email me a info@daxwilcox.com
Dr Jay’s Reply:
Thanks for those suggestions. I am familiar with the work of Weston Price and his book and Sally Fallon, too. It’s all good and very admirable considering when it was done.
Also, check out the book biochemical individuality by Roger Williams
and Metabolic Typing by Walcott and Fahey.
In Health,
Dax Wilcox
Hi Dr. Jay:
i recently went on a website that had recipes for a bread and pizza crust that are made with flax seeds. What do you think about them? The site is About.com.
I really miss bread but don’t tolerate it very well (puts me to sleep).
Thanx in advance for your opinion.
Dr. Jay’s Reply:
The cravings for our favourite carbs can be quite strong. Early on I tried some of the substitute low-carb breads but found them wanting. After awhile it occurred to me that the trick was to get over the craving and to modify my way of eating so that the carbs that used to be central to my diet were gone and a new and different pattern had taken over. It reminds me a little of the vegetarian products that mimic meat. Why, if you are committed to being a vegetarian, would you want to eat fake meat? It just doesn’t make a lot of sense to me, so I stopped seeking products that are essentially fake carbs. I know this probably doesn’t help if you are craving your favourite bread. I understand that flax meal is relatively low in carbs so I wouldn’t discourage you from trying it but I would also caution that too much of something that is low in carbs can still cause your total carb count to add up. You may find, as I did, that these substitute carbs aren’t worth the trouble.
Dr. Jay,
The institutional diet in federal penitentiaries across Canada relys almost exclusively on refined carbs and sugar. This is having a huge impact on the health of federal prisoners in medium and maximum institutions. Someone inside Saskatchewan Penitentiary informed me that the incidents of Type 2 diabetes and heart disease is very high, diagnoses that have developed since the prisoners were incarcerated. A study of the institutional diet would be interesting from a nutritional/health point of view. The Aboriginal population is over-represented inside all Federal Prisons, so the results experienced in the Alert Bay project may be duplicated inside an institutional setting.
I have been following your Big Fat Diet story with great interest, as it parallels my own story. I followed the South Beach, lost 60 lbs, and got off Type 2 meds completely, and follow a carb restricted diet and have maintained my weight/no meds status for over 3 years now.
Dr Jay’s Reply:
Thanks for your comment. I agree that there is much work to do in the corrections system. There have been some interesting studies done on omega-3 supplements and mental health in prison populations. They showed that inmates behaviour improved with increased omega-3. I imagine that the standard prison diet would be low in omega-3 and high in omega-6 on top of the high sugar and refined carb content that you point out. I would love to do a diet study in a prison population sometime. Nutrition is so important to mental health and this would be a big part of the problem for prison populations.
So much to do and so little time!
Dr. Wortman. I watched the documentary that was re-aired about the high fat diet you proposed in Alert Bay. I can see what you were trying to do and thought I should tell you little about myself and my quest for bettering my health. A few years ago I was diagnosed with type 2 diabetes while I was working on a rather stress evoking project. I like anyone listened to my doctor and took the pills that was prescribed to me and all seemed to be better. however the weight continued to slowly incline as the years went by. I met my wife while in Japan working their during a three month exposition on future technologies and lost approximately 20 kilograms due to the amount of work I was doing and the high temperatures I was working in. upon returning to Canada I yet again ballooned to a high weight of 145 kilograms. I pursued helped and found a fantastic doctor who thought he could assist me in the right direction. I proceeded to follow his directions and immediately stopped taking the pills that was prescribed by my family doctor, now don’t get me wrong, I understand my doctor was not a specialist in diabetes so she knew no better than to follow what the medical book tells her to do. I quickly learned that the pills I was taking was actually part of the problem. Metformin causes you to have to eat every four hours in order to maintain your sugar levels. The two pills I was taking to handle a possible degradation of my kidney function was also something that I was not informed about. One pill helps with the assistance of normal kidney function while the other was actually designed by the Pharmaceutical company to fool the tees to give me a false sense of hope. After removing these pills from my daily intake I started to feel much better. drinking four liters of water per day along with a high intake of LOW FAT proteins, NO FAT cooking and high intake of green vegetables with absolutely no carbs, no fats and no sugars. I lost over 31 kilograms in 3 months. I actually lost 3.6 kilograms in one night and found out about KETOSIS and the loss of harmful body fat through urination. The understanding of current TREATMENT and not CURING of PATIENTS not PEOPLE has caused me to be an advocate of helping people find a cure for diabetes and to stop the treatment for financial gain by medical practitioners and Pharmaceutical companies. I hope your program is successful and I noticed one doctor mentioning on the documentary that this diet is harmful to aboriginal people. However through my education and self practice, aboriginal people can handle a high protein diet without repercussions and these doctors with their concerns are misinformed and focus on the current food guide is only about Caucasian people and is biased on it’s opinions of what we should eat. Native people from North America can eat a high protein diet without major health concerns. The damage we do before the diet is why we should have a doctor monitor us during the diet, not the diet itself. Family Doctors need to stop worrying about purchasing their houses and expensive cars with seeing 50 patients per day and focus on curing the people they are supposed to be helping and stop treating patients with expensive pills and outdated ideas that we are all the same. It takes several generations for a genetic makeup to change and my people are only on our first generations because my parents generation was still eating our traditional diets. it is the next generation with fast foods and high carbs and sugars that are going to have more problems with health and with our people having health benefits covered by the Canadian government, it will tax the system to the point of every Pharmaceutical company become a juggernaut that cannot be stopped by our future generations no matter what we do.
Dr Jay’s Reply:
Thank you for sharing your story and congratulations on your success.
I think you are on the right track in cutting out sugars and starches but one thing I would suggest is that you may find it hard to sustain this without adding fat to your diet, especially after you stop shedding weight. It is possible to eat a low-carb diet relatively devoid of fat while you are burning off your internally stored fat. Once the weight loss stops, however, you will need to start getting those calories from your diet again. The best way to do that is to increase your intake of fat. The fats that come from meat and dairy are good as is olive oil and to some extent canola oil. You also need to get certain “essential” fatty acids (like omega-3 and omega-6) from dietary sources as they are not something we can manufacture internally. They should be in balance, however, hence the advice to avoid the high omega-6 oils as much as possible.
Congratulations on your new baby. I wish I had been a “low-carber” when I was pregnant – I had pretty severe nausea and very complicated deliveries.
I would love to correspond with you if you the time when you are on parental leave. My family story is quite interesting, I believe, and perhaps may prove a testimony to the efficacy of low-carb diets for families with the genetic condition that appears to plague all of us (My sister and I call it our “evil gene.”)
I posted a bit on one of the other threads. My name is Peggy and I live in Nebraska and have been ultra-low-carb for 10 years. My brother, sister, daughter , and son have all had health improvements from varying degrees of carb restriction, and I have become somewhat of a militant proponent of the low-carb approach. I hope to correspond with you soon. And I’m devastated I missed the broadcast, but perhaps will buy the DVD. I will definitely buy your book. For now, “Good Calories, Bad Calories” is my “bible.” (My son used the cover as the opening slide in the power point of a persuasive speech he gave in a college class – to persuade people that low-fat diets were not necessarily healthful!)
Dear Dr. Jay,
Can this work for a Type 1 diabetic on an insulin pump? My insulin is strictly manual.
How do I deal with hypoglycemia when carbs are used to elevate glucose levels?
Can you provide me with the recipe for the cauliflower fried rice?
Thank you, Rebekkah
Dr Jay’s Reply:
Reducing carbs can be beneficial for type 1 diabetes. The expert in this area is Dr Richard K Bernstein (click on his name in the links section to go to his website). Type 1 diabetics are always going to need some insulin but by reducing carbs the amount required will go down. Yes, if you do experience hypoglycemia as a type 1 you will need to consume glucose to recover. It appears, however, according to Bernstein that the risk of hypoglycemia drops significantly with the amount of insulin you need to take. I would recommend you study Dr Bernstein’s material if you are thinking of trying this.
Eva, who you met in the documentary, developed the cauliflower fried rice recipe. I believe she just used crumbled pre-cooked cauliflower instead of rice. If you want to try this I would recommend using your favourite fried rice recipe and substituting cauliflower for the rice.
Hello Dr. Jay and producers of My Big Fat Diet:
I thoroughly enjoyed the documentary that was re-broadcast. Thank you for a job well done. I learned something about current First Nations culture on Vancouver Island, as well as how an Atkins-like eating plan could work at a community health level.
The question I have for Dr. Jay is whether you will be experimenting with the gradual phase-in of more carbohydrates in the diet…as this is what is supposed to happen with an authentic Atkins plan. Every individual body can come to an equilibrium controlled weight with differing amounts of carbohydrate.
It would make for a fascinating follow-up documentary to see if the phase-in of carbs can bring stability to peoples’ weight loss.
Sincerely,
Helen
Dr Jay’s Reply:
Thank you for your comment.
You are correct in that the Atkins diet has phases where carbohydrates are gradually increased until weight gain recurs, at which point one has found their limit in terms of carbohydrate tolerance. In the study, the diet we tested resembled the “induction” phase of Atkins in that it was very low in carbohydrates throughout. In fact, many people did start introducing carbs, often in the form of fruit. We suggested that berries would be okay if they are inclined to do that. We didn’t formally study the reintroduction of carbs along the lines of what Atkins recommends. We did discuss with people the fact that everyone has a genetically predetermined threshold of tolerance, above which they would experience weight regain and a recurrence of other problems related to cholesterol, blood pressure and blood sugar control.
It is my personal opinion that, once a person has developed metabolic syndrome and/or type 2 diabetes, they are, in effect, intolerant of carbohydrates and that the best diet for the long haul is very low in carbs. I think a major reason that people regain weight after successful weight loss on the Atkins diet is because of the re-introduction of carbs. Although, in theory, it makes sense to gradually introduce them to find your limit of tolerance, in practice I think for a lot of people it gets away on them and they resume eating carbs and pay the price in terms of weight regain.
Lately I have been intrigued by the key role that fructose plays in all this. I wonder whether, with strict avoidance of fructose, one could possibly reintroduce carbs without weight regain. This is just speculation at this point. Hopefully we will have some research to answer this question soon.
Failure…
Hello Dr. Jay, I watched the doc last year, and it inspired me to resume eating low carb, or as I prefer to call it, paleo. I’m male, turned 60 last week, and in the 1970’s, did Atkins, with great success – people didn’t recognize me after 6 months, and I’d never felt better. Unfortunately, family life precluded eating “weird”, and I eventually weighed close to 400 lbs. I managed to lose some weight, and have stabilized at 330-340 for the past 15 years. All along I’ve had hypertension, high cholesterol (esp trigs), and high glucose.
In May ‘08, I eliminated all grains, sugars, and PUFAs (from veg oils). My only cheat was beer on weekends. I started taking fish oil and vit D3. I saw my doctor in Oct ‘08. His words were very simple: “I don’t know or care what you’re doing, just keep doing it.” My AiC was 5.4, my trigs were low, and I’d lost 30 lbs. I felt great. (Unfortunately, my BP was still very high.) This continued ’til April of this year, by which time I’d lost 50+ lbs. Then the weight loss stopped, and I suspected something was wrong.
Last month I saw the doctor (a new one, the old one had retired), and shocker…my fasting glucose was 12.5. I’m not doing anything different than when I started this last year. I’ve been testing at home for the past month, and the range is 12 – 16. The doc says my cholesterol is high, but I disagree with her, my trigs are still very low. She wants to put me on Metformin. She’ll probably also suggest a statin, which I’ll absolutely refuse.
So now I’m exploring other options – chromium, alpha lipoic acid, vanadyl sulfate, high intensity resistance exercise, posting this comment – in an attempt to avoid the Metformin. I still eat paleo, and I attempt intermittent fasting, frequently not feeling hungry till late afternoon, and I’ve cut out the beer. I’m still at 280 lbs, so I’m not losing or gaining any weight. However, I feel that I’ve failed, and contemplating diabetes for the rest of my (probably shortened) life is very depressing.
Any suggestions?
Dr Jay’s Reply:
Thanks for sharing your story. It sounds like you are doing everything right (with the possible exception of the beer).
Some general observations:
Cholesterol – you want to have low triglycerides and high HDL (good cholesterol). If you do, and your LDL and/or total cholesterol are a little bit high, it is not something to be overly concerned about. We know that LDL particle size is more important than overall LDL and if you have a good HDL/TAG ratio, it is an indication that LDL particle size will be healthy, too (have a look at the Lustig link for a good explanation of this). Unfortunately, very few practicing docs understand this, especially in the context of a low-carb diet. If you have a favourable HDL/TAG ratio (ie HDL on the high side and triglycerides on the low side) and you are eating very low-carb you should be able to safely avoid taking a statin.
Blood Pressure – this usually comes down with a low-carb diet and some exercise. If it doesn’t, it is important to get it under control and an ACE inhibitor type of antihypertensive is probably your best option. ACE inhibitors have the added benefit of protecting kidney function, too. Having said that, most antihypertensives can cause weight gain in a small percentage of people which means they can muddy the water when trying to trouble-shoot a stalled diet. It is important to keep BP under control so, if your antihypertensive is suspected, you might consider switching to a different one. Use google to find the adverse effects profile of the drug you are taking and look for hyperglycemia and weight gain to figure out if this might be the cause of your problem.
Hyperglycemia – it is perplexing to have high fasting sugars when you are not eating carbs. Three possibilities come to mind. One is that carbs are sneaking into your diet in quantities large enough to have an effect. One needs to carefully consider which foods might be avenue for excess carbs. In my case, I found that my tolerance was so low that I needed to eliminate nuts from my diet. The beer you mentioned is also a potential source of carbs in the form of maltose. A second consideration, somewhat linked to the first, is that your capacity for producing insulin has diminished to the point where you will experience blood sugar problems even on a very low carb diet. Some people are going to need to take metformin for this reason. A third possibility is that you have hepatic insulin resistance which causes your liver to produce glucose in excessive amounts. This is related to non-alcoholic fatty liver disease which is remarkably common in people who have metabolic syndrome and/or type 2 diabetes. From your history, I would expect you have had NAFLD to some extent over the years. This should resolve on a very low-carb diet. Another cause of fatty liver, however, is alcohol which means if you are resolving your fatty liver through carb restriction, you may need to also reduce your alcohol intake to get the insulin resistance in the liver under control. The other thing about alcohol is that it can make your blood pressure go up, too.
All this to say that you might want to look at cutting out the alcohol, or at least significantly restricting it, for awhile to see if that is the reason the diet isn’t delivering the benefits you expect. If this doesn’t get your fasting sugars under control you should seriously consider metformin.
Good luck and let us know how it goes.
Thanks for taking the time to respond. I’ll update you in a few months
Hi Dr. Jay,
I was curious whether at the time you were diagnosed with type 2 diabetes, you were overweight or had a high body fat %. My general question is whether even leaner people with no central obesity can develop metabolic syndrome from eating too much carbs in the long run.
Appreciating your help in advance,
Helen
Hi Dr. Jay,
Thank you for taking this way of eating out of the closet. Here’s hoping you can make a noise bigger than the grain and drug companies!
I have adopted this way of eating to control my weight as well as my lipids and general way of feeling. My questions is, do the foods eaten on a low carb regime cause or exacerbate gout? I have a son and brother-in-law who both suffer greatly from gout and so will not try to limit carbs because of this affliction.
I thank you for this opportunity for all the information on this site.
Penny
Dr Jay’s Reply:
Thanks for your note and sorry for the delay. Having a newborn (whose birthday coincided with your post) has kept me busy and is my current excuse for neglecting this blog.
Your brother may find his gout improves on low-carb. The reason for this is that fructose leads to increased uric acid output. Uric acid crystals are what causes gout. Fructose is found in anything that is naturally sweet as well in any form of caloric sweetener including sugar, honey, high-fructose corn syrup, molasses, maple syrup, corn syrup, etc etc etc. Since you avoid all these foods on a low-carb diet, it is also a low-fructose diet. I would suggest that someone with gout would have to be careful not to increase protein consumption too much, at least at the beginning, but I would expect overall there should be relief from gout, not the opposite.
Dr. Jay:
My community is a test market for a new KFC “sandwich,” and a local reporter did a story in which he had his blood lipids tested, ate the sandwich, then was retested. His numbers were: HDL 50 down to 39; LDL 145 up to 155; triglycerides 135 up to 215. He used this data as “proof” that the fat (no transfat,mostly saturated) had caused these horrible changes.
The product was two breaded. fried chicken patties as the outer “holder,” (no bun) sandwiching cheese and the “Colonel’s special sauce. 590 calories, 280 from fat. No mention of carb count or what was in the sauce, or whether the chicken was processed or what kind of cheese.
I am wondering about the accuracy of blood tests immediately following a meal. I am wondering why his blood lipids appear to have reacted in a manner that is the opposite of what has been seen in longer term studies of low-fat vs low-carb. Of course, without knowing the carb count (and I expect that it was high due to the breading and suspect the sauce is full of HFCS), this is not a low-carb food and it is possible the ill-effects were due to the carbs.
I have emailed my questions to the reporter and will report back if I get the answer concerning the sauce, carbs, etc.
In the meantime, I interested in your reaction to this.
The newspaper story cited this statistic: Every point your HDL drops, your heart disease risk goes up 10%. And implied fully that dietary fat is the culprit.
Peggy in Omaha
In response to Helen:
I have no trunkal obesity – I carry my weight in my hips and thighs. (I have never actually been overweight, to tell the truth – just a bit “chubby”). However, my sister is a classic apple shape. She is official “Type II” while my very slim brother and I have never hit the “magic number” to be diagnosed, but have severe reactive hypoglycemia and other severe reactions to eating carbohydrates. My son is very thin, but has “ADHD” responses to carbs. My daughter weighed 320 at age 16, lost half the weight, but is still a bit heavy in her thighs. (She had to have massive amounts of skin removed from her abdomen and under-arms – which may have also removed some fat cells? would like someone’s take on that.) So, in my family, we are all insulin-resistant. In my generation and the next, the men tend to be quite thin but subject to emotional swings from carbs, and most of the women have trunkal obesity, except for me. I have a very tiny slim waist and no fat on my ribcage. If I get into “carb creep” I know immediately by small “love handles” just above my waist towards the back. So I guess I’m the odd one.
Another comment:
As I read more of this blog, I am more and more interested in the postings here and feel compelled to respond. I just read the question about bariatric surgery, and, as always, really appreciate Dr. Jay’s reply. My daughter, who weighed 320 pounds at her “peak’ at age 16, lost about 150 over several years with diet (modified low-carb – she prefers to be vegetarian but eventually became resigned to the fact that her heredity would make that difficult) and intense exercise. What a marvelous accomplishment for a young woman! However, by the time she graduated from college, she had massive amounts of loose skin everywhere. That is a side-effect of major weight gain/loss that few people mention. I have an acquaintance that suffered the same fate after bariatric surgery. My daughter commented once that “I worked so hard to lose weight and I’m still a freak.” It was so tragic, especially since she is a talented actress in a society that demands physical beauty for performers of her age group. She visited a plastic surgeon and arranged for surgery, only to discover that her insurance would pay for it. My acquaintance, on the other hand, had the same procedures and her insurance covered it because it was the result of the bariatric procedure. (Dr. Jay, being from Canada, might be interested in that little detail, especially as we debate public health care in the US) Fortunately, between my mother and me, we came up with the $15,000 plus for the operations and my brave daughter endured the pain and rehabilitation of two stints of operations (abdomen and under-arms performed in two separate “bouts”). She is much more comfortable now and has a slim midriff and torso, but is left literally and emotionally “scarred for life.” She is convinced that she will never have the career she wants because of the visible scars. She still has some extra skin on her thighs that leaves them looking heavy, but really can’t afford the cost and trauma of more surgery.
As her mother, I am laden with guilt that her life was so severely impacted by my mistaken belief in feeding my family a low-fat, high-carb diet. I have no doubt she suffered malnutrition and near starvation that lead her to have disordered eating as a child. She still is prone to bulimia when under stress. I write this so that anyone considering massive weight loss be warned that there are some side effects – especially if the weight is gained or lost quickly. Also, for parents with metabolic syndrome and insulin-resistance in the family, to feed your children a low-grain, low-sugar, low-processed food diet from the beginning and not to listen to the medical establishment. The saddest part of this is that her father is an MD in internal medicine and sports medicine and still believes in low-fat, low calorie diets. His health is a disaster!
Oops – I said her insurance WOULD pay – when it should read that the insurance WOULD NOT pay.
Hi PHolloway:
Thank you for your response to my previous post. I am now posting in the other string as I think Dr. Jay wanted to divert comments there.
From I read, yes extra fat cells are created as we become obese. Those who lose the weight retain the original fat cells, which sits there like empty sacs and thus the excess skin and subcutaneous tissue. After my childhood as a obese person, then two babies, I am fairly lean but retain those belly rolls of extra skin.
It sounds like your husband has perfect insulin sensitivity, and does not produce so much of it when exposed to carbs, so that eating carbs does not get away on him. For people like that, it seems a low-fat, high-carb eating style works fine.
Helen
Thanks for your input, Helen. However, my daughter’s father (not my husband anymore, for reasons that may become clear in this diatribe) has diabetes in his family and his health is a nightmare. My kids report that for him, breakfast is a handful of m&ms. He has always believed in low-fat, low-carb in spite of the terrible consequences on his family and, himself. He has always had memory and concentration issues very much like my son, and borders on paranoia, obsessive/compulsive disorder, etc. He has had major health problems that I won’t go into here, but they almost defy belief. His weight yo-yo’.s When I first started dating him, he weighed 230 pounds and he gained even more when he was in medical school and stopped competing in college sports. When he feels like he is overweight, he goes on a starvation diet. He has horrible emotional mood swings and some real cognitive impairment. (I am amazied that he continues to practice medicine, although he mostly works as medical expert on worker’s comp cases rather than seeing patients) So, no, I don’t think low-fat, high-carb is appropriate for him!
Dr Jay I just wanted to thank you for the referral to atkins. I read about your big fat diet and tried to find as much info as possible, your science made sense to me. When I couldn’t find enough info to follow the diet I read your advice to others to try atkins. Lost 9lbs in 4 days! Gotta say thank you so much for the advice!
Dr Jay’s Reply:
Thanks for sharing your story. I hope you have continued success.
I am a grocer and the only book I sell/give away is the Taubes book. I also send as many as I can to your site. Enough praise. I also push Vit D – a given. Vit C – if glucose supplants vit C and vit C is needed for healthy connective tissue, then, there would be a less trouble with VLDL and LDL. Iodine, ( a suprise ) our food comes from the same old fields, the dairy no longer uses it for cleaning and the Dr. tells us not to use salt (iodized). The solution for a sluggish thyroid is to supercharge the gland even when there is no iodine to work with. Magnesium, selenium, chromium. And last, Q10/ALA , if q10 declines with age and the heavy demand gets all the q10, then what happens (no one says ) to the less muscular demanding parts of our system? colin, skin, eyes…
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???????? ?? ?????? ????????? Please feel free to ask questions or post comments about the documentary film, “My Big Fat Diet”, or anything you see on this site or its links…..