The economics of obesity; the obesity of economics.

By now we have all heard about the enormous economic impact of obesity. The direct costs include the money spent on the care and treatment of the myriad of medical conditions that are associated with obesity while the indirect costs are reflected in metrics such as absenteeism, presentism, decreased productivity and shortened life-spans. Those of us who have come to understand that this phenomenon is driven by global shifts in diet over recent decades are perplexed at the apparent incapacity of the mainstream practitioners of nutritional science to see the obvious. The paradigm of calories-in vs calories-out still dominates the consensus view on both the etiology of this epidemic and the prescription for its cure. Since I began speaking out about my own experience and the literature that supports LCHF, I have encountered dogmatic resistance from conventional nutritionists and dieticians to the degree that I am literally astonished when I don’t get that reaction.

I recently tuned into a podcast of Dr William Davis, the author of “Wheatbelly”, a new book on low-carb eating that has recently become very popular (you can find the interview here: Dr Davis, a preventive cardiologist, was being interviewed on CBC’s “The Current” and to counter his hypothesis that the genetic manipulation of wheat has led to food products that are harming us and are driving the obesity epidemic, they recruited a PhD nutritionist from the University of Saskatchewan. Now, I can see why they would want somebody from Saskatchewan as this is the major wheat producing region of Canada. And, since Dr Davis’ hypothesis is based on events that have occurred in the field of plant genetics, I think she was at a bit of a disadvantage. In any case, her points about low-carb diet were typical of the usual blather you get from that quarter. She began by characterizing this as the “Atkins meets Paleo” diet and then went on to mischaracterize low-carb diets as highly restrictive and completely dependent on the excess consumption of meat. These are old canards. The defenders of the status quo are forced to concede that a low-carb diet is effective for weight loss, because every study so far has demonstrated that, but they attribute this to its “highly restrictive” nature. In other words, you lose weight because you can’t find anything to eat, or anything that you want to eat. What rubbish! Just look at the photos of what I eat in the preceding posts to understand how ridiculous is that concept. Her parting comments were, “Move more, eat less. Wheat is not the enemy. Worry about overeating”. Great! That has been the mantra for the past forty years during which time the epidemics have accelerated. Einstein said the definition of insanity is doing the same thing over and over and expecting a different result. This is an esteemed PhD professor of nutrition at a Canadian university. Is it any wonder that we are in the fix we are in?

I am an early to bed, early to rise kind of guy. In a household with young kids this is the best time to read. This Sunday morning I was up at 5:30 perusing some of the financial blogs while everyone else, except the cat, was still sleeping. I am fascinated with the world of economics, especially since we have witnessed such upheaval in that sphere over recent years. We were severely buffeted by these events and that jolted me into the realization that I knew virtually nothing about something that could have very important consequences for our family. Nature abhors a vacuum, so I now read broadly in this area. What I have learned leads me to the conclusion that, just as we have been led into a terrible fix with the obesity epidemic, we are being led astray, in a very bad way, economically, too.

The paradigm that I have come to accept posits that the global financial sector has grown from a necessary but small part of a well-functioning capitalistic economy to a monstrous parasite that is sucking the life out of the real economy and will do so until both the host and the parasite are moribund. Consider that in prior periods, the proportion of business profits that went to the financial sector for the services they provide to the real economy was about 8%. By real economy, I mean the sectors that produce real wealth in the form of material goods like metals, food, manufactured products, etc. The complex economies that have arisen to support those wealth-generating activities rely on a financial sector which provides services to “lubricate” the functioning of the wealth producing sector. The financial sector doesn’t generate any real wealth. The profits that accrue there are skimmed from the wealth producers.

Okay, so far so good. Unfortunately, what has happened over the past 30 or so years, is that the financial sector has grown from 8% to approximately 45% of corporate profit. This is an enormous distortion. Something changed to allow that to happen. It was not that they were providing more and better services since, if that were the case, you would expect the growth of the wealth producing sector would have continued apace and you would not see this kind of enormous shift. What did, in fact, happen is that the financial sector was able to capture the political and regulatory sectors and neutralize them in terms of the constraints that had been traditionally put on financial activities. Many of these constraints were established as a result of the Great Depression and had endured for decades during which time economies prospered.

It is normal in a capitalist economy to have cycles of boom and bust. Some argue this is an essential and healthy feature. During booms, the appetite for risk-taking increases, productivity increases and the boundaries are pushed. When the boom comes to an end, the bust is the cathartic house-cleaning that resets the economy by clearing away the excessive risk-takers and the over-producers, and over-consumers, leaving in place those whose business strategies were the most sturdy and sustainable. Booms and busts can happen in any sector. Everyone remembers, for instance, the great dot-com boom and bust. In most of the world we are aware of a more recent real-estate boom and bust (we have been sheltered in Canada, so far). There was also the stock market boom and bust and then boom again, over the past three years. However, while these are what would normally be considered a cyclical series of events to be expected in an otherwise healthy economy, they actually have taken on a more ominous tone. Underlying the recent cycles is a manipulation of the credit markets of the world that has, in fact, driven this series of asset bubbles while, at the same time, ratcheting up the amount of credit in the system with each iteration of the cycle. Much of this is has been allowed to happen because of the work of economists from the “Chicago School” who believe in the inherent perfection of the market and the lack of any need for regulation. Alan Greenspan, the former US Federal Reserve Chairman, who presided over the inflation of a massive credit bubble over the past 30 years, was a high priest of this school of thought. It was he and some of his colleagues who were instrumental in dismantling the regulations that had constrained the financial sector since the Great Depression. They did so in the belief that the market would “self-regulate”.

Consider that when credit accumulates, in other words when debt accumulates, it is the financial sector that profits. The inflation of an enormous credit bubble to drive those asset bubbles and serial booms and busts, ratcheted up the wealth, power and influence of the financial sector. Of course, the financial sector itself can experience booms and busts. Banks go under all the time in the US, for instance, and the FDIC was established to clean up when that happens and to protect the funds on deposit. The problem we have now, however, is the rise of the “Too Big To Fail” banks. These are institutions that are deemed to be so vital for economic survival that, if they were to be allowed to dissolve the way smaller banks are, it would cause irreparable harm to the economy. Therefore, taxpayer money is used to bail them out.

How could a single bank be so important? It appears to me that it is because these large banks are interconnected to a degree that is at the same time vast and incomprehensible. Again, much of this is in the shadows precisely because of the interventions of Greenspan et al who successfully prevented open and public disclosure of how much risk banks were sharing with each other. This is the area known as “derivatives” and what some call the “shadow banking” sector. During the Clinton administration, Brooksley Born, the bright woman who ran the Commodities Future Trading Commission, proposed that her agency should start regulating the growing phenomenon of derivitives trading between these large institutions. Had that happened, most agree that the financial crisis would likely have been averted. Her reward: Greenspan, Ruben and Summers ganged up and had her literally run out of town. They then had legislation passed in the US Congress specifically preventing any regulation of this increasingly important banking activity.

What the banks were doing, and have been allowed to continue to do, with derivatives is astounding. Banks have to maintain certain capital requirements in proportion to the amount of risk they are taking with loans and investments. While these ratios have been serially relaxed during the Greenspan years, the banks have figured out how to escape the restraints of even the looser requirements. They do this by buying “insurance” from other big institutions in the form of derivatives and credit default swaps. The toothless regulators accepted that buying insurance would be acceptable in place of actually having capital on hand. The banks wanted this to free up the maximum amount of capital for them to invest for profit. This would have been okay if the providers of the “insurance” were actually regulated like real insurance companies are regulated. In other words, if the counterparties to these “insurance” policies were able to actually pay out in the event of a big credit default, the large institution that bought the “insurance” would not be at risk of failing and would not require a government bailout. What actually happened is that the TBTF banks to a large extent insured each other. That’s a neat trick because it effectively reduces the cost of the insurance to zero. I pay you a premium for my insurance and you do the same for yours – wink, wink, nudge, nudge – while everybody knows that a payout would actually be impossible and, all the while, the regulators gave this sham their blessing. I read somewhere that 80% of this activity was between the top five major institutions. So, it turns out that, instead of insuring and diversifying risk by using these instruments, the large financial institutions actually guaranteed that they were too big to fail by interlocking their fate with that of the other big institutions.

This problem of interlocking credit default swaps has not been addressed and is perhaps even worse now than it was when the big collapse happened in 2008. The reason? The banks like it that way. It allows them to gamble with the maximum amount of money from which they profit enormously while also insuring that, if they lose, they will get bailed out by their governments and taxpayers. This is what is known as “moral hazard”. This is the reason all eyes are on Europe at the moment where an inevitable default in Greek government bonds threatens to trigger a chain reaction throughout the financial systems of the large European economies and across the Atlantic into the US economy.

All these shadow banking shenanigans have had the net effect of protecting the financial sector from the inevitable boom/bust cycle. They never go bust. When they are, in fact, bankrupt they get rule changes and bailouts from government to exempt them from the fate of any other type of business that gets over extended with malinvestment. Not only is this a travesty, but by kicking the inevitable default further down the road, it is driving the build-up of a much bigger calamity than what might have been the case were natural cyclical events allowed to run their course. Banks have been allowed to hide their bad debts thanks to a rule change by the Financial Accounting Standards Board which lets them mark their assets to fantasy rather than to what they are worth in today’s market. What was considered fraudulent behaviour prior to the financial crisis became permissible after thanks to the lobbying of major institutions. This is an example of the power that the financial sector now wields. When they are losing the game they are simply allowed to move the goal posts. They have turned into a cancer that will not die until it has killed the host.

So, why am I ranting about the global financial system on a diet blog? It’s because I think the underpinnings of the global financial catastrophe and the obesity epidemic have similarities. I am talking about the paradigms upon which the systems are based. In the case of the financial crisis, it is the Chicago school and their beliefs in market perfection, minimal regulation and laissez-faire economics which led us down the garden path to the precipice we now find ourselves on. In the case of the obesity epidemic, it is the current calories-in/calories-out paradigm of the schools of nutritional science that have led us to the brink of disaster with the obesity and related epidemics. Both professions, the economists and nutritionists, and their respective institutes of higher learning have become bastions of defence of the status quo, impervious to paradigm shifting ideas whose validity is well established but convenient to ignore because they are orthogonal to the conventional wisdom.

Both professions resemble priesthoods where one must first be indoctrinated and learn the catechisms and where one is rewarded for perpetuating and protecting the belief system from all manner of challengers no matter how well ensconced in evidence and reality they might be. In my opinion, this is what we saw with the nutrition professor from Saskatchewan in her defence of the status quo in the face of Dr Davis’ new challenge. In the field of economics, we saw another example this last week when the (faux) Nobel prize was awarded to one of the architects of the theories that inform the Chicago School.

In both areas, there are rewards aplenty for those who toe the line – professorships, consulting fees, jobs with industry and even Nobel prizes. And, in both cases, there is little reward for being a heretic, no matter how right you might be.

One of the financial blogs I read daily is Zero Hedge. Go there to listen to an interview with Steve Keen, a paradigm-busting Australian economist, who articulates better than I some of the points I make here about economists:

9 thoughts on “The economics of obesity; the obesity of economics.

  1. Hi Jay,
    I’m not exactly on topic here, but I wanted to let you know… so happy to have found your blog! I order the Big Fat Diet, enjoyed it and applaud your work.
    It so crazy all the opposing views, no one’s sure what the best solution is. I started eliminating carbs, slowly close to a year ago and have lost 30lbs without feeling deprived one bit. In fact I have felt a lot better, energy wise , mood wise, you name it. So, through my personal experience and all the reading I’ve done, I’m definitely on board.
    I wanted to ask you if there are any stats on the percentage of First Nations people who are celiac or gluten intolerant? I will be cooking for a First Nations group this winter on Vancouver Island and have been trying to find some information regarding this ( this is how I found your blog) but there doesn’t seem to be much out there.

    Dr Jay’s Reply:

    I am not aware of a source that can provide those data. Based on my personal experience, I would recommend reducing gluten and maybe going so far as eliminating wheat as Dr Davis recommends. My reason for this is that I am beginning to think that there is a lot of sub-clinical gluten intolerance out there. I was never gluten intolerant, but after eating low-carb for several years, I now find that I am. What I think happened is that I became accustomed to minor bowel dysfunction and considered that to be normal. When I started avoiding carbs, it took awhile for my bowels to actually become normal and I find everything works much better now. Now, if I do encounter some wheat products, I get an instant bowel reaction. I think, in retrospect, I tolerated similar things in the past because I thought it was normal. This is why I find Dr Davis’ ideas intriguing and I suspect he is right in saying that we would be better off without gluten in our diets.

  2. By coincidence, I ran across Steven Keen’s work a couple months ago, too.

    I don’t recall you mentioning greed’s role in the financial mess. It’s at the root. The regulation you mention was designed at least in part to control greed.

    In the U.S., I think the gradual dismantling of the Glass-Steagall act of 1933, especially in 1999 by Republicans, is the source of our (US) problem. Until then, the commercial banks used by the hoi polloi were separate from investment banks. The latter were always allowed to take greater risks with depositors money. After 1999, commercial banking and investment banking merged. Greater risks were taken, bets were lost, and the taxpayers bailed out the banks.

    The federal bail-outs are also a major ongoing issue.

    Unfortunately, I don’t see much has been done about the underlying problems.


    Dr Jay’s Reply:

    Yes, greed is the driver of the whole thing. It is the reason we need regulatory frameworks in the first place, IMO. The repeal of Glass-Steagal was an important milestone in the dismantling of the regulatory system that had more or less constrained the greed-driven excesses of the financial system for so long. The inflation of the credit bubble, however, started much earlier than that and was probably the largest and most destructive element in this toxic stew. That was overseen by Greenspan and his acolytes, many of whom are still in positions of power under Obama. The continuity of the economics policies and principal players from Clinton to Bush to Obama is remarkable and telling in terms of who really controls the political agenda.

    Here’s another interesting take on the “science” of economics:

    Other sites I look at include: (fairly astute regarding financial issues, a bit extreme on the libertarian front), (commentary on financial and energy issues that is generally right on the mark), (author of “The Long Emergency”, a seminal work on peak oil, provides acerbic weekly commentaries on the dissolution of empire).

  3. I only recently discovered Wheat Belly though I knew William Davis’ other blogs already. I don’t necessarily think wheat (or anything else) is the ONLY factor in our current health crisis but it surely is a big part of it. A friend grows old varieties of wheat for the straw (for thatching) and it looks like a completely different species than the modern wheats he also grows for the grains. Apart from yield they select for disease resistance which probably increases the lectin content. I suspect the wheat germ agglutinin rather than the gluten is the factor that offends my metabolism, the only thing that spikes my BG worse than wheat is wheat mixed with other carbs.

    One of my other interests is engineering and industrial history. Here in the UK we have a tradition of innovation (look back to some of the Industrial Revolution and compare with the more recent Information Revolution and there are many parallels), but the Young Lions have had their teeth extracted by Big Business and Big Banking and Modern Management.

    There’s an equally damaging reaction in the dietary world. Nutrition is expensive. Removing expensive quality fats from manufactured foodlike substances and replacing them with cheap carbs (sugar and wheat in the UK, wheat corn and HFCS elsewhere) and industrial Omega 6 seed oils, then slapping on a LOW FAT!!! label provides a major markup, then prescribing statins and ACE/ARBs to overcome the defects of the diet is stage 2, Of course the obese need *more* food by definition, so you get to increase the size of your customer base without recruiting more customers. Diabetes? Sell them even more drugs.

    Win win win.

    This must be about the only profitable part of “industry” left. As for the rest of the financial business, if they were as bad at poker as they are at economics they’d be visited by large men in Italian suits (or Italian men in large suits) and be minus their kneecaps.

    Dr Jay’s Reply:

    I look at the foods that are advertised on TV and elsewhere. When you you ever see meat and veggies advertised? Never. The whole industry is based on foods where “value” is added through processing. The central aisles of the supermarkets are full of these heavily advertised products that are spun out of starch and sugar, for the most part. The industrial farms produce vast quantities of grains and corn which is processed with the addition of the high omega-6 oils and packaged in colourful boxes and sold for large profit. And, you are right, the penalty for consuming this crap is metabolic dysfunction and a compliant medical establishment that gladly prescribes truckloads of drugs for its various manifestations.

    The thing about the ineptness of the world’s financiers is that the net effect of the mayhem they create is that someone else pays for their folly. Consider that Wall Street bonuses remained at record highs throughout the period that the banksters have run the world’s economy off cliff. The greatest swindle in the history of the world is that they have been able to transfer those immense losses to the public purse while still rewarding themselves as though they were generating profits and contributing to the real economy. I think this is why people are finally rallying to occupy Wall Street and other financial centres around the world.

  4. Hey,
    I took classes from Dr. Whiting of the U of S. Her specialty is osteoporosis and corresponding nutrients such as Vit D, K, calcium, phosphorus, etc. I really don’t why she was on the show but when I was at the U of S, no one even talked about celiac or IBS. Many of our professors were not even dietitians but biochemists or pharmacists. Maybe they still don’t have anyone who specializes in this, although most people who work in health food stores have enough knowledge about this topic. rant done.

    I am working on a report for school in which I critique the Canada Food Guide for First Nations people. They have claimed to make it appropriate for First Nations and Inuit peoples, but the only thing that has changed besides language is graphics. Putting picture of an elk doesn’t make it appropriate.

    So far I have issues with the proportions of food which leads to a 60 carb 25%protein 15% fat diet, which I think promotes diabetes and other metabolic disorders. Vitamin D is promoted through dairy products which are not only hard to access but one source had 95% of First Nations people as lactose intolerant.

    I have a hunch that First Nations people are also prone to celiac but can find no numbers on this. Most of the calories in the food guide come from wheat products.

    To me, the Food Guide is one more form of discrimination. I wouldn’t go as far as to call it genocide, but it does promote metabolic disorder, diabetes, certain nutritional deficiencies, etc.

    What is your opinion on this? Any insights?

    Dr Jay’s Reply:

    The Food Guide is produced by Health Canada which is where I also work. My relationship with the authors of the Food Guide is somewhat strained because they are concerned that the work I do on ketogenic diet runs contrary to the principles of the Food Guide. I try to make peace with them by emphasizing that I am working on a diet that is used as a therapeutic alternative to drugs for conditions of metabolic dysfunction while the Food Guide is a recommendation on healthy eating for the general population. Even so, I think they are still concerned about mixed messaging from Health Canada. It is therefore not appropriate for me to be seen as criticizing the Food Guide.

    I can however make some general observations. As you note, there is an Aboriginal version which includes traditional First Nations and Inuit foods. The problem, of course, is that the pre-contact traditional diet in most of Canada was low in sources of starch and sugar. As you correctly point out, starchy and sugary foods are plentiful in the Canada Food Guide and in the Aboriginal version, as well. While I think the intent is to make the Food Guide more relevant and useful to people from a variety of ethnic backgrounds, this doesn’t reflect any change to the underlying dietary pattern advocated which is primarily based on carbohydrate sources for energy. In some areas, First Nations and certainly the Inuit, ate almost zero carbohydrates for extended periods and appear to have had no problems with chronic disease. This type of low-carb/high-fat diet is anethema to conventional nutritional thinking, however. In my work, I am advocating that to deal with the epidemics of chronic disease they now face, First Nations and Inuit consider returning to a traditional diet or perhaps a modern interpretation of that diet which includes market foods. This is the type of diet we tested in the Alert Bay study. It is also similar to the low-carb diets that have been researched in numerous studies over the past decade, all of which demonstrate huge therapeutic benefits.

    The question of wheat products and whether there is something especially harmful in them is the subject of “Wheatbelly” by Dr William Davis. I haven’t read the book but I suspect there may some truth in what he says. I do think there is a lot of sub-clinical gluten intolerance out there. I don’t know what the rates of celiac are in Aboriginal people or whether they are higher than those of the general population. If someone is concerned, on an individual basis, a simple elimination diet would an easy way to figure it out.

    Sorry I can’t be more helpful. Good luck with your studies.

  5. PS: When I knew her, Dr. Whiting was somewhat overweight. As were others in the department. I guess their old “move more, eat less” was either too hard to follow or too simplistic.

    Dr Jay’s Reply:

    Oops! Don’t you know we are never supposed to comment on someone’s weight problem. Even when, no, especially when, they are supposedly an authority on nutrition. It is political incorrectness of the highest order to blame someone for their medical condition, don’t you know, even when the paradigm we use to explain it, ie calories in/calories out, is implicitly a “blame the victim” model. This is one of the central cognitive dissonance issues that constantly boggles my mind, especially when I attend the big scientific meetings on obesity and related conditions. Many of the leading proponents of the current dogma cannot make it work for themselves. It would be like attending conferences on tobacco reduction where the leading speakers were chain smokers. But, one must never articulate this blatant contradiction. No, no, no!

  6. 🙂 I forgot. Let me clarify. The Dr’s build was not slender; I thought she looked good but how we view adipose tissue is another issue.
    The message that calories in/calories out is a simple equation does not take into account the complex mechanisms of metabolism. Thyroid hormones, steroid hormone balance, cortisol levels, seratonin levels, metabolic flexibility, sleep patterns, and more all impact how we metabolize food. This was rarely taken into account. People who ate less, exercised more and still gained weight were told to cut out butter.

  7. “I look at the foods that are advertised on TV and elsewhere. When do you ever see meat and veggies advertised? Never.”

    Too true! I mostly record my TV and fast forward through the ads but watching them can be as scary as looking at the list of sponsors for the ADA or DUK (and probably your Canadian eqivalents?)

    “To me, the Food Guide is one more form of discrimination. I wouldn’t go as far as to call it genocide”

    Maybe not genocide but eugenics. “Ignorant natives” are somehow wise enough to avoid the Diseases Of Civilisation until they eat the Diet Of Civilisation, and often respond worse. This is put down to their “primitve genes”.

    I suspect the real answer is that long term exposure to wheat, gluten, lactose etc. has actually bred out some of the genes from the Western population, and that this process is currently being amplified. Likewise for lactose and alcohol intolerance in East Asian and other populations which have not yet been “bred out” as in Western populations.

    If the Diseases Of Civilisation only strike after breeding age, as they used to do, this does not have the same effect on population genetics as now when the same diseases are occurring in childhood.

    But then I always liked reading John Brunner and other dystopian writers . . .

    “PS: When I knew her, Dr. Whiting was somewhat overweight. As were others in the department. I guess their old “move more, eat less” was either too hard to follow or too simplistic.”

    Dr Jay’s Reply:

    It sometimes reaches absurd proportions. There was recently a well-funded nutrition project aimed at Inuit living in remote communities across the Canadian Arctic which was based on the low-fat paradigm. They advocated using products like skim milk to make banana and pineapple smoothies and even gave Inuit families blenders for that purpose. Consider the madness of promoting a low-fat diet to prevent chronic disease in a population known for their almost uniquely high fat diet at a time when they had zero chronic disease. Classic case of cognitive dissonance!

    Thanks for the link to the Dr Davis piece. The fascinating part of that are the comments from overweight dieticians objecting to his post and completely missing the point.

  8. The UK has the fattest and most diabetic population in Europe, or so I believe. Meanwhile the WHO were targetting France “because they ate too much saturated fat” (not sure if that’s still occurring, I haven’t looked since they revamped their website and deleted all reference to their dreadful CINDI diet)

    This is hysterical, like watching a car crash in slow motion

    Catherine Collins and Chris Cashin (posting as Ally) are two of our leading dieticians, along with Susan Jebb.

    Ths mayhem continued on a doctor’s blog which has now been closed and strangely deleted from the Wayback Machine but resulted in threats of legal action.

    If these people were as right as they believe they are there would BE no “epidemics” of diabetes, obesity or other metabolic diseases just like there used not to be.

  9. Hi Jay,
    I’m a MD and work with First Nations, for many years we have been using the Paleo diet with much success in reducing DM2, HTN and obesity in those that are motivated.
    I’m currently working with a colleague that is adamant that all the research shows that consuming saturated fat increases mortality regardless of level of carbohydrate intake. Since you are so familiar with the research, I’m wondering if you can post studies that support the intake of saturated fat in low carb eating plans.
    Much Appreciated!

    Dr Jay’s Reply:

    There is some good evidence that saturated fat is not associated with CVD risk as was once thought. A meta-analysis published in 2010 which looked at 21 prospective cohort studies could find no association between SFA consumption and any type of vascular disease. Here is a link to that study:

    Apart from the lack of association in the observational literature, there has also been some good evidence emerging from dietary trials. The work of Jeff Volek and his team at UConn has shown that a low-carb diet allows you to eat more SFA and yet have lower circulating levels. It appears that when you cut carbs you become efficient at burning off the SFA. Here is a recent article that covers this:

    And an earlier one by Cassandra Forsythe who did her PhD with Jeff:

    I also like the work that Ron Krauss has done on LDL subfractions which demonstrates that it is carbohydrates and not SFA that drive LDL particle size in an unhealthy direction. He found that a combination of carb restriction and higher SFA consumption delivered the healthiest LDL particle size profile. Here is one of his seminal articles on this subject:

    Here is an article in Slate that covers a lot of this:

    If none of this moves your colleague you might have to resort to a smack upside the head.

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