Overweight, hungry, diabetic, and fat-free

15. December 2009 William Davis (52)
Let me tell you about my low-fat experience from 20 years ago.

At the time, I was living in Cleveland, Ohio, and served on the faculty at a large metropolitan university-affiliated hospital, supervising fellows-in-training and developing high-tech cath lab procedures like directional athererectomy and excimer laser coronary angioplasty. (Yes, another life.)

I was concerned about personal heart disease risk, though I knew next to nothing about lipids and coronary risk prediction outside of the little I learned in training and what the drug industry promoted.

I heard Dr. Dean Ornish talk while attending the American College of Cardiology meetings in Atlanta. Dr. Ornish spoke persuasively about the dangers of fat in the diet and how he "reversed" coronary disease using a low-fat, no added oils, no meat, vegetarian diet that included plenty of whole grains. So I thought I'd give it a try.

I eliminated all oils; I removed all meat, eggs, and fish from my diet. I shunned all nuts. I ate only low-fat products like low-fat yogurt and cottage cheese; and focused on vegetables, fruit, and whole grains. Beans and brown or wild rice were a frequent staple. I loved oatmeal cookies--low-fat, of course!

After one year of this low-fat program, I had gained a total of 31 lbs, going from 155 lbs to 186 lbs. I reassessed some basic labs:

HDL 28 mg/dl
Triglycerides 336 mg/dl
Blood sugar 151 mg/dl (fasting)


I became a diabetic. All through this time, I was also jogging. I ran on the beautiful paths along the Chagrin River in suburban Cleveland for miles north and south. I ran 5 miles per day most days of the week.

It was diabetes that hit me alongside the head: I was eating low-fat meticulously, exercising more than 90% of the population, yet I got fat and diabetic!

I have since changed course in diet. Last time I checked, my lipid values on NO statin agent:

HDL 67 mg/dl
Triglycerides 57 mg/dl
Blood sugar 91 mg/dl

That was my lesson that fat restriction is a destructive, misguided notion. The data since then have confirmed that restricting total fat is unnecessary, even undesirable, when fat calories are replaced by carbohydrate calories.

This is your brain on wheat

10. December 2009 William Davis (32)
Here's just a smattering of the studies performed over the past 30 years on the psychological effects of wheat consumption.

Oddly, this never makes the popular press. But wheat underlies schizophrenia, bipolar illness, behavioral outbursts in autism, Huntington's disease, and attention deficit hyperactivity disorder (ADHD).

The relationship is especially compelling with schizophrenia:

Opioid peptides derived from food proteins: The exorphins.
Zioudrou C et al 1979
"Wheat gluten has been implicated by Dohan and his colleagues in the etiology of schizophrenia and supporting evidence has been provided by others. Our experiments provide a plausible biochemical mechanism for such a role, in the demonstration of the conversion of gluten into peptides with potential central nerovus system actions."


Wheat gluten as a pathogenic factor in schizophrenia
Singh MM et al 1976
"Schizophrenics maintained on a cereal grain-free and milk-free diet and receiving optimal treatment with neuropleptics showed an interruption or reversal of their therapeutic progress during a period of "blind" wheat gluten challenge. The exacerbation of the disease process was not due to variations in neuroleptic doses. After termination of the gluten challenge, the course of improvement was reinstated. The observed effects seemed to be due to a primary schizophrenia-promoting effect of wheat gluten."


Demonstration of high opioid-like activity in isolated peptides from wheat gluten hydrolysates
Huebner FR et al 1984


Is schizophrenia rare if grain is rare?
Dohan FC et al 1984
"Epidemiologic studies demonstrated a strong, dose-dependent relationship between grain intake and the occurrence of schizophrenia."

Small LDL: Perfect index of carbohydrate intake

8. December 2009 William Davis (15)
Measuring the number of small LDL particles is the best index of carbohydrate intake I know of, better than even blood sugar and triglycerides.

In other words, increase carbohydrate intake and small LDL particles increase. Decrease carbohydrates and small LDL particles decrease.

Why?

Carbohydrates increase small LDL via a multistep process:

First step: Increased fatty acid and apoprotein B production in the liver, which leads to increased VLDL production. (Apoprotein B is the principal protein of VLDL and LDL)

Second step: Greater VLDL availability causes triglyceride-rich VLDL to interact with other particles, namely LDL and HDL, enriching them in triglycerides (via the action of cholesteryl-ester transfer protein, or CETP). Much VLDL is converted to LDL.

Third step: Triglyceride-rich LDL is "remodeled" by enzymes like hepatic lipase, which create small LDL.


Carbohydrates, especially if they contain fructose, also prolong the period of time that triglyceride-rich VLDL particles persist in the blood, allowing more time for VLDL to interact with LDL.

Many people are confused by this. "You mean to tell me that reducing carbohydrates reduces LDL cholesterol?" Yes, absolutely. While the world talks about cutting saturated fats and taking statin drugs, cutting carbohydrates, especially wheat (the most offensive of all), cornstarch, and sugars, is the real key to dropping LDL.

However, the effect will not be fully evident if you just look at the crude conventional calculated (Friedewald) LDL cholesterol. This is because restricting carbohydrates not only reduces small LDL, it also increases LDL particle size. This make the calculated Friedewald go up, or it blunts its decrease. Conventional calculated LDL will therefore either underestimate or even conceal the real LDL-reducing effect.

The reduction in LDL is readily apparent if you look at the superior measures, LDL particle number (by NMR) or apoprotein B. Dramatic reductions will be apparent with a reduction in carbohydrates.

Small LDL therefore serves as a sensitive index of carbohydrate intake, one that responds literally within hours of a change in food choices. Anyone following the crude Friedewald calculated LDL will likely not see this. This includes the thousands of clinical studies that rely on this unreliable measure and come to the conclusion that a low-fat diet reduces LDL cholesterol.

Fat "conditioning"

4. December 2009 William Davis (0)
Here's a great study from the prolific laboratory of Dr. Jeff Volek from the University of Connecticut. (Full text here.)


http://jn.nutrition.org/cgi/content/full/134/4/880

Video Teleconference with Dr. William Davis

2. December 2009 William Davis (0)

Dr. Davis is available for personal
one-on-one video teleconferencing

to discuss your heart health issues.


You can obtain Dr. Davis' expertise on issues important to your health, including:

Lipoprotein assessment

Heart scans and coronary calcium scores

Diet and nutrition

Weight loss

Vitamin D supplementation for optimal health

Proper use of omega-3 fatty acids/fish oil


Each personalized session is 30 minutes long and by appointment only. To arrange for a Video Teleconference, go to our Contact Page and specify Video Teleconference in your e-mail. We will contact you as soon as possible on how to arrange the teleconference.


The cost for each 30-minute session is $375, payable in advance. 30-minute follow-up sessions are $275.

(Track Your Plaque Members: Our Member cost is $300 for a 30-minute session; 30-minute follow-up sessions are $200.)

After the completion of your Video Teleconference session, a summary of the important issues discussed will be sent to you.

The Video Teleconference is not meant to replace the opinion of your doctor, nor diagnose or treat any condition. It is simply meant to provide additional discussion about your health issues that should be discussed further with your healthcare provider. Prescriptions cannot be provided.

Note: For an optimal experience, you will need a computer equipped with a microphone and video camera. (Video camera is optional; you will be able to see Dr. Davis, but he will not be able to see you if you lack a camera.)

We use Skype for video teleconferencing. If you do not have Skype or are unfamiliar with this service, our staff will walk you through the few steps required.

Track Your Plaque challenges

1. December 2009 William Davis (31)
Of all the various factors we correct in the Track Your Plaque program in the name of achieving reversal of coronary plaque, there are two factors that are proving to be our greatest challenges:

1) Genetic small LDL

2) Lipoprotein(a)

More and more people are enjoying at least marked slowing, if not zero change or reduction, in heart scan scores following the Track Your Plaque program. We achieve this by correcting a number of factors. Some factors, like vitamin D deficiency, are easily corrected to perfection--supplement sufficient vitamin D to achieve a blood level of 25-hydroxy vitamin D of 60-70 ng/ml. Correcting standard lipid values--LDL cholesterol, HDL cholesterol, and triglycerides--child's play, even to our strict targets of 60-60-60.

However, what I call "genetic small LDL" and a subset of lipoprotein(a) are proving to be the most resistant of all.

Let's first consider genetic small LDL. Small LDL is generally the pattern of the carbohydrate-ingesting, overweight person. It has exploded in severity over the past decade due to overconsumption of carbohydrates due to the ridiculous low-fat notion. Reduce or eliminate carbohydrates, especially wheat, which permits weight loss, and small LDL drops like a stone. But there is a unique subset of people who express the small LDL pattern who start at or near ideal weight. Take Chad, for instance. At 6' 2" and 152 lbs and BMI of 19.6, there's no way excess weight could be triggering his small LDL. Yet he starts with 100% small LDL particles. All efforts to reduce small LDL, such as wheat, cornstarch, and sugar elimination; niacin; vitamin D normalization; thyroid normalization; and several supplements that yield variable effects, such as phosphatidylcholine, all leave Chad with more than 90% small LDL.

Lipoprotein(a) is a bit different. Over the past 5 years, our choices in ways to reduce Lp(a) expression have improved dramatically. Beyond niacin, we now have high-dose EPA + DHA, thyroid normalization that includes use of T3, and hormonal manipulation. In the Track Your Plaque experience, approximately 70% of people with Lp(a) respond with a reduction in Lp(a). (In fact, the 4 out of the 5 record holders for reduction of heart scan scores have Lp(a) that was successfully treated.) But about 30% of people with Lp(a) prove resistant to all these treatments--they begin with a Lp(a) of, say, 260 nmol/L and, despite niacin, high-dose EPA + DHA, and various hormones, stay at 260 nmol/L. It can be frustrating and frightening.

So these are the two true problem areas for the Track Your Plaque program, genetic small LDL and a subset of Lp(a).

We are actively searching for better options for these two problem areas. Given the collective exploration and wisdom that develops from such collaborative efforts as the Track Your Plaque Forum, I am optimistic that we will have better answers for these two stumbling blocks to plaque reversal in the future.

I'll supply the tar if you supply the feathers

30. November 2009 William Davis (13)
The results of the latest Heart Scan Blog poll are in.


DIRECT-TO-CONSUMER PHARMACEUTICAL ADVERTISING HAS:

Increased public awareness of medical conditions and their treatment
19 (11%)

Has had little overall effect on health and healthcare
29 (18%)

Needlessly increased healthcare costs
81 (50%)

Further empowered the revenue-obsessed pharmaceutical industry
130 (81%)


Clearly, there's a lot of negative sentiment against direct-to-consumer (DTC) drug advertising.

It looks as if a small minority believe that good has come from DTC advertising, judging by the meager 11% who voted for increased awareness. In fact, the poll results are heavily weighed towards the negative: 50% voted for "needlessly increased healthcare costs," while an astounding 81% voted for "empowered the revenue-obsessed pharmaceutical industry."

It is, indeed, an odd situation: Pharmaceutical agents available only by prescription being hyped directly to the consumer.

Personally, I would vote for choices 1,3, and 4. While awareness has increased, it has come with a hefty price, not all of it well spent. I believe the pharmaceutical industry still adheres to the rule that, for every $1 spent on advertising, $4 is made in revenue. They are, in effect, printing money.

What goes up can't come down

28. November 2009 William Davis (13)
According to conventional wisdom, heart scan scores cannot be reduced.

In other words, say you begin with a heart scan score of 300. Conventional wisdom says you should take aspirin and a statin drug, eat a low-fat "heart healthy" diet, and take high blood pressure medications, if necessary.

If your heart scan score goes up in a year or two, especially at an annual rate of 20% or more, then you are at very high risk for heart attack. If the heart scan score stays the same, then your risk is much reduced. These observations are well-established.

But more than 99% of physicians will tell you that reducing your heart scan score is impossible. Don't even try: Heart scan scores can go up, but they can't go down.

Baloney. Heart scan scores can indeed go down. And they can go down dramatically.

It is true that, following conventional advice like taking a statin drug, following a low-fat diet, and taking aspirin will fail to reduce your heart scan score. A more rational approach that 1) identifies all causes of coronary plaque, 2) corrects all causes while including crucial strategies like omega-3 fatty acid supplementation, vitamin D supplementation, and thyroid function normalization, is far more likely to yield a halt or reduction in score.

While not everybody who undertakes the Track Your Plaque program will succeed in reducing their heart scan score, a growing number are enjoying success.

A small portion of our experience was documented this past summer. (I collected and analyzed the data with the help of Rush University nutrition scientist, Dr. Susie Rockway, and statistician, Dr. Mary Kwasny.)


Effect of a combined therapeutic approach of intensive lipid management, omega-3 fatty acid supplementation, and increased serum 25 (OH) vitamin D on coronary calcium scores in asymptomatic adults.

Davis W, Rockway S, Kwasny M.

The impact of intensive lipid management, omega-3 fatty acid, and vitamin D3 supplementation on atherosclerotic plaque was assessed through serial computed tomography coronary calcium scoring (CCS). Low-density lipoprotein cholesterol reduction with statin therapy has not been shown to reduce or slow progression of serial CCS in several recent studies, casting doubt on the usefulness of this approach for tracking atherosclerotic progression. In an open-label study, 45 male and female subjects with CCS of > or = 50 without symptoms of heart disease were treated with statin therapy, niacin, and omega-3 fatty acid supplementation to achieve low-density lipoprotein cholesterol and triglycerides < or = 60 mg/dL; high-density lipoprotein > or = 60 mg/dL; and vitamin D3 supplementation to achieve serum levels of > or = 50 ng/mL 25(OH) vitamin D, in addition to diet advice. Lipid profiles of subjects were significantly changed as follows: total cholesterol -24%, low-density lipoprotein -41%; triglycerides -42%, high-density lipoprotein +19%, and mean serum 25(OH) vitamin D levels +83%. After a mean of 18 months, 20 subjects experienced decrease in CCS with mean change of -14.5% (range 0% to -64%); 22 subjects experienced no change or slow annual rate of CCS increase of +12% (range 1%-29%). Only 3 subjects experienced annual CCS progression exceeding 29% (44%-71%). Despite wide variation in response, substantial reduction of CCS was achieved in 44% of subjects and slowed plaque growth in 49% of the subjects applying a broad treatment program.

Gretchen's postprandial diet experiment

27. November 2009 William Davis (11)
Gretchen sent me the results of a little experiment she ran on herself. She measured blood glucose and triglycerides after 1) a low-fat diet and 2) a low-carb diet.









Gretchen describes her experience:

Several years ago I received a windfall of triglyceride strips that would expire in a week or so. I hated to waste them, so I decided to use them to test my triglyceride and BG responses to two different diets: low carb and low fat.

The first day I followed a low-fat diet. For breakfast I ate a lot of carbohydrate, including 1 oz of spaghetti cooked al dente and ¾ cup of white rice. For the rest of the day I ate less carbohydrate but continued to eat low fat.

The second day I followed a low-carb diet. For breakfast I ate a lot of fat, including a sausage, mushrooms fried in butter, 2 slices of bacon, and ¼ cup of the creamy topping of whole-milk yogurt. For the rest of the day I ate less fat, especially less saturated fat, but continued to eat low carb.

Both days I measured both BG and triglyceride levels every hour until I went to bed. On the low-carb day I had 3 meals. On the low-fat day, I was constantly hungry, had 4 meals, and kept snacking.

You can see the results in Figure 1. On the low-fat diet, after a “healthy” low-fat breakfast of low-glycemic pasta with low-fat sauce, my BG levels shot up to over 200 mg/dL and took more than 6 hours to come down. My triglycerides, however, remained low, and at first I thought perhaps the low-fat diet might be better overall. However, after about 6 hours, the triglyceride levels started to increase steadily, and by the next morning, they were higher than they had been the day before.
On the low-carb diet, my BG levels stayed low all day. However, after meals, the triglyceride levels skyrocketed. After meals they came down, and by the next morning they were lower than they had been the day before.

As I interpret these results, the high triglyceride levels after eating the high-fat meals represent chylomicrons, the lipoproteins that transport fat from your meals to the cells of your body. The high triglyceride levels the morning after eating the low-fat meals represent very low density lipoprotein, which takes the cholesterol your liver synthesizes when your intake of dietary cholesterol is low and distributes it to cells that need it, or again, to the fat for storage.

There are several interesting factors to consider here. First, when you have a lipid test done at the lab, it’s usually done fasting, which means first thing in the morning after not eating for 8 to 12 hours. It tells you nothing about what your triglyceride levels were all day.

Second, the low-carb diet resulted in lower fasting triglyceride levels, but much higher postprandial triglyceride levels. Which are more dangerous? I’m afraid I don’t know. You should also note that the high-fat, low-carb breakfast was extremely high in fat, including saturated fat. I don’t normally eat that much fat but wanted to test extremes.

Third, although the low-fat diet didn’t produce the very high postprandial triglyceride levels that the high-fat diet did, it produced extremely high BG levels that persisted for 6 hours. Some people think that it’s oxidized and glycated lipids that are the dangerous ones, so high BG levels and normal triglyceride levels might be more dangerous than very high triglyceride levels and normal BG levels. Note that high BG levels also contribute to oxidation rates.

Fourth, this shows the results of an experiment with a sample size of one. My physiology might not be typical. If you want to know how your own body’s lipids respond to different types of diets, you should get a lipid meter and test yourself. Unfortunately, your insurance is unlikely to want to pay for this, so it will be an expensive experiment.

The main point of this is that the results of different diets are complex. We have to eat. And what we eat can affect many different systems in our bodies. Finding the ideal diet that matches our own physiology and results in the best lipid levels as well as BG levels is a real challenge.



This was a lot of effort for one person. Thanks to Gretchen for sharing her interesting experience.

Gretchen makes a crucial point: Some of the effects of diet changes evolve over time, much as triglyceride levels changed substantially for her on the day following her experiment. Wouldn't it be interesting to see how postprandial patterns develop over time if levels were observed sequentially, day after day?

The stark contrast in blood sugars is impressive--Low-carb clearly has the advantage here. Are there manipulations in diet composition in low-carb meals that we can make to blunt the early (3-6 hour) postprandial lipoprotein (triglyceride) peak? That's a topic we will consider in future.

More of Gretchen's thoughts can be found at:

http://wildlyfluctuating.blogspot.com
http://www.healthcentral.com/diabetes/c/5068

After-eating effects: Carbohydrates vs. fats

25. November 2009 William Davis (17)
In the ongoing debate over whether it's fat or carbohydrate restriction that leads to weight loss and health, here's another study from the Oxford group examining the postprandial (after-eating) effects of a low-fat vs. low-carbohydrate diet. (Roberts R et al, 2008; full-text here.)

High-carbohydrate was defined as 15% protein; 10% fat; 75% carbohydrate (by calories), with starch:sugar 70:30.

High-fat was defined as 15% protein; 40% fat; 45% carbohydrate, with starch:sugar 70:30. (Yes, I know. By our standards, the "high-fat" diet was moderate-fat, moderate-carbohydrate--too high in carbohydrates.)

Blood was drawn over 6 hours following the test meal.




Roberts R et al. Am J Clin Nutr 2008

The upper left graph is the one of interest. Note that, after the high-carbohydrate diet (solid circles), triglyceride levels are twice that occurring after the high-fat diet (open circles). Triglycerides are a surrogate for chylomicron and VLDL postprandial lipoproteins; thus, after the high-carbohydrate diet, postprandial particles are present at much higher levels than after the high-fat diet. (It would have been interesting to have seen a true low-carbohydrate diet for comparison.) Also note that, not only are triglyceride levels higher after high-carbohydrate intake, but they remain sustained at the 6-hour mark, unlike the sharper decline after high-fat.

It's counterintuitive: Postprandial lipoproteins, you'd think, would be plentiful after ingesting a large quantity of fat, since fat must be absorbed via chylomicrons into the bloodstream. But it's carbohydrates (and obesity, a huge effect; more on that in future) that figure most prominently in determining the pattern and magnitude of postprandial triglycerides and lipoproteins. Much of this effect develops by way of de novo lipogenesis, the generation of new lipoproteins like VLDL after carbohydrate ingestion.

We also see this in our Track Your Plaque experience. Rather than formal postprandial meal-testing, we use intermediate-density lipoprotein (IDL) as our surrogate for postprandial measures. A low-carbohydrate diet reduces IDL dramatically, as do omega-3 fatty acids from fish oil.
Are humans meant to be omnivores?

Are humans meant to be omnivores?

28. September 2008 William Davis (24)
Are humans meant to be omnivores?

Does the ideal human diet include animal products like meat, fish, cheese, eggs, and dairy products?

Or should the ideal diet be devoid of all animal products?a vegetarian diet?

Though the argument is distorted by modern food processing methods (e.g., factory farming, long-term administration of antibiotics), convenience foods, and pseudo-foods crafted by food manufacturers, there are, obviously, proponents of both extremes.

The Atkins’ diet, for instance, advocates unrestricted intake of animal products, regardless of production methods or curing (sausage and bacon). At the opposite extreme are diets like Ornish (Dr. Dean Ornish’s Program for Reversal of Heart Disease) and the experiences of Dr. Colin Campbell, articulated in his studies and book, The China Study, in which he lambasts animal products, including dairy, as triggers for cancer and heart disease.

So which end of the spectrum is correct? Or ideal?

For the sake of argument, let's put aside philosophical questions (like not wanting eat animal products because of aversion to killing any living being) or ethical concerns (inhumane treatment of farm animals, cruel slaughtering practices, etc.). Does the inclusion of animal products provide advantage? Disadvantage?

The traditional argument against animal products has been saturated fat. If we accept that we’ve demoted the saturated fat question to a place far down the list of importance (though this is yet another argument to discuss another time), several questions emerge:

• If humans were meant to be vegetarian, why do omega-3 fatty acids (mostly from wild game and fish) yield such substantial health benefits, including dramatic reduction in sudden death from heart disease?

• Why would vitamin K2 (from meats and milk, as well as fermented foods like natto and cheese), obtainable in only the tiniest amounts on a vegetarian diet, provide such significant benefits on bone and cardiovascular health?

• Why would vitamin B12 (from meats) be necessary to maintain a normal blood count, prevent anemia, keep homocysteine at bay, and lead to profound neurologic dysfunction when deficient?


Omega-3 fatty acids and vitamins K2 and B12 cannot be obtained in satisfactory quantities from a pure vegetarian diet. The consequences of deficiency are not measured in decades, but in a few years. The conclusion is unavoidable: Evolutionarily, humans are meant to consume at least some foods from animal sources.

That's not to say that we should gorge ourselves on animal products. Gout (excessive uric acid) and kidney stones are among the unhealthy consequences of excessive quantities of meats in our diets.

It pains me to say this, since I’ve always favored a vegetarian lifestyle, mostly because of philosophical concerns, as well as worries about the safety of our factory farm-raised livestock and rampant inhumane practices.

But, stepping back and objectively examining what nutritional approach appears to stack the odds in favor of optimal health, I believe that only one conclusion is possible: Humans are meant to be omnivorous, meant to consume some quantity of animal products in addition to vegetables, fruits, nuts, and other non-animal products.

The question is how much?
Tags :

Comments (24) -

  • Francis

    9/28/2008 4:55:00 PM |

    From the title I thought the debate would have been omnivore vs carnivore instead of omnivore vs vegetarian. Any solid arguments against a carnivorous lifestyle?

  • GK

    9/28/2008 6:21:00 PM |

    Hm, fingering meat as a cause of gout again?  Peter's Hyperlipid blog had some fairly convincing arguments that fructose may be worse.  See http://high-fat-nutrition.blogspot.com/2006/12/which-drink-causes-gout.html and http://high-fat-nutrition.blogspot.com/2008/02/fructoase-and-gout.html

    --GK

  • Jeremy

    9/28/2008 9:09:00 PM |

    The comment about gout is not true. Loren Cordain, author of the Paleo Diet, has reviewed the literature on gout in his Paleo Diet Newsletter, Volume 2, Number 4.

    The back issues of the newsletter are products you must pay for, so I won't discuss the contents in extreme detail. But he argues the body adjusts uric acid execretion in response to purine intake. Meanwhile, he cites studies showing fructose and alcohol for increase uric acid levels in the body.

    He cites a study where a high-protein diet relieved gout in 7 out of 12 patients!

    Jeremy

  • rabagley

    9/28/2008 10:24:00 PM |

    Personally, I find the analysis of the paleolithic diet to be most compelling.  In that analysis, we were almost entirely meat eaters, with the occasional smattering of vegetables, fruits, nuts, etc.

    There have been several indigenous cultures, both modern (Masai) and in recent history (Inuit) that lived long and healthy lives almost entirely free of diseases like diabetes or heart disease while eating almost 100% animal products.  I refer to the Inuit as "recent history" because their modern diet only rarely resembles their historical (and much healthier) diet of seal and whale fat and meat.

    After reading "Good Calories, Bad Calories", I'm convinced of the merits of the position that humans are non-obligate carnivores.  We can fall back to non-animal foods if absolutely necessary, but it's a bigger compromise to our health the farther you go.

    I do agree that the biggest problem with being a modern-day carnivore is the inhumane treatment of meat animals by agribusiness.  I spend quite a bit of money on meat that I trust has come from humanely treated animals.  I know the names and faces of the people who raised those cows, chickens, pigs and lambs.  This is a luxury.  Most people don't have the food budget that I do.

  • JD

    9/29/2008 1:13:00 AM |

    I think a better question is what diet was mankind's genetics formed from over 2 million years. Agriculture is only 10,000 years old. If you read Good Calories Bad Calories by Gary Taubes, there were cultures such as the Inuit and the Masai who basically only ate meat and did not suffer from the diseases of civilization including heart disease, cancer, etc.

  • Stephan

    9/29/2008 3:26:00 AM |

    Hi Dr. Davis,

    I agree there are many animal nutrients that seem important to human health: you mentioned long-chain n-3s, vitamin K2 MK-4, and vitamin B12; I'd also add preformed vitamin A and heme iron to the list.

    I read a paper a while back in the AJCN that analyzed the diet composition of 229 historical hunter-gatherer groups (Loren Cordain's group).  The average percentage of calories from animal foods was about 70%.  Many groups were completely or almost completely carnivorous, while none ate less than about 15% of calories from animal foods.  

    That being said, the diets varied widely, from complete carnivory to plant-rich omnivory.  By all accounts, none of them suffered from the modern diseases of civilization such as cardiovascular disease.  I posted on this study a while back:

    http://wholehealthsource.blogspot.com/2008/08/composition-of-hunter-gatherer-diet.html

  • Peter

    9/29/2008 12:23:00 PM |

    Hi Dr Davis,

    Great post. I have to agree with your concerns about modern meat production techniques and animal welfare as serious issues which need addressing, but we humans have always been pretty awful to our prey. Just thinking of traditional "harvesting" of marine mammals in the Faroes and subsistence whaling techniques here. No excuse for any of us to feel comfortable with these practices or to support factory farming, but humans are humans and we are top level predators after all. Lions are not exactly kind to their prey either.

    To be driven to omnivory acceptance by logic and evidence, against ones basic inclination, shows a great respect for facts and evidence that is seriously thin on the ground in both conventional and more alternative cardiological circles.

    What else can anyone say? Great post.

    Peter

  • Jeanne Shepard

    9/29/2008 3:00:00 PM |

    Vegans say that if the walls of slaughter houses were glass that noone would eat meat. I'm inclined to think that instead, there would be demands for humane animal handling.
    Agriculture kills many small mammals and ground nesting birds, with heavy farm machinery and fertilizers/pesticides. If you want to eat, there is no free lunch, in terms of animals losing their lives.
    As someone who is humane but feels that being a carnivore is essential to my health, I buy locally grass fed beef that is is humanely slaughtered.

  • Anonymous

    9/29/2008 3:32:00 PM |

    I wonder how it would be possible to gather 2000 to 2500 calories' worth of wild plant foods every day to survive.  It would amount to something like a bushel-basket full of stems and leaves and fruits -- every single day, for every member of the group. Maybe 20 pounds a week per person.  The only way around this is to include relatively large amounts of high-fat nuts, or high-starch tubers, or high-starch grass seeds, such as wheat.  And to have to do that ALL YEAR LONG.  Nuts and seeds aren't always available year round.

    Leaf-eating vegetarians, such as the gorilla, have HUGE guts amounting to some 70% of their body volume to process the vast amounts of leaf matter needed to survive.  And they eat pretty much constantly.

    That isn't us.

    If

  • Anonymous

    9/29/2008 5:03:00 PM |

    Man evolved eating lots of animal products, with some vegetation thrown in seasonally for hundreds of thousands of years. Then about 10,000 years ago we began introducing agricultural products into our diet. So rationally, we have evolved to process animal products much better than vegetation.

    Speaking for myself, gout runs in the family (among other things). Eating high animal products/low vegetation, relieves all my pains (gout and arthritic) and solves dozens of my other health complaints. And my bloodwork is the envy of people 1/2 my age.

    My only concern is how the animals are treated and raised. I only buy organic free-range eggs and try to buy organic meats and wild fish.

  • Anonymous

    9/29/2008 5:57:00 PM |

    I think we don't lose the abilities formed as evolving.  We evolved to eat nuts and bugs, then fish, then plants and finally meat. We're a true omnivore with the ability to choose.  I choose not to eat meat because I'm a veterinarian with 25 years experience dealing with unwholesome meatpacking industry.

  • stephen_b

    9/29/2008 7:38:00 PM |

    In my opinion any conversation about vegetarian vs. omnivore diets or low-carb vs. low fat diets need to take into account how the food is prepared. Any diet with high advanced glycation endproduct (AGE) content will be unhealthy.

    StephenB

  • Jeff Consiglio

    9/29/2008 9:11:00 PM |

    Holy synchronicity Batman! This is the exact question I've been mulling over for a long time and have just recently resolved the issue in my own mind, to my satisfaction. Having done and advocated low carb diets for a long time, I no longer do.

    There are numerous traditional cultures that live on a high carbohydrate intake - WITHOUT obesity, diabetes etc. So that inarguable fact always bothered me, when it came to trying to justify extreme low carb.

    For instance, here's a link to a Men's Health article on a tribe in Mexico that thrives on about an 80% carbohydrate diet.

    http://www.menshealth.com/cda/article.do?conitem=3b4b1ca01e91c010VgnVCM10000013281eac____&page=1

    Also, I believe the science is pointing more and more toward fructose being the primary "bad carb" as opposed to starches which are chains of glucose. It is the fructose half of sucrose causing the problems, rather than the glucose.

    Not that eating pure glucose is a good idea. Nor starches that convert too rapidly into glucose.

    But I can tell you from my personal experience that as someone who once was sure that I was "carb intolerant" I now thrive on a high carb diet of WHOLE FOODS.
    I eat legumes, sprouted grain bread, slow cooked rolled oats etc. And yes I eat lean, and minimally processed meats as well.

    And my grocery bill is MUCH cheaper than it was when my wife and I were both living the low carb lifestyle. By the way, I used to suffer from reactive hypoglycemia, yet I thrive on plenty of UNREFINED carbs now.

    Here's a link to an amazing interview with a Dr. Lustig who discusses how fructose causes de-novo lipogensis, insulin resistance and high uric acid levels. he also discusses the Atkins diet and why Asians are able to thrive in spite of high intake of white rice. Ties in very nicely with this topic.

    http://www.abc.net.au/rn/healthreport/stories/2007/2104024.htm

    And here's just one more link that I think ties all this together. it's an seminar by Micheal Pollan who wrote  "In Defense of Food."

    http://www.youtube.com/watch?v=I-t-7lTw6mA

    Having read literally thousands of books and scientific papers on the topic of nutrition, I feel Micheal's is the all time best. It exposes the fallacy of nutritional reductionism - what he calls "nutritionism - the idea that we should study individual macro or micro nutrients, rather than looking at overall eating patterns. He makes a brilliant case for the notion that to discover the "secret" to what constitutes the ideal human diet we need look no further than what traditional healthy cultures eat. Traditional, healthy cultures have all kinds of varying macro-nutrient ratios. But they all eat REAL FOOD.

    And I now believe that explains why totally "opposite" diets like Atkins and vegetarian can both work. Because they are both based on real food!

    Sure, some folks don't do well on high carb intake. Some don't seem to tolerate a lot meat very well. But I do not believe most people need to go to extremes in regards to high/low carb. Forget about macronutrient ratios and just eat real food and avoid sugar and refined carbs.

    And probably take a vitamin D3 supplement since most of us do not get enough sunshine to make it on our own these days.

    Sorry to make this so long, but I just had to get this off my chest.

    Keep up the good work. I enjoy your blog very much.

  • Stephanie

    10/1/2008 12:31:00 AM |

    Just to concur with your findings, at a recent 'food aid' symposium at Columbia University, sponsored by Doctors Without Borders, and a WHO conference in Geneva, it was concluded that animal proteins must be included in international food aid in order to save the millions of children who die each year of malnutrition. The standard emergency food distributions of grain-based flours (corn-soya blend) are not working. The milk powder seems to be the essential ingredient that prevents both wasting and stunting in children under 5.

  • Anonymous

    10/1/2008 6:33:00 PM |

    As a vegetarian this sort of thing interests me. I used to think it necessary to supplement with lots of nutrients (such as omega-3 fats) and be careful in order to be healthy. However I'm lately beginning to wonder if a plant-based diet is actually the key to health.

    According to several studies such as the China study, cultures who eat a plant-based diet very low in fat and animal products (even if not expressly vegan very close to it)  tend to be protected from "diseases of civilization" such as obesity, diabetes, and heart disease.  Certain doctors who've researched this like Dr. Ornish have used this type of diet to reverse heart disease. This idea certainly has been attacked, but I'm sure it hasn't been actually refuted.

    If this is true maybe nutrients like K2 and fish oil become less important, (assuming you're getting the required amount of essential fatty acids and other nutrients). Afterall, if you don't have atherosclerosis to begin with you don't need large amounts of special nutrients such as vitamin k2 that fight against it. Still, I guess vitamin B12 is an issue.

  • Anonymous

    10/2/2008 2:43:00 AM |

    I think it's very telling about who stands to profit if Americans embrace a vegetarian or vegan diet.  Soy, rapeseed, and cereal grains are all much easier to make high profits from than factory farmed chickens, cows, and pigs, not to mention properly, humanely raised animals.  I've noticed the push to dissuade Americans from beef, and cattle are some of the hardest animals to fit into a factory farm model, because the calves must live on grass in a field for a while - they can't be jammed up eating grain the whole time.

  • donny

    10/2/2008 1:28:00 PM |

    They did a study in rats where they either fed the rats a certain amount of vitamin k alone, or a certain amount along with Nadh, and then measured gamma-carboxylation of certain proteins. Increased levels of Nadh increased the levels of gamma-carboxylation just as if more vitamin k had been administered.
    Exercise, alcohol, and niacin all increase levels of Nadh. It's possible that something about our modern lifestyles is exaggerating our need for vitamin k2.
    The same goes for b12. Other vitamins like folic acid, b6, etc., either help in the b12 cycle, keeping it in the system, or spare it like b6 which cycles homocysteine into cysteine instead of back into methionine. People with low thyroid who receive replacement therapy have their homocysteine levels go down as well as their triglycerides, almost as if a b vitamin deficiency had been corrected.

    Dean Ornish shows increased bloodflow on his diet, but what is that diet's effect on calcium scores? Just eating a cup of sugar should increase blood flow, in the short term; vasodilation is an acute action of insulin.

  • rabagley

    10/2/2008 4:38:00 PM |

    First, the China Study authors didn't read the China Study data, or they would have noticed that the Chinese only eat about 12g/day of soy (almost entirely of one fermented form or another).  It is far from a dominant staple.  They also might have noticed that only those extremely close to starvation ate a nearly vegan diet.  Anyone who could afford to eat meat, ate meat.

    Second, Ornish is the master of selectively paying attention to study data.  Any study which can be spun to support his goals is blown all out of proportion to its actual significance.  Those studies that directly contradict his goals?  No mention...

    Personally, I know three people who've tried Ornish.  They were incredibly hungry all the time and gained all of the weight back within six months.  Their blood sugars and cholesterol numbers were even worse afterwards than before.  I and one other friend tried paleo (carnivory) instead.  Now one year into our meat-centered diet, we're both stable with moderate BMI's (me 22, him 23), normal hunger, few or no cravings, my blood sugar is way down, HDL is up, triglycerides are down...

    Ornish is a vegetarian activist claiming to be an authority on diet.  Too bad his diets are counter-productive for real people in the real world.

  • ganeshan

    10/3/2008 8:23:00 PM |

    not exactly ,humans can be carnivores too but they must go through the exact working so as to avoid any disease.being an omnivores will make us much safer.
    --------
    ganeshan

    Sreevysh Corp

  • Diana Obesity News Watcher

    10/16/2008 12:02:00 PM |

    Canadian consumers have different dietary needs depending on the end-goal they want to achieve, such as disease prevention, weight control or overall healthier dietary lifestyle. On this principle, the Compliments Balance program was developed in partnership with the Heart and Stroke Foundation's Health Check program to provide consumers with healthier options for managing their personal diets. http://www.phentermine-effects.com

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