Some of you may already be familiar with Matt Stone, either from his own blog or from his always-interesting comments on this blog. Matt and I agree on many issues, but he’s taken me to task a few times for scaring people away from starches. I asked Matt to write a guest post to explain his views more fully. He graciously agreed. Here it is:

Just Say No to In-Breeding

by Matt Stone of 180DegreeHealth.com

In-breeding is just wrong. I mean, if two things are related to one another, they just shouldn’t be comingling. Things get nasty. People talk. Banjos run wild.

But it’s totally okay for insulin resistance and glucose to hook up. They can shag all night. Get married. Have kids with the normal 10 fingers and 10 toes. All kinds of good stuff. Nothing the least bit immoral or chromosomally risky about. Why? ‘Cuz glucose and insulin resistance are unrelated.

Recently, I was asked to do a guest blog post by Fat Head Master and Commander Tom Naughton, a man who I hold in the utmost regard for translating the work of Gary Taubes into something smart, clever, understandable, and friggin’ hilarious. It’s a tough task indeed — making Taubes palatable to a broad audience is like making a low-fat product taste good. You need lots of high-fructose corn syrup. Crap, bad example, Gary Taubes is a mad HFCS hater! And Naughton too! Don’t worry, I am too. I can usually count the grams of fructose I eat per week on one hand.

Round of applause for Tom. Tom contacted me to do this guest post PRECISELY because he knows that some of my research, theories, and therefore beliefs are not congruent with his and the rest of the low-carb crowd. That is the mark of a real researcher. It still amazes me how much the disease called “like-minded camaraderie” stifles the great health debate. Some low-carb gurus are more stubborn and set in their beliefs than frickin’ vegans. I won’t name any names.

So let’s take another look into insulin resistance, because one thing I can promise you is that it is more complicated than Glucose = Insulin = Obesity, Type 2 diabetes, heart disease, and Cancer. If you get absolutely nothing out of this article, if I lose you along the way, don’t forget that. Everyone who demonizes ANY macronutrient group, especially one that can be found in the milk of every mammal on earth, is a hopeless intellectual cripple.

To begin with, let’s look at just how fragile the Carbs = Disease hypothesis is. You thought the Fat = Disease hypothesis was comical in its simplicity and oversimplification, wait ’til you get a load of this! (Note: I’m not a fan of a low-fat diet, don’t think saturated fat is harmful, and am not a vegetarian, a food-combiner, calorie-counter, or any other kind of diet-dogma nutcase. I’m a researcher with an open mind who’s tried it all).

One of my favorite examples is that continent that eats a primarily low-fat, starch-based diet, but has health that is irrefutably better than the status quo in the United States and many European countries. It’s called Asia. In reference to the British article about Big Fat Lies in which starch was demonized, I created a fun game. It’s called “Count all the obese people on a low-fat, starch-based diet.” Feel free to participate.

Another fine example that shows the greater complexity of the issue of insulin resistance and the disease that stems from it — and its relationship to dietary carbohydrate — is that of the Pima Indians.

Now, wait a second. Didn’t Gary Taubes show that the Pima Indians of Arizona are now the most obese, diabetic, insulin-resistant people on earth? Yes, he did! That I won’t deny. What I’m talking about is the Mountain Pima of Northern Mexico. They don’t live on the American reservation and they continue to follow their traditional farming practices. Their diet does not consist of mostly meat, white flour fried in vegetable oil (fry bread), Pepsi products, alcohol, and packaged “food” products — like the diet of the American Pima. They are the genetic twins of the American Pima, but they, as Andrew Weil describes, “remain lean, active, and free of the diseases of Western civilization, while their relatives from the same gene pool have ballooned into the fat, hypertensive, diabetic Indians who are now so numerous in southern Arizona and northern Mexico.”

What their diet does consist of, in contrast to the American Pima, is EVEN MORE high-glycemic carbohydrates. Their staples are corn (gasp), potatoes (shriek), beans (Holy Lectins, Paleo Man!), and other grains and tubers, along with primarily game meats. Oh, and by the way, I’m not a big fan of Andrew Weil either. Dr. Santa has some kind of boner for soy products and eats enough fructose and polyunsaturated fat to, well, be fat.

What about fructose? Taubes talks about its unique metabolic property. He calls it “the most lipogenic carbohydrate.” Is this significant? I thought high-glycemic carbohydrates that raised our blood sugar and insulin levels the fastest caused insulin resistance and the constellation of metabolic syndrome. I wonder what Richard J. Johnson, author of The Sugar Fix (2008) has to say about that?

“…we have powerful direct evidence to show that consuming too much fructose-rich sugar and HFCS causes the toxic brew of conditions known as metabolic syndrome. Moreover, this same body of research suggests that starchy foods do not induce metabolic syndrome.”

“It’s worth noting here that the glucose in starchy foods may cause blood glucose levels to rise, which stimulates the pancreas to produce insulin. But this is normal and healthy. Dietary glucose does not cause insulin resistance; fructose does.”

“And so begins a vicious cycle caused by eating high-GI foods, which overstimulate the pancreas. It’s an interesting theory, but it is not well supported by the metabolic facts. Stimulating the pancreas to produce insulin is not the problem. Your body is supposed to produce insulin when blood glucose levels rise, so that’s normal and healthy. It is insulin resistance that is closely linked to metabolic syndrome and weight gain. Glucose does not cause insulin resistance. Fructose does. Glucose does not trick your body into persistent hunger. Fructose does.”

Jesus, Dick, settle down. Take it easy, bro. We get the point. Ever think to enroll yourself in fructose-anger management class?

Of course, fructose is a low-glycemic carbohydrate. It causes the lowest blood sugar spike of any carbohydrate. It makes Pepsi (caffeine also can intensify insulin resistance), look like a better choice than a baked potato, when the metabolic effects of the two are as different as Anthony Colpo and Ghandi (they are both bald, but that’s about it). Hence the name of one of the chapters in my most recent book , “The Glycemic Index Catastrophe.”  This is just the tip of the iceberg when it comes to analyzing the glucose vs. fructose issue.  And that is one hell of a big iceberg involving leptin, the hormone with the greatest influence over metabolic rate, appetite, and levels of lipolysis (fat burning) and lipogenesis (fat storage) of any other biochemical. 

In fact, if you had to narrow down insulin resistance to one primary biochemical reason, it would be the state of “leptin resistance,” also thought to be caused primarily by fructose — whereas other dietary carbohydrates have the opposite effect. That’s why starch-based cultures in Asia and elsewhere don’t overeat, have healthy metabolisms, and are generally better off than people in places that put “sugar on top.”

So let me throw this out at you. Even if your blood sugar and insulin surge after ingesting potatoes or rice due to having insulin resistance, let it be known that those potatoes and rice didn’t cause your insulin resistance. Low-glycemic fructose played the heaviest hand in creating that fabulous metabolic state you find yourself in. Cortisol-triggering inflammation from omega 6 overload is a prime suspect as well. If you don’t believe that cortisol can trigger metabolic syndrome, then shoot yourself up with cortisone every day for a year and tell me how it goes for ya. Fructose, cortisol, and other factors, such as lack of key nutrients lost in the carbohydrate-refining process, all play a role.

Which brings up another key point. Refined and unrefined carbohydrates cannot be equated. Even Gary Taubes makes this general assertion in GCBC. T.L. “Peter” Cleave, author of Diabetes, Coronary Thrombosis, and the Saccharine Disease, on which Taubes built a large part of his hypothesis, hit the nail on the head when he stated on page 15 of that book:

“…carbohydrates should not be taken as a single group but as two very different groups; one being natural, unconcentrated carbohydrates, such as unrefined grains, potatoes, and fruits, and the other being unnatural, concentrated carbohydrates, notably refined flour and sugar.”

This was the conclusion he came to after seeing plainly that rural Zulus, eating an extremely high-carbohydrate diet, had none of the health problems of the urban Zulu, who ate a high refined-carbohydrate diet and had every facet of what Cleave called “The Saccharine Disease.” Sounds like metabolic syndrome to me:

“The saccharine disease includes dental decay and pyorrhea; gastric and duodenal ulcer and other forms of indigestion; obesity, diabetes, and coronary disease; constipation, with its complications of varicose veins and hemorrhoids; and primary Escherichia coli infections, like appendicitis, cholecystitis (with or without gall-stones), and primary infections of the urinary tract. The same applies to certain skin condition. Not one of these diseases is for practical purposes ever seen in races who do not consume refined carbohydrates.”

Taubes was right on track to echo this conclusion early on in GCBC (which is one hell of a badass book overall)…

“If cavities are caused primarily by eating sugar and white flour, and cavities appear first in a population no longer eating its traditional diet, followed by obesity, diabetes, and heart disease, then the assumption, until proved otherwise, should be that the other diseases were also caused by these carbohydrates.”

… but veered into Keto Land when he stepped up to the plate in the bottom of the ninth, which is a massive, unfounded, unwarranted, unnecessary, and unfortunate leap.

Yep, it wasn’t until the Epilogue that he sings the praises of a ketogenic diet, which is, don’t say I didn’t warn ya, metabolic suicide if continued long-term. Trust me. My blog has become a sanctuary for low-carbers in metabolic rehab. And I low-carbed for 3 years and felt all the initial benefits too — weight loss, energy, clear skin, fewer allergies — then watched them all fade away, along with my emotional state, and come back with a vengeance. Low-carb is seldom a happily-ever-after, and don’t be stubborn if you start having problems with it. End rant.

The final question is simply, “Where do we go from here?”

If we, as a race of people, are becoming increasingly insulin-resistant — then does that mean that the right “diet for our metabolic type” is a low-carbohydrate diet? Well, it’s a huge step in the right direction that we have good folks like Michael Eades and Uncle Tom Naughton that can at least step outside of the “repeat after me: artery-clogging saturated fat” wacky world of the American Dietetic Association. Finally, we’re getting somewhere at least, and see that our woes are all about hormones, not willpower.

But I think the grandest solution is not to cater to the metabolic disorder known as insulin resistance by running from carbohydrates in fear. Rather, my ambition as a researcher and writer is to truly find the pathways that allow us to topple insulin resistance completely — freeing us to eat whatever macronutrient combo we feel like without compromising our health. We don’t have all the answers yet, but we’re making progress. Dropping my fasting and postprandial glucose levels by 25% recently is a testament to the fact that it can be done. Eating two baked potatoes with my blood sugar peaking at 75 mg/dl one hour later is a metabolic feat few can claim.

Most importantly, people are overcoming hypothyroid symptoms and a low body temperature very quickly, and without medication, by following some of my ideas. I think this is key, as the most successful doctor in history at preventing type 2 diabetes and heart disease (Broda Barnes) did so by keeping the metabolism high, but had to use medication to do it.

And therein lies the true danger of uber-low-carbohydrate diets. All my experience tells me that, the first few years aside, a low-carbohydrate diet and certainly a full-blown ketogenic diet exacerbates a low metabolism. It is not a matter of having a genetically-doomed dysfunctional thyroid gland; it is fixable, and it lies at the core of the health problems we’ve seen explode over the last century. This is why all prolonged restricted diets, low-carb included, in the words of Robert Atkins himself (from page 303 of Dr. Atkins’ New Diet Revolution):

“…tend to shut down thyroid function. This is usually not a problem with the thyroid gland but with the liver, which fails to convert T4 into the more active thyroid principle, T3. The diagnosis is made on clinical grounds with the presence of fatigue, sluggishness, dry skin, coarse or falling hair, an elevation in cholesterol, or a low body temperature.”

To that I will add constipation, bad moods, heartburn, cold hands and feet, and a whole host of other minor but significant health problems. To get an idea of how “shutting down the thyroid” can manifest, Mark Starr’s chapter on Hypothyroidism symptoms is 83 pages long.

This is why the acronym FAD is thrown around 180DegreeHealth quite frequently. The AD stands for All Diets. I’ll leave it up to your imagination as to what the F stands for.

Anyway, if you like compelling health conversation, stop by my blog at www.180degreehealth.blogspot.com. It is a cesspool of agenda-free health information and discussion. It is also free to become a member of my website and access long-winded but very fascinating monthly eZines and podcasts. Go to www.180degreehealth.com to get a piece a that.

Thanks everyone, and best of luck with your health pursuits. I hope that you too can someday achieve that blessed metabolic state that allows you to do what Tom’s son and way-out-of-his-league wife do: sit down and eat whatever they want, until they are full, without becoming obese or diabetic.

Thanks once again to Tom for keeping the conversation going. Clearly mankind hasn’t solved all the riddles of health yet. But thank the Lord Almighty that the low-carb movement got us all eating fatty meat and butter again. What a stupid phase that low-fat thing was!

Thank you, Matt, for sharing your research and your ideas. My wife is indeed out of my league, but fortunately for me, she doesn’t believe it. — Tom

The post last week about Cocoa Krispies and the immune system generated a lot of comments about vitamin D, so I thought I’d post a YouTube interview with Dr. John Cannell in which he talks about the topic:

By coincidence, a reader also sent me a link today to another YouTube video about vitamin D and cancer.  You may remember Dr. Garland, who appears later in this video, from a previous video post as well.  In that video, he explains the DINOMIT theory of cancer.  It’s fascinating stuff.  This one is pretty good too:

In reading a little more about vitamin D over the weekend, I even came across some information suggesting that an adequate level of vitamin D in the blood may prevent the balding gene from expressing.  Now they tell me.  If only I’d heard about that one in my thirties.

But if keeping my vitamin D level up saves me from the horrors of colon cancer and chemotherapy, which I’ve seen my dad go through twice, I can live with the Kojak look.

Okay, so maybe you’ve tried to get your loved ones to read Good Calories, Bad Calories, only to watch them experience brain-lock the first time they see the words lipoprotein lipase. 

Hey, it happens.  I was a pretty good student, but I was out of school for many years before I could read a chemical name without experiencing unsettling classroom flashbacks — in my case, visions of a stern nun who responded to questions such as “Could you please explain that again?” by shaking her head and staring at the ceiling as if to plead, “Dear Lord, why are you punishing me by enrolling dolts in my class?”

Gary Taubes is working on a more consumer-friendly version of his ground-breaking treatise, which I’m looking forward to reading.  But in the meantime, there are some good books out there that offer scientifically sound advice for losing weight and improving your health, minus the heavy-duty science. 

I read one this week.  Actually, I read it in an afternoon, which is what makes the book worthwhile: it’s a nice little summary of what works and what doesn’t.  If your Aunt Martha isn’t willing to read this one, it’s time to just give up.

The book is titled S.P.E.E.D., which is an acronym for Sleep, Psychology, Exercise, Environment and Diet.  I’m pretty sure the particular arrangement of the chapters was done on purpose … I mean, they could’ve called it D.E.E.P.S., or P.E.E.D.S., or P.E.D.E.S., but S.P.E.E.D. is easier to remember and more eye-grabbing.  And as the authors point out, each chapter stands alone.  You could read them in reverse order without losing any comprehension.

The book was written by Jeff Thiboutot and Matt Schoeneberger, personal trainers who between them hold several degrees in fields like nutrition, psychology and exercise science.  (See their web site here.)  Normally, when I see Bachelor of Science in Nutrition after an author’s name, I start to worry … here comes the brain-dead parroting about the evils of saturated fat and all that.  I’m pleased to say, however, that these two have actually done their research.  Pretty much everything they state in the book is followed by a string of citations from scientific journals — so if you do enjoy jumping head-first into the science, you can look it up.

And if you don’t, you can still learn what works and what doesn’t when it comes to losing weight.  Here are some highlights:

• A lack of sufficient sleep screws up your blood sugar, promotes insulin resistance, and increases your appetite.  (As someone who deals with occasional bouts of insomnia, I can attest to the appetite problem.)
• Achieving any goal, including weight loss, requires defining a vision and a specific action plan, then sticking to the plan.  The plan should focus on what you can do, not on pre-defined results.  (There’s some good advice in this chapter on avoiding negative mental patterns that undermine your success.)
• Exercise alone rarely produces any meaningful weight loss — but the right kind of exercise combined with the right diet does work, and exercise is important for your overall health, fitness and mood.
• A whole-food diet with a minimum of sugar and starch is best for supporting both health and weight loss.  Yes, you’ll need to create a calorie deficit to lose weight, but keeping insulin in check by restricting carbohydrates makes the process much easier.

The scientific evidence presented in each chapter is neatly summarized, straightforward, and easy to digest.  You’re not going to learn intricate details about biochemistry or metabolic pathways from this book — but again, that’s the point.  (Remember Aunt Martha.)  You can think of it as a case of “We did the heavy lifting, so you don’t have to.”

And it’s clear that Thiboutot and Schoeneberger know how to separate the good science from the bad.  One of my favorite sections of the book is actually an appendix that gives an overview of the Scientific Method and explains the differences among various levels of scientific evidence — or what the authors call The Great, The Good, The Bad and The Absolutely Worthless. 

Much of the nutrition reporting that appears the media is based on studies (and I use the term loosely) that fall into the last two categories.  More than a few health and nutrition reporters need to read this book … or at least be smacked over the head with it. 

But don’t smack Aunt Martha.  Just put the book in her hands and hope she reads it.

Some months ago, I discovered that Stanford University has quite a few class lectures available for free on iTunes.  I enjoy listening to books and lectures during my long walks, while driving, while sitting on airplanes, and sometimes even while working on programming projects if I’m not in the middle of a real head-scratcher.  (Don’t tell my clients.) 

I’ve downloaded and listened to several lectures on subjects that interest me:  history, politics, science, economics and, of course, health and nutrition.  I had planned to transcribe portions of a couple of nutrition lectures so I could comment on them, but since I don’t like typing all that much, I kind of put that project aside.

Turns out one of the lectures I wanted to write about is also on YouTube, as I found out when I visited Mike Eades’ blog this morning.  I enjoyed it on iTunes, but it’s even better when you can see the visuals.  So in case you haven’t already seen it, here it is.  The speaker is Dr. Chris Gardner, a director of Nutrition Studies and an associate professor of medicine at Stanford:

A few things struck me as I listened to the lecture the first time, and again as I watched it today.  One is that all diets are difficult to follow to some extent — just look at the dropout rates for the other studies Gardner mentioned.  There’s no getting around that.  If your weight is going up and your health is going down, you’re on a bad diet.  To turn things around, you have to give up some foods you love.

I miss fettuccine alfredo and sourdough toast, but I’ve found it much easier to stick to a low-carb diet than any of the others I tried.  Low-fat diets, by contrast, made me feel lethargic and depressed.  I’d start cheating, then eventually give up.  (Good thing, in retrospect.)

Along those lines, notice what happened in Gardner’s study with the group assigned to the Ornish diet: on average, they began eating double the amount of fat Ornish recommends almost immediately and eventually moved up to triple what he recommends.  Ornish has complained that this wasn’t a fair test of his diet since most subjects didn’t stay within the 10% fat limit.  I think it’s more likely they couldn’t stay within the 10% limit … their bodies rebelled.

(Here’s how someone once described the Ornish diet:  put food in your mouth. If it tastes good, spit it out.)

To be fair, the Atkins group drifted back towards a higher carbohydrate intake as well.  If you do the math, it appears that by the end of a year, most of the women in the Atkins group were consuming something in the neighborhood of 150 carbohydrates per day.  They ended up on a restricted carbohydrate diet, but not exactly a low- carbohydrate diet.

But that actually makes their weight loss more impressive.  Remember, they weren’t told to count calories, as two other groups were.  And yet the Atkins group lost the most weight, even though they ate more carbohydrates than Atkins recommended.  And as their carbohydrate intake went up over time, so did their weight — again, they weren’t counting calories.  This would seem to confirm what Atkins said all along:  carbohydrates make you hungry.  You have to find the level of carbohydrate intake that keeps your insulin in check and your appetite stable, then stay there.

I also noticed that the Atkins group had the lowest dropout rate.  Once again, I’m not surprised.  Yes, you may miss your sugars and starches on a low-carb diet, but at least fat is satiating.  I never felt satiated on a low-fat diet, unless I ate huge meals.

What really perked up my ears the first time I heard the lecture was the comparison of the health parameters.  The Atkins group showed the most improvement in weight, blood pressure, triglycerides and cholesterol levels.  No other diet out-performed Atkins on any health parameter.  So much for the notion that a low-carb, high-fat diet will kill you.

Gardner even explains, in response to a question, that low-fat, high-carb diets tend to make triglycerides go up, HDL go down, and produce a higher proportion of small, dense LDL.  And remember, we’re hearing this from a guy who’s been a vegetarian for 25 years — not exactly a shill for the meat industry.

I also found it interesting the relative success of one diet versus another seems to depend on the dieter’s level of insulin resistance.  Now and then, I hear from people who swear they lost a lot of weight on a low-fat diet and felt fine doing it.  I believe them.  But I’m guessing those are people who aren’t insulin-resistant.  They can eat plenty of carbohydrates and lose weight by restricting fat and calories because they don’t end up with high insulin levels that command their bodies to continue storing fat.  Good for them. 

The problem is, the rest of us are told that if it works for them, it should work for us, too — assuming we just had the proper discipline. But it doesn’t work for us.  We produce too much insulin in response to sugar and starch.   We have to give up the carbs, or we’re setting ourselves up to fail.  And given the steep rise in metabolic syndrome and type II diabetes, I think most overweight Americans are probably insulin-resistant. 

This lecture — recounting a study conducted by a committed vegetarian — confirms what I already knew:  the usual dietary advice given to overweight people who are developing metabolic syndrome is a load of bologna.  Hats off to Dr. Gardner for reporting his results with no apparent attempt to manipulate them.  We could use a few more researchers like him.