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In this episode Adam, Mike & Neil continue the conversation with Gary Taubes, journalist and author of the bestseller Why We Get Fat. Gary reveals a pet peeve of his: the establishment still considers Ketogenic and Low Carbohydrate/High Fat (LCHF) diets very unhealthy ways to eat.
Now listened to in 100 countries, The InForm Fitness Podcast with Adam Zickerman is a presentation of InForm Fitness Studios, specializing in safe, efficient, High Intensity strength training.
Adam discusses the latest findings in the areas of exercise, nutrition and recovery with leading experts and scientists. We aim to debunk the popular misconceptions and urban myths that are so prevalent in the fields of health and fitness and to replace those sacred cows with scientific-based, up-to-the-minute information on a variety of subjects. The topics covered include exercise protocols and techniques, nutrition, sleep, recovery, the role of genetics in the response to exercise, and much more.
Inform_Taubes 2_June 11.mp3
Arlene [00:00:01] The Inform Fitness podcast with Adam Zickerman and co-host Mike Rogers is a presentation of Inform Fitness studios, a small family of personal training facilities specializing in safe efficient high intensity strength training. On our bi monthly podcast Adam and Mike discuss the latest findings in the areas of exercise nutrition and recovery with leading experts and scientists. We aim to debunk the popular misconceptions and the urban myths that are so prevalent in the fields of health and fitness. And to replace those sacred cows with scientific based up to the minute information on a variety of subjects. We'll cover exercise protocols and techniques nutrition sleep recovery the role of genetics in the response to exercise and much more.
Arlene [00:00:59] On this episode Why We Get Fat. Part two. We welcome back national best selling author Gary Taubess.
Gary [00:01:06] If it's a physician who is overweight. I say Why don't you try it yourself. An experiment. Not going to kill you to go without carbs for two months. You know if at the end of two months you haven't don't feel healthier you haven't lost weight your blood pressure hasn't come down your waist size hasn't gotten smaller. Go back to eating potato chips.
Adam [00:01:27] Well we're back with Gary Taubes. He is the co-founder of Nutrition Science Initiative and author of The Case Against sugar Why We Get Fat and the tome Good Calories Bad Calories. And I'm here again with Mike Rogers and Neil Holland to continue our conversation. I would like to talk about a recent article that you wrote in Canada's The Globe and Mail. You make so many good points and I hope we get to cover most of them. And we'll put a link to it in our show notes. Totally worth the read. And correct me if I'm wrong Gary but I believe it's a response to the recent resurgence in popularity of the low carbohydrate high fat diets particularly the ketogenic diet. Or like we mentioned in the last episode Keto for short and while you admit that much more research needs to be done you take exception to calling Ketogenic Diets a fad, correct?.
Gary [00:02:17] Well yeah. Well again the reason I wrote that is there's this dichotomy that emerge. So when I look back I got into this right around the year 2000 and since then when I first started doing this research there were I figured there are maybe a dozen physicians in America who were pushing low carb high fat ketogenic diet you know and half of them had written books about them. So you know you had. The Atkins and they the Eades Mike and Mary Nan Eades and the sugar Buster people and at the time if you want to lose weight they accepted the idea was you had to eat less basically that you had to eat a calorie restricted diet maybe cut 500 calories or a thousand calories day. And it had to be a low fat diet and these ketogenic diet would kill people you know Atkins was a quack and he was a con man and a shyster and that's it. So now you come 19 years or 18 years into the future and we've now got thousands maybe a few tens of thousands of physicians around the world who have decided like you guys that these low carb high fat ketogenic diet just make their patients healthier. So if you can get people with obesity and diabetes who eat this way it's a way of eating the short term diet. You can put their obesity in remission and then one way to think about it you get significant weight loss you can put their diabetes in remission and get them out their diabetes drugs and their hypertension drugs and they have chronic pain that tends to get better and. A few years ago 2017 there was a letter to the Huffington Post co-authored by a hundred plus physicians in Canada saying look. Not only do we. Low carb high fat ketogenic diet. But that's what we prescribe our patients. We see these remarkable results and we can't unsee them. That's a phrase these Canadians like Can't unsee what we're seeing and we're not changing we're not going back to the you know we were we used to eat the conventional diets are the healthy conventional healthy way of eating our patients. Did you know some of us were vegetarians and most were vegan some of them were world class athletes and they were getting fatter or they were getting diabetic they had become pre diabetic anyway and when they shifted to this low carb high fat Atkins like eating they got healthy and when they prescribed it to their patients and then the flip side is you still have organizations like every year U.S. News and World Report has a committee of you know quote expert nutritionists and authorities who decide on what the healthiest diets are. And they always say the same thing. And the low carb high fat ketogenic diet come in the least healthy diets imaginable. I think they included 39 or 40 diet and these ketogenic diet were 35 to 40 and really basing a they're basing it on the assessment of the expert and the experts are the people who for the last 50 years have been telling us we should eat less and not too much and mostly plans you know a Mediterranean diet all the things we've been doing and getting fatter anyway doing so. I wanted to sort of explore this conflict. And. You've got physicians more and more every year saying if I can get my patients to eat this way I can get them healthy. Get them off their drugs.
Adam [00:05:55] You quoted one doctor saying you know maybe it's not that my patients aren't listening to my old advice. Maybe my advice stinks or has in the past.
Gary [00:06:04] Well this is one of the problems with people like us is we can sound like zealots. So you. Spend your whole life getting fatter and you try everything and you're dieting all the time and then tell me try this low carb high fat thing and your excess weight goes away or you're diabetic which is great you've got your physician who's got a patient who the Type 2 diabetes let me tell you the story I tell in this article which resonated with me and I'll see if I could tell it without tearing up. This was by a physician associate professor at the in Virginia and she gets a call one day from our client an endocrinologist who says look I got a patient in my office. She's 24 years old. She thought she was healthy and I just diagnosed with Type 2 diabetes and her hemoglobin A1 C is over 10 which means when hemoglobin A1 C you guys you know as a measure of blood sugar control and under six, under five and a half is considered healthy over 10, you are supposed to start the patient on insulin. So she's got this woman sitting in her office who she's supposed to start on insulin doesn't even know that she was sick. And she calls this Dr. Sue over and she says who can you help or who's got a six month waiting list to get into a practice. But she says Send her over. Tell her I'll see you tomorrow morning and the next morning this woman comes in and Sue explains to her how do you eat a low carb high fat Ketogenic diet. What do you have to do which is just don't eat carbs and replace it with fat. And says I've got a course that starting on. Yeah you come to the course that I teach every Thursday evening will teach you how to pick foods how to cook and all this stuff. But by even Thursday the woman has already started. And then Sue tells me. Let's flash forward three months later she just came in a few weeks ago for her three month checkup. She's lost 30 pounds. Her hemoglobin A1 C is down below 6. She's no longer diabetic and she says I tell her this and she's crying and I'm crying and I call the endrocronologist. Who comes over and she's crying and Sue is telling me this. Because you've got to see that I've given this woman her life back instead of managing a chronic disease for entire life which is what this you know what doctors do with type 2 diabetics. Do you know that routine some managing drugs and increasing insulin doses until they eventually die from the the side effects of the disease. Instead she's healthy. Sue says I feel like I've cured cancer.
Adam [00:08:45] Right so in a sense she did.
Gary [00:08:48] Yeah I mean it's it's how can you stop these people from being zealous and passionate about this. And then when I told you in our previous episode I interviewed over 100 doctors for my my next book or it's about 90 physicians some dietitians. There was a dentist few exercise physiologist chiropractors on a lot of these people said it's like medicine is one form. I don't go into medicine to manage disease. To manage chronic disease I wanted to medicine to make people healthier and now I can do it.
Adam [00:09:21] So what do you say when they hear your story your personal story with Atkins and even hear the story that you just told I mean they still say well that's great but it's still anecdotal.
Gary [00:09:31] Oh it's anecdotal and yeah it's an anecdote. What more can you make of it. And it depends who the person is. So if a physician is saying that's great it's just an anecdote. Then my response is OK it is an anecdote but there are. Hundreds of thousands of them out there. And what I would want you to do is next time you know your waiting room. Everyone's waiting rooms are getting more and more crowded with patients with obesity and Type 2 diabetes and hypertension metabolic syndrome it's called when these patients come in why don't you try this and see if this anecdote can be reproduced in your patient population if it's a physician who is overweight. I said Why don't you try it yourself as an experiment. It's not going to kill you to go without carbs for two months. You know if at the end of two months you haven't don't feel healthier you haven't lost weight your blood pressure hasn't come down your waist size hasn't gotten smaller. Go back to eating potato chips. I don't care but try it. And that's the message how do you get people to try it. Because again 20 years ago the assumption was if you did it you'd drop dead the next day. And when I wrote this New York Times magazine article about it I am said the end they described sitting in my local diner in New York which of course has since closed which one of the reasons we moved to Oakland. I love this place. I had breakfast there every morning in my life you know greasy eggs bacon sausage hold the potatoes hold the toast and I would look at the eggs and bacon and wonder how it's going to kill me. Clearly it's going to kill me. That's what we had been taught. And now at least 20 years later people accept that it's not. And so you could try and see what happens. See how you feel.
Adam [00:11:17] So given those anecdotal evidence then why do we even bought why we bother with studies almost like it's like obvious right that this works. So what do what do we need studies for.
Gary [00:11:27] OK. So that's the interesting thing because people say well there aren't long terms and you don't need a study to find out if you lose weight effortlessly on a diet. OK. So that you don't need. I could go on Atkins I could become vegan tomorrow and if I feel better. Great. Well you know that's I don't care what a study shows. Could I have I have tinnitus for instance my ears head buzzes All day long and if I were to become a vegan and the tinnitus went away that would be such a blessing that I would probably stay a vegan. By the way I had tinnitus before I tried Atkins so I don't have to link the two on. You know I think I had a symptom and you're gonna diet and the symptom goes away then X stick with the diet would you need to clinical trial for us to know one whether there's a better diet. So maybe I go vegan and my tinnitus gets a little better but if I went to go lactose vegetarian and added eggs and dairy to the vegan diet I would. The clinical trial would show that the tinnitus might get even better still so now I have a motivation to try it. Over lack lactose vegetarian diet the other thing you need clinical trials for is long term harm. Maybe this diet is going to kill us eventually maybe. And there are a couple ways to think about this. And I'll tell you my favorite I have a lot of acquaintances now in the world to one of them was a woman who on her Instagram account pointed out she'd lost she was 380 she went on the ketogenic diet she lost 150 pounds. And a friend started worrying that bacon would kill her. So they never cared about what I ate when I weighed 380. But now that I've lost hundred and fifty pounds are saying the bacon is going to kill me. Yeah it's hard to believe that she's not healthier at 230 with bacon than healthier at 380 with out but you could do clinical trials to find that out. Maybe there's something about eating bacon that she's going to chug along at 230 perfectly happy for 10 years and then our hearts gonna going to blow up whereas she might have lasted 30 years at 380 without bacon in clinical trials can give you a probabilistic estimate of whether that's going to happen.
Mike [00:13:42] I thought I was just thinking about like anecdotes and stuff like that and like for example like Bill Clinton a few years ago he read the China study I think and became a vegan and all of his health markers improved. And I say I'd like a guy that works for him then why. That's good. You know that it seems like something that doesn't really make sense for me and I don't have any desire to do that. I don't have any problems like he had before but I thought it was you know when people sort of look at examples like that I kind of like you know invite them to try it and see if it actually works out for them.
Gary [00:14:18] Well that's the thing in tone right. There was a period when this Netflix film what the health came down to what the health is vegan or vegetarian propaganda and it's compelling. If you don't know anything about the science and you watch this show you're likely to want to become vegan for your health not for ethical reasons but because you think it's the heathiest way to eat. And so I had doctors say to me What should I what do you think I should say to my patients coming in and who say I want to go vegan and I should just let them. You know it was fine just tell him let's let's do a you know a comprehensive panel of tests to see what your baseline health is. Because if you go vegan and you get less healthy then it's probably not the way to eat. And if you go vegan and you get healthier and you're happy that way that's fine. But then you would need the clinical trial to tell you is it healthier to go vegan or to go you know what else CHF ketogenic that the clinical trial could give you that information. It's interesting about Clinton because he did get healthier. You also always have to ask when people go me a vegetarian dislike when they go low carb high fat they give up a lot of the crap in their diet and the food like substances so they stop drinking beer and sodas and eating desserts and sweets and then somebody might say I go vegan and that means they also stop eating Cocoa Krispies for breakfast and instead ate, I don't know, a kale smoothie. So there are a lot of things to change and they feel healthier but you know it's because they gave up meat and as you notice as Clinton went along. He started to not look so good as a tremble in his hands.
Adam [00:15:59] Yeah, he looked a little guant.
Gary [00:16:02] I mean that being the spouse of a presidential candidate probably is exhausting so I can't swear I wouldn't look better and then I think I'm pretty sure he's not a vegan now.
Neil [00:16:16] Yeah, I'm pretty sure he gave that up.
Gary [00:16:17] Yeah. And that's the thing. So you try the diet and you might feel better in the first three months and then you find after a year you're not feeling so good. Then ideally you will try something else. One of the arguments I wanted to make in this Globe and Mail article one of the arguments I make in my new book is you know if we're we have some kind of chronic ailment whether it's excess fat or diabetes or hypertension or chronic pain or anything it makes sense to do these experiments and if somebody comes up to you and says You know I gave up carbs and my chronic pain went away and you've got a chronic pain problem I'd try giving up carbs and seeing if it works and if it does then you could decide if it's worth if you miss. The Donut beer chronic pain trade off. Maybe you miss donuts so much you're willing to live with the pain. I don't know but it makes sense to do these experiments because the medical community clearly has stopped helping us after awhile on these things.
Neil [00:17:20] Hey Gary I have a question. This kind of all has me thinking about the idea of how do you convince people they're skeptical despite seeing all these results. You know personally I remember I had a client once who was diabetic on the meds and I advised they they adhere to a low carb high fat diet. They lost like 80 pounds. They went into the doctor that their doctor was like This is wonderful we can get you off the meds what have you been doing. You know that person said what they'd been doing the doctor was like absolutely not you should be eating a couple of slices of whole wheat bread a day a sweet potato. He was concerned about Keto acidosis and so I put all this information studies together sent it to the doctor. Doctor refused to get on the phone with me but conveyed to the client your trainer is not incorrect. However I still want you to do what I said. So I'm just curious what you would say to people that you know it's hard to find a doctor that is going to it's going to be on board with this kind of stuff. And you know here we are trying to advise them.
Adam [00:18:28] Not as not as hard as it was 20 years ago, right Gary?.
Gary [00:18:31] I think so when it's getting easier and funny again and in my book I do have sort of steps the new book steps to go through the transition to this way of eating and the first step is find an informed doctor. And if you can't if you're a physician where we read at least one book on this subject then find another doctor. It's just you've got the wrong doctor anyway if they're that close minded. Yeah it's a problem. I mean it happens less and less what you're describing. I think more and more people become are they're having their minds open to the fact that this is a relatively you know the kind they're. Probably over 100 clinical trials suggesting this is a healthier way to eat than any other. So at the very least you know you say look why don't you tell your patient your physician might freak out especially like the LDL cholesterol goes up which often happens on these diets. So I mean it's fascinating. There's a company in San Francisco called Berta health which is putting type 2 diabetics on nutritional ketosis so basically ketogenic diet with health coaches and telemedicine physicians always on the other side of a telephone to help and their results they've now had patients who have been following for 2 years and they have 24 markers of cardiovascular risk and diabetes risk and twenty three of them get better. On this diet, one of them, LDL cholesterol gets worse which is God's joke because if physicians have been trained to think LDL cholesterol is the be all and end all heart health and so human health. You've got to convince your clients look this is what your physician might say and if he does say that then the client should say look I'm clearly healthier than I was. Can we just let me keep doing what we were doing and maybe we can just keep running tests and following my health status. And if something should go awry we can jump on it even if all LDL goes up and always put him on a low dose statin. I'm not a fan but they're cheap and other than that I'd just say get another doc... We can find a doctor in every state. There are 10 doctors in every state who are now informed about the health benefits of eating this way.
Adam [00:20:52] Do you think this controversy will end. I mean once and for all do you think the food pyramid will completely change to 2 DLC using American. In other words will the ACA finally say this is the way we should be eating the way they've been so staunch about the food pyramid all these for the last 60 years.
Gary [00:21:09] No I don't think the controvery will ever end. I think at some point they will say I mean at different levels of controversy. So they're already saying. Refined grains and sugar is funny. 20 years ago a healthy diet was defined by being a low fat low salt diet. Today they'll say it. You know it's got no sugars and no white bread. So they're moving in the right direction. They'll probably accept that these diets as they already will say that these diets can be used for a year because that's all of the clinical trials we have for weight loss or diabetes control and I think they'll move in that direction the USDA will probably take longer to get there because saying people should need a low carb diet is like saying people should not eat many of the food products that are agricultural industry creates and the U.S. Department of Agriculture is the supposed to support those agricultural industries. That's partially what they do. So it's hard for them to ever go there. I think we'll get to the point that some of these things already you hear people saying oh no one ever said it was only about calories in calories out. You know what it's like.
Mike [00:22:24] Gary how much does that. You mentioned the Cochrane Collaboration in your article and how you know basically what they've been able to find in regards to the biases and stuff but I really love in your article how you said Put simply if this were a legal case saturated fat would be easily acquitted. And I thought that was very interesting. But my my question is kind of about like aren't doctors aren't these organizations I mean is that does that have credibility with them t the Cochrane Collaboration. And why aren't they looking at that.
Gary [00:23:01] I guess the answer is no they don't really pay attention. An organization like the American Heart Association which will review these guidelines every five years will put together a committee of learned experts and the learned experts who are senior figures in the field and these senior figures in the field who have created in effect the conventional wisdom more they've been heralded the conventional wisdom and reinforced it. And then those experts will put together a committee of people they respect and the people they respect. This is true of all of us are people who think just like they do. This is sort of classic group thing phenomena. So these for the most part these organizations will just keep recapitulating what they've always said and it doesn't matter what anyone else says if somebody like the Cochrane Collaboration comes in and even the Cochrane thing I picked and chose what I want out of there. Abstract at the end of the abstract so they say there's no real evidence that saturated fat raises causes heart attacks and there's even less evidence that saturated fat will shorten your life. But there's some evidence and therefore maybe if these studies were done better we would have more evidence and so maybe people should limit saturated fat. And when I hear things like maybe people should limit saturated fat that also means the fact that maybe they shouldn't. And we don't know. So what if somebody like you know one of these dogma tests and the saturated fat world good read that Cochrane collaboration they would point to one sentence and I would point to another. What happens in these worlds is you know we all do and we all select the evidence we like that agrees with us.
Adam [00:24:51] Confirmation bias I think the call that.
Gary [00:24:53] Confirmation. We all do it. You can't escape it. So I mean we try a good scientist tries to escape it but it's difficult. So they'll point out that the glass is half empty and they'll point out that it's half full and I'll point out that it's half empty and then because it's half empty I think we could always butter and bacon. And I hope I'm right and because it's half full they say none of us should eat butter and bacon and they know they're right.
Adam [00:25:21] Well thanks Gary. Always as always is very insightful. Thank you for joining us. We appreciate it very much.
Gary [00:25:27] It was a real pleasure. Thanks guys.
Adam [00:25:29] Hopefully you'll come back on when the new book comes out. I'll be great.
Gary [00:25:32] I would love to. I would love to.
Arlene [00:25:34] This has been the Inform Fitness podcast with Adam Zickerman. For over 20 years Inform Fitness has been providing clients of all ages with customized personal training designed to build strength fast. Visit Inform Fitness dot com for testimonials blogs and videos on the three pillars exercise nutrition and recovery.