Overweight or Obese? Maybe it’s not just you

Caveman Doctor was recently arguing with another physician about the cause of the obesity epidemic. Caveman Doctor was trying to explain that people are “eating too many carbohydrates and modern/processed foods”, while the other doctor was falling back on the typical conventional wisdom. He kept saying things like it’s all about calories in (what we eat) versus calories out (exercising), and people have become essentially lazy and poor decision makers. They started to get into the data, and Caveman Doctor became furious as he realized, once again, the other doctor has never even looked at the data but was merely following recommendations from the ”authorities”. Caveman Doctor became so enraged that he challenged the other doctor to a good ole club off.  Caveman Doctor is now looking for a new job, so if you know of anyone hiring, please contact him on the internet (whatever that is).  
 
 

Maybe we’re not all just fat, lazy, and stupid: The psychological advantage of fats over carbs

In 1977, after intense discussion on the state of the diet of the people of the US, the McGovern Committee issued a set of nutritional guidelines they thought would “combat” heart disease, cancers, stroke, high blood pressure, obesity, and diabetes. Three years later, the official Dietary Guidelines for Americans were made, with fat chosen as public enemy number one. The guidelines can be summed up by the infamous Food Pyramid above. Thus the low-fat campaign began in this country, demonizing fats, and especially saturated fat. Since then, saturated fat has been held responsible for obesity, diabetes, cancer, the Pittsburgh Steelers losing to the Cowboys in ‘95, and even the fall of the Soviet Empire (ok, maybe not the last two, but almost any health problem was linked to fat).  With fat now no longer part of a healthy diet, it had to be replaced by some other food source, and the experts recommended we start eating more carbohydrates. Never mind that we only consumed carbohydrates in small amounts over the past several million years; they were the new health food. Here is how we have done with obesity since these recommendations (adapted from the National Health and Nutrition Examination Survey [NHANES] database)1:
 

Obesity Overweight or Obese? Maybe it’s not just you

Around 1980 obesity rates started to increase drastically


 
Even a caveman could look at this graph and follow the pattern, and it looks like something changed right around 1977 (the same year as the McGovern report). We started demonizing fat, and fat sat by, laughed a little, and watched the weight of our population grow to epic proportions. The exactness of this graph is absolutely remarkable, down to the very year. This is not surprising though. Take a look at the food pyramid below, which is the visual aid of our government’s recommendations. I can’t even imagine eating 11 servings of bread or pasta a day: I would gain a ton of weight and would be tortured by the blood sugar highs and lows.
 
Food Pyramid Overweight or Obese? Maybe it’s not just you

Our Dietary Recommendations...


 
What do we make of the obesity epidemic that seems to have started at the exact time we shifted the dietary paradigm? While we all agree it’s concerning, I disagree with many of the “experts”, who will essentially tell you the reason people are all getting fatter is:

  1. People are stupid (they can’t follow the dietary recommendations).
  2. People are lazy (they just don’t exercise as much).
  3. People are gluttonous (they are eating way too much).

Notice these are all based on the premise that the recommendations are 100% appropriate. The recommendations can’t be wrong, but rather people are fat, lazy, and stupid. How do you feel about this? Well, it bothered me, so I started to think about it more… A lot more. Actually, I thought about it nonstop for the past several weeks and did some reasearch. As a result, I have a slightly different theory.
 
 

Caveman Doctor’s Theory:

  1. People aren’t stupid (most people actually follow the US dietary guidelines).
  2. People have decreased their activity thanks to technology, but this is not fully responsible for us getting bigger.
  3. Certain foods make people more gluttonous.

Let’s review both sides of the argument.
 

Expert Theory 1: People are stupid and can’t follow guidelines.

Caveman Doctor’s Theory: We are smarter than they think and actually are just following their stupid directions.

First off, let’s look at hot we did at following these new recommendations – are we really that stupid? Here is a recent graph from the NHANES Database showing the percentage of calories, carbohydrates, fat, and protein in our diet over thirty years:
 

Diet Changes NHANES Overweight or Obese? Maybe it’s not just you

Dietary changes from 1971 to 2000


 
It looks like we are actually doing very well following the recommendations. Fat intake has consistently dropped, while carbohydrates have replaced them to a greater degree, just as our authorities told us. This data has been confirmed in several other nutrition and diet databases and published3, leading the authors to conclude:
 
“It appears that efforts to promote the use of low-calorie and low-fat food products have been highly successful and have been in line with the objectives of the US Public Health Service.”
 
The well-intentioned McGovern group gave us this diet in 1977, mostly in an effort to avoid heart disease and cancer. It boils down to this: replace high fat foods that we have been eating for millions of years and those which our bodies process like a well-oiled machine, with high doses of modern carbohydrate-laden grains. It looks like not only were we all smart enough to comprehend the new guidelines, but we ate them up – literally! The foundation of our diet, just like the food pyramid, became grains. Think about the average daily meals most people eat:

  1. Cereal, oatmeal, or bagel for breakfast (grains, and massive carbohydrate amounts)
  2. Slice of pizza, quesadilla, or sandwich for lunch (even more grains and carbs)
  3. Potatoes, rice, beans along with meat and vegetables for dinner (more grains…)

And notice, this would be a “healthy” diet! I didn’t even get into fries, potato chips, pasta, or sweets. Grains and carbohydrates have become a major part of every meal for most Americans, under the direction of our leaders. Not only are we smart, but we are a trusting people: we trusted the “authorities” enough to follow their recommendations.  In conclusion, we are not too dumb to follow directions. We are just misdirected.
 
 

Expert Theory 2: People are lazy (they just don’t exercise as much).

Caveman Doctor’s Theory: We could benefit from increased activity, but this hardly accounts for the massive increases in obesity, especially in the past decade.

 
Less Walking, More Driving:
I was recently giving a talk on cancer and low-carb/high-fat diets to an audience of medical personnel. As always happens, the conversation took a turn to low-fat diets surely being the best for cardiovascular health and fighting obesity. A friend of mine who has closely followed a caveman diet (i.e., high fat and low carb) for a year lost 10 pounds and watched her cholesterol levels dramatically improve. I shared her story, and her labs, as proof of my argument. The viewers were in disbelief – rightly so as it was in contradiction of everything they were taught in medical school. The next questions was the classic response, “Yes, but how much has her exercised increased?” Amazingly, before I could answer, a physician stood up and exclaimed: “I am on the same diet and made no alterations in my activity levels. Yet, I witnessed the same changes in my weight and lipid levels, irrespective of exercise.” An amazing moment for sure and extra amazing as it shows more people (and physicians) are returning to the diet we are meant to eat.
 
This is another simple topic that has eluded our nation’s best and brightest policy makers. However, if you go to your local gym and ask the first jock you see how to lose weight, he’ll tell you that he “cuts carbs” before the beach or a bodybuilding competition to “get ripped”. In fact, many body builders do no more cardio than 30 minutes on the treadmill a day walking. Granted, they are lifting heavy weights, but the point here is that activity can stay the same and restricting carbohydrates alone results in cutting fat and extra pounds.
 
However, let’s look at the data below. Did people mysteriously turn very lazy overnight, roughly around 1977?  Or did something else happen at this period that can explain it? A common remark is that people used to be much more active. While that’s true, it’s not the whole story as you’ll see below. Another similar common criticism is that we used to walk everywhere, and now we drive everywhere. This lack of walking is a major cause of the obesity crisis. However, if you look at the graph below (adapted from the Federal Highway Administration), we stopped walking and started driving a lot sooner than 1980. In fact rates shot up far before this period and as of recently, they are plateauing!
 
Yearly Miles Driven Per Capita and Per Licensed Driver

Miles Driven Overweight or Obese? Maybe it’s not just you

Yearly miles driven increased steadily before the obesity crisis and have plateaued recently


 
 
Physical Activity:
This next graph shows the percentage of those that engage in no physical activity during their free time from 1988 to 2008. Unfortunately, data is limited prior to this time period. While the graph shows an amount clearly lower than we would all like to see, the rates changed little in almost 20 years and have actually decreased since 1996 (adapted from data from the CDC)4. Other data supports the minimal change in activity levels during this time3. Yet, obesity has continued to explode during this time.
 
No Leisure Time Activity Overweight or Obese? Maybe it’s not just you
 
Better, yet, let’s look at recent gym membership trends (from Google Trends):
 
Google Trends Gym Membership Overweight or Obese? Maybe it’s not just you

Gym membership, uncommon in the past, continues to rise


 
And the trend continues to increase. How many people belonged to gyms in the 50’s, 60’s, 70’s, or even 80′s? It was pretty much limited to Gold’s Gym in California, Arnold, Franco Colombu, Lou Ferrigno, and Joe Weider. Did people go jogging during these periods? Nope. So while some people are becoming more sedentary, many people are likely becoming MORE active.
 
Overall though, yes, many people are likely less active. Can this explain the ever-climbing trends in obesity? No.  Especially if you look at data from the last ten years or so. The two factors of activity and weight gain are uncoupled, and, as in this case, are not always directly proportional to each other.
 
 

Expert Theory 3: People are gluttonous (they are eating way too much).

Caveman Doctor’s Theory: Certain foods make people more gluttonous.

 
Returning to the graph above, people are eating more and more carbohydrates each year, while dropping the amount of fat and even protein. Let’s look at calories eaten:
 

Diet Changes NHANES Overweight or Obese? Maybe it’s not just you

Dietary changes from 1971 to 2000


 
So it would appear that people have slightly increased their caloric intake according to the CDC (Center for Disease Control). However, compilation data from several databases actually shows that caloric consumption actually decreased by 4% from 1976 to 1991, the same period where the initial surge in weight gain occurred3. People love to look at all these factors individually, as if there is no connection between increased carbohydrate intake and increased caloric intake. Fat usually has the bull’s-eye on its behind because it has nearly double the calories per gram than carbs or protein, but this is a shortsighted view as we are ignoring the physiological and hormonal response to eating carbohydrates.
 
When we eat carbohydrates we get a physiological response that makes us eat more food. The increased carbohydrates cause large increases in insulin and a plummet in our blood sugar (after the initial spike). This then stimulates our hunger, leading us to eat more carbs or anything else around (but especially carbs, as they can quickly spike your blood sugar back up, leading to a vicious cycle). And let’s not forget that sugar and carbohydrates affect the same area of your brain where cocaine and drugs act5-8. Some of cavelady’s patients tell her they are “addicted” to bread, and they are right in a very real way. All food is not created equal, nor does all food have the same effect on your body.
 

Tom Naughton explaining why we get fat.
 
A simple way to view this is to ask yourself how many times have you binged on pure fat and protein foods. A salty steak is absolutely delicious. How many times have you eaten one and just HAD to eat another steak or two? How many times have you lathered vegetables with some grass-fed butter and salt and became out of control and couldn’t stop eating them?
 
Replace those vegetables with a piece of bread. How many times have you had “just one” piece of bread only to turn possessed and finish the basket? Caveman Doctor tried bread once, and after he went savage on the restaurant to get more, even his simple mind realized that there is a lot more to this food than its caloric content. Something different happens when we eat carbohydrates. 
 
Looking at things from the perspective that we are made to process the same foods we have eaten for millions of years, this makes perfect sense. Fructose, a sugar that makes our brain go a little crazy for food every now and again, has been found in safe food sources throughout the lifetime of humans: fruit. Fruit, and by fruit I mean mostly fibrous smaller-sized fruits in small amounts(not the modern fruits that are loaded with sugar and the size of your head), has been a safe food for us has been around for millions of years (unlike grains). Therefore, it is not surprising that it activates a part of our brain that says “good stuff here”. Unfortunately, even small amounts of carbohydrates hit the same receptors in our body and make us crave more food, especially more carbs. When we changes this to large amounts of carbohydrates, all bets are off.
 
Telling people to eat more carbohydrates and less food overall is not a diet, it is torture. It is the ultimate test of someone’s willpower. When carbohydrates hit our brain and turn our blood sugar levels into a roller-coaster ride, we crave more and turn into gluttons. The recommendations to eat more carbohydrates are the CAUSE of our current gluttonous state, NOT THE RESULT of it – down to the exact date of these recommendations!
 
People have been fighting about whether eating fat gives you a metabolic advantage over carbohydrates for years.  Well, we can ignore the controversial, but very compelling “metabolic advantage” theory of fats versus carbohydrates9,10 and turn our attention to the “psychological advantage” of eating fats over carbs, which can be viewed all around us. Let’s stop blaming people for gaining weight.  Let’s at the very least re-examine the recommendations.
 
The “experts” have updated the food recommendations with the recent “Food Plate”, which pushes fruits, grains, protein, vegetables, and a side of dairy. There is once again a general theme of avoiding fats, which, depending on how you look at the table, can actually make up no part of the diet. Judging by the past, I would expect such recommendations to have little effect on reducing the weight of our nation.
 

Foodplate Overweight or Obese? Maybe it’s not just you

The "new" food plate: more of the old...


 
Yet, fat is getting the last laugh as we now have anecdotal evidence and high quality level I evidence that a low-carbohydrate and high fat diet is vastly superior to a low-fat diet in not only weight loss, but also in reducing inflammation, blood sugar, insulin, and triglyceride levels, while increasing HDL (healthy cholesterol)11-15. The fact that it actually improves cholesterol is perhaps the bitterest pill to swallow for our health leaders that have been clinging to these horrendous recommendations.
 
Here is what the simplistic real food pyramid should look like:
 
Real Food Pyramid Overweight or Obese? Maybe it’s not just you
 
If you are struggling with losing weight, maybe it’s not just you. Maybe you are just following bad advice.  You are not a lazy, gluttonous, stupid person.
 
SIGNATURE2 Overweight or Obese? Maybe it’s not just you
 

References:

1.            Ogden CL: Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1960–1962 Through 2007–2008, 2010

2.            CDC: Trends in Intake of Energy and Macronutrients — United States, 1971–2000, 2004, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5304a3.htm

3.            Heini AF, Weinsier RL: Divergent trends in obesity and fat intake patterns: The american paradox. The American journal of medicine 102:259-264, 1997, http://linkinghub.elsevier.com/retrieve/pii/S0002934396004561?showall=true

4.            CDC: Physical Activity Statistics, 2012, http://www.cdc.gov/nccdphp/dnpa/physical/stats/leisure_time.htm

5.            Avena NM, Hoebel BG: A diet promoting sugar dependency causes behavioral cross-sensitization to a low dose of amphetamine. Neuroscience 122:17-20, 2003, http://www.sciencedirect.com/science/article/pii/S0306452203005025

6.            Avena NM, Rada P, Hoebel BG: Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience & Biobehavioral Reviews 32:20-39, 2008, http://www.sciencedirect.com/science/article/pii/S0149763407000589

7.            Colantuoni C, Schwenker J, McCarthy J, et al: Excessive sugar intake alters binding to dopamine and mu-opioid receptors in the brain. NeuroReport 12:3549-3552, 2001, http://journals.lww.com/neuroreport/Fulltext/2001/11160/Excessive_sugar_intake_alters_binding_to_dopamine.35.aspx

8.            Rada P, Avena NM, Hoebel BG: Daily bingeing on sugar repeatedly releases dopamine in the accumbens shell. Neuroscience 134:737-744, 2005, http://www.sciencedirect.com/science/article/pii/S0306452205004288

9.            Feinman RD, Fine EJ: “A calorie is a calorie” violates the second law of thermodynamics. Nutrition journal 3:9, 2004, http://www.ncbi.nlm.nih.gov/pubmed/15282028

10.          Fine EJ, Feinman RD: Thermodynamics of weight loss diets. Nutrition & metabolism 1:15, 2004, http://www.ncbi.nlm.nih.gov/pubmed/15588283

11.          Forsythe C, Phinney S, Feinman R, et al: Limited Effect of Dietary Saturated Fat on Plasma Saturated Fat in the Context of a Low Carbohydrate Diet. Lipids 45:947-962, 2010, http://dx.doi.org/10.1007/s11745-010-3467-3

12.          Forsythe C, Phinney S, Fernandez M, et al: Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation. Lipids 43:65-77, 2008, http://dx.doi.org/10.1007/s11745-007-3132-7

13.          Hite AH, Berkowitz VG, Berkowitz K: Low-carbohydrate diet review: shifting the paradigm. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition 26:300-8, 2011, http://www.ncbi.nlm.nih.gov/pubmed/21586415

14.          Volek J, Phinney S, Forsythe C, et al: Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet. Lipids 44:297-309, 2009, http://dx.doi.org/10.1007/s11745-008-3274-2

15.          Westman EC, Yancy WS, Edman JS, et al: Effect of 6-month adherence to a very low carbohydrate diet program. The American journal of medicine 113:30-36, 2002, http://www.sciencedirect.com/science/article/pii/S0002934302011294

 
 
© Caveman Doctor 2012. All Rights Reserved.

Comments
45 Responses to “Overweight or Obese? Maybe it’s not just you”
  1. Louise Myers says:

    Caveman Doctor, you rock! Just found you on Facebook and am happy to see you spreading the word that fat is what we need, not carbs! Rock on.

  2. jk says:

    I’m not surprised caveman doc had an argument with another physician because most doctors are not adequately train in nutrition. I once went to see a GI due to an illness and the doctor actually said, “you can eat anything you want” unfortunately this GI didn’t believe in the link between disease and nutrition. Oh well…

    PS: Are you really looking for another job or did you make up the story? :)

    Thanks!

  3. dj says:

    i can back you up on the weight loss without excercise…after years of running injuries at a weight of 195lbs, and recognizing that i was too heavy to distance run, my new years resolution was to not excercise until i hit 180lbs. 3 months into a caveman diet i hit 179 and have been able to keep my weight at 179 with 3 months of running free of injury….i know caveman doctor would look down upon distance running….

    • cavemandoctor says:

      Haha DJ. Awesome about your weight! And the fact that you are running free of injury speaks volumes.

      Great stuff.

    • mv says:

      DJ, that’s a great plan. I’m going to try that too. Did you do any type of exercise, like walking? I don’t think I could be completely sedentary. It’s kind of funny, but it’s going to be harder for me to NOT exercise than it is to exercise

  4. kb says:

    I’m curious about the logistics of your hypothetical food pyramid – how can you have such a large proportion of fats w/out adding more carbs? And where would many fruits and veggies be, if not carbs? I’m not disagreeing with the basic point that we eat too much processed foods (breads, pastas, etc); I’m just not sure I see the feasibility of your food pyramid, either.

    • cavemandoctor says:

      KB,

      I’m not sure I fully understand your question. The point is to eat more fat (and protein), while reducing carbs, which is actually much easier than you think. Vegetables contain very few carbs and really can be eaten as much as one would like. It is pretty hard to overdo the carbs when you are eating leafy greens.

      Thanks!
      -CD

  5. I’m so glad you posted this article, it basically sums up everything I’ve been thinking for a year now since I cut out grains. Instead of wondering what is wrong with me when I can’t lose weight on a “healthy diet” with lots of whole grains and low in fat… I am now losing weight consistently just with eating very little starchy carbs and a whole crap-ton of fat. It’s hard to convince the masses, though. I imagine once I reach my goal weight I’ll be a little more convincing :)

    • cavemandoctor says:

      Bethany,

      Great to hear! It is really amazing when you ignore the recommendations and instead eat a nice amount of fat, and watch your weight drop. And yes, it is very hard to convince the masses.

      -CD

  6. R. Michael Litchfield says:

    One other issue with the carbohydrates that doesn’t get much mention is that they are the major cause cause of tooth decay. Everyone sort of gets the sugary drink issue (though they don’t seem to get they are grain carbohydrates in liquid form) but they tend to miss that the grainmush most other carbohydrates come in is as bad for the teeth. .

    • cavemandoctor says:

      Michael,

      Great point. I heard this nonstop from my grandfather as a kid and it definitely deserves a louder voice.

      -CD

      • Paul N says:

        Also, grains have crept into our diet in more subtle ways…
        Almost all the meat and dairy we eat are grain fed, not grass fed.
        One of the lesser known consequences of this is that vitamin K2, which is *essential* for tooth and bone health, is now deficient in or diets. One of the best sources of K2 is(was) dairy from cows eating leafy green grass.

        some googling on vit K2 will tell you lots more, as will this excellent book that came out earlier this year;
        “Vitamin k2 and the calcium paradox”

        K2 (and magnesium), *not* calcium, is the secret to bone, dental and arterial health…

        • cavemandoctor says:

          Paul,

          Thanks for the comments. You are spot on with the vitamin K2 and calcium comments. I approached this in another post where I discussed bone health.

          Thanks!
          CD

  7. Danielle says:

    I am totally in agreement that carbohydrates/fat are the main factor that has caused a drastic increase in obesity and overall poor health in North America. However, it is not as simple as increasing fat intake and eliminating grains. I don’t think gorging on meat and veggies (by todays standards) is the way to solve the problem. There are many aspects of our food supply which have changed in the last 100 years.

    1) Lipid profiles: We went from high in saturated, high in omega 3 and low in omega 6 fatty acids to high in saturated, low in omega 3 and high in omega 6. The omega 3/6 ratio has been shown to be a major factor in the presence and progression of many metabolic diseases. Switching to increased CONVENTIONAL meat consumption, in place of wheat/grains will not produce long term health benefits. Increased grass-fed pastured meat consumption might though. Cows were not made to eat grains, and we were not meant to eat cows that eat grains. Most Paleo advocates know this but it isn’t emphasized. Then you get the high protein/fat craze where people are out purchasing cheap ground beef like it is their job!
    2) The nature of our carbs: Our carbs are heavily processed. Eliminating bread, pasta, crackers, chips etc. will surely result in health benefits. The problem is, who is to say that is due to the elimination of wheat/potatoes per se? What if we replaced bread with cooked wheat berries and chips with baked potatoes? I think you would see just as many benefits. It is the refinement and additives (including sugar, oil and salt) which makes these processed foods unhealthy.

    Overall you are right. It is not the people’s problem. The food policy, current medical training, and government food regulations are all against us in the battle against obesity. However, one must be careful in the recommendation to increase fat consumption. Those who aren’t as education in nutrition might go off on the wrong track with that. From my almost vegan perspective, I am a firm believer that you cannot go wrong with a plant based whole foods diet, and if you choose to eat meat, only choose pastured meat.

    ps. have you seen the recent study out of Sweden? I am not suggesting we go out and eat refined carbs but it is an interesting result of a 25 year diet shift in the Swedes. http://www.nutritionj.com/content/11/1/40/abstract

    • cavemandoctor says:

      Danielle,

      Great comments. We definitely need to get our omega 3:6 ratio back into shape. I also agree with the nature of carbs making them even worse. However, for many people, I think this includes potatoes and wheat, especially since these foods often make them crave more carbs (though I do eat sweet potatoes and love them).

      Thanks for the link. Nutrition only posted a preliminary copy. I am pretty busy at work and I only skimmed it so maybe I am missing something, but it looks like they quantified cholesterol increase by total cholesterol (only) and by stating use (!!). While cholesterol rises means little to me (especially the minuscule amount that it did in the study), how much of this was HDL? What happened to triglycerides? We know statin usage have gone up, based on very little science. I look forward to the full release of the article and when I get a minute I will give it a closer look. Thanks again for your post and for the link.

      Thanks!
      -CD

    • Paul N says:

      @ danielle,

      Eating lots of wheat – in particular – is asking for trouble regardless of how it is prepared (soaked, sprouted, sourdough, etc). Even though anti nutrients like phytates are degraded, the glutens, lectins, wheat germ aggluttenins etc remain. Even worse, the recommendation to eat “whole wheat has resulted in more consumption of oxidised/rancid omega 6 oils from the wheat germ. (this is true for all whole grains, including rice).

      There is also evidence that the insoluble fiber in whole grains causes problems. Colon cancer has gone from 37th on the list of cancers to third in the last century – as whole grain consumption (and insoluble fiber) has *increased*, and fat consumption has decreased.

      Other starches can be almost as bad, especially if they are used to replace wheat “gluten free” breads etc.

      “I am a firm believer that you cannot go wrong with a plant based whole foods diet, ”

      Well, a celiac may disagree with you there.
      Even worse, some 50% of vegetarians and 80% of vegans are B12 deficient link

      The common plant sources of b12 (spirulina etc) are actually B12 analogues and interfere with proper b12 function.

      Additionally, vegan diets are low in the fat soluble vitamins A, D E and (especially) K2 (unless you eat natto).

      While there are valid ethical reasons for going vegan, there is little health benefit, and much risk of malnutrition if not done carefully.

      I totally agree about the “whole foods” part, as , I expect, will every other poster here. if you make it all yourself, vegan or otherwise, you are way better off than the standard American diet.

    • jake says:

      Yes, I so agree. If someone just goes out and eats alot of grocery store meats with fat, they might likely die of a heart attack. For example, although it is highly controversial, this might well be what brought Dr. Atkins into heart disease.
      On the other hand, if they eat fat with a hunter-gatherer-like Omega6/3 ratio – they will thrive. This is true whether they have a high animal content diet or high plant content diet, as long as the plant food is also hunter gatherer like.

      Dr. William Lands of Univ. of Michigan and NIH has been a too little quoted genius in understanding and trying to illuminate this discordance.

      What is so beautifully pointed out in this article, along with what you state, produce the same effects as the health of our hunter gatherer ancestors and evolutionary nutrition. I try to define this way of eating at Evolution Diet.

  8. Katie says:

    This is always what my 90 year old grandmother says to do to lose weight and she is still slim and going strong :)

    • cavemandoctor says:

      Katie,

      Yes! via the original Banting diet, we have known for some time that this diet works. We just choose to forget this every once in a while…

  9. Jennifer says:

    For lunch today I ate a bowl full of sugar snap peas. After that, why did I crave carbs? Seriously, no matter what I eat, afterwards I want a bunch of carbs before I feel satisfied. What gives?

    • cavemandoctor says:

      Jennifer,
      Sugar snap peas are pretty high in carbs. Eating them with no fat or protein likely made your blood sugar go up and then down, causing cravings. Also, maybe that’s just not a substantial enough lunch for you. I try to eat some satiating fat and protein with each meal to curb my hunger.
      -CD

  10. Atxitmom says:

    What advice do you have for someone who’s essentially addicted to carbs? She has no problem buying and eating (prefers) whole grain versions but they aren’t available for every meal. She also doesn’t want to fall into (keratosis? State.

    • cavemandoctor says:

      Recalibrate your sweet tooth (click here)! I was addicted to carbs as well at one point, as are/were most people.

      Low-carb and ketosis are sepeate entities and you don’t have to be in ketosis to get the benefits of low-carb.
      -CD

  11. Scotty says:

    Hi Caveman Doctor,

    I think you may have some discrepancies in your premises that lead to your conclusion.

    Let me make sure I understand your stance correctly.

    High Carbohydrate Diet -> High Insulin -> Increased Lipogenesis/Decreased Lipolysis -> Increased Body Fat -> Obesity

    Decreased insulin sensitivity in the skeletal muscles = increase in storage of fat in adipose

    That is the typical Gary Taubes, Rosendale, Dr. eades theory, which I assume you are in general agreement with because you site tom Naughtons fat head clip.

    If I misconstrued your hypothesis I apologize

    First and foremost we can make the simple observation of societies doing well on high carbohydrate diets. Such as the Kitavans, Trombo islanders, the gaelics and swiss from Weston a Prices book, as well as thousands of other documented societies eating roughly 70% of their diet as carbohydrates and being virtually free of obesity, tooth decay and/or diabetes. Thus the observations used above may be misleading when compared with other sample means.

    Second would be the physiology of insulin. In the assumption presented above you state that insulin makes you hungry, will cause eventual fat accumulation because it causes you to eat more. I highly suggest anyone interested in Insulin read this paper before following the message of gary taubes and co.

    http://bja.oxfordjournals.org/content/85/1/69.full.pdf

    Now in Gary Taubes land we believe that excess glucose gets sent to the fat cells when insulin resistance occurs. However this statement seems to be universal among doctors and implies that Glut-4 is down regulated in the adipose as a consequence of insulin resistance.

    “A major cause of type 2 diabetes is impaired insulin action in adipose tissue, skeletal muscle and liver. Overt hyperglycaemia develops when increased insulin secretion no longer compensates for insulin resist- ance. Even without diabetes, insulin resistance is a major risk factor for cardiovascular disease and early mortality1. Resistance to insulin- stimulated glucose transport in adipose tissue and skeletal muscle is one of the earliest defects detected in insulin-resistant states2. Transmembrane transport of glucose by GLUT4 is the rate-limiting step for glucose use by muscle and adipose tissue2. With the development of insulin resistance, GLUT4 expression is down-regulated selectively in adipose tissue but not in skeletal muscle2,3. Downregulation of GLUT4 expression in adipose tissue is an almost universal feature of insulin-resistant states, including obesity, type 2 diabetes and the metabolic syndrome.”

    “GLUT4 expression is decreased in adipocytes in nearly all insulin- resistant states in humans and rodents, but the mechanism by which this contributes to systemic insulin resistance has not been clear, as adipose tissue contributes relatively little to total body glucose disposal.”

    - http://www.nature.com/nature/journal/v436/n7049/abs/nature03711.html

    For those who don’t know what Glut-4 is: “Few physiological parameters are more tightly and acutely regulated in humans than blood glucose concentration. The major cellular mechanism that diminishes blood glucose when carbohydrates are ingested is insulin-stimulated glucose transport into skeletal muscle. Skeletal muscle both stores glucose as glycogen and oxidizes it to produce energy following the transport step. The principal glu- cose transporter protein that mediates this uptake is GLUT4, which plays a key role in regulating whole body glucose homeostasis.”

    So it would seem that the theory imposed on insulins excitatory actions is being overplayed where as the inhibitory actions of insulin are much more important for ketone formation and excess NEFA in the system competing with glucose.

    Thirdly in regards to insulin and hunger, let be noted that in a normal physiological scenario that insulin will actually suppress appetite.

    “Insulin’s role is more clearly explained in Ivy’s book The Future of Sports Nutrition: Nutrient Timing. He writes that, yes, insulin is a promoter of fat synthesis. But it is also a crucial hormone for promoting protein synthesis, reducing protein degradation (including suppressing cortisol, which can be catabolic in nature), and promoting glucose uptake and glycogen storage in muscle. Insulin, notably, also suppresses appetite.” – http://evolvinghealthscience.blogspot.ca/2012/05/good-insulin-bad-insulin-its-role-in.html

    With those type of factor thrown into the mix along with these helpful links

    http://wholehealthsource.blogspot.com/2012/01/insulin-and-obesity-another-nail-in.html#more

    http://carbsanity.blogspot.com/

    We can see that there is wealth of information out there contradicting the premisses that ultimately lead to your conclusion.

    “I hope you can see by now that the carbohydrate hypothesis of obesity is not only incorrect on a number of levels, but it may even be backward. The reason why obesity and metabolism researchers tend not to take this idea seriously is that it is contradicted by a large body of evidence from multiple fields. I understand that people like ideas that “challenge conventional wisdom”, but the fact is that obesity is a complex state and it will not be shoehorned into simplistic hypotheses. ” – Stephan Guyenet

    • cavemandoctor says:

      Hi Scotty,

      Sorry – I found your comment in my spam bin, I think due to its length, thus the late reply and post. There is definitely much support for the other side of the hypothesis as is there for my side. Your links are interesting, though I think some of them actually may lend support to some aspects of my side. In reference to your sports nutrition article, yes insulin serves importance for protein synthesis etc. which is why I personally tend to eat most of my carbs before and after workouts to increase it at this point (not great data either, though some in the literature and personal n=1 anecdotal). Also, this is why consuming a sliding scale of 50-150 g/day of carbs will get levels of insulin up throughout the day, but hopefully not to very high levels.

      As for insulin not stimulating hunger, there is absolutely data supporting both sides – take your pick in the literature. I personally and professionally have seen a massive increase in appetite after high carbohydrate meals and insulin stimulation, tipping me towards my views described above, supported by the data. Is it the insulin? – perhaps and there is definitely data to support this. Is it merely blood glucose values rising and dropping or many other factors as well? – perhaps and most likely. Is it other environmental factors – likely as well. One thing is for sure, hunger is much much more manageable for many and most people when foods that increase insulin release are held in check and the model of insulin as a major factor for obesity seems reasonable and probable for many. Very low carb diet diet studies show this as well when participants reduce their total caloric intake even when on an ad libitum diet, merely by reducing carbohydrates. I’m not promoting cutting carbs to less than 50 (though this may be fine as well), but the Volek/Westman mark of 150g/day or less seems to make dieting and fat loss much easier in my experience and that of others. There is definitely data for and against this, with of course the level one evidence in randomized trials most often supporting low-carb for fat loss.

      Finally, I think a high carbohydrate diet can be followed and not result in fat gain for some, especially in societies where energy output tops 3,000 calories per day like the modern Ache or others (just throwing out a random number). Everyone is individualized. However, in our society this is very difficult, if not impossible for some individuals. Many sources of carbs result in increased hunger (often uncontrollable) after consuming. Let’s give people a chance here.

      As for why much of the scientific community doesn’t agree – not going to get into this as this has been torn to shreds for years now and would merely be repeating the issues with conventional wisdom.

      P.S. Obesity is a very complex state – no argument there. This website pushes to provide simplified answers for people in several areas of health, especially within our present society.

      Thanks!
      CD

  12. mv says:

    I don’t know if I understand this correctly, but a couple refutations of the calories-in calories-out hypothesis were my brother-in-law and my sister-in-law’s dad (an MD). Each one contracted type 2 diabetes. Even though he had a ravenous appetite, my brother-in-law lost a ton of weight after he contracted type 2 diabetes and before he was diagnosed. It looked like he’d discovered a miracle weight loss plan before he got the bad news. The MD said he inexplicably lost that 15 pounds he’d always wanted to lose without changing anything in his diet. Then he found out that he’d contracted type 2 diabetes.

    I’m not a doctor or a nutritionist, so I don’t understand this subject very well, but I don’t understand how this isn’t a clear example that there are other things at play besides calories-in calories-out. Seeing that type 2 diabetics frequently experience dramatic weight loss after contracting the disease and before diagnosis, this may indicate that that “other thing” at play may be insulin.

  13. Andrea says:

    I am so happy I stumbled onto your website. I struggled with my weight for most of my adult life, with matters only getting worse through two pregnancies. For 4 long years, I followed the “traditional” advice to eat less, exercise more, get more grains than anything else, avoid fat like the plague and DID lose weight, but it was such a slow, agonizing process I hit many plateaus along the way. It just didn’t make sense to me: I was eating less than I was burning, and yet the scale barely inched along (I was LUCKY to lose 4 lbs in one month despite being “obese”). After being stuck for 6 months at the same weight, in an act of desperation I tried the HGC diet a friend was doing (eating more calories than recommended). I was amazed to see the immediate difference that eating more protein, and less carbs made on my overall well-being. The last 20 lbs dropped off, my arthritic knees gave me no grief whatsoever, and I lost that feeling of fogginess and fatigue that carbs promote. I know that diet is controversial, probably for good reason, but the main thing for me is that it opened my eyes about nutrition and how MY body works. I would never do that diet again, but then, I feel I don’t NEED to since what I learned led me to the Paleo lifestyle.

    Now, I cringe when I see people struggling to lose weight, and doing it by eating “low fat” products, “baked” products that claim to so so mush healthier, and food after food sweetened with artificial chemicals. Hard to help them see the light when the “professionals” are telling them they are doing the right thing.

    • cavemandoctor says:

      Andrea,
      Great to hear abut your health transformation! It is amazing how these simple changes can make losing weight so much easier (and less painful…)

      Take care!
      CC

  14. Sian says:

    Your information is very useful (as I am doing assignment on Physiology) and i found this has helped a lot. However i must know; the graphs that you have used, is the data based on the world’s general population or Australia’s population?

  15. Jeff says:

    Great article C.DR. It is sad to me that so many in the medical community are still not thinking objectively on these issues. I really appreciated the graphs and the correlation for 1977. Amazing. It’s too bad, the docs must be overwhelmed providing care for conditions that should not be there and are in some way untreatable through conventional practice. Keep up the good work brother, I’m sure you will help open eyes in the medical community as well as help us lay-folk with your approachability and clarity. May it be that our own bodies provide the evidence to move friends and family to a healthier way of life!

    • cavemandoctor says:

      Thanks Jeff!

      I think things are starting to change. So many physicians are so overworked that at the end, they have little time to analyze the recommendations they are pushing. However, these recommendations are getting torn to pieces so they will start noticing.

      Thanks again,
      CC

  16. Hypertrophy, Hyperplasia, or Microtrauma?
    What Really Happens When A Muscle Is Developed?

    I have answered my own question.

    http://valerietonnerhealthcoach.blogspot.ca

    Would you like to comment about this? hat about aging muscle?

    Kind regards, Valerie

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