High cholesterol low heart disease – The Sami

(Of course, it is a paradox…. Paradox number 112, or thereabouts)

As a nod to a regular contributor to this blog, who lives not far from the area, I thought I should write about the Sami. When I was younger we would probably have called the Sami ‘Eskimos’ – because anyone who lived north of the Arctic circle and dressed in fur was, clearly, an Eskimo. This term is now, I believe, a dread insult. A bit like calling a Scotsman an Englishman, or an Austrian a German. Or, I believe, a Canadian an American. Wars have been fought over less.

The Sami, unlike the Inuit, who reside mainly in North America, live in the North of Scandinavia: Northern Sweden, Norway and Finland and suchlike. In what used to be called Lapland. However, we now call the Lapps, the Sami (please keep up), so do they live in Samiland?

What I know about the Sami is that they obviously enjoy the cold, eating reindeer and smoking. They must do other things too, but I am not entirely sure what. This makes them very similar to the Inuit, who also enjoy: the cold, eating seals, caribou, and smoking. Neither the Sami, nor the Inuit, have the least interest in eating vegetables. I suppose there may be the occasional frozen carrot – or suchlike – from Iceland (that is a UK based joke).

Apart from not eating vegetables, smoking, and eating lots of fat, the Inuit and the Sami have one other thing in common. You can probably guess what it is. Yes, they both – those that live a traditional lifestyle anyway – have a very low rate of death from heart disease.

This came to my attention during an e-mail discussion I was having about whether the human brain required any glucose – at all. Those taking part were the usual suspects, Richard Feinman, Gary Fettke, Nina Teicholz, Jimmy Moore, Jason Fung, Tim Noakes etc. [Yes, good bit of name dropping there].

The consensus was that the human brain could use Ketone bodies for much of its energy requirement. However, there was an absolute need for about forty grams of glucose per day. The final statement on this matter, the one everyone seemed to agree on anyway, was as follows:

1)     The brain requires no dietary glucose. It has a requisite use of 40 grams/day, but these grams can easily be provided from glycerol, and normal ingestion of not particularly high amounts of protein in a high fat, zero carbohydrate diet.

2)     But this is a time dependent situation. Short term fasting will not be a problem for most otherwise healthy people. However, more prolonged starvation will eventually kill you as the brain will pirate 40 grams of glucose/day from protein and lipid, until you have neither fat stores, nor adequate diaphragm or heart muscle left to survive.

Don’t worry, there were about a thousand papers quoted in creating these statements, so the science seems robust. This discussion started because I had an interest in how hunter gatherers, who ate no carbohydrates, kept their brains going. What was the mechanism by which the Massai, Inuit and Sami, power their brains with glucose, if they don’t eat any carbohydrates?

Well, it seems that you can get a certain amount of glucose from fat. Fat is made up of triglycerides, and each triglyceride contains three fatty acids and one glycerol molecule. Two glycerol molecules stuck together (by the liver) makes one glucose molecule.

In short, pure fat does contain some glucose, which can be used to power the brain. However – assuming you are eating no carbs – the brain requires more glucose than can be provided by the glycerol held in triglycerides. Thus, you still need to convert some dietary protein into glucose. If you are not eating any food at all, the body will need to break down muscle to get at the protein required to synthesize glucose.

To cut a very long story short, the end point of the discussion was an agreement that you do not actually need to eat any carbohydrates to remain heathy. The body, and the brain, can get all the glucose it requires from glycerol and dietary protein.

The reason why I was interested in this issue was that ‘the absolute need for carbohydrates’ is a ‘fact’ that is thrown at me from time to time by ‘experts.’ I have always known they were wrong, because there are people e.g. the Massai, who never eat any carbohydrates, and remain far healthier than any expert I have ever cast my eyes upon. However, I wanted to be sure of the facts.

Anyway, time to return to the Sami. For, during this lively discussion, someone posted up two papers on the Sami that I had not seen before. Both papers noted that the Sami, despite having very high cholesterol levels, a high level of smoking, a high fat diet and almost zero carbohydrate intake – and suchlike – had a very low rate of cardiovascular disease.

This was particularly interesting for a couple of reasons. Firstly, most of the Sami live in Finland, and the Finns – at one time – had the highest rate of heart disease in the world. Not only that, but the Sami live in an area of Finland, North Karelia, which had the highest rate of heart disease in Finland. The worst of the worst.

In addition, the Sami had considerably worse ‘traditional’ risk factors for heart disease than the surrounding population. Higher cholesterol and LDL, high fat diet, far more smoking etc.

‘The finding of high cholesterol and high prevalence of smoking the Sami area are compared with the reference rate, and high cholesterol in the Samis and Finns in the north, conforms with similar observations. in studies performed previously. As the classic risk factors indicate a high risk of CHD in the north, other factors, possibly the antioxidants, are important in the low CHD mortality there.’1

[Antioxidants and their impact on CHD were studied in the Heart Protection Study (HPS), and found to have no effect on CHD whatsoever. Whilst this study was done by Rory Collins, and has many issues, the data on the lack of impact of antioxidants on CHD appear robust].

Other researchers have also tried to establish why the Sami have such a low rate of CHD/IHD. As noted in the paper ‘‘Low mortality from ischaemic heart disease in the Sami district of Finland’:

An exceptionally low mortality from IHD was found here in the Sami district of Finland and an exceptionally high mortality in a neighbouring Finnish area, a 2-3-fold contrast or even wider, depending on age and time. No difference in IHD of this magnitude between areas located so close to each other has previously been described in the literature.’2

Of course, they looked for the reasons.

‘Reasons for the rarity of IHD in the Sami district of Finland

Our current knowledge of cardiovascular risk factors cannot explain the low mortality from IHD in the Sami district of Finland. Serum cholesterol is, in fact, relatively high in the far north of Finland, and it is higher in the Sami than the Finns, the same being true of the prevalence of smoking, while the low blood pressure frequently found in the far north and among the Sami would be insufficient to cause any substantial reduction in the risk of IHD. Similar differences in serum cholesterol, blood pressure and smoking have also been found between Norwegian Sami and Norwegians of Finnish ancestry. Serum high density lipoprotein cholesterol (HDL)is usually similar in both ethnic groups, although a Finnish study found even lower HDL-total cholesterol ratios in the Sami, which would indicate an elevated risk of IHD… The high serum cholesterol in the Sami can be attributed to their fatty diet.’

In short, the Sami live in area of Finland that had the highest rate of heart disease in the world. Their risk factors were worse than the surrounding population (LDL 4.45mol/l on average), yet their heart disease rate remained very low. It was postulated that this was due to a high intake of antioxidants, but the impact of antioxidants on heart disease has been subjected to large double blind placebo controlled trial, and antioxidants were found to have no impact on heart disease.

At this point you may cry, enough of finding populations that eat a high fat diet, have high LDL levels and low rates of heart disease. It is like shooting fish in a barrel. Not that the experts pay the slightest attention to such contradictory facts. They merely label such findings a ‘paradox’ and move on. But I thought it was interesting. Another nice shiny nail in the cholesterol hypothesis. ‘You call it a paradox, I call it a contradiction… let’s call the whole things off.’

Next, my series on what truly does cause heart disease continues.

1: ‘High serum alpha-tocopherol, albumin, selenium and cholesterol, and low mortality from coronary heart disease in northern Finland’: P. V. LUOMA, S. NAYHA, K. SIKKILA & J. HASSI. Journal of lnternal Medicine 1995; 237: 49-54

2: Simo Nayha: ‘Low mortality from ischaemic heart disease in the Sami district of Finland.’ Soc. Sci. Med. Vol. 44 No. 1, pp. 123-131, 1997

P.S. I am feeling much better, thanks for those who were concerned over my welfare.

397 thoughts on “High cholesterol low heart disease – The Sami

  1. robin micheli

    Indeed, I truly am so happy you’re feeling better–I was worried about you! Thank you for continuing to share your intelligence and wit.

    Reply
  2. anton kleinschmidt

    On BBC World tonight – an insert about the growing incidence of scurvy among Australians on low carb diets. That is going to cause some ructions

    Reply
    1. rockingbass

      Hum I wonder what low carbohydrate diet those folks are doing.Stefansson found that a diet of fresh seal and caribou meat cured scurvy in the arctic and later with a college lived on butchers meat for a year .It is worth reading the whole of the Bellevue hospital experiment papers.

      Reply
      1. chris c

        And In Latest News, diabetics must eat more fruit to guard against amputations. If dieticians were worth the money they are paid they would be finding ways to increase Vitamin C without jacking blood glucose through the roof. Such as vegetables and meat. They might also know that the requirement for Vitamin C decreases without glucose spikes, and that various bioflavinoids/micronutrients recycle what Vitamin C is already there.

        Reply
    2. Bill

      From what I’ve read of late about the ‘professional’ nutrition and dietician community in Australia they will do just about anything to try and nail LCHF. I haven’t eaten a piece of fruit for years. I do eat green vegetables, and from time to time potatoes and things like carrots. I have been doing this for the past 20 years +. I should be dead by now if this ‘finding ‘ is correct. They should be more concerned with the factual increase of incidence of rickets in the vegan inclined middle classes. Got that from my wife’s cousin who’s a senior nurse in the UK NHS. Talk to her about fat though and she gets very uppety.

      Reply
  3. Sávoi

    As of Saami ancestry, I must say that we cannot eat bread, porridge, sauce made with flour etc, if we do then we get the same diseases as surrounding populations that eat a lot of such. Well, I think so.

    Reply
    1. Stephen T

      Savoi, I’m sure you’re right. A number of doctors travelling to traditional societies noticed their good health and its deterioration when ‘civilisation’ arrived, bringing with it a diet of sugar and wheat. The following is taken from ‘The Big Fat Surprise’.

      “The British Royal Navy’s Surgeon Captain Thomas L. Cleave had seen the same phenomenon in so many remote areas to which he travelled in the early 1900s that he called all chronic diseases the ‘saccharine diseases’, because so many of these ailments arrived in concert with the introduction of refined carbohydrates – principally sugar and white flour.”

      (Page 300 of my paperback version)

      Reply
  4. Sharon Caswell

    Just wondering if you have every looked at the research around metabolic typing – as in one size doesn’t fit all. Many propenents of this perspective – Dr Nick Gonzalez for one – of course he was on the “dark ” side of medicine.

    Reply
  5. Gay Corran

    Another nice shiny nail in the cholesterol hypothesis indeed. So glad you are better, Dr K. And thank you for blocking the waffleblogger whose words sounded almost scientific, but who didn’t know the difference between affect and effect. We are all looking forward to the next in the Roman numeral series, I think.

    Reply
  6. Errett

    This should be read by all—-http://jeb.biologists.org/content/214/2/337

    The largest organ of the body is skeletal muscle—-which is very active when “used” in its production of cytokines (IL6 exp.)—in this case called “myokines” since they are produced in muscle cells—-these myokines can be juxtaposed to adipokines which are produced in adipose (fat) tissue—–physical activity increases the release of myokines which act as hormones on various major organs/tissues——when the fat tissue production of adipokines dominates due to lack of physical exertion it directly leads to a panoply of diseases—-CVD–T2D–depression–dementia—colon cancer—breast cancer—-Dr. K is right it seems concerning inflammation as a fundamental causal factor in many modern diseases plaguing us—–

    Reply
  7. Dan

    I am interested where the antioxidants are coming from in the Sami diet if they are eating fat and protein and little vegetables if none at all.

    Reply
    1. Jyri Ylöstalo

      They eat a lot of berries, but so do ethnic Finns as well, so the whole antioxidant thing seems really silly.

      Reply
    2. rockingbass

      Just fresh meat soles this problem Dan see my life without bread Dr Lutz at 90
      which has a good reference section and commentry

      Reply
  8. Mr chris

    Just reading this told me you were feeling much better. I am really pleased.
    Trouble about carbs for me is that I like porridge and bread with home made marmalade!

    Reply
    1. mikecawdery

      smartersig

      Many, many thanks for the link. Selenium is a largely ignored essential element in medicine. I can remember the time when selenium caused alarm bells ringing in the drug authorities because of its toxicity. In veterinary medicine deficiencies cause severe muscular problems in sheep and cattle round the world. That it causes heart problems in humans is no surprise (eg Keshan disease a cardiomyopathy condition in China) and as Dr Graveline brought to my attention statins by their action on the mevalonate pathway also affect the selenoproteins of which there are some 30+ affecting the thyroid and pancreas and the antioxidant capacity of blood.

      This again that is totally ignored by the statinists

      Reply
    2. Gary Ogden

      smartersig: I recall reading somewhere that the highest rates of CHD in Finland were in areas with selenium-poor soils, and conversely, lower rates in areas with selenium-replete soils. As for the reindeer, could it be that they instinctively know what to eat and what to avoid, in order to provide the necessary minerals?

      Reply
  9. Stephen T

    So, the awkward Sami are another cholesterol paradox. How many paradoxes does it take before a theory has to be wrong? One paradox would have an engineer rushing back to the drawing board, but in medicine you can just keep adding them to the list.

    Reply
    1. mikecawdery

      Stephen T
      Unfortunately, when the “gospel” is concerned the number is infinite – too much money and status is involved. There is no such thing in medicine as “a safety policy”. One just has to look at the official (NHS, medical establishment, GMC) attitude to whistleblowers. Causes of death are simply swept under the table. The FDA has finally acknowledged that iatrogenic deaths are now tthird on their list of US causes of death.

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      1. Stephen T

        Sadly too true, Mike.

        If engineers and practitioners in other hard science subjects had the same cavalier and biased attitude to evidence, planes would crash every day and you’d never cross a bridge. There’s no guessing or ignoring inconvenient evidence in these fields, but medicine kills people by the million and it’s tolorated because of the tight grip of vested interests and bogus medical ‘authority’ figures. When you can’t question your boss, he or she will make a lot of mistakes and keep making them.

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      2. David Bailey

        Stephen,

        My suspicion is that every aspect of science that isn’t absolutely pinned down by the need to avoid planes crashing, or the need for chips to actually run at the desired speed, etc, has become suspect!

        After reading how scientists behave in the medical field, do you really believe that the universe is 95% dark matter, or that scientists can probe to within 10^-33 of a second after the big bang (if indeed it happened) by studying minute fluctuations in the CMB, or that they have detected particles such as the Higgs, which only lives for 10^-25 second – not enough time for light to cross the diameter of a proton!

        Reply
  10. JanB

    You’re on form and obviously feeling better. Good.
    Some time ago there was a strange programme on television about the Sami. No sound track – just the filming for hours and hours of women leading reindeer and sled through a snowbound landscape. A demonstration of the truly beautiful traditional lifestyle of the Sami people and just about as far as you could get from our hectic, stressful Western way of life. I wonder if anyone else saw it?

    Reply
  11. Martin Back

    I’m glad to hear you are better, Dr. Kendrick. Personally, I avoid mixing with sick people; it helps me keep healthy. Alas, that is not an option for a doctor.

    Regarding the Sami: Is there any information on plaque formation? If they take as much exercise as the Maasai, walking many miles per day, it could be they have built up so many collateral arteries in their hearts that even if they build up plaque at the same rate as Westerners, a few blockages won’t be enough to cause IHD. Autopsy results could be interesting.

    Reply
  12. luanali

    Dr. Kendrick, thank you for another great article. A couple of questions:
    1) When you said, “…you do not actually need to eat any carbohydrates to remain healthy,” by healthy you mean getting enough glucose, or do you mean that as a general statement across the board, even for getting enough vitamins and minerals?

    2) You mentioned that the beneficial impact of antioxidants on heart disease has been dismissed by some very good studies. Did these include vitamin C? We’ve talked so much here about the benefits of vitamin C on heart disease. Could you comment on these studies up against our discussions on C?

    Thank you again for your wonderful service.

    Reply
    1. mikecawdery

      Just a point. When such results come out have the researchers actually measured the Total Antioxidant Capacity of blood? So far as I can find this never is considered. ROS (Reactive Oxygen Species) pops up in many conditions. As Dr Graveline pointed out uncontrolled ROS can cause mutations in both mitochondrial DNA (mtDNA) and in nuclear DNA. In 80% of pet-CT scans of solid tumours typically there is evidence of mitochondrial damage. (Christofferson, Travis. Tripping Over the Truth: The Metabolic Theory of Cancer ). Another reason why statins may cause cancer in humans as they do in rodents.

      Reply
      1. John U

        I can’t say that I know much about ROS, but after reading the book by Nick Lane (Power, Sex, and Suicide, the story of the mitochondria), and I read it twice, I have come to question this whole concept of treating ROS with antioxidants. From what I understand, ROS are formed in the Mitochondria, a result of electrons leaking from the ETC, the Electron Transport Chain. These free electrons rapidly combine with any available molecule which might be an electron receptor, to form an ROS. There is no reasonable mechanism for ingested antioxidants to affect what happens in the hundreds to thousands of mitochondria in our cells. Besides, the ROS produced are often used to signal the apoptosis of cells, something that happens some 10 billion times per day in our bodies. It would not be beneficial for us to interfere with this process. Are there other sources of ROS other than from the mitochondria? How would a very reactive oxidizing ion be created other than in the mitochondria? Perhaps this flood of information we receive almost daily to eat veggies and fruits for their antioxidant properties is totally without scientific merit.

        Reply
      2. Craig E

        Mike I am part way through Seyfried’s book on this subject…tis a very heavy read even for someone who studied biochem at Uni. I must say the mitochondrial/energy disruption theory of cancer seems more plausible as a cause than does the genomic theory. From what I have read all tumors must use either glucose or glutamine as fuel to generate ATP due to OxPhos problems in the mitochondria. There is also the experients where nuclei from tumor cells were transplanted into healthy cells and the cells stayed healthy…surely that puts pay to genomic causality. Also how could so many different gene mutations lead to the same outcome ie anaerobic fermentation of glucose/glutamine even in the presence of oxygen.

        Reply
      3. mikecawdery

        John U

        You are right about the mitochondrial generation of ROS in the process of cell energy production. However, to counteract this problem the mevalonate metabolic pathway also forms isoprenyl and ubiquinone or CoQ10. Thus disruption of the mevalonate pathway by statins inevitably disrupts not only cholesterol production but also CoQ10, the seleno-proteins (one of which is GPX), the dolichols etc. This was pointed out by Dr. Graveline, to quote:

        I have written before about the genetic complications secondary to statin use, but always with reference to mitochondrial DNA damage and mutations. Because of the programmed inhibition of the mevalonate pathway by statins, this will inevitably inhibit CoQ10 allowing excess free radical oxidation of mitochondrial DNA causing damage and mutations

        https://www.spacedoc.com/articles/statin-damage-gene?utm_source=December+4%2C+2016&utm_campaign=November+2016+Newsletter&utm_medium=email

        This action of statins is well known to the pharmaceutical industry to the point where Merck has US patents (#4,933,165 and #5,082,650) to combine CoQ10 with their two statins which are given orally. As you may have noticed this is very rarely if ever mentioned by the industry. I would point out that this disruption of CoQ10 occurs in every cell of the body, and may be responsible for the extensive range of adverse events reported to the MHRA and listed in their DAPs.

        Dr Langjoens has long supported the use of CoQ10 in association with statin use, (Chapter 5;
        Paul J Rosch, Editor. Fat and Cholesterol Don’t Cause Heart Attacks and Statins Are Not The Solution) and has several publications on this issue (Expert Rev Clin Pharmacol 2015; 8: 189-99.; Expert Rev Clin Pharmacol 2015;8: 189-99.And others)

        This would tie in with Ames claim many years ago (Ames BN 2040 CANCER May 15 1984 Vol. 53) that statins were caecinogenetic in standard rodent tests. It also ties in with the fact that most solid tumours under a Pet-CT scan show mitochondrial damage (ie reversion to a primitive energy fermentation process for energy production – Christoferson: ISBN: 1500600318 & ISBN 13: 9781500600310).

        I would also point out that the TAC (total antioxidant capacity of blood) is now being used for evaluation of general health and peak fitness in man and horses (http://www.KnightScientific.com). Low TAC is also a feature of diabetics. May be someone will catch on and check levels of TAC in other chronic diseases.

        Reply
        1. luanali

          Just to clarify, Dr. Langsjoen doesn’t encourage statin use with CoQ10; he takes his patients off statins entirely and then helps them recover their CoQ10. He then tells them not to worry if they just paid for a prescription because they can use the statin as a free pesticide for things like fire ants. Kills weeds and house plants too, he says!

          Reply
      4. mikecawdery

        Craig,

        Seyfried’s book is beyond my purse and probably beyond my comprehension as biochemistry is not in my qualifications 60+ years ago. However I did find Christoferson’s book ISBN: 1500600318 & ISBN 13: 9781500600310 highly interesting and informative. There is also the fact that solid tumours may revert to the primitive an inefficient form of glucose utilization as suggested by the research of Pedersen and KO.. I note that Tom Watson (of DNA fame) is also considering the possibility of cancer being a metabolic disease. Makes sense to me but does not provide a profit motive for Big Pharma to provide grants.

        Personally I believe that public money (ie charitable donations and tax-payer money) should be used for such research rather than assisting research designed to enhance Big Pharma profits.

        Reply
      5. mikecawdery

        luanali

        Yes indeed you are right. I apologize for the misrepresentation. I believe he also has a US patent on the subject. I love the bit about it being both a parasiticide and weed killer. I will certainly pass that on to doctors.
        And many, many thanks too you for the video. Again I will pass that on.

        Reply
  13. Jennifer.

    Dr Kendrick….Along with others, I am so pleased to hear you are feeling better.
    Having read you new blog, which I found most interesting, thankyou, I think we would all agree that dietary intake is an important factor in good health. What we would agree as consisting of the definitive dietary intake, is up for debate all around the globe.
    I removed a lot of CHO from my diet almost 4 years ago, and found it beneficial. I mentioned recently that I have been re-introducing particular carbs, and without any detrimental effects. Now….having studied the topic almost to the point of gaining a PhD ( I should be so lucky), I now understand the phenomenon of FERMENTABLE carbs….. I do believe all carbs can be fermented, but many would not be particularly palatable. However, if the carbs I choose to eat are properly FERMENTED, such as the grains I use when making sourdough, then I believe they become safer. Note…SAFER. Caution is still required.
    Maybe I am treading a tight rope by reintroducing carbs, (which in my heart I am convinced are not absolutely necessary for health). But, we humans do love carbs……and at pushing 70, I am willing to take the qualified risk of eating certain carbs, whilst being very careful in what I chose to eat, and, more important, how I prepare them for consumption.
    As a nation, we have lost so many of the traditional ways of producing good, nutritional foods, and it saddens me that recent generations have been reduced to eating fast junk food etc…..the folks reading this blog know what I put into the category of junk….at the behest of commercial enterprises.
    I am most interested in the various communities around the globe, and their individual diets, but here in the UK, we must remember that we, too, must have been weaned on decent foodstuffs, and commonly based on carbs E.g. I always believed gruel was a poor man’s food, barely sustainable for health, but now I understand that when prepared over a longish period of time, as with making porridge with groats, these fermented foods were indeed healthy.
    So….I say…chuck out the refined carbs, and add in some carbs, but in their FERMENTED form.

    Reply
    1. mikecawdery

      Jennifer

      I think we would all agree that dietary intake is an important factor in good health.
      Indeed.
      The trouble is that the experts of Big Pharma and the medical establishment believe otherwise. Their solution is always more pharmaceuticals. Until training in medicine includes a substantial element of basic biochemical nutrition this will not change

      Reply
      1. Jennifer

        Mike, I have resorted to my own means this last few years (with much help and direction from this blog), and no longer use anything from Big Pharma unless I fully understand the reasons why something is prescribed for me ( I needed treatment for a bout of shingles last year).
        I try my utmost to avoid processed food, but as can be imagined, total fresh food production is very time consuming, but a price worth paying for my husband and I, now that we are well retired from having to earn an income.
        Alas, I can’t see how modern lifestyles can accommodate endless hours of food preparation. The families are stuck in a spiral of over working long hours, short sleeps, convenience (junk) food, and the endless pharmaceuticals needed to try to reverse the poor health conditions associated with such a way of living.
        And it suits industrial food producers and Big Pharma to encourage such debilitating lifestyles.(ching, ching). I believe if the medical profession were to incorporate proper nutrition into their training, and also how to convince their patients as to what they ought to eat, it would fall on deaf ears….or, even worse, the shadow of litigation would hang heavy on their shoulders.

        Reply
    2. Nigella P

      Jennifer, I am a single mum of two & I work full time but I have no difficulty preparing, healthy, economical meals. There is no need to spend hours in food prep. My slow cooker is the best buy I ever made. It take me 15 minutes to prepare a casserole. Fry off everything I’m chucking in it, a pint of stock, a few herbs & seasonings & when I come home in the evening there it is waiting for me. 15 minutes!!!!! Stir frys take about 15 minutes. Slow cooker also makes great soups, again taking very little time. I do one pot risottos, which take about 10 or so minutes chopping & frying time & then just the occasional stir for the next 30 mins. I could go on & on & on. Healthy family cooking can be cheap, easy & quick. I cannot quite get my head around why more people don’t do it.

      Reply
      1. Jennifer

        Nigella.I appreciate how quick it is to make decent, quality dinners in slow cookers. I worked
        full time as a Nurse and fed my family a decent diet….BUT….we like other things in life other
        than savoury dinners, and there lies the problem. Kids like puddings….(I make my own plain
        yogurt and flavour it with nuts, seeds and a dash of fruit.) Kids like crisps (I dehydrate
        veggies). I like fizzy drinks…..water kefir is a fine substitute. The whole family enjoy bread….I
        grind my own organic wheat/rye berries and make true sourdough bread……a longish process that needs to be planned(despite what the cook books say). We love pastries and pies for our trips away from home, and I make egg-based pastry-free flans, I pickle eggs, onions and red cabbage. I produce preservative-free sausages and do salted beef joints, I make sugar-free chutney to serve with cheese. I am struggling to make healthy sauerkraut, but have mastered making my own raw, health-enriching vinegars.
        Now, I don’t want to sound conceited, but these are the foods that take time to make, and time to clean up after, but I make them because they give a variety of healthy, additive-free accompaniments, to serve alongside the healthy dinners. They make life interesting. By doing so, I avoid as much commercially produced ‘food’ as possible, but I can assure you it is time consuming.

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      2. Bill

        Nigella
        You took the words from my mouth on this one. ‘We all live such busy, modern, lifestyles’ is an excuse for laziness and plays right into the hands of our friends the food ‘manufacturers’ (that word when it comes to food bothers me a lot). Despite myself and my wife working through the ’80’s and ’90’s we almost always had freshly prepared food for us and the kids. What’s more important, your health or the latest episode of your favourite soap?

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      3. PeggySue

        Actually, not just laziness, there is a shocking lack of know-how amongst the under 40’s in this country. They were never taught fundamentals of home economics at school and the majority of “cookbooks” these days are just ways to assemble expensive ingredients.
        Give them a shoulder of pork and a few veg and they’d be stumped.

        Reply
    3. Martin Back

      Jennifer, as you say, “we humans do love carbs”.

      While mowing the lawn I had a thought. Why is it that almost everyone loves the smell of new-mown grass or hay? Evolution posits that something only becomes wide-spread if it has survival value. So there must be some human survival value to loving the smell of new-mown hay. What could it be?

      My first idea was that in the distant past before the lawnmower was invented, grasses were only cut to harvest the seeds, therefore the smell alerted one to the fact that newly-harvested grass seeds were probably stored nearby and it might be a good idea to organize a raiding party and steal them.

      My second idea was that the smell of new-mown hay is quite close to the smell of stable dung, and if one were to smell a recently-dropped turd lying unseen in the grass, it was a sign that food on the hoof was nearby and it might be a good idea to unsheathe the bow and arrow.

      My third idea was that eating fresh camel or horse dung was the cure for dysentery among the Arabs, as Rommel’s Afrika Corps discovered during WWII, and maybe the smell meant the cure for a runny tummy was nearby. (Dysentery was likely a major problem in more primitive times.)

      I asked Mr. Google why we liked the smell, but apart from saying the smell is a defensive move on the part of the grass, he was silent on the matter.

      Reply
      1. Jennifer.

        Oh Martin! I know I want to encourage getting back to more basic ways of food production and natural ways of storing food…..but I don’t think I could go back that far…..However, you have described an important fact that is being used ( and apparently with excellent results), in the modern day…..that of inoculating faeces into the bowel ( rather than eating it), for those with severe digestive disorders. What goes around, comes around, as they say. Is there anything new in the world today?
        But you made me chuckle….remembering the old nursing joke of the rectal suppositories used to help with breathing difficulties….only to discover someone had shoved them up each nostril….much to the alarm of the poor patient who was struggling even more to breathe.

        Reply
      2. mikecawdery

        Martin,

        An interesting thought. The cholesterol myth started with rabbits being force fed cholesterol and since the concept of a rabbit reflecting what happens in humans is apparently valid, I always wondered why these researchers did not suggest a raw grass and herbage diet to prevent heart attacks in humans – after all it does work for rabbits. But of course grass is not patentable so no profit motive.

        Reply
    4. Maggie

      Jennifer why not be guided by your glucometer? Eat the carbs you love and test afterwards at intervals to see how you are reacting. You will know if they are safe for you to eat.

      Reply
      1. Jennifer.

        Maggie. I stopped using my glucometer when I stopped my meds. Sounds mad? I had changed my diet over a period of months, and the endocrinologist was amazed at my blood profile. He asked how I had achieved it. Well, I had reverted to the rules I learned in the 1960s as to how to manage diabetes ( type 1, although I was type 2, I reckoned I would be doing myself no harm).
        I have mentioned the way I prepare foods ( now including carbs), so that they are as health giving and safe as I know possible. My time is better spent on food prep rather than endless visits to the surgery for tests upon tests, repeat prescriptions for loads of drugs ( which have been shown to be unnecessary), and the dreaded finger pricks which were dominating my every day, post-prandial hours.
        As I always say, though, I do not advocate anyone following my methods, I merely tell my tale, and comment on my progress, nearly 4 years after the changes.

        Reply
      2. chris c

        I did this for a long time

        http://loraldiabetes.blogspot.co.uk/2009/04/test-test-test.html

        stopped bothering when my BG was usually between 4 – 6 and sometimes 7, which I largely achieved by eating the exact opposite of what the dietician told me.

        Now I use the Mk 1 nose – if my pee whiffs of ketones first thing in the morning and less during the rest of the day, then I reckon I am generating them at about the same rate I am using them. Which is good.

        Reply
  14. Ben Gunn

    I understand that people living the primitive life tend to die young from accidents and infection. So might they not live long enough to show CHD as a cause of death in significant numbers?

    Reply
    1. Jyri Ylöstalo

      Their life isn’t as primitive as you may think. The Sami have regular, public health services just like anybody else in Finland. I can’t see any reason why they would die young from infection.

      Reply
      1. smartersig

        Nothing wrong with creating ad hoc hypothesis or lateral thinking as I prefer to call it. Agree that to then nail your colours to them without data is a sin

        Reply
    2. annielaurie98524

      It’s time we retired the silly old woozle that “primitive people” have/had an inherently low lifespan and are/were mostly dead by forty. The short AVERAGE lifespans of truly primitive folk result from their high rates of infant/maternal mortality (a not unexpected result of the evolved configuration of the human head combined with the higher vulnerability to infections/accidents in infancy). Don’t confuse average lifespan with individual longevity. It is simply a fallacy that “primitive people” age more rapidly than “civilized folk”. Did you know that life expectancy in “civilized” regions in Greek and Roman times, the Late Medieval era, and the Victorian era was only 35 – 40 years? It was only in the early 20th century that global human lifespans started to rise beyond the 30 – 40 year range. Do you really believe that “primitive people” aged faster, when, today, modern pre-teens suffer in large numbers from what used to be the degenerative diseases of old age: so-called “adult-onset” diabetes and atherosclerosis?

      Reply
      1. Gaetan

        Plato lived up to 80 y.o. and Socrates up to 71 only because he had to drink a poison. Their diet was probably not LCHF, So even before Christ, human beings lived pretty old. The mortality of infatns was very high and even teenagers. Maybe 1 out of 20 made it past 20 y.o. but after that they lived up very old.

        Reply
      2. Sylvia

        Of course during the industrial revolution, mid 19th century, it did not help that very young children were used in industry as cheap labour, stuffed up chimneys etc,
        Edwin Chadwick a champion of sanitation, made a great difference. Now we just have to worry about fluoride in the water supply and goodness knows what else they would like to mass medicate us with. Not too long ago, here in Lancashire we had the crypto bug in our water supply, not only people but some of our animals became quite ill for a time. Worrying.

        Reply
      3. Stephen T

        True. Children died in shocking numbers in earlier times, but they got through childhood they had a good chance of a decent lifespan.

        Reply
      4. Bill

        I live in a small village in the middle of Norfolk. I am interested in the local history and often visit churchyards. There are plenty of headstones of people who died in their ’70’s and ’80’s in the 19th century. They of course were the local more well to do people in general. They must of had access to much better quality food methinks. This would have been good meat and veg etc, the peasants were eating crap bread, cheese and dodgy meat. Sounds a bit like now really.

        Reply
      5. chris c

        Much the same this side of the border in Suffolk. Part of it may be genetic, one line of my family is from around these parts about three generations ago, My mother lived to 95 (record holder AFAIK) her cousins 88 and 91, her own mother 90. Males don’t do so well though, there’s a weird kind of diabetes which killed her brother when he was not much older than I am now (heart attack) and there are a bunch of others, mostly but not exclusively male, and also a significant number of children who died before or soon after birth like my siblings.

        One of my neighbours was 108 1/2 though I wouldn’t really recommend that.

        When even the checkout girls in the supermarket have noticed the fat people buying their “Low Fat!!!” foods and getting ever fatter, while the fit healthy old folks are all in the butchers, greengrocers and farm shops, there’s a strong environmental factor also. Part of it may be that the glaciations came down this far and I understand Norfolk and Suffolk soils except for the much later coastal sands are relate with selenium.

        Reply
  15. celia

    Makes you want to jump up and scream! We have to remove vested interests from medicine and stop the drug companies “educating” both doctors and the public. It’s a scandal!

    Reply
  16. dearieme

    Could there be some genetic difference between the Lapps, and their Finn and Swedish neighbours, that explains the different vulnerability to CVD? Or could there be something protective in their diet? Or could it be that they live at low population density, thus protecting them from particular infections?

    Reply
    1. Eric

      Just from the appearance of a classmate in elementary school who was half Sami (albeit from the Norwegian side), you could not distinguish her from other central Europeans. Quick look at wikipedia tells me that they have predominantly European genetic heritage but maybe a branch that got isolated early. There are also studies that hint at a part Asian influence, but they appear to be disputed.

      Reply
      1. annielaurie98524

        Gee, do you think so? Why, that would make them similar to so many other “primitive people” that eat whole foods and are free of modern diseases! Rather than these folks being “anomalies”, it seems there is a fairly consistent pattern here. There you go, being logical again!

        Reply
    1. John U

      Peter made an arithmetic error in this post, I believe, and will be reposting eventually. However, I don’t understand your question.

      Reply
  17. mikecawdery

    That statement made my blood pressure rocket.

    First, the so-called “vitamin cocktail used” excluded the antioxidant CoQ10 despite the fact Merck holds two patents for combining it with their two statins. Its exclusion was obviously a deliberate attempt to divert attention from this fact and the fact that CoQ10 has been found to be of value in CHD and in avoiding some of the adverse reactions caused by statins.

    Second, the study was designed as a two-by-two factorial. This means that there are effectively four treatments:
    1) Simvastatin alone, 2) simvastatin + vitamin cocktail,
    3) placebo 4) Vitamin cocktail alone,.
    Its analysis gives:
    Treatment 1 prob of effect
    Treatment 2 prob of effect
    Interaction prob of effect
    I have never been able to find the result of the interaqction effect

    The data can also be analysed independently for:
    TRT 1 versus placebo
    TRT 2 versus placebo
    Sufficient data has never been available for these analyses as pointed out by Dr de Lorgeril

    Third, there are also the data from the dead and alive in each treatment group. For example, the TC levels between the dead statin treated and the dead no statin group etc, etc. The flaws and hidden data in this study are horrific. In my assessment this study should never have been published.

    Reply
      1. mikecawdery

        Dr Kendrick,

        As with most commentators I am delighted you are back in form and fighting for common sense and proper science. I am afraid that the para

        Antioxidants and their impact on CHD were studied in the Heart Protection Study (HPS), and found to have no effect on CHD whatsoever. Whilst this study was done by Rory Collins, and has many issues, the data on the lack of impact of antioxidants on CHD appear robust

        (which unfortunately was left out of my initial comment) so annoyed and distracted me that my congratulations were missed for which I sincerely apologise

        I will come back with my views but for the present the following are my contributions to the BMJ rapid responses. Drs de Lorgeril, Ravnskov, Kendrick, Graveline, Rosch, Sultan, Kauffman, Gotzsche, LeFanu, Angell and many others and my own general experience in research have lead me to my conclusions. Frankly I find inflation of efficacy with Rrs, ORs and HRs is deplorable but Collins’ “ Treat 3 million and “save10,000 p.a.”, a simple one third of one percent efficacy rate in reducing deaths in and already affected statin tolerant population against a placebo really takes the biscuit for commercial astroturfing and agnotology

        http://www.bmj.com/rapid-responses Search on “cawdery” for all of them

        re: statins (if anyone approves a tick would be appreciated)

        http://www.bmj.com/content/349/bmj.g4745/rr/761544

        http://www.bmj.com/content/353/bmj.i3379/rr

        http://www.bmj.com/content/349/bmj.g5038/rr/762382

        http://www.bmj.com/content/348/bmj.g3306/rr/699558

        Reply
  18. Gary Ogden

    The paradox of all paradoxes! And they’re not even French! Makes you wish you were born Sami. Methinks they could teach us something, or at least teach the tormenters of Dr.’s Noakes and Fettke something.

    Reply
  19. Sue Richardson

    As my Dad used to say when someone just wouldnt or couldn’t see the point “oh for goodness sake, get a mallet!” I think it needs more than a mallet.

    Reply
  20. Frederica Huxley

    Fascinating! One may wonder what the Sami are not doing/eating that is protecting them from CVD even though they indulge in ‘traditional’ high risk behaviour.

    Reply
    1. annielaurie98524

      Duh! They are eating weird, mysterious substances that are almost unknown in modern civilization — whole foods! No magical mushrooms, pixie-dust-sprinkled arctic mosses. Just real, unprocessed foods. And they are living the life most humans did throughout our history — no job stresses. Normal social support relationships. Schedules dictated by the natural diurnal cycle. Etc. As for the so-called “risk factors”, they are so much unscientific balderdash. If those alleged risk factors really were inherent risk factors, we would not be seeing all these “anomalies” and “paradoxes”. When the number of paradoxes exceeds the number of cases that fit the current pet hypothesis, it’s time to abandon the hypothesis. That is one of the steps in the scientific method.

      Reply
      1. Martin Back

        Annie, while I agree that traditional people had healthier diets because of eating fresh, minimally processed food, I’m not sure they had less stressful lives.

        “no job stresses” means no income to pay for medical aid or insurance policies or savings against a rainy day, so illness or misfortune were probably far more catastrophic than to a modern Westerner.

        “Normal social support relationships” are a two-way street. In return for social support, you are required to do your bit in helping others in your social network. And you might be expected to chip in when it doesn’t suit you. My limited experience of African social obligations is they are extremely strong. People will go to great lengths to avoid being ostracised for not meeting their traditional commitments.

        “the natural diurnal cycle” means limited time between sunrise and sunset to accomplish the tasks for the day and back to safety in camp. Being isolated means being at the mercy of local extreme weather. Records of ancient times are full of mentions of famine. And you can’t just pack up and leave. Neighboring tribes will dispute your access to farming or grazing ground, when they aren’t actively stealing your cattle, grain, and women.

        Reply
  21. kuukelikyy

    Did anyone look for inheritated high cholesterol? Or other genetic factors??

    A female friend of mine, born in North Karelia lives now 68 years with a cholesterol of 300(!) and is doing fine.

    All my relatives – Karelians – died aged 59-63 of IHD.

    I`m 69 now… but living in Germany since 1968. Is it the beer perhaps…

    Best regards & wishes Tuulikki Kyytsönen

    Reply
  22. Gaetan

    A Possible explanation is, these people have a strong social identity to their group, a great social cohesion and support from their peers, as opposed to the dislocation, poor identity, very low social interaction of modern societies. Nothing to do with their diet, altho it might protect them from CHD, CVD or IHD ( we would need to compare with other natives population who haven’t been totally disseminated, and fell into hard drugs and alcoholism )

    Another thing important to point out is, they might not live, in general, old enough to suffer from heart problems, and if they do live very old (85+) they still die of something. So what kills them?

    Reply
    1. Sylvia

      From some little history I have read about Sami, it is said their health and mortality is the same as the rest of the Northern scandi people.
      Dr Kendrick, you do take us around the globe and it is utterly fascinating. Thanks for another good blog. Our education is still evolving on such important matters as health. Taking responsibility for our own health should be on school curriculums.

      Reply
  23. Randall

    My son worked on a project in a small Inuit community in Nunavut a few years ago. At the time I questioned him about the people and their diet. One of the local Inuit told him the Inuit that hunted the local animals and fish were doing fine health wise, but the Inuit that ate food from the south did not fare so well.

    Reply
  24. Mark Johnson

    Widely reported across the media: the world’s oldest woman has just turned 117. Born in 1899, Morano, of Verbania, Italy began eating eggs religiously when she was 20 years old (97 years ago!), after a doctor diagnosed her with anemia and told her to consume two raw eggs and a cooked one each day.

    Her current doctor, Carlo Bava, confirmed that his patient didn’t follow conventional nutritional advice. (Probably was conventional nutritional advice 100 years ago…)

    “Emma has always eaten very few vegetables, very little fruit. When I met her, she ate three eggs per day, two raw in the morning and then an omelette at noon, and chicken at dinner,” he said.

    Shock, horror. The world’s oldest person alive doesn’t eat 5 (or whatever number it is in Italy) a day. Don’t tell the nutritionists – they’ll have a heart attack! 😉

    Reply
    1. TS

      Thank you for this – interesting because I have sometimes wondered if eating a very varied diet is so very good for us. Eggs provide an embryo chick with everything it needs. I have tried to encourage my 93 year old mother to eat them but she’s been told they are bad for her (cholesterol!). The body likes to form habits. Do we give it extra work by providing it with so much variation? It seems to be able to adapt to certain conditions, but if those conditions keep changing or are too varied…..??

      Reply
      1. Martin Back

        I can’t find the reference now, but apparently the Maasai with a monotonous diet have a wider variety of gut flora than Westerners with a much more varied diet.

        They have found the same pattern in fish: “The researchers expected that the generalists, the fish dining on the mixed diet, would have more diversity in their gut microbes than the fish that specialized in one type of prey. Because the mixed diet would expose the fish to a larger variety of microbes and their guts would hold a more diverse buffet for the microbes to munch on, it seemed a logical conclusion.

        The researchers found the opposite to be true: The fish that favored one type of food item had more bacterial diversity in their guts than fish that ate a mixture of prey.”https://news.utexas.edu/2014/05/28/variety-in-diet-can-hamper-microbial-diversity-in-the-gut

        Reply
  25. Eric

    Very interesting, thank you. Never knew they were into smoking. Must be a relatively new habit?

    Also (not having reat the studies), what time do they cover? I would suspect the Sami, much as the Inuit in Canada and Greenland, have had access to Western food for many decades, and I find it hard to believe entire districts kept sticking strictly to traditional diets.

    To take up a theme from the previous thread: where do they get their vitamin D? They probably don’t make much up that high, and I doubt the Reindeer make much from such little sunlight and eating what grows up there. Is their diet supplemented with fatty fish? My understanding is that plankton the fatty fish feed on also will make vitamin D only when exposed to UVB.

    Reply
    1. Doug

      I can’t speak for the Sami but in Canada the distance ‘modern foods’ have to travel to get to the Inuit makes them very costly. These people live on very limited resources monetarily so to say they have had exposure to modern food, while true, misses the reality.

      There is also a pushback by the Inuit for many things that do not enhance their way of life. As an example they will adopt modes of transport that prove better than traditional modes while using these modes to support traditional ways of life like hunting, even though hunting with modern tools has supplanted historic tools.

      They do keep a very traditional diet because it also supports the traditional way of life and histories. Those that stray from the traditional oftentimes find themselves in trouble.

      Reply
    2. Doug

      This comment is for the doc, context is everything.

      Being on the other side of the pond, you guys might not truly understand how isolated the Inuit are, even in today’s age. So I thought I would add a little context to my previous post:

      Nunavut is a Territory in Canada whose capital is Iqaluit. It is a little over 2 million square kilometers in area and is primarily populated by Inuit, although they also live in many other locations

      How to get to Iqaluit from Canada’s capital of Ottawa:
      Fly – ~4 hours at $2,500 per person.
      Drive – you can’t
      Water – yes, the ocean does open up for a couple of months in the summer at Iqaluit but not for many other areas. Only large ocean vessels can make the trip.

      From Iqaluit to many smaller villages could be several thousand kilometers (again, no roads) by dog sled, four wheel trike, or snowmobile, all the while carrying all your provisions and fuel with you as well as any ‘modern foods’ you might want.

      The Inuit still practice traditional hunting/gathering because they don’t have a choice.

      Kepp up the good work doc, glad you’re feeling better.

      Reply
    3. Eric

      Doug,

      thanks for your perspective. On the other hand, I remember reading plenty of reports about Inuit having among the worst obesity rates because of the switch to non-traditional food.

      I just found this:

      Canada, which paid one third the cost of generating the IOM report, is in a particularly difficult situation. Its First Nations peoples, living near the Arctic Circle, do not get any vitamin D from the sun, as do those of us living at more temperate latitudes. They are totally dependent upon food and supplement sources. Their ancestral diets, based largely on seals and whales, constituted a rich source of vitamin D. They are much less commonly consumed today, in part because of the ready availability of low nutrient density foods flown in from the south, and in part because environmental pollution has made seal and whale products a source of dangerous toxins (as well as necessary nutrients). The Canadian government, responsible for the health of all of its citizens, can turn only to the existing IOM recommendation (600 IU per day) to set standards for the people living in its northern territories.

      from: http://blogs.creighton.edu/heaney/2015/02/13/the-iom-miscalculated-its-rda-for-vitamin-d/

      Reply
      1. TS

        Yes, and my understanding is that vitamin D from food sources is tiny compared with that available (in the right latitudes) from sunlight. And if standard cod liver oil is consumed there is supposed to be a risk of vitamin A overdose, since vitamin A is stored in the body. I would like to know more about how people in such northern latitudes managed to keep healthy before supplementation. Seems rather enigmatic. Especially since some suggest that sunlight has “missing ingredients” (e.g. nitric oxide?)

        Reply
        1. smartersig

          I am hoping for some Brazil nuts from Santa this xmas, but he would be advised to park the reindeer around the corner

          Reply
      2. Doug

        Hi Eric,

        Yes, when First Nations and Inuit switch foods they are quick to ‘catch’ the diseases of modern society. Be careful though, there is a very big difference between First Nation and Inuit when they live in their communities. Most First Nations live very close to modern cities and have easy access to modern foods. Also, heath may be adversely effected because many of them also live in poor conditions because of many factors, not the least of which is how the Canadian government, and by extension the Canadian people, have ignored them. In many cases they are the poorest people in Canada, by a very large margin, without properly treated water and sewage.

        Inuit, those living outside of Iqaluit, are by far some of the most remote, isolated peoples on earth. They would rely on traditional ways of life more closely aligned to pre European times.

        Your second paragraph of the original post is true “… and I find it hard to believe entire districts kept sticking strictly to traditional diets.” Some districts have not kept to traditional foods but some have. I was just giving context to our non-Canadian readers. It’s hard to ignore a Tim Hortons Double Double with a doughnut. (a coffee with two heaping spoonfuls of sugar taken two or three times a day by most Canadians including First Nations, and I’m not even exaggerating. So important is a Tim Hortons that we set one up in Kandahar, Afghanistan)

        http://www.timhortons.com/ca/en/corporate/news-release.php?id=7542

        As I said in my second post, Context is everything.

        Reply
      3. TS

        Just a quote from the reindeer uv eyesight article: ‘The frozen wastes of the Arctic reflect around 90 per cent of the UV light that hits them; snow-free land typically reflects only a few per cent.’ This obviously helps.

        Reply
  26. Lee

    In your next series on what really causes heart disease, could you please summarise major influencing factors that either promote or prevent heart disease; practical things that people can use in order to manage their risk? Thanks

    Reply
  27. rockingbass

    Very Pleased you are felling better Mike..A fascinating blog.I remember reading these papers and many others when I was researching and thinking of going on a low carbohydrate diet.back in 1995-7 From what I can understand the protein need to make carbohydrate for use by the body can be made from the waste products of our dead body cells.
    It is apparently essential when eating an all meat diet to eat enough fat and not just lean meat..The ratio appears to be 30% fat to 70% lean.(Blake Donaldson-Strong Medicine)This can be a problem today when much of the fat on butchers meet is taken off…I add a bit of butter if the meat is too dry..But there is no worries about this as one’s seems to regulate fat intake provided one keeps to 70 grams of carbohydrate a day (Uncle Wolfi’s Secret .a tribute to Dr Wolfgang Lutz 2nd edition) By the way just butchers meat seems to be fine….(Steffanson, Discovery)

    Reply
  28. Jyri Ylöstalo

    No, the Sami do not live in North Carelia. This is about as silly as claiming that the Scottish Highlanders live in Norfolk.

    Reply
  29. DavidMac

    I tried to post this yesterday but it didn’t work.

    I don’t know whether any of you saw the French/German Arte TV programme “Cholestérol – Le grand bluff” (85mins) on Tuesday morning. I caught some of it, but have now found a download link https://openload.co/f/wBlKY3GB9JA. Those of you with better French than me might appreciate it. Arte is a mainstream channel and it will be interesting to see if the programme gets the same reaction as did the recent Australian progammes.

    Reply
    1. Gaetan

      thx for that video. at 11:35 Dr. de Lorgeril says, The Framingham study shows that there is a direct link between smoking and heart diseases, hyper tension and heart diseases and sedentary and heart diseases, but no link between cholesterol whatsoever and heart diseases. ” il n’y a aucune relation entre le cholestérol et le risques de maladies cardio-vasculaires”

      Reply
  30. Nigella P

    I’ve been spending a week in Finland, right up in the Arctic Circle, every year now for 7 years now and have noticed that the Finns eating a traditional Finnish diet – not even a Sami diet – generally eat less carbs then we would here in the UK. They eat much less dairy produce and much less refined wheat products. Tonnes of salmon, at every meal there seem to be huge plates of it (smoked, poached, dried, baked), lots of reindeer meat, root vegetables & their various berries, in juices, jellies etc. They are also incredibly outdoorsy. In Winter they do a huge range of outdoor snow based activities & in the summer they camp, hike, canoe & spend as much time as they can out of doors.
    Not to mention saunas, ice dips, rolling in the snow & then back in the hot tub. They start doing all of this as babies & you see very elderly people taking part too. Must be great for relaxation & circulation.
    Appreciate that this is just my own anecdotal observation but it seems to me that there are many aspects of this lifestyle that would be good for heart health.

    Reply
    1. Jyri Ylöstalo

      This again shows how we are on a slippery slope when talking about the “traditional” diet of this and that ethnic group. So you have been in a restaurant serving “traditional” Finnish food, probably something like salmon flambéed with cognac… It is NOT true that Finns would eat very little carbs – they eat lots potatoes and rye bread. They DO use a lot of dairy – drinking milk with food is quite common. Also, the general health of Finns is NOT especially good by EU standards – look at statistics for DM2, IHD, Alzheimer.

      Reply
      1. Nigella P

        Apologies Jyri, I didn’t mean to offend, as I said it was just my observations. I stay with Finnish friends & yes we do go out to eat at restaurants sometimes – although I’ve never had anything flambéed in Finland! I didn’t say they ate very little carbs, I said less than in the UK & those that they did were less refined. Perhaps you could let me know more about what the traditional Finnish diet really is?

        Reply
  31. jgt10

    So good to hear you are recovered!!!

    What has confused me about this brain carb requirement is that I thought it was ATP that was actually used in a cell to get stuff done.

    A quick google takes me to cellular respiration where the input is “biochemical energy from nutrients” into ATP. There is, of course, the Krebs cycle that generates ATP. But there isn’t there also a ketosis cycle of some sort that also results in ATP?

    Or, is there something about brain cell respiration that I’m missing?

    Reply
  32. JDPatten

    And yet . . . and YET!
    Per Dr Kendrick: “I have come to the conclusion that the relationship between diet and CVD consists of so much noise, and so little reliable data, as to be worthless – in all directions.”

    Do we all think this might deserve some elaboration?

    Reply
    1. mikecawdery

      JD Patten

      I would agree that the association between diet and CVD is confounded by so much noise as to be worthless. On the other hand there is much nutritional biochemistry that shows that specific factors have an important effect. For example Kraft’s book Diabetes Epidemic & You provides a lot of information on insulin and the effect of hyperinsulineamia on arteriosclerosis. Feinmain’s The World Turned Upside Down: The Second Low-Carbohydrate Revolution includes much nutritional information on diabetes which is acknowledged to increase risk disease. Then there is Dr Zoe Harcombe’s contribution on evidence based medicine. In recent correspondence there are some interesting comments that you might like to read.
      http://www.zoeharcombe.com/2016/11/cebm-centre-for-evidentially-biased-medicine/

      I was surprised to learn that one Dr Collins was the initiator of CEBM as he is one of the worst offenders for selecting favourable evidence and hiding the harmful (Big Pharma and his own status) data.

      Reply
    1. KidPsych

      I think we are all left with the same puzzler. I am sometimes reminded of the good work of Michael Rutter (Sir, if you’re so inclined), who studied risk factors for mental illness. His conclusion was that, while the first three factors are additive (such as familial history of mental illness, divorce, intense fighting between parents, etc.), he found that when risk factors hit four, they multiplied risk dramatically. Maybe it’s that dietary inflammation is bad, smoking is bad, etc., etc., but when we hit too many, our health is impacted dramatically. So eating high carb, but exercising and living relatively stress-free might work out fine for you, but what if you have dietary inflammation, don’t exercise, and then something stressful happens (historical or individual)? Just a thought…

      Reply
      1. Anna

        I’ve been thinking something similar. I’ve been pondering the rise in childhood obesity, allergies, food allergies, mood disorders and it seems to me that several factors may be congealing, lack of exercise, lack of time outdoors, chemicals, processed food, too much sugar, fluoride.

        Reply
      2. chris c

        Yes great notion. Also I suspect that while LCHF may well be an excellent “cure” this doesn’t necessarily mean HCLF was the cause, or the only cause. Probably part of it though. Lots of things changed between the time there were no “epidemics” of metabolic diseases and now.

        Reply
  33. Joe

    I’m glad you’re feeling better, Doc! Good enough to “finally” keep your promise? 🙂

    “Finally, I will put together, what I believe, are the ten (or so) best things you can do to protect yourself from CVD.” March, 2016, by Dr. Malcolm Kendrick.

    Reply
  34. Juan

    Hmm let me google something……. finland 1990s…. (loading…)….. results: banking crisis, economic depression, unemployment…..
    Sure it’s another paradox, cholesterol theory remains intact. 😉
    Thanks for the blog!

    Reply
  35. Dave Watson

    I would like to thank you Dr K for your stand against the cholesterol hypothesis. To make such a stand against this hypothesis from within the profession that pushes it takes a lot of courage and must be very stressful. Your stand has enabled me to avoid being statinated after a fairly minor event which was retinal embolism- I know someone aged 16 who had this. One can say “oh but statins even in the best secondary prevention trials only add 4-5 days of life expectancy for each year they are taken” One is told ” you are exactly the kind of high risk patient who would benefit from this”. This misses the point entirely. This is followed by anyway statins are excellent for preventing non-fatal events. Really? That would suggest they work by a different mechanism for fatal and non-fatal events. Anyway the most positive 4S trial has 16 non-fatal embolic strokes in the statin arm versus 13 in the placebo arm, hardly impressive. So where does this come from? Most of modern medicine seems to consist of reading a computer screen which spews out the NICE guidelines. This does not make for much creative thinking.

    Reply
  36. Jerome Savage

    Good news. My consultant, at the behest of my GP sent me for an angiogram. Coronary stent in 2004, very significant blockage and on to a diet of pills one of which was of course the statin. Cognitive function suffered, concentration became difficult & after a particularly difficult time over 6 yrs ago I stopped taking statin after carrying out some research. Gradually , very Gradually, things improved. I resisted pressure to go back to statins. hence the concerns of the medical folk. Inspecting the Angio screen , the eminent consultant stated, ‘nothing remarkable there – whatever ur doing, keep on doing it’
    What I’m doing is: lots of exercise, almost no alcohol, avoiding processed food , more fruit & very little sugary cake & biscuits.
    Your articles,Dr Malcolm Has confirmed that I am doing the right thing & despite pressure, encouraged me to stay off the statins.
    Thanks

    Reply
      1. Jerome Savage

        I did refer to an article that had appeared in, the Times I think, that made reference to a recent conference, the the role of cholesterol in CVD was queried. This was in October this year. The eminent cardiologist indicated that he was at that same conference. He added that genetics had a role to play, (paraphrasing here) and that different ethnic groups were affected differently by high cholesterol. I didn’t think I was in a position to argue with him

        Reply
      2. Janet Cole

        After watching the talk by Dr Langjoen, (who actually practices in the same Texas city as her doc) my daughter asked her doc to prescribe a statin. Texas is “fireman central”. The doc was reluctant since my daughter had an Achilles tendon tear on static s in the past. When she told the doc why she wanted a supply, (at $4/rx it is much cheaper than Amdro) the doc was appalled that my daughter would put something so TOXIC on her yard!!!!!! Can’t use it to kill ants, but you should put it in your mouth and swallow?

        Reply
    1. Mr chris

      Jerome,
      Love reading stories like that. I really believe in exercise, also, I am afraid to say, a bit of wine and whisky.
      When you say, avoid processed food, what does that actually mean, no pizzas, or no sausages and pork pies?
      Most foods when we buy them have been more or less processed.

      Reply
      1. Jerome Savage

        Well I am certainly not a dietary puritan. I believe in a little bit of danger in life, mountain biking in wild pathways of Galicia being my most recent expedition. Likewise, I hav been known to sample a sausage, pick at a pizza & fraternize with a fruitcake but do not indulge. Alcohol means I am sitting for longer than normal & recovery is long & stressful. I hav also an additional complication, Auto Immune Syndrome which has adversely affected liver function. BTW, there is some suggestion that statins can induce AIS though I am not aware of Dr Malcolm making any such connection. (Mr Google can b consulted). My breakfast consists of small portion of oats, with liberal mix of chopped fruit & nuts. Lunch is mix of cooked veg with small portion of meat, usually. I confess to eating grainy bread & cheese or jam for tea. Night time is difficult, chocolate is not always resisted. I finish with washed down chopped raw garlic.
        Apart from some jam & chocolate, sugar intake is minimal. Did I mention daily ginger, chopped ?
        My diet is a long term project, currently taking on board the LCHF advice.

        Reply
      2. Jennifer.

        Mr Chris, I think we use the term ‘processed’ inappropriately, because even excellent foods produced at home from the best ingredients frequently require ‘processing’. I think of processed food as that produced in factories, and more than likely full of additives and preservatives. Such toxins are generally absent in home made food which is generally produced for immediate consumption.
        It is the toxins in the food that are the problem, not the act of processing the food.

        Reply
  37. eissen@tango.lu

    Dear Dr Kendrick

    I am not disputing anything here I just want to remind you that many of the FEPOWs survived on a daily intake of 300 calories coming mosly from unpolished rice plus whatever they could scavange = not a lot.

    > prolonged starvation will eventually kill you as the brain will pirate > 40 grams of glucose/day from protein and lipid, until you have neither > fat stores, nor adequate diaphragm or heart muscle left to survive.

    My father was a FEPOW. He survived 3.5 years of long-term starvation as did many other FEPOWs and they were forced into hard labour to build the Thai-Burmese Death Railway My dad was 5ft 11 and only weighed 5 1/2 stone when he was released from the FEPOW camp in Thailand The US navy doctors fattened the FEPOWs up with steroids during the journey back to the UK

    My father reached 81 years of age and died from a blood clot on the brain

    kind regards Lor

    Reply
    1. Dr. Malcolm Kendrick Post author

      Thanks for your contribution. I do not believe it is possible to survive (long-term) on 300 Kcal. Long-term starvation experiments during WWII by Ancel Keys (yes him) found that the absolute minimum was 1,000 calories.

      Reply
      1. Joe

        The longest water-only fast on record lasted 382 days. That’s on no food at all. So survival time might also depend on how fat a person is.

        Reply
  38. Randall

    US National Library of Medicine National Institutes of Health – The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. First sentence – Field studies of twentieth century hunter-gathers (HG) showed them to be generally free of the signs and symptoms of cardiovascular disease (CVD).

    Reply
  39. S Jones

    If the Sami people rarely die of CVD then I would love to know what they do usually die of and at what age?
    Having low levels of CVD but (for example) dying of cancer aged 50 is not a particularly desirable alternative from my point of view.

    Reply
  40. Patricia Daniels

    Great that you’re feeling better, and thanks for searching through all the research data and sharing it with anyone who IS interested in knowing the real facts. Very much appreciated x

    Reply
  41. sandra

    I am really worried about my blood pressure. On two meds but want to come off these as I have no idea what they are doing to my body. When I come off them my pressure shoots to 180 over 110. This is when I first come off them. Go back on them because that high scares me. If I stay off them for longer will it settle. How can I find out what is causing my high BP. GP isn’t really interested apart from giving the meds. I am following a low carb diet now for 3 years. Lost weight but made no difference to bp.

    Reply
    1. Gaetan

      You should tell us a bit more about your health and habits in general. For example, do you smoke, do you exercise regularly (daily), do you salt your meals, are you in a stressful environment, would you qualify you relationships as good etc.

      Reply
      1. sandra

        Hi, not overweight. Do circuit classes two to three times a week. Don’t smoke. Drink a couple of glasses of red wine with dinner on a evening. Don’t use a lot of salt. Take various supplements. Walk most days for about an hour. Am nearly 57.

        Reply
          1. sandra

            looked this up and it says its rare. It says if blood pressure cannot be controlled to check for this but my bp is controlled with meds. Could I still have it and how do they sort it out. If I ask to be tested will my GP do it.

      2. Stephen T

        Gaetan, low salt is a far greater risk than high salt. At least for people on here, I thought the salt is bad for blood pressure thing was long in the past. The difference it makes to blood pressure is tiny.

        Reply
        1. Gaetan

          I know about salt! i was going to say increase your intake 🙂 Especially good is hand picked salt which contain trace minerals.

          ”Commonly purchased iodized salts, available at super markets or sitting on the table of your favorite restaurant, have synthetic chemicals added to them. These chemicals include everything from manufactured forms of sodium solo-co-aluminate, iodide, sodium bicarbonate, fluoride, anti-caking agents, toxic amounts of potassium iodide and aluminium derivatives. It may come as a shock, but most table salt is not only unhealthy, but can sometimes be toxic.”

          Reply
      3. gillpurple

        I’m not at all convinced that lowering salt intake has any health benefits, I think it’s part of the horribly flawed dietary advice that has been handed out for years. I chuck loads of salt on my food, always have done, and have had lower range of normal blood pressure throughout my life. I think the only time it got accurately measured was when I was visiting a doctor friend when I was about 34, reading was 75 over 49. Still alive and kicking age 63. I don’t give it a thought, although I’m probably a bit of an odd case. I don’t have a clue what is is now, because last time I was in a GP’s surgery a few years ago GP just said it was “normal”. So possibly still on the low side because I definitely get the white coat response. If I feel a bit light headed in very hot weather I just eat a packet of salted nuts or similar, works every time, even though I don’t experience it often now.

        My brother tells me when he was in the army they were trained to give sodium tablets to any soldier who put his foot on a landmine in hot conditions – so soldier didn’t pass out in the heat and take his foot off the landmine before it could be disabled.

        Story in Guardian today about a patient who got very ill (lack of sodium) after following doctors advice to make sure she drank plenty of water, and another who died – https://www.pressreader.com/uk/the-guardian/20161202/281569470343495

        It quite amazes me how this water/dehydration thing has taken hold in the way it has, so even doctors are sometimes giving advice that may be harmful, as above. Another example of big business laughing all the way to the bank, under the guise of being concerned about our health and well being.

        Reply
    2. mikecawdery

      Sandra,

      For what its worth I have cut my Tenoretic by a half to the smallest available combination and Ramipril to 1/8th (lowest available tablet). Only change was to start taking L-arginine in the hope of boosting NO. Now even when doing things the SBP never goes above 160 and after a few minutes rest is down below 140 -120. At 83 oldstyle it could be 180+. These BPs are at home – anything can happen at a surgery – talking about statins can elevate it – bit of a joke with the practice nurse. Unfortunately a personal response but who knows without trying.

      Reply
      1. Jennifer.

        Mike, it would seem that a great number of us present with what is considered to be high B/P readings at the surgery. As you know, the phenomenon of white coat was acknowledged many years ago. In the days when 100 + age was generally accepted as a normal systolic, and in consideration with reasonably decent health, it was certainly an acceptable rule of thumb. Of course, that did not bring enough people into the category of requiring anti-hypertensives…..so the parameters and definition had to be lowered and thus changed to sell more drugs.
        Like statins, we also know that anti-hypertensives, especially when not truly required, cause side effects…..but try having a discussion with the surgery nurse and some GPs, and you will never win the argument, because COMPUTER SAYS….
        In the 1960s I was a Radiographer ( diagnostic). Many hours were spent doing IVPs (intravenous pyelograms, sounds so old-fashioned nowadays) to find out WHY B/Ps were elevated. These days, it seems drugs are the first line of attack.
        I have always wanted to know what the cause of poor health was. I am not a promoter of prophylactic medicine ( except vaccination against contagious diseases [but I am against the ‘flu vaccine] ) and I feel that we have been let down by medics not looking at us as individuals. Invasive procedures and time to talk, ( more especially, listen) are both expensive commodities in our lovely NHS.

        Reply
      2. chris c

        Happens to me too, my home readings were much lower than the doctor or nurse readings. They gave me a 24 hour monitor which showed exactly the same thing, it varied a bit but stayed mostly in what they considered a “healthy” range. Disclaimer: all done with 5mg amlodipine, my metabolism was mashed up for decades. On the dietician’s low fat diet it was climbing steadily and I needed a medication increase and was heading for another one. On LCHF it went back down again. Went through the roof while I was hyperthyroid and came back down again when that was controlled. I eat plenty of sea salt and to maintain potassium also Lo-Salt just in case my veggies aren’t providing enough.

        Reply
  42. Dr. Göran Sjöberg

    Well – nothing can ever be proven about diets!

    Still you can make something more likely to yourself by successful experiments.

    So if you don’t believe in the “power of Low Carb” but carry an overweight, high blood pressures, high blood suger levels, have T2 diabetes with insulin injections you can still do an experiment onto yourself by taking away all the carbs (which was the traditional fare among the Sami people a hundred years ago before the introduction of the flour and sugar but hardly today) for a couple of weeks and see what happens.

    There are no risks involved except if you are on insulin when you most probably immediately have to reduce the amount injected to avoid too low blood sugar levels.

    Well – if your short time low carb experiment turns out to be a success there is danger that you may turn into a LCHF – “convert”

    🙂

    Reply
    1. smartersig

      I agree, monitor yourself and experiment. I find that Vit C lowers my Lp(a) and that as a vegan type who eats fish my Homocysteine go’s up if I do not take Vit B12 with Folate. Both of these I discovered myself through self experimentation and of course blood tests.

      Reply
        1. smartersig

          Not convinced that it will have an effect on BP. My partner suffers but when we spend some time abroad each year it always go’s down to an around 125 / 80. I can only put this down to one of two things. Firstly she does more walking when abroad and secondly she is probably more relaxed. I would suggest therefore you track this yourself in a similar way

          Reply
      1. BobM

        Intermittent fasting reduced my blood pressure more than did low-carb. I think it’s the reduction in insulin resistance, particularly for the liver and pancreas, which I believe intermittent fasting corrects faster than doe low-carb. I was overweight, though.

        Reply
  43. John U

    Mike Cawdrey, thanks for those links to the BMJ site and the series of Rapid Response. I read almost all of yours and I would like to say that I found them to very interesting and extremely well written. I have gained a whole new respect for your knowledge and talent in writing coherent criticism. Well done.

    Reply
  44. Kay

    John U. wrote: ” Perhaps this flood of information we receive almost daily to eat veggies and fruits for their antioxidant properties is totally without scientific merit.”

    Seems to be. A number of people have written about the total absence of any science behind the recommendation to eat more fruits and vegetables. In her book “The Obesity Epidemic” (p. 197), Zoe Harcombe describes how the “five a day for better health” was launched in 1991, and has been promoted by a number of enterprises that stand to profit from the idea, from fruit and vegetable growers to shipping companies.

    Reply
  45. Kay

    While the Massai have traditionally derived most of their livelihood from their cattle, their diet. even if it includes little or no plant food, is not zero carb. Milk contains lactose. Enough milk would provide a fair amount of carbohydrate.

    Reply
    1. Errett

      Kay–I enjoy your posts—-I have always been interested in the Massai—-tremendous warriors—capable of truly amazing physical feats of endurance/strength and of course bravery—-their rites of passage are also quite impressive—–to your point on their sugar consumption—they also consumed blood which contains glucose in addition to the lactose in milk——I personally don’t think that reasonable consumption of complex/natural carbs is an issue at all regarding people who are free of the modern diseases—I limit my carbs to about 150 gms/day. I enjoy this board because of the uncommon number of intelligent/informed and searching individuals like you who are on it—–please continue to question and look for the answers and share them with us—-Thanks Errett

      Reply
      1. Kay

        Thank you, Errett! Yes, the Masai are beautiful people.

        It’s my impression that:
        — cattle have been an important source of food for the Masai for eons.
        — the diet often attributed to the Masai — exclusive use of meat, milk, and blood from their cattle — seems only to have been used by warriors, for about 15 years of a warrior’s life.
        — from time to time, silly Westerners who refuse to believe that a diet rich in animal food could possibly be healthful, have pestered the Masai with “studies.” Those Westerners have then gone home and written papers advancing all manner of theories about why the Masai haven’t all dropped dead from their obviously harmful diet.

        I know for a fact that many of the Masai now eat a diet that is mostly carbohydrate — famine relief shipments of grain, soy, beans, etc. The late 19th century German researcher mentioned by Chris Masterjohn — Moritz Merker — was stationed near Mt. Meru in Tanzania. I have dear friends who are involved in a clinic and relief efforts near Mt. Meru.

        Reply
  46. smartersig

    Had an exchange with Zoe Harcombe on her blog mainly about the veggie vs meat debate. One thing she said which resonated and is without doubt a starting point for all of us was that its not whats in the diet but what we leave out that is most important for health. In other words we are back to parking the oils, grains, sugar and any processed foods.

    Reply
  47. mikecawdery

    I am always amazed at the level of informed comment on Dr Kendrick’s articles. May I suggest again that many posters (patients, carers and definitely doctors) should apply to the BMJ to become patient reviewers. As a patient reviewer I find the whole process to be both interesting, informative and stimulating. I would whole heartedly recommend it. I would like all medical journals to follow the BMJ lead in involving patients’ input on health.

    Reply
  48. mikecawdery

    I would like to introduce a set of genetic conditions which can impact on CVD. These are connective tissue disorders which have many effects on the body including reduced vascular integrity, cardiac valves, and to my surprise even an effect on the blood-brain barrier to the point where some drugs that normally would be blocked can pass through with some very odd and/or rare results in the form of adverse reactions. May be this is a possible future article for Dr Kendrick to examine.

    What is certain in my view is that the human body is such a finely tuned metsbolic system that any imbalance may cause a series of interactions resulting in unexpected areas. Good health is basically when the system as a whole is in balance. As i was taught “first know what good health, then you can look at ill health”

    Reply
    1. Jennifer

      Mike. As a student nurse we were taught to understand what good health consisted of, and what was considered the ‘norm’ in most humans. eg. how a usual birth delivery took place; how a child usually developed; how aging proceeded over the decades of 3 score years and 10. Only by knowing the ‘norm’ can we begin to understand when the body is not functioning as we would wish it to. The observant Nurse could then report to medics the factors likely to be causing disease. As I understood many moons ago…..medics were taught about abnormalities, and how to perhaps correct them. Nurses were taught which diverse conditions were worthy of reporting, how urgently or otherwise, and also to whom.
      I fear the boundaries between the 2 occupations have become blurred. Nurses are doing the diagnostics( reading the computer screen) and prescribing medication to match the statistical ‘average’ patient, whilst Doctors see the worried well, and act according to NICE guidelines. What a shambles.

      Reply
    2. Joe

      “I would like to introduce a set of genetic conditions which can impact on CVD. These are connective tissue disorders which have many effects on the body including reduced vascular integrity, cardiac valves”

      Simple nutritional deficiencies, e.g., of vitamins C and E, collagen, elastin, etc., according to various studies, can also be responsible for connective tissue disorders. Even a history of smoking can be problematic.

      Reply
  49. mikecawdery

    BMJ Open 2016;6:e012000.doi:10.1136/bmjopen-2016-012000
    http://bmjopen.bmj.com/content/6/12/e012000.full.pdf+html
    A quote from the abstract conclusions:
    NNTs were found to be very difficult to understand. This raises the prospect that some patients might reject medicines because of disappointment with the perceived low benefits of their medicines. The self-reported impact on behaviour appeared minimal with reports of intentions to ‘do what the doctor tells me’. Further research is needed to explore the impact of such statements on people who are yet to be prescribed a statin.

    NNTs are difficult to understand? May be if the NNT was described in terms of a simple probability (taking the Collins example 1 in 300 saved each year) of “you, the patient, will probably be one of 299 that will not be saved in any one year”. Ooops! That will not get the researcher Brownie points for a research grant.

    Reply
    1. Sasha

      Yes, NNTs aren’t difficult to understand when explained properly. Sometimes physicians themselves don’t understand the NNT concept.

      Reply
    2. David Bailey

      “NNTs were found to be very difficult to understand.”

      Perhaps that really means that patients do understand what it means, and don’t want to take a medicine with a vanishingly small chance of any benefit!

      Reply
  50. Dr Liz Stansbridge

    Malcolm
    You have reviewed all the science in your time.
    What do you think you could do to improve your health?

    Reply
    1. chris c

      Hmmm, I appear to be back! Time and again the same thing happens, mainly but not exclusively on Google blogs, I make a few posts and get blocked. Meanwhile on other blogs this has NEVER happened. Either my stalkers have caught up with me and report me for “spamming” or some dumb algorithm decided I have posted on one too many low carb blogs.

      How’s this for dumb algorithms? My phone died (after a mere 14 years) and of course the steam powered SIM didn’t fit in the new phone. Since Virgin service went downhill when they stopped using O2 for connectivity and switched to EE I decided to abandon them and go to GiffGaff who still use O2. Tried to buy airtime on GiffGaff and was blocked, not only that but my card was blocked so I couldn’t even take out any cash to get on air to ring the number to have it unblocked.

      Apparently buying airtime on a new network is seen as a fraud! Who knew? Well probably a large number of people who attempt to change phone networks.

      Reply
  51. Bryan Hemming

    Judging from some of the names in our family tree, it’s very likely I have some Sami blood.

    The Sami do not all survive on reindeer meat, as many live in coastal areas and have been fishermen for countless centuries. These days most Sami are settled, though a significant proportion follow a semi-nomadic lifestyle.

    Part of my grandfather’s family still live in Hammerfest, which I visited in search of my roots in 2000. Located way above the Arctic Circle in Norway Hammerfest used to be the farthest north town in the world. You can read a little on my own research into the Sami and their culture here:

    Joiking – Songs of the Sami

    Despite living far apart – one in Andalucia and the other in the south of England – both my sister and I registered quite high in the cholesterol stakes, but you wouldn’t guess that from our diets or other lifestyle details. We walk all the time, eat plenty of fish, fresh vegetables and fruit and follow what most doctors would term a Mediterranean diet.

    At 5′ 9″ and having weighed around 10 and a half stone for most of my adult life, many would regard me as being slightly underweight. I am 67 and my sister is 69 and we both have had heart problems despite not fitting the stereotypical CVD patient the medical establishment is so intent on forcing down our throats.

    Apart from our similar lifestyles and family heritage, there is one other factor my sister and I share that stands out. Though stemming from very different causes we both have led stressful lives for quite different reasons.

    In the 20 years leading up to my first heart problem I suffered a long series of incidents that caused me tremendous stress, leading me to believe that the overproduction of the chemicals our bodies produce to deal with stress can harm us, and eventually lead to CVD.

    I stopped taking statins almost four years ago because I ceased believing that cholesterol played a significant part in solving my health problems. The one size fits all approach most doctors follow was giving me pains in my legs that inhibited my ability to walk the distances I need to enjoy life. Even more importantly, to lead it as independently as possible. As I do not drive, and never have, it seems rather perverse that I should have to give up walking in order to be able to take statins.

    Reply
    1. David Bailey

      Bryan,

      I also gave up statins about three and a half years ago, and for exactly your reason – they were causing severe pain in my leg, such that walking any distance was becoming impossible. I recovered, but *not everyone does*, so I think it is really important to get that message out to anyone dithering over whether to stop their statins. If someone of about my age (also 67) mentions pain in their limbs, I always enquire if they are taking statins. From conversations I have had, I can tell you that a lot of people now refuse them when they are first suggested – the word has got out!

      Maybe we both should have posed the same question to our doctors – which is more beneficial, to take statins or take exercise!

      The sheer sense that illness becomes more likely as we get older (and is ultimately certain!) can be very stressful unless you get on top of it. Perhaps the most sensible approach is to relax, and stop worrying about illness – nothing can take away the years we have already lived.. I also gave up all the various screening procedures that are offered – these too can be very psychologically stressful, and sometimes yield false positives!

      Reply
      1. Bryan Hemming

        I heartily agree, David.

        But telling doctors you prefer quality of life over quantity can result in being lectured at length, as I discovered very recently. My ears pricked up when I was told that cholesterol could only reduce cholesterol by 15%, almost as though that meant statins could only add 15% pain to my legs, and that shouldn’t be a cause for concern. Though I couldn’t see how the two were connected, I pointed out that the figure was actually 10%. She corrected me saying it was around 12%. I stopped listening after that, as she had taken to lying outright. Even companies advertising so-called cholesterol reducing yoghurt type potions don’t claim they reduce cholesterol by that much.

        Reply
      2. Jennifer.

        David…a man after my own heart, for exactly the same reasons. My life has been transformed for the better in the nearly four years since removing statins, anti-hypertensives and hypoglycaemics. I realise I am like a stuck needle on this blog….but I speak from experience, and, as anecdotal as it is, it is a fact!

        Reply
      3. mikecawdery

        David,

        I have just done a quick numerical check on the probabilities of statin benefit (ie lives “saved”) and the probability of adverse events. It is 60 time more likely that an otherwise healthy patient diagnosed as being at “risk” will have adverse reactions rather than be saved. Incidentally the DoH considers it unethical to treat patients with a drug to which they are intolerant; but provide no practices/methods to endure this.

        Reply
    2. JDPatten

      Bryan,

      Um . . . trying not to be intrusive here, but I’m wondering what sort of heart problem you had. Electrical? Hypertensive? “Plumbing”? So many possibilities.
      It might make a difference to our understanding.
      Here’s hoping you’re good to go after those four years! ?

      Reply
      1. Bryan Hemming

        As my decision was taken weighing up quality of life as opposed to quantity I don’t see the relevance of giving further details of my particular case. My decision was based on the damage I felt statins were doing to leg my muscles, and in the knowledge there is no guarantee statins will lead to a longer life

        People must make their judgements based on what they are told, what they value about life, and what they can find out by doing some research.

        In my case, the only result that will mean anything is my death, which might be attributed to my refusal to take statins. And as it’s doubtful that the length of my life will ever be attributed to not taking statins, I don’t see the point of presenting any more information than I have already.

        I’m not trying to influence others to give up statins, I’m just saying that, in my case a shorter life without being subject to pain whenever I walk is preferable to a longer one where I might get to a stage where I can’t walk at all. Statins are being presented a though there is no alternative, and we all have an obligation to live as long as possible to increase the profits of the companies supplying them.

        But to give an idea of how healthy I feel, and what I would be giving up, last Friday, I walked for almost two hours in the morning, then two in the evening. I walk for at least 20 minutes to half an hour each day, as well as excercising with weights for up to 40 minutes most mornings. I walk faster than most people, and rarely get short of breath.

        I must add here that reindeer meat is one of the leanest on the market and the University of Tromsø, in the north of Norway, did a study showing that reindeer is one of the healthiest kinds of meat you can put on your plate. But I suspect they might have an interest as they are situated bang in the middle reindeer territory. On the other hand it is very tasty, but don’t tell Santa that.

        Reply
        1. Jerome Savage

          Bryan,
          I can identify with what U say.
          However, while looking out for muscle pain as a statin side effect , that seems to have escaped me. On the other hand, I began a tough fitness regime that saw me completing 9 marathons before a hip issue in 2011 ended LD running. Did the physical demands of running hide or counteract statin induced muscle damage? What I do know is that around this time I went thro what I would identify as th most miserable time of my life. This was after years of short term memory loss, unable to find words, conversation stoppages, interview failures culminating finally in severe anxiety, sleeplessness. I hav a recollection of the consultant, unmoved, regal like as I read out the notes jotted down on a particularly bad night, dispassionate. The assistant to his right, laughed softly, pointing out that that was a ‘lot of things that was wrong with me”. Such fun !
          This episode pursuaded me that so much of medical world was a world removed.
          I became my own consultant, stopped statins & as I stated earlier, I was vindicated 5 weeks ago to the surprise of the professionals.
          Like others here, I do not suggest my example should b followed. Meanwhile. am concerned about other meds, including my BP prescription but am equally concerned about effects of high BP so no change in that dept – for now.
          On a separate but related matter, the dieticians solemn advice after my 2004 stenting, was, alongside other dubious nuggets, “no eggs”, too much cholesterol.

          Reply
    1. Stephen T

      Mike, thanks for the link. Once again Tim Noakes and Zoe Harcombe made mincemeat out of the incompetents trying to fix the research. ‘Mistake or Mischief?’ A less polite title would be ‘Incompetence or vested interests?

      Despite the breath-taking incompetence of the dietitians involved and the almost amusingly stupid HPCSA, Noakes has had a fairer hearing than Dr Gary Fettke in Australia. Their treatment of Fettke is a disgrace.

      Reply
      1. mikecawdery

        Stephen

        I am the same weight that I was 50 years ago when I stopped smoking bar a brief period when we followed the official dietary “advice” on high carb, low fat, oil spreads, no eggs etc. I rapidly put on nearly 3 stone and ended up with diabetes. At that point I listened to the NHS nutritionist, asked a few questions and realized that she hadn’t a clue. I have worked most of my life in close contact with animal nutritionists, physiologists, chemists and biochemists and frankly I am appalled at the extent (or lack of it) of medical and human nutritionists and dieticians.

        Reply
        1. smartersig

          Hi Stephen, 3.5 years ago at the age of 56 I was 14st which is way above my early twenties of 11st7lbs. This was despite running with a running club each week on 6 mile runs plus a 2 miler on my own later in the week. I was aware that I was a little too heavy but nothing seemed to have an effect not even a few extra miles. Then I changed my diet, (note eating as much as I wanted), but cutting out all simple carbs, meat, sugar and processed foods. I ate well but only real food, no meat but some fish. What happened astounded me and made me realise that the whole diet industry based on excercise and calories is a lie. I went from 14st to 11,st 7lbs in 4 months and remain there to this day.

          Reply
          1. Mr Chris

            Smartersig
            This sounds great stuff”
            I eat real meat as well from a farm butcher. When we buy game there he can tell when it was shot and where. The farmer treats his animals with essential oils to avoid antibiotics.
            I notice in these comments many definitions of processed food. When I boil an egg, that is processing. So what do we mean by processed food, stuff out of a factory?

          2. smartersig

            I generally say that if you cannot identify the food as a natural product then dont eat it. When I eat Broccolli its essentially unchanged. If I eat a cornish pasty then its some sort of white flour hybrid of a food. Also agree on the meat, I tell people that if they can source and afford grass fed meat then its probably fine to eat in moderation but if you cant and lets face it most of us cannot then switch to a whole food plant based diet

      2. chris c

        I’m with J Stanton (gnolls.org)

        Birdseed and diesel fuel are NOT food groups

        If you can put it in a truck and the truck starts it is NOT food.

        To which you could probably add, if a dietician recommends it avoid it like the plague. (I typoed plaque then, and nearly left it in)

        Reply
        1. Gary Ogden

          chris c: Thanks for giving the gnolls.org link again! Great stuff there. This time I had sense enough to bookmark it.

          Reply
    2. Martin Back

      I read the paper. Clearly, the original meta-analysis showing that low-carb diets were no better than ‘balanced’ eating was sloppily done. And the media reports saying that it ‘debunked’ the Noakes diet were misleading.

      But I am not convinced that you can conclude the opposite if you re-analyse the data, as Noakes and Harcombe claim. I note they are far from disinterested parties, and the diets cited were not designed to be strictly comparable weight-loss studies, but examined various medical factors with a variety of diets. In many cases weight loss was an incidental effect.

      To my mind, the only study worth a damn would hold protein constant while varying fat and carb percentages, keeping calories the same, and with the same type of fat, protein, etc. (i.e. don’t compare fat from olive oil with fat from seed oil or fat from dairy; don’t compare protein from whey with protein from meat, etc). The only study like this I know of was discussed on this blog some time ago. Four months of low-carb followed by four months of high-carb, and vice versa. Conclusion: no difference in weight gain or loss.

      The authors complain that the diets were iso-caloric, whereas “a key effect of the low-CHO diet is to reduce hunger by increasing satiety despite a reduced energy intake”. So Noakes and Harcombe admit: you lose weight on a low-carb diet because you eat fewer calories, but you don’t really notice it.

      Finally, I was interested to see they say the diets cited weren’t really low-carb. They define a ‘therapeutic’ low-carb diet as 5% carbs (less than 50 g carbs per day). Frankly, this is freakishly low-carb. I can’t see any normal person keeping carbs this low day after day, year after year, as a healthy eating plan for life. I think the authorities were right to be concerned that people would cut out vital nutrients from fruit and veg in an attempt to meet this standard. If you are diabetic or morbidly obese and under medical supervision, it’s a different matter.

      Incidentally, Tim Noakes is a local hero here in Cape Town and everyone seems to be Banting (his diet has become a verb now). A woman I know returned from lunch with her friends, ladies of a certain age who are all Banting, and the main topic of conversation was how expensive the diet was, and how rapidly you gained weight if you slipped up for a few days.

      Reply
      1. luanali

        Martin,

        50 grams is high carb in our world! My husband and I eat around 20 grams, but possibly get up to 50 with the occasional wine. Our diet is so easy and satisfying, even “luxurious,” as Jeff Volek describes it. Last night we had roast bone-in pork loin with a cracklin-crisp fat cap served with a dijon shallot cream sauce served over bacon-braised collard greens. Tonight we’re having wild salmon with a lemon caper cream sauce, served with avocado cucumber chutney over buttered cabbage. Two nights ago we had chicken roasted with garlic and raddishes, served with broccoli rabe and a decadent sauce made from homemade chicken stock. I could go on, but needless to say, we’re not suffering! We’re both very trim and feel great.

        In terms of the “authorities” being right about this being a dangerous diet, I don’t know what they base their authority on. Historically, fruits and vegetables haven’t been a staple in the diet (although, as you can see, we eat plenty of vegetables), and to whatever degree they were included, it was only seasonal and geographic, which drastically limited their availability. Nina Teicholz’s Big Fat Surprise reviews some of this fascinating history and the misconceptions about fruits and vegetables, and Dr. Kendrick seems to be making a similar point in this current post.

        If anything, the evidence seems to be that our diet provides a much higher nutrient density, and if hair, teeth, and skin, plus how we feel, are any indication, we’re on the right track, just as so many who have been on this diet year after year report.

        Reply
        1. JanB

          Luanali, can I come to dinner? Please? That’s definitely my kind of food.
          By the way, I’m totally in agreement with you. One can’t do better than to EAT REAL FOOD.

          Reply
        2. Gary Ogden

          luanali: Gorgeous meals! Very similar to the foods I eat, although I only cook fancy like this when my daughter visits. I fully agree with all you’ve written. Thanks.

          Reply
      2. Stephen T

        Martin, I think ‘fraudulent’ is a much more appropriate way to describe the way the study was done rather than ‘sloppily’. It was clearly a bungled attempt to rig the evidence and discredit Tim Noakes.

        The deliberate mistake was to call diets with 35% carb ‘low’. This is the consistent trick that’s performed across the world in rigged comparisons. No definition of low-carb I’ve seen has ever been above 20% and most are lower, so how could such an obvious mistake be made? This has been done many times before and I think it’s close to impossible to conclude that it wasn’t deliberate. If the authors had wanted to study low-carb diets they might have looked at Volek and Phinney’s work, but the findings are inconvenient. That’s why the American Dietary Guidelines ignored them.

        The difference between Tim Noakes, Zoe Harcombe and the South African fixers is their reputations and methods. Noakes and Harcombe’s work will stand the scrutiny it will inevitably receive. When you’re outside the orthodoxy, you can’t be sloppy. That’s a luxury reserved for those supported by the system and vested interests.

        The 5% carb diet was ‘therapeutic’ for diabetics and for people needing real weight loss. As for a lower calorie intake on low carb, I take that for granted from Noakes and Harcombe’s work. They make the point repeatedly that by being low carb, you’re appetite isn’t constantly being spiked. In contrast, fat satisfies the appetite. Once people find something that actually works, after perhaps thirty years of failure, they can adjust accordingly, adding or reducing carbs to suit their goals.

        As for low-carb costing more, it’s possible, but you can’t have it both ways. If you eat less, as you rightly suggest, it’s likely to cost less. Eating two real meals a day is far cheaper than three meals and often expensive sugar-laden snacks. I’d accept that the cost per calorie is likely to be more because the quality is better, but you eat fewer calories and get more energy from those you do consume. I ate my first meal today at 1.30 p.m. so it’s not increasing my grocery bill. It’s about health and telling people the truth.

        Reply
      3. John U

        Martin, you said.
        “To my mind, the only study worth a damn would hold protein constant while varying fat and carb percentages, keeping calories the same…..”
        Why? If eating a low carb diet alters your hunger response, would that not be a useful feature? That is exactly what happens. So what if holding calories the same in both diets leads to the same weight results. Nobody is saying that calories do not affect weight. They do, but not is the way most people think. If your body cells (muscle and other tissue cells, not fat cells which only become resistant much later in the game) are not sensitive to insulin, you will partition the glucose in the circulation into immediate energy needs and into fat storage because insulin is relatively high. When the available glucose in the circulation is gone, and insulin remains above baseline level, you will have no nutrition available to feed you cells, because insulin stops your fat cells from supplying fatty acid for nutrition. You start to get hungry, and you start eating again. The vicious cycle continues. If you are not insulin resistant, you can eat anything you want and not have any problems. That is the way we are when we are young. So what is the point of proving that an isocaloric diet leads the same weight gain or loss?

        If you are on low carb diet and have been adapted to low carbs, you will not have this response after eating carbs. Your fat cells will supply all the nutrients you need to function because insulin is at or below baseline. You will not feel hunger. I am like that. I can fast for a day and not really feel deprived.

        Any study that is iso-caloric will not take advantage of this phenomenon. All the researchers know this, and that is why they want to have an iso-caloric study if they want to show NO advantage to low carb diets.

        You also said “They define a ‘therapeutic’ low-carb diet as 5% carbs (less than 50 g carbs per day). Frankly, this is freakishly low-carb.”
        That is what I do day in day out, but I don’t count. I just don’t eat many carbs. Not a problem. I love the fatty foods and it is not freakishly low. Starvation is freakishly low, but even that would have been fairly common in past centuries.
        People who are insulin resistant usually don’t know it, and they just keep eating when they are hungry and just put on a few pound very year. Eventually they are overweight and are told to eat less and move more. They try it and fail, because the science behind the advice is wrong. What Noakes and Harcombe are doing is trying to provide advice which is based on good science and calories don’t factor into it. Insulin sensitivity does.

        Reply
      4. mikecawdery

        Martin the problem I have with carbs is that they reduce to C6 sugars and are absorbed as such. With adequate insulin (non-resistant) surplus glucose is directed to fat cells. Dr Feinman in his book ( The World Turned Upside Down: The Second Low-Carbohydrate Revolution) gives an excellent assessment of the biochemistry involved and is well worth reading.

        In my own case a high fat intake reduces appetite (but I do like spuds for dinner) and once a week I eat nothing for 24 hours (upto 48 at a pinch) without problems. Does not do much for blood glucose but I suspect glucagon and glucogenesis is the problem there.

        Reply
      5. chris c

        Yes my mother used to recall that dieting was called “banting” when she was young ( born 1915) and it WORKED: there were no “epidemics” of obesity or diabetes and “everyone knew” that if you put on weight you needed to cut back on the starches and sugars.

        Both she (95) and her own mother (90) pretty much practised “clean eating” – grass-fed meat, poultry (rare in those days), game and fish on friday with vegetables from the garden/allotment. This is now seen as a danger by dieticians

        https://www.bda.uk.com/news/view?id=153&x%5B0%5D=news/list

        Reply
    1. Dr. Malcolm Kendrick Post author

      You cannot be zero carb because pure fat (triglyceride) contains glycerol molecules, and two glycerol molecules will be joined together in the liver to form a glucose molecule. Thus, as trigycerides are broken down into free fatty acids, and further into ketone bodies, they are also, effectively, releasing glucose.

      Reply
    2. Jyri Ylöstalo

      Lots of talk about low carb here, which is, I think, mostly irrelevant. The Sami do not eat low carb and the last time they did so was perhaps a few hundred years ago. Most of you people seem to think that Lapland is like northern Greenland, extremely isolated from the rest of the world – NOT true. My mother spent her childhood in northern Lapland in the Sami district in the 30-40’s. She told that already back then there was a grocery store in the village, from which people could buy e.g. flour to bake bread. Stuff was transported on rivers and in the winter on a sled over the hills. After WWII a road was constructed up to the northernmost village in Lapland and from then on there has been no problem in transporting goods. Nowadays the Sami buy food from a supermarket just like anybody else.

      Reply
      1. Sasha

        Unfortunately, LCHF has become the latest “silver bullet” in the world that forgot what real food is. I am lucky to have grown up at a time and in a place where people weren’t subjected to processed foods and where they stuck to traditional methods of food preparation (like cooking at home, for starters). And using things that look like food. I believe that if one does that, we can eat everything: proteins, fats, and, yes, carbs.

        Reply
        1. Gary Ogden

          Sasha: Well put. Real food is the key. This is what I grew up with as well, and this what Dr. Price found. However, there is much to be said for reducing carbohydrate intake (which increased dramatically after the dietary guidelines were imposed upon us in 1980), especially for diabetics, those with metabolic syndrome, and those who are seriously overweight. I have none of these conditions, yet I know that giving up grains, and thus reducing carbs, has been only positive for me. I miss my homemade sourdough bread with heaps of butter, but I can live without it.

          Reply
        2. luanali

          Sasha,

          Unfortunately that just hasn’t been my experience. For most of my adult life I have been a very devoted natural food adherent, cooking almost all my meals from scratch. (I’ve been so ridiculous at times that I’ve even shipped in my food when traveling!) And all I can say is that, at least for my husband and me, “real food” is not enough. We have felt pretty lousy on most versions of natural food diets (including Weston Price type version), and like Gary, we didn’t really begin to feel great (and satisfied) until we gave up the grains, and in our case, all starches and sugars. And neither of us were obese or diabetic to start with.

          That’s just been our experience. I don’t know if everyone would respond the way we have, or if LCHF is right for everyone (I doubt it). And I don’t know if like Jennifer there will come a time when we’ll want to reintroduce more carbs (Gary, I TOTALLY get missing the homebaked bread!!). I guess my point is that while we don’t know if there’s one diet that’s right for everyone, my husband and I are two cases in point (but there are many, many others) that can attest from experience that your diet won’t work for us.

          Reply
          1. smartersig

            I had a disagreement with Zoe Harcombe, the dietician over meat but she did say one thing that resonated and that was the most important thing about diet is what we leave out rather than what we include. Your post backs this up.

      2. BobM

        I think it is more complex than this. For instance, the number of times we eat per day has gone up. They now recommend eating 5+ meals per day. In the 1900s, this was probably one or two meals per day. Also, wheat in the 1900s is completely different from the wheat we eat today. Today’s wheat has been hybridized. I use Einkorn wheat, which has not been hybridized. It has a completely different gluten structure. I use this only for holidays.

        As for low-carb being a silver bullet, for some of us it is. I have lost over 55 pounds mainly by going low-carb. I also started intermittent fasting, and combined that with low-carb. Finally, I have been testing a ketogenic diet. For someone like me, who is severely insulin resistance due to 30+ years on a high carb/low-fat diet, low-carb is a Godsend.

        Reply
      3. John U

        Unfortunately everyone seems to ignore those people who exibit a significant degree of insulin resistance.
        Gaetan, read the study abstract to which you linked.
        http://ajcn.nutrition.org/content/early/2016/11/30/ajcn.115.123463.abstract
        This is a study which is done with no mention of insulin levels or insulin sensitivity in the subjects. Of course if you are normal, you can eat carbs or fats without problems. I did it for years. Here the subject were of high body mass index greater than 29. No so high, but high none the less. They were put on an ISOCALORIC diet, with energy restriction!!!!!!!!!
        This is a study designed to show no difference. Why not let them eat all they want and then check the results? Because those who ate the high fat diet would probably eat less and lose more weight, and they can’t have those results to report because publishing would be difficult.
        Have you EVER seen a study done where subjects ate as much as they want in both groups? Usually it is done with the low carb group, again to stack the odds. It is no wonder that all diets are the same when you have no insulin resistance, you eat a calorie restricted diet, and you eat the same amount of calories. The benefit of a low carb diet is the fact that when you are adapted, you are not hungry all the time, so you actually eat less than before and lose weight because you are NOT HUNGRY.
        It seems nobody wants to test this fact. The study is worthless just like so many others and a colossal waste of money, but a least they did conclude that fat was not a villain. Unfortunately we should all have know this for decades.

        Reply
        1. Gaetan

          While your analysis might be valid, you could try to write to those who made this research and mention your points, who knows you might get an answer! Personally, i eat plenty of carbs and plenty of fats (mostly saturated ones, butter, coconut oil, salmon or mono fat in olive oil) and i rarely feel hungry if ever, in fact i must motivate myself to eat otherwise i lose weight and im already skin and bones mostly…So, i would tend to say that eating carbs do not make me hungry. i rarely eat more than 2000 calories a day if ever. i do not count them but looking at what i eat everyday, i would think its between 1800-2000. If i also look into my direct family, they eat plenty of carbs and none of us got extra weight, nor do we eat all the times. I should point out that we all eat fairly healthily, for example we don’t drink sodas, or eat milk chocolate candy bars or pastries etc. We do eat bread and occasionally cereals.

          Eating too much is an addiction i believe. Just like using drugs, or gambling. When people have emotional pain or suffering or are overstressed, they indulge in food or heroin, cocaine, gambling, compulsive work and so on. War on drugs is useless, because drugs sooth people of their pain and they’ll do anything to find relief. What they need is love and compassion. Its the same thing with eating disorder, address the emotional pain or what hurts (usually its unconscious, requires a lot of self work) and usually addictions tend to diminish in intensity or go away completely.

          I know what i just wrote is gonna upset many but that’s not my goal here. i don’t know who likes to eat when stressed and who doesn’t, not easy to find out. But for those of you who do not over indulge in eating and still get overweight, then by all means switch to LCHF if it works for you.

          That being said, its very possible that a LCHF diet is helpful to those with diabetes or other digestive problems, (just like methadone helps with heroin addicts) is it a permanent solution? i don’t know, time should tell. And yes, we need more studies – saturated fats producers could finance one maybe? –

          Reply
          1. luanali

            Gaetan,

            Thank you for sharing your diet. It really is fascinating to see what diets work for some and not others. I think you’re right that eating disorders play a role for some people, but I think true eating disorders are rare. Like with most things, there’s a wide range of “normal”. Some people overeat out of boredom, not because they are stressed or emotionally upset, and some overeat because the food is so chemically compelling (like sugar) or just plain delicious (!) that they want more.

            While it’s true that LCHF seems to work exceptionally well for those suffering with diabetes or obesity, it’s not limited to them. I’ve never been fat, or had diabetes or any eating disorders, and yet I thrive on super low carb, high fat.

            I’ve noticed there are various comments in this community that attempt to pathologize LCHF, and I wonder if it’s a natural reaction to some of the LCHF dogmatists out there. We’re obviously all here because we’re committed to our health and are independently-minded enough to seek out what’s true. So why should we pick on each other’s diets, as if we’re the better judge of what someone else should be eating?

          2. Gaetan

            ”and yet I thrive on super low carb, high fat” Just out of curiosity, if you didn’t have any problems, why did you try this diet? And when you say you thrive, what is the difference you notice?

            I would like to point out of a few things. Eating out of boredom is not ”normal”, obviously there is a problem there. The act of eating is associated with chasing the boredom away or something like that. Sugar can be an addictive substance, just like nicotine or alcohol. So yes many people eat because they are addicted to sugar. They are addicted to sugar, because it soothes something, the question is what are they using their sugar addiction for, to cope with what? Even if food can be delicious, usually people don’t overeat, unless it triggers a reward mechanism etc.

          3. luanali

            Gaetan,

            You may be right that all forms of overeating, regardless of any other factors is unhealthy, but from a psychological perspective (my background), it does’t qualify as a psychological illness, which I take from your comments is the point you are making (perhaps I’ve misunderstood). It’s probably not healthy to not floss your teeth every single night (or more often), but to not do so doesn’t mean you have a psychological problem. It could. It depends. For sure the pursuit of rigid perfectionism is problematic. We all act in ways that are against our self-interest. We try to do better but commonly fall short in any number of categories. Oh well.

            The reason we tried a LCHF diet is because 1) we read Gary Taubes and Nina Teicholz and felt utterly compelled by them, and 2) because my husband had very high cholesterol and we were worried at the time about heart risks. Long journey of education and discovery. I of course did the diet along with him because I’m the cook in the family. The discovery of how dramatically better we both felt was a complete surprise to us. So we’ll continue doing this for as long as it feels right to us.

          4. Gaetan

            Hi Luanali,

            Thank you for sharing!

            ”The discovery of how dramatically better we both felt was a complete surprise to us. So we’ll continue doing this for as long as it feels right to us.” Can you be more specific? You have more energy? etc.

            Also, for me dis-eases do not exist. Our body is intelligent and always have an intelligent response. The symptoms we get are an intelligent response from our body. Whether we pay attention to the symptoms or not, is totally another thing tho. Do we visit the doctor and have him/her prescribe drugs to get us high so we don’t feel our symptoms anymore, or we pay attention and seek answers.

          5. luanali

            Sorry Gaetan, I realized I didn’t answer your other question about what difference we noticed with LCHF. Specifically, we both have energy even if we don’t get enough sleep for whatever reason. Before we were often hit with the sleepy-wave during the day. When we do sleep, it’s much better and deeper. It’s quite amazing actually, but it’s something I heard from Jeff Volek is common with LCHFers.

            I also used to have shaky episodes (meaning I’d feel weak and shaky) regardless of healthy diet. That’s completely gone with LCHF. And keep in mind that my HA1c was very low before LCHF.

            Also, our gums and teeth have improved significantly (deep pockets have reversed). Our skin is healthier, and for the first time in my life (!!!!), I can actually get a tan. I had no idea that would happen. I went out for some vitamin D, came in with a tan! Always before I would just burn straight away.

            And most importantly, my husband has been able to go off the omeprazole he was put on 9 years ago due to his hiatal hernia/Barrett’s esophagus. The importance of this cannot be overstated, but Dr. Kendrick did outline it in a recent post.

            Hope that answers it!

  52. Dr. Göran Sjöberg

    Just now I wonder about the effect of getting used to the low carb living. As with everything else your body accommodates (homeostasis).

    For seven years on LCHF I haven’t had a single serious cold but six weeks ago I was hit by an influenza which turned into a very nasty pneumonia lasting for four weeks but from which I now happily recover.

    It is known among low carb adherents that when you suddenly break your habits your blood sugar sky rockets on the carbs. But what happens more? Before I was hit I had been cheating severely on the carbs for a month and I do wonder if this immediately compromised my immune system.

    Any LCHF people with any similar experiences on “cheating”?

    Reply
    1. rockingbass

      Yes, I have Dr Sjoberg. Firstly about 25 years ago I was very poorly with back problems and colitis.I gave up wheat and after about 72 hours I was able to walk again. To try to help the colitis, lead me to investigate diet (Already been on the F plan diet for about 6 years previously and knew from attempting being a vegetarian for a month in the 70’s that I could not tolerate beans and pulses) .My wife bought me a book Dr Walter Yellowlese “Dr in the Wilderness” which helped me cut down sugar.But the turning point was that in the book there was a reference to the work of the Austrian Dr Wolfgang Lutz .We got his book “Dismantling a Myth -The role of Fat and Carbohydrates in our Diet” His English, translation of the German book “Life Without Bread”from the British Library. This lead me and my wife on a facilitating journey about diet and heath.
      We cut our Carbohydrates slowly to about 72 grams per day .this was about 20 years ago. I know that if I cheat I have all my old symptoms back again..(Dr Lutz was very concerned about the reaction of the immune system in some of his patients and always recommended reducing carbohydrates slowly.) I now have to be very strict with keeping to around 72 grams of carbohydrate per day.
      My wife and I got to know Dr Lutz very well over the years. IMy wife wrote his obituary in the Guardian ,his autobiography and a book about Dr Lutz’s work for the lay person. We are still learning

      Reply
      1. Dr. Göran Sjöberg

        rockinbass,

        Trying to get the “Dismantling a Myth -The role of Fat and Carbohydrates in our Diet” I found it at Amazon with an unbelievable price tag.

        Four copies each 13 669 USD and another one at 20 000 USD.

        Can you explain that?

        “Life Without Bread” is though available at 20 USD

        Reply
        1. rockingbass

          It is in the British Library system, which is where I found it.If you read German you can still get his last edition of Leben Ohne Brot .. on Amazon.which Dismantling a myth was a translation in the 1986
          “Life Without Bread” was a joint book with Christian Allen .(2000)Dr Lutz was not happy with it and my wife helped him with his autobiography , My life Without Bread Dr Lutz at 90. We hope to reissue his English synopsis of Leben Ohne Brot sometime in the new year and possibly later ” Dismantling a Myth” which is along term project. Unfortunately we only have one compete copy of it.
          Best Wishes
          Mark

          Reply
        2. rockingbass

          Just to add to my previous answer Goran.” Life without Bread” by Allen and Lutz dose contain lots of Dr Lutz’s medical work and Christian Allen has made some fascinating observations and discovery’s.You can find it on Amazon UK for £0.01 plus postage-It is a good addition to Dr Lutz’s Biography .
          Seasons greetings and what a fascinating blog this is….
          Mark

          Reply
          1. Gary Ogden

            rockingbass: Fascinating indeed. The best blog on the Internet. I’ve learned an enormous amount from my daily perusal.

  53. Jennifer.

    Sasha. I so agree with you. However, to the people who are unwell due to poor diet, I believe LCHF is an excellent start to getting back to a trim body and better health. In the 1960s I learned that it is what was advised to diabetics,( but not the general public, as they did not require such restrictions). Unfortunately, the dreadful industrialisation of food arrived and the vilification of fats and promotion of excessive, unhealthy carbs took hold, and we are where we are. I commenced Nurse training in 1983, just as the carbohydrate explosion was taking hold, and I had little option but to follow suit in the NHS of the time; I fell for it like the rest of the globe.
    As you may have seen from my posts, I resorted to the LCHF way of eating nearly 4 years ago, and it transformed my health for the better, along with eliminating all medications. Once my weight and blood profile was stabilised, and I felt confident, I started to increase healthy carbs, ( and the way I deal with them in the kitchen), and the rest is history.

    Reply
  54. Anna

    David Bailey,

    Re your reply of Dec 2, 6:25 pm, I have to second the motion. I do not think the Big Bang is true and right now I’ve been listening to David Talbott, who with others has been investigating the electric universe theory. He’s got a couple of really good talks. He says that nearly every attribute of the sun is one of those anomalies under the current system, which is that gravity is the sole important force in the universe on a cosmic scale, and that all of them make sense under the electric universe theory, which is that electromagnetism is an ignored force that is the main one, or at least more important than gravity. As to Big Bang, there are several highly qualified detractors such as Halton Aarp, Paul LaViolette and the one I’m currently reading is The Big Bang Never Happened. What is interesting about this current book is that he waxes philosophical about how concepts of the universe and how it works are all of a piece with the way society feels about the human condition and also about authoritarianism. I think the author is Eric Lerner. Certain theories are closely tied to observation and others not so much, which comes as a surprise to me. He takes the argument back some thousands of years between those thinkers who believed that observation was key and those who actually thought that one should use reason to decide what is so. And, supposedly, we don’t do that any more, and yet we do. Also surprising to me was that at least one or two ancient and middle ages thinkers understood the need for observation (the scientific method).

    Reply
    1. David Bailey

      Anna,

      Thanks for those comments. Yes indeed, both gravity and electrostatic forces follow the same inverse square law, and yet electrostatic forces are very much stronger by a factor of about 10^39, so the assumption that gravity alone dominates at cosmic scale, seems unlikely!

      Astronomers can’t really look at Halton Arp’s ideas because they would invalidate a huge amount of their own work, which is based on interpreting the red shift in terms of distance.

      The bogus ideas about saturated fats and cholesterol have already run for about 60 years, and along with all these other examples, I think that science may have only been self-correcting, long ago when it was less institutionalised and more insulated from commercial and political pressures. Indeed the horror at the consequences of changing direction must only grow with time, because the damage already done keeps on growing, which is why they are now resorting to quasi-legal pressures to try to silence the likes of Prof Tim Noakes.

      dave at dbailey dot co dot uk

      Reply
      1. Sasha

        Fascinating. I read The Big Bang Never Happened a couple of years ago. It wasn’t an easy read for me, I was never smart enough for physics. Organic chemistry was easier for me. Interestingly enough, most of the people I went to pre-med with couldn’t even handle org chem, despite having 3.8 GPAs. They were extremely good at route memorization, that’s about it. Sort of explains why medicine is such a mess…

        Reply
  55. Anna

    Jennifer,
    I’ve been teaching myself to make Saurkraut for my Slavic husband (they ferment everything, even watermelon!) and I changed my ways after reading this:

    http://www.foodrenegade.com/3-biggest-fermenting-mistakes-youre-already-making/

    Although I must say we made mistakes #2 and 3 and were not harmed. I think a Fido jar is best. But the big difference is that I was not clear that it’s best to keep oxygen out.
    Some say that an airtight seal can explode, but I think that is quite rare and if you’re worried about it, you can lift the lid slightly to hear a bit of a hiss and put it right back without opening or losing all the hiss. Because that hiss is CO2, which is what protects your ferment.

    Reply
    1. Frederica Huxley

      I make my sauerkrauts in either Kilner or Fido jars, as they allow offgassing without taking in oxygen, and do not need burping. I’ve found the most important factor to achieving successful ferments is to ensure that the cabbage, and all other vegetables and herbs, are safely under the level of the brine. Dr. Göran Sjöberg’s plastic bag works well, or there are excellent glass or ceramic weights on the market. I cover the kraut with some of the outside leaves of the cabbage, to keep little slivers from floating on the brine!

      Reply
    2. Gary Ogden

      Anna: It is essential to allow CO2 to escape during fermentation; this is why winemakers use a burper on top of the vat. The jars may not explode, but will surely crack and leak if closed tightly (happened to me several times). I always close them loosely while they’re on the counter. You exclude the oxygen by keeping the vegetables below the top of the liquid, pushing them down once in a while, if necessary. It would be nice to keep them on the counter for four weeks, but who has that much counter space? What I do is give them 3-11 days on the counter, then 4 weeks to two years or more to age in the fridge. They continue to improve in flavor indefinitely.

      Reply
        1. smartersig

          There is a good explanation here of why certain foods perhaps protect against heart disease, the gut microb’ connection and in particular fermentation

          Reply
        2. Gary Ogden

          Frederica Huxley: I’m sure you’re absolutely right. I made six jars of kimchi today, and I’m going to give it a try. It just occurred to me that I can rearrange some cupboard space to store them. When you consider that on Captain Cook’s second voyage, of 27 months, with two equatorial crossings, they had one of 60 barrels of kraut remaining when they made their last port of call returning home, at Lisbon, and the the Portuguese nobles who came aboard liked it so much they took it with them when they disembarked, to share with others. No scurvy on the voyage, either.

          Reply
          1. Frederica Huxley

            How long do you intend to leave your kimchi at room temperature? I can’t find chapter and verse, but virtually every article/recipe on kimchi says to ferment for only 12-48 hours before refrigerating:
            “Everything in moderation” applies to probiotics too! To keep things from getting out of hand, kimchi must be refrigerated after about 12-24 hours of fermenting at room temperature. Probiotic activity slows down at lower temperatures, where they enjoy life at a more relaxed pace and for longer”.
            Why the fermenting process is so fundamentally different from fermenting cabbage in sauerkraut, I do not understand!

          2. Gary Ogden

            Frederica Huxley: After I wrote that comment, I decided to get out the “Bible,” “The Art of Fermentation” (Sandor Ellix Katz). I read it cover to cover when I got it three years ago, but it is truly encyclopedic, I’ve forgotten a lot, and I haven’t yet found anything about ferment times. Interesting, though, that I’ve had failures with kraut (pink color on top), but never with kimchi. So your comment gets me thinking. I commonly leave ferments out three days, except beet kvass, which sometimes gets two weeks. I’ll keep that routine with the kimchi, but with the kraut, in a couple of months (the oxheart cabbages are slower to grow, but more nutrient-dense, than the Chinese), I’ll give them four weeks.

  56. Jennifer.

    Anna, many thanks for the article, and it is very good.
    After a few mishaps with my sauerkraut over the last couple of years, I decided to import a couple of sauerkraut crocks from Germany ( because I reckon they must know about such things), and voila….using the oxygen-free method with half-moon weights, is proving perfect. I have great expectations of the outcome. I have green cabbage and onion in one crock; green cabbage and celery in a 2nd crock, and red cabbage and apple in the 3rd.
    I am using a water gutter to keep the contents safe, and am greeted with healthy burping sounds every so often, so trust that their contents are behaving as intended.
    My face was almost as red as the cabbage when I went through the supermarket checkout with 7 enormous green and 3 pretty red cabbages….I did explain to the puzzled cashier that they were for sauerkraut, but I didn’t feel able to say much else.

    Reply
    1. Sasha

      I know a guy who uses them, they work great. I think you will be very happy with the final product. Make sure you salt in layers and pound each layer with your fists before moving on to the next layer

      Reply
    2. Gary Ogden

      Jennifer: When I make kraut I put the shredded cabbage in a giant bowl (my once-upon-a-time two-loaf bread bowl) and beat the crap out of it with a homemade hickory mallet, rounded on the business end. This releases the juices, and I think speeds fermentation; in any case I can’t fill the jars very full because it really grows over three days. I mix in 1 tbs (15 ml) sea salt and 4 tbs (60 ml) whey per quart (l) right in the bowl. Works like a charm. I also grow my own cabbages, a lovely variety called Cour di bue, which come to a point at the top. I plant the seed as soon as it cools off in early fall, and harvest mid-winter.

      Reply
  57. Gary Ogden

    Sasha: Other than sushi rice a couple of times a year, yes. Also, no legumes. I think white rice is perfectly OK. But I eat everything else, and I eat very well. Probably some people are fine eating grains, but I am better off without them. I think wheat is the worst, and rye and barley not so good. I discovered this past summer that I can’t enjoy a beer any more, though I was never much of a beer drinker. Felt terrible the next day after one 20 oz bottle, although it had chocolate in it, of all things.

    Reply
    1. Jennifer.

      Thanks for the encouragement, Gary.
      I like grains, and had reluctantly eliminated them for about 3 years in order to go quite low-carb. Now feeling good about my state of health and having a better understanding of how to manage grains, I am reintroducing particular types.
      I am descended from North British stock, and I think oats and barley are more natural to those of us with genetics derived from north of a line drawn between the Humber and the Severn. Apparently, humans with genetics derived from below that line, are better able to cope with wheats. ( I read about these ‘facts’ when studying nutrition for a Diploma in Nursing, in the early 1990s, but seeing as the NHS was closely following the high carb, low fat regime at the time, I take such ideas with a pinch of salt).
      Nevertheless, I am reintroducing the 3 grains mentioned, but I only purchase organic berries. I make rye-based sourdough to add to organic wheat flour, because I believe the long fermentation helps with digestion and the body’s ability to cope with its starches. I love oatmeal porridge. I lightly mill the organic groats daily, and leave them to steep for 48 hours, during which time they gently ferment. Yes, it is an acquired taste, but easily tolerated and enjoyed with a dash of double cream. Barley was a staple in northern climes,( good growing conditions for barley and oats) but other than steeping for 24 hours before adding to stews, I am still looking for a few different ideas. Those who know me better of course , know I like a tipple of single malt whisky….so there is a start for the barley……..

      Reply
      1. BobM

        Try Einkorn wheat if you can find it. While I think modern wheat is terrible, Einkorn (sourdough of course to reduce anti-nutrients) does not seem to affect me. However, I only eat it very infrequently (but it doesn’t seem to cause chest congestion, which regular wheat causes me).

        Reply
      2. David Bailey

        “This blog is a wealth of cooking ideas”

        Take 10 grams of fat – 60% saturated, 40% mono-unsaturated (select carbon chain lengths to taste), and heat with 100 grams of plant-derived protein and a sprinkling of selenium, magnesium and zinc trace elements. Add co-enzyme Q10 if any of your guests are silly enough to be taking statins.

        Serve with sodium chloride seasoning, and an aqueous solution of ethanol.

        The sweet course is a bit difficult!

        Reply
      3. Gary Ogden

        Jennifer: I don’t know about my mother’s side, but on my father’s side my ancestry is Scottish (William Munro, b. 1550) and English (William Nickerson, b. 1604). So I may be from both sides of the line. What I did before I quit grains was to use rye for both the sourdough starter and the bread, buying organic berries and grinding them fresh. I never really had a problem with grains, but gave them up as an experiment. I was pleasantly surprised when, in a matter of weeks, my tummy disappeared. It wasn’t a big tummy, but I was a long-distance runner, training five days a week, 20-25 miles a week, so I believe it when they say exercise is of little value for weight loss. One of the most important results of limiting carbs is that you eat less because you have less hunger, thus the weight loss.

        Reply
        1. Jennifer.

          Such interesting stuff on Dr K’s blog….(.which I joined primarily regarding the Cholesterol Myth, and which I would go so far as to say has saved my health and sanity.)
          I realise, yet again, we discuss the topic of food production, and with the interesting things contributed by yourself, Dr Goran, Anna, BobM, Frederica to name but a few, it is an important factor in achieving good health and our fight against expensive medications.
          I live in Captain Cook Country, a stone’s throw from Staithes, where Captain Cook apprenticed as a grocer, (and maybe learned about food preservation). He transferred to nearby Whitby, and the sauerkraut and fermented foods he ultimately used on his Royal Navy voyages, show that they knew a thing or two back then. The vitamin C discussion is so interesting, and could be covered in another blog, I am sure.
          Anyway, I am now motivated to make kimchi, and, when my supply of organic, stoneground wheat flour is used up. ( short shelf life as it still contains all the potentially rancid oils etc that are normally removed in roller milled flour), I will look for Einkorn.
          Thanks everyone….such good food for thought.

          Reply
          1. Frederica Huxley

            You may consider keeping your organic stoneground wheat in the freezer until you need to use it, thereby keeping it from going rancid.

  58. John U

    Gaetan and luanali,
    It is difficult to respond to comments in the order in which they appear so this comment is intended to follow the thread above which suggest that we all have peculiarities which make it fine to eat lchf or hclf.
    This is no doubt true, but not if one is insulin resistant to any significant degree. Then it is not OK to eat HC. I think it is as simple as that. If a person thrives on HC, insulin resistance is probably not a factor. It is important to make this distinction when analyzing why some diet work well for some and not others.

    Reply
    1. BobM

      See also this genetic variation:

      http://robbwolf.com/2014/01/15/understanding-genetic-differences-carb-metabolism/

      “Recommending a high starch diet to people with low amylase gene copies is setting them up for insulin resistance and diabetes. Another thing to think about is the diversity within each group. Humans can contain anywhere between 2 and 15 copies of the AMY1 gene (http://www.plosone.org/article/info:doi/10.1371/journal.pone.0013352). This means there is a wide difference from person to person on blood glucose levels following the exact same intake of starch.”

      I guarantee I have low amylase gene copies.

      Reply
    2. luanali

      JohnU,

      My point was coming from the opposite direction which was to say that even if you’re not insulin resistant, a LCHF diet can provide significant benefits, at least in my personal experience.

      With regard to your statement, “…This is no doubt true, but not if one is insulin resistant to any significant degree. Then it is not OK to eat HC. I think it is as simple as that”: The problem with absolutist positions like this is that you have to account for the exceptions. I personally know someone who claims to have cured his diabetes with a rawfood vegan diet, which is about as high carb (nearly fruitarian) as you can get. He went from highly processed, fast foods and sodas to mainly fruits and nuts and threw away his insulin. There are many stories out there like this, and assuming they’re true, it would argue for a more complex explanation. Dr. Kendrick has also argued for a fuller insulin resistance/diet understanding.

      I would also add that I personally know (don’t you?) people who have lived to high 90’s and ate white bread and sugar every day. Clearly there aren’t cookie-cutter explanations.

      Reply
      1. John U

        I still stick by my “absolutist” position regarding carbs and insulin resistance, however what appear to be “exceptions” may not be as exceptional as we think. For example, a diet of fruits, nuts, and veggies may be fine and not spike insulin to a significant degree, especially if it is energy restricted at the same time. If it is, then a substantial amount of fat will be metabolized to make up for the calorie deficit if activity is maintained at the normal level and insulin levels may remain moderate. It is not carbs per se which are harmful, it is the insulin spikes which accompany them in most cases. Those whose diets are high in foods which do not increase insulin levels appreciably are likely fine. If one’s insulin resistance is compensated by eating high carb foods which do not requires much insulin (the area under the insulin-time curve), then no problem. However, that is not usually the case, so the advice I give is correct in general (no downside), but if it doesn’t improve your blood sugar levels, it means you are not suffering from any glucose related metabolic deficiencies and the diet you are eating is OK. Most people are not eating fruit and nuts and low starch veggies, if they are over weight. And one will be hard pressed to eat enough fruit and veggies to compensate for the calories displaced by eliminating the previously lost crap carb calories from the old diet. Also the question of fruits in the diet needs to be clarified. Fruits are usually fairly high in carbs. or at least they get metabolized into saccharides in the liver and then require insulin to process further. This could lead to fatty liver problems, just like any fructose heavy diet. We really need to examine the exceptions to see if they really qualify as an exception to the rule that high insulin levels are harmful, and that insulin resistance is the primary cause of these high levels (excluding TD1 or other insulin dependent conditions).

        Reply
        1. luanali

          John U,

          I agree with you that there is a lot of missing information and that we need to examine the exceptions.

          Thanks for speculating on possible alternative explanations.

          Reply
      2. Martin Back

        Gaetan, an interesting fact about dolphins is that their sonars are so sensitive they can “see” each others’ internal organs. So in theory they can pick up signs of disease very early and take corrective action.

        Or it could be that to be a good-looking dolphin and attract your share of suitors you have to be healthy inside and out, so they learn to take better care of themselves than we humans do with our layers of clothing that conceal defects.

        Reply
        1. Gaetan

          Martin,

          i am not sure what to conclude from what you wrote!

          Also “Grizzly bears become ‘diabetic’ when they hibernate” They stop responding to insulin. when they wake up from their long slumber, insulin starts working out again and they put on extra fat for the next winter. Strange isn’t it?

          Reply
    3. chris c

      Yes indeed! And to take this further, IMO insulin resistance evolved as an adaptive mechanism for nutrient partitioning and the rapid storage of a glut of food – see Peter at Hyperlipid’s posts on Physiological Insulin Resistance from the right sidebar.

      It is only adaptive when it can take on different values at different tissues, and be switched off when not required.

      Such gluts of food might be fruit (high carb/high fructose) or possibly honey, nuts (high Omega 6), seeds and grains (high carb, high Omega 6) which would be seasonal/temporarily limited. Then the rapidly stored body fat can only be metabolised when the IR is subsequently switched off and insulin levels drop (same is true for ingested fats). The rest of the time we would be eating meat, fish, eggs, small mammals, insects etc. with a side order of (green leafy) veggies so such things would not need to signal for IR to be switched on as they would be around all.most of the time.

      Modern diets switch on IR and leave it locked on so fat metabolism is permanently disrupted and stored body fat (palmitate which is saturated, who knew?) is unavailable, so people are forced to depend on glucose and hence eat carbs every few hours.

      NOT everyone is genetically prone to IR. I think Volek and Phinney estimate around 30% of the population can eat HCLF, whether they got that from research (they’ve done a lot) or simple observation (they are not stupid) I don’t know, but what is interesting is that Joseph Kraft came up with a similar figure – that as much as 70% of the population he studied with his “insulin assay” showed what he called “Diabetes In Situ” which I suspect to be IR triggered by a high carb load.

      Reply
      1. JanB

        Thank you for that link. A splendid read. My surgery, in common with all/most others, doesnt test for insulin levels so I shall look for private means to have it done. As a T2/mody, I would find living without a BG meter extremely tricky, but I think actually knowing what my insulin levels are would help further. (and thousands like me.) My DN insists that I am insulin resistant even though my lipid ratios HDL 3.4/trigs .5) are excellent and I have a waist measurement of 25 inches and am very lean. I really want to know – but then, I’m a bossy cow and don’t like to take ‘facts’ as gospel just because I’m told something is so. MY body, MY responsibility.
        Yay!
        AND I’ve recently beeen told that at 5.9%, my HbA1c too low??????
        Help me, someone.

        Reply
    1. Jennifer.

      Thanks John..this study confirms what I wanted from the NHS 4 years ago, but was refused..i.e..I wanted to have my insulin level measured, rather than subject myself to the endless glucose measurements. My requests fell on deaf ears, and I would go so far as to say, it is because the people responsible for ‘management of diabetes’ are stuck in a time warp of ignorance. I suppose I could have ‘gone private’….but I think I have spent my time and money better by educating myself regarding such matters.
      Now don’t get me started on statins influencing type 2 on females……it is a living nightmare, and a serious cause for concern. Only last week I was told of a 70 year old female being commenced on statins, against her better judgement. She was in an acute vulnerable situation at the time, and easily convinced to comply. However, she did decline the anti-hypertensives, without much of a discussion. Strange state of affairs, or am I getting paranoid about modern ‘preventative’ medicine’. After all, these drugs were prescribed BEFORE any diagnostic tests have been instigated. I wonder if she, unfortunately, develops diabetes?

      Reply
      1. chris c

        The standard explanation is that insulin levels are “irrelevant” because “the treatment would be exactly the same”, ie. HCLF and add more meds when the HbA1c reaches 8% or whatever is the current cutoff. (To quote one source of information for doctors, “monitor the expected decline in health” followed by an ordered list of which medications to use next). Usually only diagnosed Type 1s can have insulin tested, not even Type 1/LADA diabetics who are wrongly diagnosed as Type 2.

        My trigs/HDL ratio was nearly 7 indicating massive IR. On LCHF it’s around 1 or less. (My “other defect” is a lack oh Phase 1 insulin probably since childhood but still a relatively healthy Phase 2, but of course I can’t prove it). Worth noting in a recent paper on the pathways leading to “diabetic” complications, the money shot was in the results – the “obese diabetics” had a fasting insulin FIVE TIMES that of the controls. God knows what it would have been after they ate their Diabetic Breakfast of a bowl of oatmeal with a banana and low fat milk, a slice of toast with low fat spread and no sugar added marmalade and a glass of no sugar added orange juice, eh?

        As I wrote in one of my posts that was blocked, the reason for the paranoia about low A1c in diabetics comes from a study called ACCORD where the intervention was basically heroic amounts of medication to counteract the effects of the high carb diet, including things like Avandia which was since banned for causing CVD. What it actually proves is that using hyperinsulinemia to counteract hyperglycemia is not so hot.

        NICE rapidly picked up on this and doctors were instructed not to use “intensive treatment” to reduce A1c below 6.5%. Many doctors and most PCTs took this to mean that low A1c was dangerous per se and many diabetics have been told to increase it or they will have their treatment (including for other conditions) stopped. One was told that he must eat a high carb diet “and we can tell if you are complying because your triglycerides will go up” words fail me!

        At the same time many doctors have taken to “undiagnosing” diabetics when their A1c goes below 6%. Obviously this improves their stats but not the health of their patients, as shown clearly by EPIC-Norfolk (Kay-Tee Khaw) and the five year followup, and a HUGE New Zealand study (Elley et al.) both of which related CVD risk linearly to A1c starting from truly normal values of 5% or less.

        Even some Type 1 diabetics have been undiagnosed and had their insulin prescriptions cancelled, which is unforgivable. To be fair in some cases the doctors themselves didn’t even know this had been done so I suspect data mining by accounting clerks at the PCT.

        Reply
        1. JanB

          Thank you for that, Chris C. That explains why my DN nurse at my last visit on seeing that my HbA1c at 5.8% at last qualifies me for membership of the “5% club” – hurrah – immediately stopped one of my meds because my levels were ‘too low’ and I was in ‘grave danger’ of hypos – I NEVER have hypos. The bad news is that straightaway my post meal BG spiked at 16.6.
          I was so disappointed, firstly because all my assiduous low carbing obviously hadn’t done anything for the underlying condition, but mainly because I was treated like a fool, even more so when I had to go back to get my meds reinstated and I was lectured about the dangers of hypos by the locum doc. and that a BG in the 7s was good. Honest to goodness, I’ve lived with this for 59 years. I ‘ad ‘I’m though; because when I asked him why he thought that my low renal threshold was much improved from when I was younger he hadn’t a clue what I was talking about. I rather naughtily suggested he Google it.
          HAPPY CHRISTMAS 🎄 TO ALL, and especially to our wonderful Doctor K. What would we do without him.

          Reply
      2. chris c

        Retweeted by a UK dietician

        That’s going to prevent the “inappropriate reversal of diabetes” at a stroke eh? Probably also cause the stroke . . .

        Sadly a lot of medical professional assiduously follow “evidence-based medicine” without realising that half the evidence is missing (but can be found on PubMed)

        I DID used to get hypos, as a direct consequence of eating the recommended high carb low fat diet. My insulin would turn up late for the party and then hang around after all the glucose had gone home. Because the combination of postprandial highs and post-postprandial lows left me with a “normal” HbA1c no-one knew what was actually occurring until I bought a glucometer.

        Reducing the carbs stopped the hypos stone dead. Fortunately I “met” a number of patients whose doctors had more Clue than average and learned from them what to try.

        I was half hoping that the replacement of PCTs by CCGs might delete some of the worst nonsense, which seems to have happened at my GP practice, but it will obviously take time for reality to be engaged elsewhere.

        Reply
    2. chris c

      Excellent, Amy has a load of good stuff on her blog. Check out especially the “It’s The Insulin, Stupid!” series of posts.

      Reply
  59. Anna

    I’ve tried growing cabbages these past 3 years but with little success, and ditto broccoli. I’ve had moderate success with making saurkraut by keeping the cabbage below the level of brine, but it is difficult to keep it there. Perhaps I need to add a little water. Adding whey is a great idea! But who has whey. So the baggie of water is a little bag placed over an open top of a jar? That might be good in that if pressure builds, it can easily burp.

    Oh, Sasha, I don’t always get everything I’m reading but I am very thirsty for this sort of thing. I get frustrated sometimes and write my questions at the bottom of the page, or other commentary. The better I like the book, the more it gets scribbled in. There are definitely certain things that are not quite coming together for me but I do get most of it. Some people are better at writing for the layperson than others. As for me, I am quite uneducated, having dropped out of school after the 8th grade. In nursing school I took 2 algebra classes and1 chemistry, having never taken such things before. The chemistry class was like an acid trip. Amazing stuff.

    Reply
    1. Frederica Huxley

      You may like to keep a few of the outside leaves of your cabbage before shredding them. Having tamped down your kraut, releasing as much juice as possible, cover it with cut up pieces of cabbage leaf – this helps stop veg from coming over the level of liquid. Classic sauerkraut lactoferments with salt alone – whey is considered to alter the fermentation process! If you do need more liquid, make a 2% solution of salt and water to pour over the kraut. The fermentation process needs to be anerobic, so needs to have some form of airlock, be it a water moat, a fido jar or a water airlock. Any other lid would have to be carefully burped daily for the first few weeks.

      Reply
    2. Gary Ogden

      Anna: The key to growing cabbages, or anything, is soil health. If you have access to compost or leaves (but not all kinds, generally the leaves of deciduous trees work well, but not evergreen leaves), you can make a dramatic difference in the fertility of your soil in six months to a year. Simply spread an inch or so (2-3 cm) of compost or two or three inches (5-8 cm) of leaves on top of the soil in the planting area. The leaves feed the earthworms who make soil. After six months to a year gently and lightly work the compost into the top inch of soil with a steel rake (not a leaf rake), or, if leaves, simply rake them aside, then plant. Some things, such as carrots I simply sow seed, but most things, such as cabbages, I start from seed in tiny pots where the snails don’t live, then transplant when the look big enough to survive. Another tip: I always mix about half compost in with the soil I backfill around the plant, then water very well, even if the soil is relatively moist. This will give them a good start. The more hours of sun in the planting area the better. Hope this helps.
      Also, I make whey this way: Leave a bottle of raw, skim milk on the counter 1-4 days, until it separates (the good bacteria in raw milk protect it from spoilage; don’t do this with pasteurized milk). Put a tea towel in a colander in a pot and dump in the milk, cover (a dinner plate works well), and let it drip for a few hours. Then tie the tea towel to a wooden spoon, hang it up, and allow it to finish dripping. Put the whey from the pot in the fridge to use as needed, and do whatever you like with the solids. If you use whole milk, the solids are like cream cheese.

      Reply
  60. Roger Arnold

    Dr Kendrick
    I remember you saying in a previous blog, that regardless of the overwhelming evidence that official guidelines re dietary advice and lipid profiling need changing, the process would never be more than gradual.
    Maybe it’s started.
    Advice on the web of the Association of British Dietitians says we can help control our blood glucose levels by reducing carbohydrate intake. And that a lower carb diet could be an option.
    The information also starts off with a rather interesting advisory contradiction.

    Click to access diabetestype2.pdf

    Regards and thanks
    Roger

    Reply
    1. Stephen T

      Roger, a miniscule step in the right direction, probably because of strong criticism of dietitians by diabetics. But the whole emphasis is still towards 50% carbohydrates and eating all the time. And there’s the usual stuff about fat being bad and raising cholesterol. It’s a terrible document fixed in the backward low-fat paradigm.

      Amongst all the dross it states: “A lower carbohydrate diet could be an option for you but talk to a healthcare professional first, preferably a dietitian, as it may not be suitable or your medication may need adjusting.” Hardly a ringing endorsement of the most effective diet for most diabetics.

      I’d rather bang my head on a brick wall than talk to most dietitians.

      Reply
      1. Maureen H

        Stephen. A couple of years ago I was at a dinner meeting with people I didn’t know well. The conversation turned to diet, someone mentioned low carb, and one of the ladies there said her son was a Type 1 Diabetic and had to have his carbs. His dietitian and physician told her that it was ok for her son to eat like other kids, because they could control blood sugar with insulin. I was horrified. I tried not to say anything but couldn’t help it. I said that if she was interested I could point her in the direction of some websites that discuss reducing glucose levels with a low carb approach and she might want to look into it. I thought that was pretty non confrontational but her reaction was quite savage: ‘Are you a doctor or dietitian’, ‘No’ ‘well don’t presume to be giving me advice you’re not qualified to give’. Ouch. I won’t do that again, but oh those poor kids, and their parents being give such criminally destructive advice.

        Reply
    2. Dr. Göran Sjöberg

      Roger,

      In Sweden low carb is an officially approved option for treating diabetics and overweight people although there is a profound resistance within the health care system itself to support this option.

      Reply
    3. David Bailey

      Since I am naturally slim, and don’t believe in the NHS dietary advice anyway, I don’t normally look at such sites, but when I do, I usually have a laugh. Thus we read that a portion size is:

      • a fist size of carbohydrate
      • a palm size of meat/fish or poultry
      • two handfuls of vegetables or salad
      • a cupped-handful of fruit
      • top of your thumb size of oil or fat spread

      If this advice were to mean anything at all, surely it would start with some weights, and maybe interpret those a bit in addition, but fists vary in size, as do palms and thumbs, and the owner of the hands isn’t necessarily the one who will eat the food!

      I wonder how many thumb sized portions of olive oil there are in a litre bottle!

      I don’t think this vagueness is accidental, it is because nobody want to sound too specific right now because they know the current advice is untenable.

      Reply
      1. chris c

        Funny, I eat a fist-sized portion of fat, a palm sized piece of meat fish poultry or game, a handful of veg, not very much fruit and a fingernail sized amount of carbs, and I have been “inappropriately reversing” my diabetes for nearly twelve years now.

        Reply
  61. Anna

    Gary,

    Thank you very much. I started gardening 3 years ago. We have heavy clay soil. The first year I got a soil analysis and made some amendments. I’ve added some horse manure mixed with sawdust, aged at least 6 months but perhaps not enough. The soil is still heavy and when I dig down a bit it is pure clay. Now, I am going through a lot of effort and simply digging up a deeper lay and carrying it out in buckets and dumping it. I’ve had reasonable success with carrots, and I work the soil deeply. I’ve wondered if more soil improvement is what I need. We have been steadily working on creating more leafy compost, sometimes mixed with chicken litter/straw. Perhaps this spring I’ll really have a good bit of it. I will take a row and be extra good to it, and see the results, because I’ve been puzzling over whether my problem is the soil or what. I also have to do a lot of weeding and I lay the weeds down around the plants to provide a bit of mulch and it eventually gets composted.

    Yes, I also plant them in pots. Plenty of leaves around here, ha, ha. The garden is on the edge of the forest.
    The whey will be easy to make.

    Reply
    1. JDPatten

      Anna,
      If you want to try it, I’ve got a solution for clay problems that worked very well for me.
      Garden gypsum. Here in the U S of A it comes in a granulated form for the purpose. Some digging in is required, but not a lot. It broke down my concrete-like gravelly yellow clay and I now have great drainage. Took a year.
      I used it for a flower garden. Don’t know about veggies.

      Reply
    2. Gary Ogden

      Anna: Great! You’re doing what I would do. We attempt and we learn. I would only caution about deep cultivation, as this disturbs the microbial web of life that provides the nutrients to the plants, in exchange for some of the glucose the plants produce. I know nothing about heavy clay soils, as I live in a grassland (converted to agriculture), which has a sandy loam from eons of alluvial deposition, and is very happy with added organic matter. So you will have to do some things differently than I do. What I have learned in recent years about the garden that has been most helpful is to pay attention to Nature. She is in charge. Why do certain plants (what we call weeds) grow in certain places in certain seasons? This tells us something about the fertility of that patch of soil, and the timing for planting, and things I haven’t even thought of. I’ve come to highly value wild edibles in the garden, such as dandelions and chickweed, and naturalized edibles, which I no longer have to plant, such as parsley and mustard. The best results seem to come from letting the plants decide where to grow, rather than us. I let a few carrots and onions go to seed each year, as this seed is far superior to bought seed. I wish you the best!

      Reply
  62. TS

    Ground almonds can be substituted for flour in cakes (makes them lighter and delicious too). I don’t make anything that requires caster or granulated sugar – natural molasses sugar makes lovely cakes and is, I think, really quite wholesome (being a pretty unrefined food) if you don’t overdo it. Cakes made with real molasses sugar never leave you feeling full or on the sick side as other cakes often do.
    Suggestion re. the foraging: Look out for young sorrel leaves on your walks. (I even pick ones at dog-level!) They are lovely and tangy in salads if you haven’t munched them en route.

    Reply
    1. Gary Ogden

      TS: Both Sorrel (Rumex sp.), also called Dock, and Wood Sorrel (Oxalis sp) are good foraged foods. Only downside is the high oxalate content, like spinach.

      Reply
  63. chris c

    The Big Picture I see, which is an opinion and thereby subject to change by evidence, is that “ignorant savages” all over the world are somehow wise enough to avoid the “Diseases Of Civilisation” pretty much whatever they eat.

    Once they are suckered into eating the Diet Of Civilisation it’s game over, they tend to succumb far worse than us westerners who have eaten this diet for long enough that we have become somewhat adapted on a population level, not necessarily as individuals..

    The factors that produce the decline in health may not be the reciprocal of the factors that cure it.

    Once your metabolism is broken LCHF is far and away the best way to fix it. The worse your metabolism is broken the further back in time you need to go. I do pretty well on “what my Gran used to eat” plus avoiding wheat, sugar/HFCS and trans fats and grossly reducing all other starches and Omega 6 seed oils.

    I wonder how many of these “primitive” people would attack their witchdoctors, medicine men or shamans for “inappropriate reversal of diabetes”, which also makes them less savage than us.

    Reply
    1. Sasha

      It’s not as simple as what “primitive people” eat. It’s also bacteria they are exposed to, how much of the herd is “culled” by infectious diseases in the absence of vaccines thus, possibly, conferring some protective effects and so on.

      There’s a reason why prevalence of T1D in clean, successful Finland is 30 times that of rural China. “An Epidemic of Absence” goes in great detail into the reasons why.

      Reply
          1. Sasha

            The problem with the statement: “epidemic of T1D correlates with increased immunization” is that correlation is not causation.

            I am not saying I agree with the current immunization schedule but there are plenty of co-factors that come into play with development: movement away from rural lifestyle and its exposure to beneficial bacteria, environmental pollutants, processed foods, etc.

            It’s not just vaccines.

          2. Gaetan

            Yeah its multi factorial, i was just pointing out that vaccines are not as safe as they want us to believe, its also a multi billion dollars industry. Just like statins.

          3. Sasha

            Also, older fathers, mothers get pregnant later, etc.

            In the Soviet Union in the 70’s a woman who was pregnant at 25 was considered to be old and it was looked at as higher risk pregnancy.

          4. Gary Ogden

            Sasha: There is an excellent new book which explores (from 3,000+ scientific papers) this horrific and growing worldwide epidemic, “The Environmental and Genetic causes of Autism,” by James Lyons-Weiler, PhD, a very bright fellow.

          5. Sasha

            Thanks, Gary, I will look it up. I think it’s important to first determine the pathogenesis of autism which will help find causes. I have heard plausible theories but nothing definitive.

        1. Sasha

          It very well may be. For those who survive childhood. About 75%, I would guess.

          Also, I don’t think increase in autism can be pinned just on vaccines. They are a factor but not the only one, IMO. “An Epidemic of Absence” goes into it in some detail.

          Reply
      1. chris c

        Latitude and vitamin D has been implicated, also wheat/coeliac. Little known fact which I don’t know if it is still true, at one time the rate of increase in Type 1, especially among adults, was higher than the rate of increase of Type 2.

        Reply
        1. Sasha

          Prevalence of T1D in Finnish Karelia is many times that of Russian Karelia. Same latitude, same vitamin D. Even same genetics.

          Reply
          1. Gary Ogden

            Sasha: Any difference between theses two regions and the selenium content (or perhaps other minerals) of the soil?

          2. Sasha

            I doubt it. The two Karelias are virtually the same. Used to be one region but the Soviet Union took half from Finland 80 years ago. The only difference now – the Finnish part is clean and first world while the Russian part is third world: dirty water, parasites, snotty kids, infectious diseases and so on.

            The prevalence of T1D, asthma, allergies and other autoimmune conditions in the Russian part is a fraction of that of the Finnish part. “An Epidemic of Absence” makes the argument that in the absence of bacteria and parasites with which we co-evolved, the immune system turns itself on the rest of the body.

            That’s why I think “primitive people” owe their health not only to unprocessed foods.

          3. Dr. Malcolm Kendrick Post author

            I have been interested in Karelia for a long time. Finnish Karelia had the highest rate of CVD in the world for many years. I have always argued that this was due the forced relocation of over 400,000 people, creating terrific social dislocation, stress and CVD.

          4. JanB

            And I wonder about the slum clearances in this country, too. Whole communities torn apart. The benefits of better housing, running hot water, bathrooms, etc., must have been somewhat sabotaged by the stress of losing friends, family and a way of life that had survived for so long.

          5. smartersig

            Was it not the Danish who during WW2 were occupied by the Germans and when they confiscated all their animal produce heart attacks plummeted. This is in spite of the fact that they were more than likely experiencing a very stressful occupied period. I am not discounting stress but something played a factor in these dropping levels which then returned when occupation was over

          6. Sasha

            If that anecdote is true, it would contradict the LCHF theory. Were the Danish really keeping track of their heart attacks during WWII?

          7. Gary Ogden

            smartersig: As I recall from reading about this, they compensated for this by foraging in the woods for mushrooms, berries, etc, and by increasing the amount of seafood they ate. Someone correct me if I have only part of the story.

      2. chris c

        Yes again probably a big factor. When I read that the volume of gut bacteria is about that of the human brain I thought “that explains dieticians then”.

        Many interesting not-quite-patterns, In addition to the possible wheat/gluten and vitamin D links, many people who develop Type 1 and other autoimmune diseases have them start after an infection like flu or measles etc. One theory is an “adventive” virus which only infects people already weakened by some other infection.

        I spent the first five high carb decades including three low-fat decades suffering from minor but chronic skin, eye, sinus, gum, and fungal infections, and outbreaks of thrush, and caught every cold, flu, stomach bug etc. doing the rounds.

        The result from the last nearly twelve years of low carbing has been stunning, I hardly ever catch anything, as a result of no longer being flooded with glucose (I assume). Even this latest cough which laid Malcolm and Goran low and also hit many people around these parts, leaving them coughing and hacking and retiring to their sick beds, left me with a few minor symptoms which carried on and off over a few weeks but never developed into anything.

        Yet it was a couple of years back that my thyroid exploded, currently suspected to be autoimmune (Graves). My father had the same thing, only his was when he was young, mine waited until I got old. One of his brothers became Type 1. My mother, who then lived in the same village, developed Crohns. To my knowledge no-one else in either family had any other autoimmune disease, until me recently.

        I’d like to dig them up and ask them if all these illnesses started around the same time, which may indicate an environmental cause, maybe a flu pandemic.

        On the other side of the coin I know a couple of families where everyone has an autoimmune disease and several have more than one. This is blamed on HLA subtypes, but that doesn’t explain why they get different diseases at different ages at different times.

        There are no end of interactions between genes and environmental factors in pretty much all diseases. Some people are even immune to AIDS.

        Reply
  64. Eliot

    Has anyone checked the Sami’s taurine levels? Foods high in taurine (according to Livestrong) are fish, meat, human breast milk and sea algae and plants. Taurine is said to be good for cardiovascular health. The Japanese and Okinawans have high levels from their diet and low rates of heart disease (that is until they move and start eating Western-style food).

    Reply
  65. Martin Back

    I don’t have a problem with the LCHF diet. Personally, I have reduced my carb intake, increased my fat intake, cut out breakfast and sugary drinks, and the results have been good, although I refuse to give up my home-baked sourdough bread.

    Where I do have a problem is where proponents of the diet claim benefits that are actually due to some other factor. In particular, calorie restriction. There seems little doubt that many of the benefits reported by people on a LCHF diet are simply due to eating less rather than any biochemical reason involving fat metabolism.

    This is what Gary Taubes, arguably the father of the modern LCHF movement, had to say:

    “If we got fat, we had to overeat. That’s always true; it’s obvious, and it tells us nothing about why we got fat, or why one person got fat and another didn’t. It’s what logicians call ‘vacuously’ true. It’s true, but meaningless. It tells us nothing.”http://garytaubes.com/2010/12/inanity-of-overeating/ (slightly edited)

    Sorry Gary, but I don’t think it’s at all vacuous. In fact, I think it’s the central question in the whole diet-obesity syndrome. We got too fat because we ate too much. Why is it that some humans eat too much, whereas every other living thing on this earth seems able to regulate its appetite?

    It’s not because there’s not enough fat in our diet. There are too many counter-examples of high-carb diets leading to excellent health. From my own country, when rural Africans were recruited by the mines in the 1950s they were perfect physical specimens on a diet of maize porridge, sour beer made from maize and millet, and a bit of meat and wild spinach and starchy vegetables. Not to mention the Zulu impis who gave the British a hard time at Rorke’s Drift. They didn’t do too badly on their mostly vegetarian diet.

    There is something about the modern Western diet that causes people to lose control of their appetites and over-consume calories. We need to find out what it is and fix it. As long as you are getting adequate vitamins and minerals, I don’t believe it makes any difference whether your calories come from fat or carbohydrates. The body is able to handle either.

    I’ve just finished reading Stalingrad by Anthony Beevor. He mentions that starved people given fatty food died because the food was too rich. Not a good advert for fat. I remember that in Alive by Piers Paul Read, about the Andes plane crash where they turned to cannibalism to stay alive, the first guy to make it to civilization gorged on beans and something (can’t remember the exact meal. I gave my copy of the book away). He was told to control his food intake but he ate ravenously and recovered quickly on a non-fatty diet. Note that we have enzymes to break down starch in out mouths. We don’t have acids to break down fats. Which tells me the body rates starch as of higher importance because it’s the first to be digested.

    Insulin seems to be an important factor in appetite regulation. American POWs rescued from Japanese camps were given insulin by the medics to fatten them up before they returned to the States (sorry, don’t have a reference). A psychiatric patient prescribed insulin shock therapy reports: “I perspired and ate like a pig because insulin makes you ravenously hungry as it lowers the blood sugar– the doctors call it hypoglycemia. Before the shocks, I weighed roughly 145 pounds, 6 weeks later when the shocks stopped, I weighed 194 pounds.”http://coalitionagainstpsychiatricassault.com

    Reply
    1. chris c

      “Which tells me the body rates starch as of higher importance because it’s the first to be digested.”

      Now turn that around. The body digests starch and sugar quickly to get the glucose stored away as fat before it goes around glycating everything.

      The body misses out some important rate-limiting steps in order to pump fructose out of the blood even quicker. Alcohol even more so.

      You’re spot on about the insulin though, it’s the elephant in the room. Without constantly alternating between glucose spikes and insulin spikes my appetite has settled down. There’s a qualitative difference as well as a quantitative difference between hunger and carb craving.

      Reply
    2. Eliot

      “Why is it that some humans eat too much, whereas every other living thing on this earth seems able to regulate its appetite?”

      Pet dogs and cats get fat. I think it is mostly when their owners leave full bowls of dry food for them to eat all day and the pets don’t regulate their intake. Dry pet food is much higher in carbs than their natural diets.

      Reply
      1. Maureen H

        Eliot, my dog was 20lbs overweight eating regular kibble, which is very high in carbs. When my husband and I changed our diet to LCHF we lost 20 and 30lbs respectively with no effort. So we changed Rocky’s diet too, to low carb, and he lost his 20lbs which was a large percentage of his body weight, starting at 80lbs down to 60. He wasn’t fat because he was inactive, or nibbling kibble all day, he ate the recommended amount of kibble for his ideal weight daily. As for activity, he’s a border collie and active all the day long working sheep and going on long walks. He is slim and trim and has more energy than ever now.

        Reply
      2. Martin Back

        “[Polar bears] eat only two or three months of the year and live for most of the year on desolate ice floes. There, they may kill an occasional seal, but discard the protein-filled flesh and eat only blubber.”http://www.nytimes.com/1992/04/21/science/hibernating-bears-emerge-with-hints-about-human-ills.html?pagewanted=all

        You can understand why they need to get fat. Presumably they are using a variation of the bears’ hibernating metabolism, where for six months they neither eat, drink, urinate, nor defecate, but still manage to build muscle and bone by recycling waste products, using the energy stored in fat to drive the process.

        Reply
        1. rockingbass

          Martin the answer to your question is that we humans get fat by overeating carbohydrate. see My life Without Bread Dr Lutz at 90 by Valerie Bracken.

          Reply
      3. chris c

        Some migratory birds deliberately become fat. Sedge Warblers are mainly insectivores. At the end of the breeding season they turn to plum-reed aphids which are basically little protein bags filled with high sugar plant sap and DOUBLE their body weight. Then the use the stored fat to fuel a Trans-Saharan migration to where they overwinter.

        Currently my tame blackbird prefers sultanas to his usual mealworms. Many thrushes switch from insects to berries prior to winter in order to gain fat to see them, through hard weather and fuel local movements.

        Of course a dietician would tell you that your pets are eating too much and not using their treadmills enough

        Reply
  66. TS

    Having worked with people with autism I got the idea that autism might simply (or perhaps not so simply) be the brain’s way of making progress – and during this continual development, some people fair better than others. There are many children with autistic qualities who, because they have sufficient normal development alongside the autism, do better than the rest of us in many fields. The autistic aspects of the brain can be quite linear, or computer like. If you have this ability and also sufficient social development to cope with the world, you might do rather well.

    Reply
  67. John U

    Sorry, Martin, I just don’t get what it is you’re saying. You quote from Gary T, and what he says is quite correct and the statement IS vacuous. It is like saying that a room which is full of people is crowded because more people entered than left. Of course, but that is not the REASON or CAUSE for the crowd. Something else motivated people to want to enter and stay. That is what insulin does. So, yes, of course, more calories consumed is causative in weight gain. The question is why were these calories consumed? Do fat people really like being fat? Is it that they cannot control themselves to eat less? If it was easy to eat less, then we would not be facing and obesity epidemic. The fact is that it is not easy to NOT eat when you are hungry, some might say starving. And that is due to insulin. What causes high insulin levels? IR!

    Reply
    1. Gaetan

      John U,

      In Animal studies, they become insulin resistant when they know there will be a period of food scarcity ahead. This IR is beneficial, as it prevents the energy or blood glucose to be stored as fat, allowing muscles and especially the brain to keep functioning normally. Bears become IR when they hibernate and they would die otherwise, dolphins become IR when they wont have anything to eat etc.

      Reply
      1. John U

        Gaetan, that is physiological IR, not pathological IR. I am insulin resistant on my LCHF diet, in the sense that if I eat some carbs I will not instantly generate lots of insulin. My body is ADAPTED. So are bears. Those who are metabolically broken are not. That is the difference.

        Reply
        1. Gaetan

          i am not sure what metabolically broken means or what it is. One thing i was trying to point out is, the body always has an intelligent response to what we do or think or dont do etc. Nothing is random or due to bad genes (ok, maybe in some rare exceptions) So, diabetes is not a ”diseases” even tho the medical community say otherwise. Its an intelligent adaptive response from the body to prevent more harm and or more decay, and in case of bears, it allows them to survive.

          So, we need to understand why in some human beings ( a vast minority but still millions of people overall ) become diabetic to the point in threatens their health. Is it because they are addicted to refined sugar? Is their a reward mechanism involved in the brain in over eating sugar? (serotonin production increase) etc.

          I don’t know honestly.

          Reply
    2. Stephen T

      John, I agree completely. One point: Dr Jason Fung would say that insulin resistance is caused by too much insulin, provoked by continually eating, mostly carbs. IR = too much insulin, and not the other way around.

      Reply
      1. John U

        Stephen T, yes I saw Dr. Fung’s presentation on insulin resistance and I was a bit confused by some of the statements. I would have to review it again to quote the areas which sounded questionable. There is a lot of controversy about what is the cause of IR, so I am holding my comments in this area until it becomes more clear. He based his hypothesis on the fact that adding more insulin to the diet did not help. Well it wouldn’t if the problem is already too much glucose entering the cell. If the reason for the IR is really high glucose level, then more insulin is not the solution. High insulin levels seem to me to be the effect not the cause. Does the body really shut down glucose entry into the cell because insulin is high? Seems odd. Insulin is high because glucose in the circulation is high so the two do together, that makes sense. But I would expect that it is the glucose receptor (with Lipoprotein Lipase) which regulates the entry of glucose. A type 1 diabetic often gets into a situation where exogenous insulin is added in excess for one reason or another. If this happens too often, will this lead to IR. Is it better to err on the side of high glucose levels than high insulin levels? I wonder.

        Reply
  68. Dr. Göran Sjöberg

    Martin,

    I fully agree with Gary Taubes – he seems to grasp the issue in my eyes.

    To claim that you get fat because you eat too much as an EXPLANATION to why we get fat is sheer stupidity. It is just an irrefutable tautology or the first law of thermodynamics if you like and as such doesn’t make you any more “clever”.

    Reply
    1. Martin Back

      Dr. Goran, I believe that it is essential to recognise that the first step in the chain of reasoning is to admit that we get fat because we consume too many calories.

      The next step, obviously, is to ask why we can’t we control our calorie intake when every other creature on God’s earth manages to maintain a healthy weight even when surrounded by food e.g. rats in a grain store.

      Taubes et al would say it’s because we who eat a Western diet have too much carbohydrate and not enough fat in our diet. But that can’t be the whole answer, because there are millions of people who eat a carb-rich diet and remain at a healthy weight.

      The LCHF diet is a kludge. It is a work-around diet that keeps us at a healthy weight, but we mustn’t fool ourselves that we fully understand why we get fat on the modern Western diet.

      Reply
      1. John U

        Martin, you said
        “Taubes et al would say it’s because we who eat a Western diet have too much carbohydrate and not enough fat in our diet. But that can’t be the whole answer, because there are millions of people who eat a carb-rich diet and remain at a healthy weight.”
        I don’t think GT would say that at all. Of cours millions of people eat a high carb diet and remain at a healthy weight. So what does that prove? Take a million people who are IR and then check their health. That is the issue, not the millions who are not metabolically broken. I think you are might not be understanding the science. Low or baseline insulin and you don’t gain weight and you are fine. High insulin a lot of the time and you will gain weight whether you over eat or not. Just ask a type 1 diabetic or read Dr. Bernstein’s book.

        Reply
        1. luanali

          Martin,

          I’m with John U. It’s clear you’re not understanding the science Taubes has put forth, which is understandable because it’s complex and is a 180 from what we’ve all been trained to think about weight (calories in/calories out) for the last several decades. But honestly, what I don’t understand is how you could cherry-pick a quote from a Taubes article, and use it completely out of context, as some sort of “gotcha”. Even if you didn’t fully understand the article you linked, did you not at least understand the title, “The Inanity of Overeating”? Or his clear framing at the start, “…So what do I mean about overeating being a nonsensical explanation for why we get fat?”

          I think an open, rigorous debate on dietary theories is not only necessary, but critical, so I’m glad you have a different perspective and are willing to share it. But to have an intellectually honest debate, you have to first understand your opponent’s position, and then argue on the merits, not straw men and mischaracterizations.

          Reply
  69. Gary Ogden

    By the way, speaking of reindeer, whose hooves will be touching down on our roofs in a few days, I’ve just learned that what, in Europe, are called reindeer, are called caribou here in North America. Apparently the same species. In Alaska there are vast herds who migrate great distances. Lots of them in Canada, too. Apparently, too, Santa’s team are composed of females only, since the females shed their antlers much later in the season than the males.

    Reply
    1. Maureen H

      Hey Gary, just to make it more confusing, what we call Moose in North America, is called an Elk in Europe. What we called Elk is actually a Wapiti.

      Reply
    2. rockingbass

      An interesting fact about reindeer. In the1920’s in Canada they imported a heard of reindeer from Lapland into the Canadian arctic .the experiment did not work because it was found that the reindeer’s digestive system could not adapt to the different food supply.

      Reply
      1. JanB

        Well, that doesn’t surprise me at all. We humans would do better to stick to foods which our localities provide rather than eating a load of imported stuff which would have been completely unknown to our grandmothers. When I was a child, rice was eaten as an occasional pudding, pasta? – what’s pasta? to give only two examples, as for all the tropical and/or out of season fruits and vegetables……..grrrr. Stuff being carted about all over the poor planet…..grrr.
        Here endeth my daily rant.
        HAPPY CHRISTMAS, ALL. 🎄🎄🎄🎄🎄🎄🎄

        Reply
  70. rockingbass

    There is some fascinating research which needs to be done with genetics and mitochondrial DNA .(our cell “engines” ) .A fascinating book by Brian Sykes called the Severn daughters of Eve lead me thinking about the coming of agriculture some 10,000 years ago, and particularly in the amount of starches and sugars over the last 150 years and what effect this has to our ability to digest different proportions of food (Protein,Fat and Carbohydrate) and how the mitochondria convert it into energy.
    A very Happy Christmas all

    Reply
    1. Frederica Huxley

      I have just finished Seven Daughters of Eve and, like you, found it fascinating – one of the most intriguing books that I have read this year!

      Reply
      1. Gary Ogden

        News flash: Heart disease rates in the U.S., after holding steady from 2011-2014, went up 0.9% in 2015. Also, life expectancy has gone down, 0.2 years for men, and 0.1 years for women. Must be due to global warming, or Trump or something.

        Reply
        1. Sasha

          White people with no college degrees popping Oxys and drinking themselves to death because their country, the richest in the world, doesn’t think that social net is something to aspire to..

          Reply
          1. Gary Ogden

            Sasha: Interesting article in the January Harper’s about Flint, MI. Turns out that what hollowed out the inner cities was social engineering. During and after WWII the growth of Northern industry drew many black (and white) migrants from the South to upper Midwest cities, but through zoning laws and real estate covenants, blacks were largely confined to the cities, keeping the burgeoning suburbs safe for whites. The author also references Robert Gordon’s “The Rise and Fall of American Growth,” which argues that the large middle class that emerged between the mid-forties and mid-seventies was a one-time occurrence, never to be repeated. He’s undoubtedly correct, since the industries which fueled it are gone for good. Funny how the media are blaming everything since the election on Putin! I have to laugh. Threat inflation writ large. And it appears both Trump and Putin are rattling sabers about a new arms race. Russia certainly can’t afford to pour vast sums into such foolishness, and we can only afford to by printing more money. The world has gone mad. And the health statistics for Americans will continue to get worse because the medical industry is in charge, and it is in their financial interest to keep people as sick as possible. Even in Scotland there is a crisis, at least for mental health services for children. Nearly 7,000 (>1% of the student population) children were turned away from services last year because there was no room for them.

          2. Sasha

            Gary: thanks, I will look up the article. I heard something similar on NPR recently. An interview with a person who wrote the book on the subject. I didn’t realize how sinister some of those social engineering policies were (and are) and how they confine generations of people to poverty…

            It truly is twisted, isn’t it?

          3. Gary Ogden

            Sasha: Yes, this is why our “racial” (in quotes because it is not a biological classification, but a purely social one) relations are so fraught. Tragically, the War on Poverty beginning in the 60’s, and the War on Crime in the 90’s have just made life worse for many blacks. And the disappearance of industry has made life worse for whites, too. Even in China, robots are rapidly replacing humans in manufacturing. Looks bleak for the working class. The loss of demand for labor, I think, is part of the explanation for both Brexit and Trump.

          4. Sasha

            Gary: I think in the near future the governments of the developed world will stop pretending that money is something real (at least as far as central banks are concerned) and will institute guaranteed minimal income for their citizens, i.e. “helicopter money”.

  71. Martin Back

    Some commenters have fingered selenium deficiency as a causative factor in CVD. It turns out that while the nutrient content of fruits, grains, and vegetables has declined in Finland, as everywhere else in the West, the selenium content has actually increased.

    This might explain the Sami, but what about the other Finns? Presumably they also enjoy the benefit of higher selenium.

    “Ekholm et al. (2007) reported declines in mostly Finnish foods from the mid-1970s to the 2000s. Considering 17 vegetables, six berries, four grains, and apples as a group, they reported statistically significant “average” declines in the nutrients K, manganese, zinc, and Cu but an increase in selenium (Se) (attributed to Se fertilization begun in Finland in 1985).”http://hortsci.ashspublications.org/content/44/1/15.full

    Reply
    1. Sasha

      Partially explains why traditional societies have less degenerative diseases. They may eat not as much corn as we do but when they do eat it, they get more bang for their buck. And probably why Italians can afford to eat so much bread and pasta – their wheat is better, tomatoes in their tomato sauce is better and so forth. They know it too and most of them say that they don’t want to adopt the agricultural practices of countries like the US.

      Reply
  72. AH Notepad

    There is so much information (un-indexed too) in these blogs, I didn’t remember if this has been referred previously, and if so where. However it’s interesting (to me at least) that eating a low cholesterol diet will raise your cholesterol. How so? https://youtu.be/k8-TT87WLBg Should help the understanding. There is also the significant problem from glyphosate, lest any gardening readers here think it is harmless to humans.

    Reply
  73. Sandy Gottstein

    What is the Sami life expectancy? I know it has been low among Eskimos/Inuit here in Alaska but that may be entirely attributable to being exposed to deadly infectious diseases they had previously not been exposed to and/or the stress of the erosion and loss of their (beautiful) culture.

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