You've just heard me praise the benefits of a low carb diet for glucose control in diabetics in the past post. While this is true, we should always be on the lookout for controlled studies or good observational studies that contradict what we think we know. More specifically, we should refine our understanding of exactly what entities are problematic in certain food groups which we are already suspicious of as causing health problems.
I recently read a blogger who said that maybe people are too uptight about carbs. I think this is true, but perhaps not for the same reasons. What do I mean by that? Well, there's a certain attitude out there that health is largely genetically determined and that we can eat whatever foods are available to us so long as we do so "in moderation." In other words, it's not really up to us whether we get obese or get heart disease or diabetes. It's pretty much genetically determined. The only thing we can do is try not to eat too many calories, exercise a bit, hope for the best, and then throw drugs at a health problem once it arises. I strongly disagree and the best science available to us does not support such an assertion. When you come to learn that certain foods are a type of slow-acting poison, the idea of "moderation" seems absurd.
That said, we really do need a better understanding of what types of foods and what entities in those foods cause health problems before making swift or premature judgments. We do have solid ideas, but limiting "carbs" may be too simplistic. Perhaps not all carbohydrate-laden food is bad for our health. (I'm speaking strictly from a standpoint of health, not temporary enjoyment. If you are after temporary enjoyment in the absence of context of any health goals, you can justify eating just about anything.)
There are some foods with a pretty high carbohydrate fraction that I believe could be part of a healthy diet. For instance, I'm not at all convinced that potatoes are harmful to anyone but the glucose-intolerant (i.e. the obese, pre-diabetic, and diabetic). We know that the Irish ate a heck of a lot of potatoes. Until the potato famine, the Irish were almost completely dependent upon potatoes. My guess is that they would have done poorly if they did not have any source of animal protein or fat, but I wonder if there is any evidence of diabetes, heart disease, etc. at that time. It would be fascinating to know whether this population from 1600s to the mid 1800s was exempt from other western diseases of civilization that some increasingly believe are caused by carbohydrate.
Not only did the average Irish family of six consume 250 lbs. potatoes weekly, the population doubled from 1800 to 1845. Because the climate was so remarkable for growing potatoes, people were able to be fairly leisurely and abandon other food production — and married earlier, had larger families, and were able to nurse more newborns. That means an average of 6 lbs. potatoes per person per day. Although potatoes are starchy -- in other words, full of sugar, yes -- they have a fair amount of complete protein unlike other vegetables. Six lbs of potatoes is 2500 calories, with 63 grams of protein if one just eats potatoes. That makes potatoes start to sound pretty decent as a major part of the diet and a source of all essential amino acids. (All of the historical information comes from Magical Mushrooms, Mischievous Molds by George Hudler.)
Although these numbers above may be a bit off for average daily intake (6 pounds is a lot -- this means men would have had to eat more to compensate for less intake among women and children), we do know that the Irish relied on potatoes heavily. When corn was imported from America to aid in alleviating the famine, the Irish rejected it, even though they were starving. Apparently their digestive systems were very conditioned to potatoes. In light of this, it would be fascinating to discover more about Irish health at that time. Were they fat? Did they get heart disease? What about diabetes?
This reflects an evolution in my thinking on such dietary matters over the past year. Gary Taubes calls for a more heavy evaluation of the carbohydrate hypothesis at the end of his book Good Calories, Bad Calories. He wouldn't have called for such an evaluation if he considered it proven. Many cultures enjoy a heavy carbohydrate intake with seemingly few health problems (diabetes, cancer, obesity, heart disease) that plague western civilization. Notably, these cultures often chiefly eat starchy tubers or rice. Potatoes lack some of the toxins found in grains and legumes that are suspected of causing modern health problems. In light of this, it would be fascinating to know more about the body composition and health of the Irish just prior to the potato famine if such case studies exist (I'll leave it to health experts to search for and evaluate that information, though). Such information could provide a basis for the types of experiments that Taubes calls for at the end of his book.
I think this excerpt from Stephan's most recent post adequately sums up my evolving thoughts on carbohydrate:
...there's a difference between post-meal glucose and insulin surges and chronically elevated glucose and insulin. Chronically elevated insulin is a marker of metabolic dysfunction, while post-meal insulin surges are not (although glucose surges in excess of 140 mg/dL indicate glucose intolerance). Despite what you may hear from some sectors of the low-carbohydrate community, insulin surges do not necessarily lead to insulin resistance. Just ask a Kitavan. They get 69% of their 2,200 calories per day from high-glycemic starchy tubers and fruit (380 g carbohydrate), with not much fat to slow down digestion. Yet they have low fasting insulin, very little body fat and an undetectable incidence of diabetes, heart attack and stroke. That's despite a significant elderly population on the island.
Yes. And we're also aware of two other native groups in Europe through Weston Price's research that apparently did not suffer from modern health problems yet they had high carbohydrate intake from soaked/sprouted grains. These are are a world of difference biochemically from "whole grains" advocated by health authorities today in phytate, lectins, protease inhibitors, and even gluten content in the case of long sourdough fermentation. Traditional processing of grains removes or greatly reduces these entities. Modern processing does not (and especially since quick-rise techniques have been adopted). Again, from the same post:
Let's take a look at how healthy cultures eat their carbohydrate foods. Cultures that rely heavily on carbohydrate generally fall into three categories: they eat cooked starchy tubers, they grind and cook their grains, or they rely on grains that become very soft when cooked...
The human digestive system is delicate. Cows can eat whole grass seeds and digest them using their giant four-compartment stomach that acts as a fermentation tank. Humans that eat intact grains end up donating them to the waste treatment plant...
Grain consumption and grinding implements appear simultaneously in the archaeological record. Grinding has always been used to increase the digestibility of tough grains, even before the invention of agriculture when hunter-gatherers were gathering wild grains in the fertile crescent. Some archaeologists consider grinding implements one of the diagnostic features of a grain-based culture.
Carbohydrate-based cultures have always prioritized digestibility and nutritional value over GI. Have nutrition authorities suddenly gotten smarter than them in the last 20 years?
I recommend his blog and the comments line of each post for some good skeptical thinking on the glycemic index, what types of carbohydrate are probably unhealthy, what types of processing are healthy and even necessary for our foods, and what we know about human health throughout human history. Much of the information on historical use of carbohydrate seems lost on, or ignored by, the larger "paleo" and "low carb" communities. All of the information on the effects of agricultural products on human health is lost on, or ignored by, our modern nutritional "authorities" and thus, the vast majority of the population.
The same type of critical thinking needs to be applied to "processed food." It's critical to examine the definition of a processed food as well as what types of processing are good and bad for our health. That said, when it comes to human diet, which we know from anthropological studies experiences heavy selection pressure, the precautionary principle is in order. In other words, deviating from the evolutionarily prescribed path needs to be proven to be healthy. What does that mean? It means that the burden of proof is on new foods in use for only 10,000 years or 40 years -- not the foods that humans have been eating for millions of years, foods that were selected for by evolution over time.
A couple of weeks ago I dropped a note on Dr. Eades' blog about my frustration with my grandfather's situation. He's 78 and has been a Type II diabetic for 25 years. He managed his condition relatively well without insulin for at least a decade. However, years of slamming himself with too high of a carbohydrate intake (although probably relatively low compared to most Americans) hasn't helped, and his kidneys recently started to fail.
At my wits end (and knowing that low carb would definitely help my grandfather), I sent him Dr. Bernstein’s Diabetes Solution last week at Dr. Eades' suggestion. My grandfather had been ordered on a low potassium diet for awhile by his doc around a month ago. Incidentally, it seems this is a slightly carb limiting diet as well, although he can still have one piece of white bread daily. He is not allowed to have bananas and a lot of other carb-heavy stuff so I suspected he is incidentally controlling his blood glucose in addition to ridding the body of potassium, although that is not the intention of the diet.
He has now read Diabetes Solution almost in entirety and told me he’s learned a ton.
Here are the results of 3-4 weeks on the low potassium diet (which is a semi-low-carb diet, although I’m honestly not sure exactly how many grams he’s eating daily) and after just 1 week of reading Dr. Bernstein’s Diabetes Solution and incorporating some dietary suggestions from that book as well:
25 lbs. weight loss in approximately a month.
Waking glucose levels down to 95 ng/mL… not sure what they were before, and it's still not ideal, but it’s definitely an improvement.
Insulin usage down more than 50% — used to be 8-10 units at a time, now down to around 4 at a time. His diet is not even uber low carb yet.
Increased energy.
He and my grandmother are pretty excited about these positive results, although he is finding the low potassium diet limiting (he cannot have things such as tomatoes). I suspect that if they just get over their fear of fat (he has "high cholesterol" and is on statins -- UGH! -- my next target once I learn about his lipid profile) and increase their range of foods they will be a bit more satisfied on a low carb diet. Also, once he is able to be off the low potassium diet his range of choices in food will increase a bit more.
I get the sense they will both definitely continue low carbing, their health and well-being will improve, and my grandfather will add some time to his life. I'm very pleased and excited for him.
As a commenter on amazon said of Diabetes Solution, "If the ADA disappeared tomorrow but this book remained, prognosis for all diabetics would be improved."
Unfortunately, that's too true. That sentiment also applies to the rejecting much of the conventional wisdom of the American Heart Association, which ultimately comes not from good medical research but straight from mouths of the USDA/Big Agriculture.
I've had several diligent people forward me this news story via email over the past few days. It's a popular summary of a new "study" that "proves" that red meat causes cancer. The particular claims with regard to this article have already been thoroughlyrebuttedelsewhere and I have it on Dr. Eades' own word that he is going to blog on this study as well. Update: he has.
The first thing that occurred to me when I read this popular report was that lots of Americans get their "cancer causing" red meat served to them on a great big white bun with a load of other carbohydrates (soda, chips, fries) and inflammation-causing n-6 vegetable oils (chips, fries, salad dressings) on the side. Correlation is not causation. The authors of this study need to go back and take a good statistics course and learn how to control other dietary variables correctly.
But now I get to my point. Interestingly, this "red meat causes cancer" article heavily mixes "dietary" science (not that the dietary science is even good) with "advocacy" science. In other words:not only is meat bad for us, it's bad for the environment. Here we go again. Articles such as these are why I recently blogged on this topic of meat and the environment here and here. Some people may not care, but I think it's important to evaluate these claims to see whether they are actually true. The idea that meat eating is unsustainable is appearing more and more in the popular press, and the message is getting shriller and shriller.
Someone whom I can't remember once said, "Advocacy science is not science." I think there's a great deal of truth to that statement. When we become advocates of something, it can cloud our judgment and objectivity and create a confirmation bias. (This is also true for "paleo" dieters and meat eaters.) We should always be on the lookout for deviations from our assumptions -- unless, of course, they are the most basic of facts.
Thankfully, I am not the only blogger who has recently picked up on this topic of meat and the environment. Here are some excerpts from an enlightening post by Robb Wolf entitled Meat, Global Warming and Markets:
The Fish paper starts off with some dismissive language about the “over-hyped” benefits of fish oil…then changes tac(sic) completely and begins hand wringing about fish-stocks and sustainability. Oweee-kayyy. Tens of thousands of studies citing the benefits of n-3’s, synergy with what we know about our ancestral diet, the ONLY cited reason for the aparent(sic) health of the Inuit on their ancestral diet…and it’s all han(sic)-waved away, never explained…and the rest of the paper is focussed(sic) on the hot topic of global warming and sustainability! Keep this in mid as we look at a clinical intervention of the paleo diet in humans.
In this paper a represnetitive(sic) paleolithic diet is compared to the the much vaunted mediteranian(sic) diet…in a sick population of folks WITH ischemic heart disease. It’s worth noting that the paleo-nay-sayers have whined for years: “there is no evidence! We need clinical studies!!” Well…here is a clinical trial showing compelling evidence for the superiority of a paleo diet over a medeteranian(sic)diet…and the main critiques of the paper focus on sustainability, not the validity of the science at hand. Here is a similar study with similar, non-science related critiques which focus instead on environmental issues and sustainability.
Before I go on I want to come clean with what my political leanings are: Lover of free-markets, strongly identify with the Liberatarian(sic) party. This puts me squarely in a position to constantly piss-off and annoy left-leaning hippies and religious right-wingers alike. If you can piss nearly everyone off, you know you are onto something good.
So, on the one hand I’me(sic) very happy to see the positive press these paleo clinical trials are getting. Right on the heels of that excitement and optimism is a sinking feeling when the discussion shifts to global warming, sustainability and the like. Why? Because it is shifting the argument just as the vegetarians are getting painted into a corner with no escape. The notion that our ancestral diet is the healthiest one, if right, will gain momentum and support. The only way to discredit this way of eating then is to throw up a boogey-man of fear and play on peoples guilt...
Fast forward to today, we still have the hand-wringing Malthusiast’s who are convinced we are all on a collision course with disaster unless we bocome low-fat vegetarians and export this lifestyle to everyone else on the planet. Much todo is made that a more meat based diet is unsustainable…but then again, modern farming practices rely on non-renewable fossil fuels, and as such plant based diets are apparently unsustainable also! Somehow the study authors find that a lacto-ovo diet is superior to alternative approaches…I’d like to dig through that study and see what they are using for numbers, but it just does not sit well. Interestingly, no one looks at the picture when we are talking grassfeeding and a more paleo type diet.
Perhpas(sic) counter intuitively, a meat, fruit and vegetables diet appears to kill FEWER animals than a vegetarian, grain based diet…this throwing the least harm notion on it’s head. Also, small scale grassfed meat production appears to not only be sustainable, but also highly profitable. Most of the energy production of meat is tied up in grain production. Shift to grassfed meat and you remove this expensive and dirty process from the equation while also increasing the health of meat consumers.
Can we feed everyone like this? Will global warming kill us all? The best way to control ALL these problems is some kind of population control and ironically, the best population control is prosperity. Rich nations have fewer children. The counter salvo from the Malthusiasts is that rich nations require a lot of energy…true, but we are only seeing the beginning of green, sustainable energy, and the main driving force here is an open market. India and China are bypassing decades of development the US went through and are comparitively much cleaner than we were. Speaking of sustainability…the US is headed for a serious problem with health/healthcare and the answer being bantied about is state funded healthcare…whcih has been a stunning failure everywhere else it’s been instituted, but we seem bent on this path…because in the words of Sen. Mcgovern(sic) “We must do something”.
My main point here is that we need to tackle these issues ONE AT A TIME. When the vegetarians start shifting arguments mid-stream this is BS and it obscures the topic at hand. This is also the classic ploy of someone who is loosing an argument. My secondary point is that the “sustainability” issue is anything but clear and history has shown that markets and innovation trump doomsayers…no matter how badly they want the end-days to be at hand.
Indeed. In my previous writings, I hadn't even gotten into the idea that cattle might create a carbon sink on pasture, because foraging on grass spurs its growth via activation of the intercalary meristem. I would not be surprised if the articles Robb links above mention this point.
I didn’t bother to do a search on Cambridge Scientific Abstracts to find articles that supported my point when I wrote about environmental effects of meat here and here, and more distantly in the past, here. Why didn't I do this? First, I already have a firm grasp of ecology (I have a bachelor's, master's, and PhD degrees in biology with a heavy focus on courses in ecology). Thus, I can already deduce that the basic arguments from the vegan/environmentalist side do not add up.
However, my arguments would have been more well-supported with evidence from quality peer-reviewed articles. (I stress the term quality since we all know there is a good deal of very bad science that has been nominally peer-reviewed.) So I have to thank Robb for providing these links to some apparently peer-reviewed sources in his post above. Though I haven't read them yet, I suspect they will provide a good start for more in-depth research.
I may do a heavier literature search at some point with better supporting documentation for the exact energy inputs for vegan/industrial, vegan/nonindustrial, meat heavy/industrial, and meat heavy/nonindustrial diets. Someone really needs to do such research and that research, whatever the findings, needs to be honestly publicized. Unfortunately, the popular press has a tendency to skew the reporting toward their own biased position. People have heard the "meat is unsustainable" claim so frequently that I fear it is growing a life of its own.
Regardless of the fact that it may be interesting to know how much energy is used to produce various types of foods, I don't understand why people are getting worked up about cattle and the potential effect of cattle on global warming. This is "science" that is conducted in a manner that is blinkered to evolutionary history, just like the dietary "science." It makes no sense, even if you think global warming is a significant long-term problem for humanity. What were pre-industrial levels of these supposed "greenhouse gases"? We know the answer for CO2, but methane is rarely discussed in global warming circles in this regard, though it is reputed to have a much more potent effect than CO2. Grass-fed cows may produce half the methane as grain-fed cows, but reasonable estimates are that there were, in pre-settlement days, anywhere from equal to twice the amount of bison biomass as the biomass in our current national cattle herd.
Thus, I pose the following questions to all enviromentalists who believe meat is a problem for the environment:
1) Was there a “methane” problem prior to white settlement during the days when millions of majestic bison roamed the plains of the Americas?
2) If the bison herd was producing roughly equivalent amounts of methane thousands of years ago in comparison to the national cattle herd today, why are we worrying about it? This is a natural level if you consider humans to be "non-natural" and the source of the problem here.
I have not yet heard or seen a logical rebuttal to these two basic questions. I'm open to reasonable arguments. Any takers?
Comedian (and former health writer) Tom Naughton replies to the blame-McDonald's crowd by losing weight on a fat-laden fast-food diet while demonstrating that nearly everything we've been told about obesity and healthy eating is wrong. Along with some delicious parody of Super Size Me Naughton serves up plenty of no-bologna facts that will stun most viewers, such as: The obesity "epidemic" has been wildly exaggerated by the CDC. People the government classifies as "overweight" have longer lifespans than people classified as "normal weight." Having low cholesterol is unhealthy. Lowfat diets can lead to depression and type II diabetes. Saturated fat doesn't cause heart disease -- but sugars, starches and processed vegetable oils do.
Q: What inspired you to make a film challenging Super Size Me?
...I thought Super Size Me was very well done and very amusing, but at the same time a couple of things about it really bugged me. One was the overall premise, that it’s McDonald’s fault people are getting fatter. That’s ridiculous. Ronald McDonald can’t force you to eat anything, and most people eat at McDonald’s once in awhile, not everyday.
But what really bugged me was when I realized Spurlock’s math didn’t add up. I spent a good part of my adult life as a serial dieter, so I have a pretty good idea what the calorie counts are at McDonald’s. When Spurlock’s nutritionist told him he was consuming 5000 calories per day, alarm bells went off in my head. There’s no way you can consume that many calories at McDonald’s if you’re following his supposed rules.
Q: So in your opinion, Super Size Me is essentially dishonest.
A: Yes, it’s dishonest. Long before I saw it, I heard people talk about how Super Size Me shows what would happen if you just ate three meals per day at McDonald’s. But that’s not what it shows. It shows what would happen if you decided to stuff yourself like crazy so you could gain weight and make a movie about it. You could stuff yourself at a vegan restaurant and gain just as much weight, if that was your goal.
Q: You did exactly the opposite: you ate nothing but fast food for a month and lost weight. How did you manage that?
A: I did it by intentionally ignoring the standard-issue nutrition advice.My doctor of course warned me that if I was going to live on fast food, I should eat as many salads and grilled chicken breasts as I could so I wouldn’t consume too much fat. But I knew better. I ate a lot of fat, because fat is what keeps you feeling full and satisfied. But I did limit my carbohydrates to about 100 per day, because that’s the real key to losing weight, at least for me.
I appreciate Naughton's stance on individual rights. He's exactly right. No one is forcing anyone to eat at fast food restaurants, and it's really none of the government's (or anyone else's) business whether McDonald's wants to sell me an entire bucket of french fries for fifty cents:
This summer when I was on the road for 6 weeks, I ate at McDonald's several times. It usually wasn't my first choice because I consider it a pretty expensive place to eat. My diet was uber-low carb at the time, so I opted for pre-packaged hard boiled eggs, cheeses, and meats at the grocery store most of the time, which I would store in my small cooler in my car. (It's pretty easy to find a grocery store when traveling on road trips.) Yet despite eating and McDonald's about 1o-15 times during the course of that six weeks, I lost several pounds.
Just yesterday, my fiance and I went to McDonald's for a quick lunch and I ordered two double cheeseburgers. I probably got some minimal amount of high fructose corn syrup from the ketchup and who knows what in the processed cheese but I otherwise did very well for less than $2.50. I pulled off the buns and threw them away. I also could have avoided the cheese by ordering a different burger or even asking them to withhold the cheese. That was my choice, and it's really not anyone else's business. Anyone could make a similar or better choice and come away with a relatively healthy meal. Some of us could make even better choices at McDonald's if political pressure of the McGovern dietary committee hadn't influenced them, and farm subsidies hadn't made it cheaper to start using vegetable oils for their French fries. I'd enjoy some fries at McDonald's if they'd return to frying them in beef tallow.
Personally, I think the least offending items to health at McDonald's are the burgers. Naughton shows in Fat Head that if you eat a lot of fat, even at fast food restaurants, your lipid profile will improve and you might even lose weight. That certainly mirrors my own experience. Just call me Fat Girl!
Fat Head appears to be a great expose of the government's role in perpetuating the nutritional myths that were displayed in SuperSize Me, too:
Check out the rest of the clips from the film at Fat Head the Movie. You can order Fat Headhere.
"People Should Not Be Allowed to Eat Eggs" By Monica @ 11:39 AM
Sounds ridiculous, doesn't it? It's not a huge step from a government saying "eggs are unwise" to "eggs should be banned." Yet this is the absurd reality of part of the British government's socialized healthcare program to fight what it views as unhealthy behaviors, according to an article by Paul Hsieh entitled "Universal Healthcare and the Waistline Police." Get a load of this:
Other countries with universal healthcare are already restricting individual freedoms in the name of controlling health costs. For example, the British government has banned some television ads for eggs on the grounds that they were promoting an unhealthy lifestyle. (my emphasis in italics added)
Believe it or not, even more terrible ideas have been proposed in the United States. What is worse is that the egg advice makes no sense whatsoever in the context of evolution or even in the context of good science. Many people now recognize that as far as diet is concerned, the government has made a good many wrong answers into almost inflexible dogma. Once public policy becomes set, reversing it becomes incredibly difficult.
I worry very much about an increasing nanny state with respect to our food. When the animal rights activists and environmentalists team up with nutritionists who have fallen down the "fat is evil" rabbit-hole, it's pretty clear that next they'll be coming after our steak. Even if this particular view was scientific it would be politically wrong from the standpoint of the proper purpose of government which is the protection of individual rights -- as Dr. Hsieh's article makes completely clear. But far too often, the proposed "public health" policies would actually be -- and have turned out to be -- a complete disaster to public health. Here is a good example. We don't need any more such wrongheaded ideas made into nutritional dogma through government policy that take literally decades to overturn, with millions of needless early deaths as the result.
Dr. Hsieh's article defending our right to eat as we choose, without advice or force from a government nanny, did not sit well with some members of the public -- particularly this commenter in the Ithaca Journal:
Health care column off mark
Where did the doctor who derided the nanny state go to medical school, and does he see patients ("Waistline police may come with universal health care," Jan. 12)? A doctor's training emphasizes the first responsibility is to do no harm. Paul Hsieh blasts medical and societal activism to promote health, instead leaving people to make choices based on free will rather than common sense and proven facts.A nanny state would totally outlaw tobacco, a known killer for 50 years. I have more sympathy for the opium growers in Afghanistan with limited choices than for tobacco growers and Philip Morris in America, who could have stopped killing us in the 1950's. Raising prices cuts down smoking, and taxing junk pop will cut down on obesity.
Rampant capitalism may stop this, despite near universal advice from nutritionists, epidemiologists, and sensible doctors, who know the relation between obesity and heart disease, diabetes, hypertension and the excess morbidity and mortality. Steps taken by doctors and an enlightened society should outweigh freewill and company profits.
I'm not a bean counter, but I'll bet the health costs for obesity, COPD, diabetes and other self-inflicted pathology costs more than the taxes on company profits of pop makers and tobacco companies pay our governments.
He stated that if one were only harming oneself, it is OK. No serious, chronic illness ever affects only the patient. It impacts family, friends and the health costs. Get real, doctor. Accept controls, either self-imposed or enforced.
Jud Kilgore Ithaca
(my emphasis in italics added)
This comment sends chills down my spine.
First, there's little evidence that in the context of a nutrient dense diet that smoking poses any serious health hazard at all. This is discussed here with regard to the Masai warriors and in Weston A Price's work Nutrition and Physical Degeneration on his chapter discussing the Gaelics in the Outer Hebrides. Their houses were absolutely filled with smoke loaded with dioxins. I do some medical needs assessment on COPD so I happen to know a bit about the disease. Only about 15%-20% of smokers get COPD, and I don't have any hard evidence yet, but I strongly suspect that onset of the disease is probably multifactorial and linked to nutritional status. I believe that's why we see COPD rates continuing to rise with poorer and poorer vitamin D status, although smoking rates have been declining for decades. I think a strong case could be made that smoking is actually not problematic in the context of a nutrient dense diet -- the very nutrients that do-gooders like Jud Kilgore likely want to eliminate from our diet in the name of "public health" and "the common good."
The acceptance of the idea of forced control of others for "their own good" and the second-handed and blind acceptance of the advice of "doctors and an enlightened society" should strike fear into the heart of any individual who thinks even remotely independently. It is downright Orwellian. There is always more to learn, and that one major problem with public policy. Public policy is based on consensus. Science is not done by consensus!
Diana Hsieh, PhD candidate in philosophy, stated in a section of a personal email (reproduced with her permission):
What I find so interesting about it -- and I've seen this elsewhere -- is the open defense of the nanny state. Defenders of universal health care don't seem deny his central claim -- that universal health care would create a nanny state on steroids. Instead, they argue that such a nanny state is necessary and proper.
That's a sad indicator of our cultural decline -- but at least the choice between freedom and statism is more clear than ever.
In short, I'm optimistic that freedom to choose the food we like, as well our freedom to choose healthcare, will prevail over statism. However, I hope that such comments as Jud Kilgore's make it abundantly clear that a veritable army of arrogant and ignorant "do-gooders" -- definitely increasing in their numbers in the past 50 or so years -- could wreak absolute havoc on not only freedom, but the health of the American people if they are allowed to force their views on everyone else through law. And far too often their views are not thoughtful or objective but average fodder for non-thinkers, also known as "conventional wisdom," "proven facts," and "common sense."
Given our societal trends, I definitely don't think freedom is going to prevail by sitting back on our fannies and hoping for the best. Everyone concerned about their health and the future of food should ask themselves a critical question: "If you think it's good that the government is banning trans fats and taxing sugary drinks, do you accept the premise that it's also appropriate for them to take your hamburger, raw milk, and fois gras away in the name of "public health"?" Do you really trust self-appointed government dictators to make such decisions for you, or to make such decisions objectively? I certainly don't.
On that note, what are you doing to up your game with regard to making sure you remain free to eat what you want?
The Real JunkFoodScience By Monica @ 10:18 PM
A silly article about raw milk has been recently published in Clinical Infectious Diseases that ends with a completely inappropriate threat to medical professionals:
"...physicians, veterinarians, and dairy farmers who promote, or even condone, the human consumption of unpasteurized milk and dairy products may be at risk for subsequent legal action."
Every few years Clin Infect Dis publishes an article like this. I think such articles and news pieces will become more frequent as raw milk becomes more popular. The acknowledgments to this particular article thank none other than John Sheehan, BSc, Jd and FDA head of safety for milk and eggs and a raw milk foe, "for valuable discussions on the subject during the preparation of the manuscript."
I don't believe crediting a government regulatory agent is necessarily proof of ignorance or corruption. I am sure there are many honest people who work for regulatory agencies and I don't believe every piece of research produced or funded by government is evidence of corruption. However, the Weston A Price Foundation has already, point by point, rebutted Sheehan's Powerpoint slides on raw milk in a 71 page PDF file. It's quite a read and anyone interested in the whole "controversy" around raw milk should take a look.
Oftentimes bias it is not evident in news media pieces or peer-reviewed articles. This is the case with the current Clin Infect Dis article. It appears to be well-written and most of the points are likely true in the context of grain-fed confinement cows. But the authors of the article make several mistakes, so that the article winds up reading more a like a political position paper than an honest evaluation of the science. Let's go through the major points.
First, they don't really understand the microbial ecology of a milk product in the context of grass feeding. For instance, Listeria monocytogenes is relatively fragile in the face of other protective factors in unpasteurized milk such as lactoferrin and beneficial coliforms that outcompete pathogens. These factors are destroyed by pasteurization and sometimes allow remaining L. monocytogenes to take off. This is why the FDA has considered making ultrapasteurization mandatory. Heat resistant strains have evolved and regular pasteurization is no longer good enough. Almost all organic milk on the retail market is now ultrapasteurized.
Second, the authors are mired in the reductionistic pseudoscience of nutrition that ignores the effect of pasteurization on the function of various proteins in the milk (lactase, phosphatase, immunoglobulins). Good science is timeless, and these authors haven't gone to older papers demonstrating the benefits. Many people anecdotally report reductions in asthma, allergies, and lactose intolerance on raw milk vs. pasteurized milk. Actually, it's not even so much that the mainstream doesn't recognize the existence of these proteins. They do, because the pasteurization test is a negative phosphatase test. Instead, they simply claim that these proteins aren't necessary and don't add any value to the consumer, nutritive or otherwise. This is paternalism on steroids.
No mention is made of the difference in grass-fed milk and grain-fed milk with respect to vitamin content, particularly a vitamin first discovered by Weston Price in the thirties, now believed to be vitamin K2 M-4. Price showed that K2 M-4 was dependent on the method of feeding and was highest in the dairy produced from cows on rapidly growing spring grass. This is widely known among those knowledgeable about pastured methods of raising animals but it still relatively unacknowledged or unknown in medical and government circles (though not unknown in the medical literature at this point).
The authors also ignore the significant difference between milk from Holsteins used for all pasteurized grocery store milk and milk from other older breeds usually used for raw milk. The latter has higher butterfat content, and thus, fat-soluble vitamins. "Milk is milk and it all comes from cows" is the FDA's position. That's demonstrably wrong.
Finally, they ignore that while there may be more outbreaks from raw milk, such outbreaks are small and easily identifiable, unlike food-borne illness outbreaks from pasteurized milk. They also don't discuss the relative risks of various foods, and give the impression that raw milk on a per serving basis is more dangerous than pasteurized milk. I don't believe we really know what the relative risks are, but my understanding is that they are about the same on a per serving basis. The WAP Foundation presents some interesting numbers on this in their two rebuttals, linked above and below.
The Weston A. Price Foundation has recently released a rebuttal to the recent Clin Infect Dis article. Unfortunately, people like Sandy Szwarc at JunkFoodScience obviously haven't seen the rebuttal. Ms. Szwarc's piece is simply a point by point regurgitation of the Clin Infect Dis article. This is curious because from what I can see of her blog she usually looks for an opposing view and does not buy into hysteria. I think this speaks to the power of conventional wisdom in creating a bias in a person's mind.
"Sound science" is not a conspiracy, Ms. Szwarc says. Most science often isn't a conspiracy, but that's really irrelevant to evaluating whether the science is actually sound and unpoliticized. The "science" used by the mainstream researchers to justify their biased thoughts about many aspects of our food is not sound. It is based on faulty assumptions that have since been disproven either in the medical literature or by simple logic and/or it is too reductionistic. Most seriously, it is almost always performed outside the context of evolutionary biology or even the history of food science in the past century. Most nutritional science simply does not operate within an evolutionary framework. It's bad science. Ms. Szwarc's readers deserve a more critical analysis than the one she says she is providing in her blog header.
In the most recent Clin Infect Dis article, the authors state that raw milk consumers "unconsciously process information in a biased manner." They encourage public health officials and physicians to speak with one unified voice against raw milk, repeating the message over and over clearly until the consumer gets it.
In other words, the raw milk consumers are knuckleheads nearly unreachable by reason, while the conventional view is based in reason and science. As I've indicated above, the situation is more complex than the authors would like health professionals to believe. At the very least, the authors and health experts ought to be recommending that people source raw milk and heat it, or that the dairy industry ought to at least convert to grass-feeding to increase fat-soluble vitamin content so critical for development of children and continuing robust health into adulthood.
The authors suggest that unlike consumers with strongly held opinions, "experts" with strongly held opinions do not selectively seek out information supportive of their views or process it in a biased fashion, yet they themselves choose to discuss the ability of pasteurization to kill pathogens without acknowledging the ability of grass-feeding to prevent contamination; they themselves choose to discuss illnesses attributed to raw milk without admitting that more illnesses have been attributed to pasteurized milk; they themselves choose to discuss modern assays with little to no destruction of vitamins without accounting for older feeding studies showing dramatic reduction in their biological activity; and they themselves choose to conclude by threatening experts who do not select information and unconsciously process it exactly as they do with the heavy hand of the law.There is a word for this kind of double standard and it is called hypocrisy.
I heard an interview of Michael Pollan yesterday on Talk of the Nation. He made some important points about nutrition that bear repeating. He's fond of saying "don't eat anything your grandmother wouldn't recognize as food". That doesn't mean your grandmother specifically, but anyone's grandmother, whether she was Japanese, American or African. The point is that commercial food processing has taken us away from the foods, and traditional food preparation methods, on which our bodies evolved to thrive. At this point, we don't know enough about health to design a healthy synthetic diet. Diet and health are too complex for reductionism at our current level of understanding. For that reason, any departure from natural foods and traditional food processing techniques is suspect.
I agree. The recent discovery of vitamin K2 is evidence that we should resist the simplistic reductionism of nutritionists focusing only on calories and macronutrients. And while I disagree with Pollan on various matters, he has done some good first-hand research on the food supply and has made this information very accessible to the public. For that he should be applauded. Real food is increasingly under government and government-sponsored industry attack in our society.
Pollan also wrote a very long piece in the New York Times entitled Farmer in Chief in which he exhorted the future president to consider the health, ethical and environmental issues surrounding government farm and nutrition policies. It's definitely worth a read and it got a great deal of attention in the farming, nutrition, and whole foods blogosphere. I don't agree with everything in that article by a long shot, but I'm going to save my (very long) critique for a future post.
So what's the problem? First, Pollan has a strong focus on our botanical heritage, but I believe Pollan's proclivities toward plants when it comes to human nutrition are less rooted in science than they are in emotion and our rich neolithic food culture. Pollan is a long-time gardener and has had interests in botany his entire life. As someone who has also personally been more interested in the botanical side of things and used to teach botany, I can attest to the fact that this can create a certain bias in a person's mind. I'm not sure that's intended but it does come out in his writing.
In the context of personal food choices and education about the rich co-evolutionary history of plants and humans, this isn't an issue. In fact, much of Pollan's writing on ethnobotany is delightful. But Pollan is the popular face of food activism. And when it comes to "food activism" and government policies with regard to food, this has become a huge problem. Since Pollan is so highly regarded and has such public appeal and charisma, people have been repeating his "eat mostly plant schtick" like it's going out of style. This dogma has most definitely overshadowed Pollan's defense of real foods. I see this arrogance and presumption a lot on the web, with many commenters in various internet venues claiming that people are fat and sick because they are eating too much meat. "Eat mostly plants. A little meat. Not too much. What is so hard to understand about that?" they preach.
A lot of people read Pollan and end up not defending food, but attacking meat. This attitude wouldn't worry me too terribly except that there's an enormous politically motivated tendency toward vegetarianism in our society already -- with a strong basis in modern environmentalism, Malthusian ideas propagated by both environmentalists and biotech corporations, and grain-based nutritional dogma. It's pretty clear that most people without extraneous health issues need animal products in their diet as a source of EPA, DHA, vitamin B12, and fat soluble vitamins A, D, and K2 -- and who knows what else since nutrition science is definitely on the low end of the learning curve. But despite that Pollan too resists nutritional reductionism; despite Pollan's focus on our corn-based system of agriculture and the problems with HFCS and hydrogenated vegetable oils; despite Pollan's endorsement of Good Calories, Bad Calories, as "A vitally important book, destined to change the way we think about food" -- those aren't the messages that the public and the media are disseminating from Pollan's writing. The message that they are disseminating is that meat is bad.
I'm not so sure this is entirely Pollan's fault rather than an effect that is combined with the result of decades of government propaganda. But even in his Farmer in Chief article, he suggests that the president and his family have a meatless day once per week. There's also little criticism of wheat being subsidized.
Below are two prime examples of how the media pick up on and then selectively disseminate some of Pollan's ideas.
First, this editorial in the New York Times by Nicholas Kristoff, in which he lauds Pollan's larger ideas about food and agriculture, but winds up with this little gem:
We face an obesity crisis and a budget crisis, and we subsidize bacon?
The implication is that obesity is caused by eating bacon. Bzzzzt. And another implication is that most of the ag money we are spending is to subsize meat. Bzzzzt.
The first absurdity has been adequately dealt withelsewhere, but I feel compelled to point out that meat is not directly subsidized. The USDA's EQIP program that Kristoff criticizes, capped at $450,000 per feedlot, is to clean up manure pollution from feedlots. While it is not a valid government spending project, why doesn't Kristof point the gun at the grain and soy subsidies that are responsible for feeding animals this way -- and dumping cheap HFCS, corn oil, and soy on the market to boot? No, it's meat that takes the blame for obesity and government spending, even though meat doesn't make people fat and it is not directly subsidized. The amount of money spent on EQIP is miniscule in comparison to commodity crop subsidies, but does Kristoff criticize subsidized wheat? Of course not, because that's not where Pollan's focus is. We've all known for decades that wheat doesn't make people fat, right? And what is to criticize in corn and soy? Only the HFCS, the feeding of corn to cattle, and hydrogenated oils, Pollan's main focus in all of his writing.
Here's the second media piece in the Boston Globe, which specifically discusses Pollan and speculates on what Obama's agricultural policies might look like. Here's an excerpt:
Obama is the most healthy eater to enter the White House in a long time, unlike George H.W. Bush who castigated broccoli as he craved pork rinds..
Guess Derrick Z. Jackson didn't see this piece, where Michelle Obama proclaims, "We're bacon eaters." Good for her and her family... and for HW Bush. Don't expect the media to pick up on stuff like that, though.
Do you see what I mean about how the media picks up on what they want to pick up on? "Plants good, meat bad." It's arrogant and ignorant. How much does Derrick Z. Jackson, the author of that article dissing pork rinds, actually know about dietary fat? Apparently, notmuch. Wait -- it gets better. Not too far down in the article, there's this little gem:
Obama purchased peaches, pears, apples and nectarines from farmers markets on the campaign trail.
Well, wonderful. It's a good thing Obama doesn't have Type II diabetes caused by a steady diet of commodity wheat, because all that modern fruit, bred for sugar and not even available 150 years ago, wouldn't help his insulin problem much. He'd be better off with the pork rinds in that case.
These are just two examples of how the media get it so totally wrong with regard to nutrition, picking up on some of Pollan's ideas and selectively disseminating them, while the general public laps up this fodder like the non-thinkers they are. I couldn't say it better than Keith Norris of Theory to Practice:
The frightening thing here, from my prospective, is the fact that there is so much of this that Kristof gets right — only to then tumble down the “fat is evil” rabbit hole. I can easily see a “fat tax” imposed, in the very near future, on suspect foodstuffs that the “informed government” will use as a carrot/stick (depending upon your point of view, I suppose) to wean us from the plethora of “unhealthy” foods. This tax would then be used, I’m guessing, to help support/promote the more “healthy” grain-based alternatives.
...
No matter how in-vogue (and fun, I’ll have to admit) it may be, however, to bash on the government, it is really the actions of the collective citizenry that will turn the tides here. Unfortunately, I don’t have much confidence in the “collective citizenry” on this issue. For the vast majority at least, it seems as if health, fitness and diet (and independent research in these areas of concern) is just not worth their time. We are living collectively (and “paying” via ever-increasing health care premiums) with the ramifications of such apathy now. One thing I’ve never suffered well is willful ignorance; being forced to financially support the ramifications of another’s willful ignorance is enough to push me over the edge.
Indeed. Keith and I are not the only ones to pick up on some of the perhaps unintended political effects of Pollan's writings. The Weston A Price Foundation released an excellent open letter to Michael Pollan two years ago, encouraging him to pursue a more objective approach to human diet. Here's an excerpt:
What's so disappointing about your conclusions is the fact that after revealing the dark side of the industrial food system, and blasting the vegetarian argument out of the water, you end up dishing up the food industry's tired old anti-saturated fat, plant-based-diet propaganda. What you've done is present your health-conscious yuppie readers with the prudent diet dressed up in designer clothes and introduced your foodie readers to food Puritanism in a silk gown. She looks lovely and slim, she's popular with all the right people, but the shocking secret that emerges on the honeymoon is her frigidity; the girl in green turns out to be barren, unable to provide us with the thing we most desire—a healthy productive life.
In retrospect, your inadequate prescription is not surprising because you actually show your hand right at the beginning of The Omnivore's Dilemma, where you tell us that foie gras and triple crème cheese are "demonstrably toxic substances" and that bread and pasta are "two of the most wholesome and uncontroversial foods known to man." You describe yourself as an investigative journalist, so we are justified in asking: have you found any science proving that foie gras and triple crème cheese are "demonstrably toxic?" These delicious traditional foods are not demonstrably toxic to the French, so why would they be toxic for us? And have you interviewed even one person among the millions suffering from carb addiction or celiac disease, or stood in the bread aisle and read the labels on what passes today for bread, the stuff made from plants that we are supposed to eat six to eleven servings of every day?
Because you are such a persuasive writer, people believe you when you say that saturated fat is bad, that lean meat is healthier than fatty meat, and that vegetarians are healthier than meat eaters. You repeat these ideologies, these "shared but unexamined assumptions" as you call them, without examining them at all, passing on to your readers many of the malicious dietary falsehoods put together by the industry you claim to dissect. Your endorsement of the McGovern Committee recommendations—at least of its original recommendations to cut back on meat and dairy products—is truly perplexing given that a quick search of the internet reveals the former senator's marriage to corporate agriculture, a system that would much rather we consumed plants, especially processed plants, than animal foods.
...
The omnivore's dilemma is not in fact a dilemma at all, but a construct of false nutritional doctrine. We need investigative journalists like you to help us clear away the misinformation. Please accept our invitation to a meal.
I hope Pollan is getting the message and will start disseminating it. I'm still skeptical but somewhat hopeful that he will, since he's now read Good Calories, Bad Calories. His food activist followers, many of whom want to cram grains, vegetables and fruits down all our throats and deprive us all of meat through shifted subsidies, coercive laws, and government nutritional edicts, could certainly stand to hear it from him.
Diet for an UNhealthy Planet By Monica @ 3:45 PM
One often hears in environmentalist circles that meat eating will destroy the planet, that the earth doesn’t have enough carrying capacity to provide meat for everyone, and that a “diet for a healthy planet” includes only plant products or at most, limited animal products. Indeed, this is a strong basis for many people to adopt veganism. But is it true?
Not only are these statements annoying for those of us who eat animal products, they’re scientifically baseless.This little post will give you some intellectual ammunition to deal with these assertions.
Until roughly 50-60 years ago, animals were the basis of a healthy farm with fertile soils. While I don’t agree with some of these political solutions proposed to our current agricultural problems, here is a portion of an excellent article that explains in greater detail why the meat myths in the first paragraph are untrue.
Let’s look at some other facts as well. The tiny country of New Zealand provides enough grass fed lamb to feed itself and much of the rest of the western world that eats lamb. 70% of its land is devoted to farming. Lamb from Australia and New Zealand runs around $5-6 per pound. (By the way, New Zealand is free of farming subsidies and the farmers there are much better off for it!) As far as the United States goes, you can get a whole side of grass fed beef for about $5.00 per pound, in bulk directly from the producer, with a range of everything from hamburger to prime steaks. That’s a very good price considering grocery store prices. Even grass-fed meat in the grocery store is affordable. I can get grass fed buffalo roasts in Costco for $5 per pound.
Isn't it funny how this grassfed system is economically sustainable all on its own with no subsidies when massive amounts of money are poured into the feedlot system yearly? This money is in the form of grain subsidies, government loans for farmers using grain as collateral, and pollution control money for feedlots under the USDA's EQIP program. Marvelous, isn't it? Provide research money to increase commodity crop production, subsidy money for grain feed, government loans because farmers produced too much of this feed, spurred by the subsidies and the government research, and finally, provide government money to clean up the pollution that these cheap, concentrated grain feeding systems cause (known as Confined Animal Feeding Operations, or CAFOs).
Most of the criticisms of eating meat are criticisms of the modern feedlot system, not meat eating as it was for thousands of years of human evolutionary history. Some of these arguments are valid objections to the US's feedlot system, which is certainly an absurd waste of taxpayer dollars. But these facts are not a case against meat eating. Even food journalist Michael Pollan is disappointingly deluded on this point and somehow thinks meat would become more expensive if it were all grassfed. What is the basis for this assertion? Grassfed meat is affordable when it is bought directly from the producer. I suspect Pollan's conclusion is not rationally but emotionally based, because he thinks it is a health and environmental problem that some of us are eating so much as 8 oz. steak per day. He wants meat to be more expensive, so he then asserts it would become so. From where I stand, I see no basis for this statement. The fact that most cattle and hogs in the United States are grainfed in feedlots is not evidence that that system is efficient or economically viable on its own. It is a system spurred by massive government intervention.
Consider that all kinds of marginal grassland could be used to feed livestock, in the United States and elsewhere. There is a great deal of land in this country not suited to growing traditional crops, but it would be wonderful as rangeland and would yield its fruit as fatted animals. We can thus dismiss the environmentalist myths that meat would become more expensive under a grass-fed or free market system.
But what about those other Malthusians (biotechnology companies) claiming that without their special technology, there will not be enough food to go around, and only they can solve world hunger problems? It's absurd. There is an enormous amount of land in the United States that could yet be converted to food production. Millions of backyards in America could theoretically be used to grow a vegetable garden and feed the inhabitants for an entire year.
Now, surely not everyone wants their lawn turned into a garden, but the fact remains that this has been done twice in the nation's history with so-called "Victory Gardens" planted in millions of American backyards in both World Wars to increase food production. According to Michael Pollan, 40% of America's produce by the end of WW II was produced by home gardens.
It would actually be profitable to rent one's yard to someone who wants to garden it, and a good profit could be made off of such gardening. This would decrease prices for store produce due to decreased demand, thus spurring even greater production efficiency for larger growing operations.
From my own personal experience I know that a 7500 sq. ft. garden can probably yield around $2000 in produce in one summer. If we had a rational immigration policy that did not prevent Mexicans from working here, such free market options could become a greater reality. I'm just thinking off the top of my head here, but imagine a system in which a Mexican family were hired as part of a community cooperative agreement to garden and sell produce from a set number of backyards, with the landowners getting some portion of the profit from the produce. (But then, if we had never had farm subsidies, so many Mexican farmers wouldn't have been pushed out of their jobs and across the American border in the first place.)
It is a complete myth -- whether propagated by environmentalists or CEO's -- that we somehow don’t have enough land to produce enough food for everyone on the planet, and that we must either decrease meat consumption or massively increase grain production through more research. I'm not against biotechnology (breeding hybrids of all kinds of plants has been wildly successful), but the myths propagated by both of these groups are absurd. If the commodity crop subsidies were eliminated, at least two things would happen. Farming in the United States would mostly return to pastured livestock which eat a more diverse diet, and subsidized grains would not be dumped on the US or world market. As a result, poorer foreign nations would also see a return to more natural systems of farming and reduce their reliance on the west. Some biotechnological research would probably divert away from grain production to other crops.
The proposed EPA taxes on animal farming are designed to move Americans toward a grain-based diet that is supposedly healthier for the planet. This type of diet is not healthier for humans or the planet. It is ecologically and economically unsustainable, not to mention unhealthy. The government should not force people toward a grain-based diet that promotes chronic dental disease, obesity, heart disease, diabetes, cancer, and Alzheimer's disease, particularly when advocting a universal healthcare system that would require more taxpayer money and more advocacy of more grain-based nutritional nonsense that will make Americans even sicker. A grain-based monocultural agricultural system not only promotes chronic illness, it creates soil erosion and depletion of nutrients, which results in a large hypoxic "dead zone" in the Gulf of Mexico, making commercial fishing there impossible. This system could not survive under a laissez-faire capitalist system with a proper application of property rights. It is UNsustainable and UNhealthy.
At my wits end (and knowing that low carb would definitely help my grandfather), I sent him Dr. Bernstein’s Diabetes Solution last week at Dr. Eades' suggestion. My grandfather had been ordered on a low potassium diet for awhile by his doc around a month ago. Incidentally, it seems this is a slightly carb limiting diet as well, although he can still have one piece of white bread daily. He is not allowed to have bananas and a lot of other carb-heavy stuff so I suspected he is incidentally controlling his blood glucose in addition to ridding the body of potassium, although that is not the intention of the diet.
He has now read Diabetes Solution almost in entirety and told me he’s learned a ton.
Here are the results of 3-4 weeks on the low potassium diet (which is a semi-low-carb diet, although I’m honestly not sure exactly how many grams he’s eating daily) and after just 1 week of reading Dr. Bernstein’s Diabetes Solution and incorporating some dietary suggestions from that book as well:
25 lbs. weight loss in approximately a month.
Waking glucose levels down to 95 ng/mL… not sure what they were before, and it's still not ideal, but it’s definitely an improvement.
Insulin usage down more than 50% — used to be 8-10 units at a time, now down to around 4 at a time. His diet is not even uber low carb yet.
Increased energy.
He and my grandmother are pretty excited about these positive results, although he is finding the low potassium diet limiting (he cannot have things such as tomatoes). I suspect that if they just get over their fear of fat (he has "high cholesterol" and is on statins -- UGH! -- my next target once I learn about his lipid profile) and increase their range of foods they will be a bit more satisfied on a low carb diet. Also, once he is able to be off the low potassium diet his range of choices in food will increase a bit more.
I get the sense they will both definitely continue low carbing, their health and well-being will improve, and my grandfather will add some time to his life. I'm very pleased and excited for him.
As a commenter on amazon said of Diabetes Solution, "If the ADA disappeared tomorrow but this book remained, prognosis for all diabetics would be improved."
Unfortunately, that's too true. That sentiment also applies to the rejecting much of the conventional wisdom of the American Heart Association, which ultimately comes not from good medical research but straight from mouths of the USDA/Big Agriculture.