I read with some amusement the debates in the blogosphere about whether the insulin/obesity hypothesis (as espoused by my friend Gary Taubes) accurately explains the obesity epidemic or whether some other mechanism is at work, like the food reward hypothesis (as promoted by Stephen Guyenet). Although I clearly fall into the Taubes camp on this, I also think there is a lack of real world sensibility in having the debate at all (I think Gary might agree with me on this). So far, as I see it, the whole argument revolves around what causes obesity. While I agree that obesity is a big problem and that there must be some kind of valid explanation for why this epidemic has taken off over a few recent decades, what is missing is recognition that it’s not just about weight. The weight gain is associated with other chronic conditions which are actually the real issue. The current paradigm implies that weight gain is a causal link in the chain that connects to diabetes, cardiovascular disease and a host of other common conditions. I think that weight gain is not, in and of itself, causal. It is another of the conditions that are symptomatic of the underlying cause which is related to carbohydrates in the diet. The fact that you can have thin people develop hypertension, diabetes and heart disease suggests that weight gain is not causal. The fact that you can have obese people with normal cardiometabolic markers and outcomes reinforces this observation. So, when it comes to applying a therapy that is effective in offsetting the harms associated with weight gain (note I said “associated with”, not “caused by”) it is important to address the actual underlying cause. The evidence supporting the highly effective therapeutic use of LCHF diet for these conditions reinforces the idea that dietary carbohydrates are, in fact, the cause. Perhaps we need to add the qualifier, “in susceptible people”. In any case, clinicians who use this approach report remarkable results that go beyond the effectiveness of the usual drug based therapies. It all hinges, of course, on compliance.
The benefits of LCHF actually extend into other realms of pathology that have been hitherto unexplored in terms of a potential dietary cause. I have collected a few anecdotal reports of the kinds of things that continually amaze me when it comes to the benefits of LCHF.
A few years ago, after I had just figured out that a LCHF diet had fixed my own diabetes and metabolic syndrome, I began to speak out about its potential benefits for others. At the time, I was the Regional Director of the Pacific Region of First Nations and Inuit Health Branch of Health Canada. I was asked to speak at an annual meeting of the nurses who worked in rural and remote First Nations communities so I gave a talk about my experiences in reducing carbs and proposed that it might be useful for the management of their diabetic patients. After the meeting ended, I was approached by a nurse who told me a remarkable story. She was caring for a First Nations woman who had severe, debilitating osteoarthritis. The disease was so severe that the woman could not get off a chair without assistance. The woman was overweight so, for whatever reason, the nurses put her on the Atkins diet. After an initial weight loss of a few pounds, the woman relapsed and regained the weight and then tried the diet again. What was remarkable about this was that, as soon as the diet was started the arthritic pain virtually vanished. It returned when the diet was discontinued and vanished again as soon as it was re-started. Clearly this amazing recovery was not associated with weight loss, but rather was directly attributable to the diet. Later, when I met with Dr Eric Westman for the first time, one of the questions I asked was whether he had seen anything like this in his patients. He said he had. I have since heard similar case reports from others who use LCHF diets in their research or clinical practices. So far, I am not aware of a study that has looked at this specific finding but I continue to hear anecdotal stories of this kind of benefit from LCHF.
When we did the trial in Alert Bay, one of the subjects was a man who suffered from Milroy’s syndrome. This is a rare condition where the lymph system malfunctions and fluid accumulates, usually in the lower limbs. The only treatments are mechanical massaging to force the fluid out and the use of devices such as support hose to minimize the accumulation of fluid. In this man’s case, the condition had progressed to the point where he didn’t want to be seen in shorts because of the disfiguring swelling of this legs. After a few months on the LCHF study diet, his condition had almost completely resolved.
Recently, I was contacted by a physician who has implemented a successful diet program in the small village in which he practices. We have been collaborating in an effort to ensure that the considerable weight loss achievements of his patients is sustainable over the long haul by re-introducing fats into their diets once they reach their weight loss targets. He has more recently been starting people on a LCHF diet at the outset. He contacted me to share the details of a woman who he was treating for hemochromatosis. This is a pathological condition where the body has excess iron stores. Left unchecked it can damage major organs and leads to other serious diseases including diabetes, cirrhosis, cardiomyopathy and arthritis. The most effective treatment is phlebotomy, ie blood letting. The woman he was treating was in constant pain and needed phlebotomy every 2 to 4 weeks. After she started the Atkins diet, she went into remission. The pain went away and she no longer needed phlebotomy. She relapsed on the diet and the pain and hemochromatosis returned. After some more phlebotomies, she re-started the diet and has been symptom free and has required no phlebotomies now for the past eight months.
I received a recent update from another successful diet project that I have been assisting in another small community. The results are pretty good for weight loss but, again, the most remarkable story is about a different condition. In this case it is Crohn’s disease. This is a very debilitating inflammatory condition of the bowel that makes life miserable for the sufferer and which is treated with a variety of drug and surgical interventions. There is no cure. A woman who had suffered from Crohn’s for twelve years went into complete remission after switching to a LCHF diet. Her symptoms completely resolved and her most recent endoscopy found no signs of the disease. She apparently cried upon hearing those results. I can understand why.
Obviously these are just case reports and more research would be needed to verify that these and possibly other conditions can be treated or cured by switching to a LCHF diet and to rule out other possible confounding factors. For the time being, however, those who suffer from these conditions should be encouraged to try the diet. As we now know, there is no downside and the potential upside could be seriously life-altering.
LCHF is about so much more than just weight loss. Eventually the research will be done to explore these other benefits. In the meantime, these squabbles about the various arcane explanations for weight gain that overlook both the well-documented and the anecdotal accounts of the other benefits of LCHF are seriously missing the mark. The proof is in the LCHF pudding, IMHO. And, as you can see from the photos of what I eat in earlier posts, you would have to agree that there is no shortage of “food reward” in the LCHF diet that I follow.