New interview at Wannabebig. Why You Should Be Skipping Breakfast: The Secrets of Intermittent Fasting.

Would appreciate readers dropping by and their sharing experiences with my method in the discussion thread dedicated to the article.

See other interviews here.

I have previously hinted that intermittent fasting sidesteps the issues associated with stubborn body fat. Indeed I rarely find any need for advanced strategies to rid my clients of stubborn body fat. I will soon tell you why, but first let me give you some background information to what I'm talking about here.


What is stubborn body fat?

Stubborn body fat refers to areas of the body that hold on to fat the longest. Generally speaking, these areas include the lower abs and lower back in men, and the lower body in women. These areas are damn hard to get lean.

How come these areas are stubborn in the first place? To understand this, let's look at how fat is mobilized (the very short version).

After you eat, insulin and fatty acids are elevated. You are in the fed state and there's zero fat burning going on. Your body is relying completely on glucose oxidation during the hours following the meal.

One way of measuring this is via the respiratory quotient (RQ). An RQ of 1.0 denotes pure carbohydrate metabolism ("storage mode"), while 0.7 denotes pure fat metabolism. To put this into perspective, consider that RQ is 0.95-1.0 for about 1.5-2 hours after a meal, 0.82-0.85 after overnight fasting and 0.72-0.8 after 16 hours of fasting.

As the hours go by and the nutrients from the meal are done being absorbed, RQ drops in conjunction with insulin. There's a shift towards fat burning and mobilization of stored fat. This process is mediated by insulin and blood-borne fatty acids; when levels drop, an energy deficit is "sensed" and catecholamines (adrenaline and nordrenaline) increase.

The catecholamines travel through the blood and bind to receptors on fat cells. A receptor can be thought of as a "lock." Hormones and neurotransmitters are keys that fit into that lock and make something happen. In this case catecholamines trigger fat mobilization by activating hormone sensitive lipase (HSL), which then shuttles the fat out of the cell to be burned off.

Now here's the critical difference between regular fat and stubborn fat: regular fat have a lot of beta-2 receptors in proportion to alpha-2 receptors.

In The Stubborn Fat Solution Lyle McDonald used the analogy of b2-receptors being "accelerators" for fat loss and a2-receptors acting as "breaks" for fat loss. That's the easiest way to think of them without getting too deep into the physiology.

The ratio between b2-receptors and a2-receptors determines how easy it is to facilitate fat loss from one region of the body. "Easy" fat has a high ratio of b2-receptors to a2-receptors, while stubborn fat has a high ratio of a2-receptors to b2-receptors.

One notorious example that Lyle brings up in his book is that women have up to nine times (!) as many a2-receptors as b2-receptors in their hip and thigh fat. Though I can't recall if similar numbers are available for lower ab and lower back fat for men, you can be sure that the a2-receptors outnumber the b2-receptors in these areas as well.



I rarely use fancy strategies for ridding my clients of stubborn body fat. They never need it. It's more or less a linear process all the way down to the shredded state.


Intermittent fasting and stubborn fat loss

How can intermittent fasting then selectively target stubborn body fat more effectively than other diets? Well, to target stubborn body fat we need to activate b2-receptors while deactivating a2-receptors. Intermittent fasting achieves this by the following mechanisms.

1. Fasting increases catecholamine levels.

2. Fasting increases abdominal subcutaneous blood flow, which means that catecholamines will have an easier time reaching those hard-to-get areas.

3. The low insulin level reached during the fast inhibits a2-receptors. A greater time spent in the low insulin state equals a greater time spent in a state where fat can be mobilized from stubborn areas. Now you're probably thinking "why not just go on a low carb diet" to keep insulin low, but keep in mind that triglycerides inhibit HSL in a similar manner as insulin.

4. My research has indicated that the ideal state of fat burning is reached after 12-18 hours of fasting. Coupled with high levels of catecholamines, increased blood flow to stubborn regions, and low insulin for a2-receptor inhibition, this time interval is the "golden age" of stubborn fat mobilization.

Let me just explain real quick what I mean by the ideal state of fat burning. Studies have examined free fatty acid (FFA) oxidation from anywhere between the overnight fasted state to three days of fasting. While FFA oxidation increases the longer time you spend in the fasted state, the contribution of fatty acids to whole body fat oxidation changes.

In short-term fasting there's a significant increase in subcutaneous FFA oxidation. That's just a fancy way of saying that you're mainly burning body fat and nothing else. For up to 14-20 hours* after a 600-calorie meal in normal-weight subjects, fat is only mobilized from body fat stores in resting individuals.

* 14-20 hours in a completely sedentary state should easily equal 12-18 hours in real life.

Past this time point, fat burning increases further. That goes without saying. But it's not necessarily the type of fat you're after that you'll be burning. Somewhere in between the 10- and 30-hour time point, the oxidation of intramuscular fat increases greatly, but no increase is seen in subcutaneous fat. Subcutaneous fat simply can't keep up with demand, so you're playing a game of diminishing returns if you push the fast too long. Coupled with the escalating rate of de novo gluconeogenesis, and subsequent risk of muscle catabolism, fasting for too long may not be very conducive for a lean individual seeking optimal lean mass retention while targeting stubborn body fat.



Men usually need to hit single-digit body fat percentage to have good abs, while women have good abdominal definition at around 15% body fat. Above is a picture of natural body fitness champ and intermittent fasting afficionado Kristine Weber.


Science vs real life

One obvious question critically inclined readers should ask themselves is whether special strategies to mobilize stubborn fat is even needed in the first place. After all, people have gotten ripped without intermittent fasting or the strategies laid out in The Stubborn Fat Solution by Lyle McDonald. Is it not just a question of dropping low enough in body fat percentage?

If we compare a traditional calorie deficit of 3500 kcal per week on a conservative diet vs 3500 kcal on an intermittent fasting setup (or with The Stubborn Fat Solution), would there be any difference in regional fat loss assuming all other factors were kept constant? I don't think we'll ever know, so this boils down to relying on theory and practical experience.

My personal experience is that intermittent fasting helps with stubborn fat loss compared to a conservative diet. This little anecdote is obviously riddled with confounders, and maybe even wishful thinking, but if you take a look at some pictures from my younger days (and here), you'll see that I was quite lean during the modelling days. However, I still had some fat covering the lower ab region and never really seemed to lean out well no matter how hard I tried. Sure, I would lose weight when I cut calories, but not from the right areas. I always ended up getting extremely lean legs, arms and shoulders. I also lost a lot of muscle in my desperate attempts to get good abs, but that might just boil down to me dieting like a retard. As you can see in some more recent pics, I don't have those types of problems any more.

Adding to this anecdotal evidence of mine, I have heard similar feedback from clients and blog readers. Intermittent fasting seems very conducive for targeting stubborn body fat. Got a similar experience to report? Let me know.

Content update, June 20th

When is stubborn body fat a problem?

There were a few things that I forgot to cover when I first finished this article. First of all, at what level does stubborn body fat become an issue? Generally speaking, people don't have a good sense of what is "just too fat" and what is a legit body fat percentage for stubborn fat to even start becoming an issue. I've had tons of clients approach me with their "issues with stubborn body fat" when they we're 15% body fat or more.

Stubborn fat is the fat you need to lose for a good four-and-a-half-pack to turn into a six-pack. If I had to put a number on it, I'd say 10% is the maximum body fat percentage you need to have reached before this is something you can start concerning yourself with.

Below are a few examples of the level of leanness required to even start thinking about stubborn body fat.








Both of these clients were approximately 10% and the marked areas denote those typically stubborn fat deposits. Note that both of them were quite lean and had good abdominal definition from the navel up. The stubborn fat is located at around the navel and below.





With females the whole lower body is "stubborn." Above is a good example of the different fat pattern seen in men and women. Note the lean midsection and lower back. At the same time the lower body appears quite smooth. If she would have dropped a few more percentage points of body fat, she would have had very visible abs - but her lower body would likely not have gotten much leaner. Even female body fitness competitors rarely come in to stage with "ripped" legs.


Stubborn Fat Strategies

Here are a few strategies that you should consider implementing to target stubborn fat. Keep in mind that your diet needs to be in order first and foremost. You can't throw this into the mix and expect results if your diet is sub par.

1. Intermittent fasting. For the reasons I mentioned earlier.

2. Increase your activity level in the fasted state. Add cardio or whatever else to get your energy expenditure up. A personal favorite of mine is lower intensity and longer duration activities like walking in the 12-16 hour time interval of the fast. Not only is this the "golden age" of subcutaneous fat oxidation, but lower intensity activities selectively use fatty acids to fuel the activity. There are other reasons I favor low intensity over high intensity activities (such as HIIT). They interfere minimally with your performance in the gym and can be done on a daily basis, which is not the case with HIIT.

3. Supplementation. While I have gotten lean without thermogenics and alpha-2 receptor antagonists, such as yohimbine, they can speed up the process.

For starters: Caffeine is a dirt cheap thermogenic that will ramp up catecholamine levels. During the fast add caffeine pills and dose depending on tolerance. If you're not a regular coffee-drinker, you can get pretty wired off 200 mg. If you're a habitual coffee-drinker (like me), it might take up to 600 mg to even get an effect. L-Tyrosine may work synergistically with caffeine so you may consider experimenting with that as well. Personally though, I have never gotten much out of it - though many people swear by it.

For more ambitious supplementation, add the alpha-2 antagonist yohimbine or a supplement containing yohimbine in addition to caffeine pills. Take the equivalent of 0.2 mg/kg body weight shortly before fasted cardio or during the fast. This works out to 16 mg yohimbine for an 80 kg/175 lbs male if you have pure yohimbine hcl.
Other commercial thermogenics, such as Meltdown, contain 3 mg yohimbine per capsule; so you'd have to take up to 5 capsules to reach similar levels. But proceed with caution:the product says, "Never exceed more than three total capsules daily or in a single dose." Personally, I haven't noticed anything out of the ordinary with such dosing (>3 capsules), but I need to throw in a disclaimer here lest someone screws himself over. It would be best to start low to assess tolerance. Meltdown contains quite a few other ingredients that might make the effects stronger and more unpredictable versus straight yohimbine hcl (i.e., 5 capsules of Meltdown might be more potent than 15 mg of Y-HCL in terms of stimulatory effect and perhaps side effects).

Important: Keep in mind that insulin negates the effects of yohimbine on alpha 2-receptor inhibition. Always take it in the fasted state and never between meals. Considering the half-life of yohimbine is very short (30 min), you can also experiment with more frequent dosing during the fast. For example, three dosages taken every second hour until your first meal. In that case I would probably not recommend starting with 0.2 mg/kg, since there will be a gradual buildup of the active compound. 0.15 mg/kg is a better starting point for multiple dosages in a relatively short time frame (every second hour).

An 80 kg male could use the following schedule.

7 AM: 12 mg yohimbine.

9 AM: 12 mg yohimbine.

9 AM-10 AM: 45 to 60 min walk.

11 AM: 12 mg yohimbine.

1 PM: Meal one.

Another option: AlphaBurn. Pure yohimbine may lead to feelings of anxiety and even panic attacks in predisposed individuals. A better alternative can be found in Alpha Burn, and other supplements containing rauwolscine, which is a stereoisomer of yohimbine. Reg from Predator Nutrition recently sent me a box of these and I can vouch for it's psychoactive effects not being as rough as pure yohimbine. While it won't make you as jumpy and jittery as yohimbine, it seems to have a pretty potent appetite suppressive effect. If you consider buying this, see my supplement guide to obtain a code, exclusive to Leangains readers, that gets you 5% off any order from Predator Nutrition.

4. Fasted Weight Training. Heavy weight training jacks up catecholamines very high and heavy training in the fasted state creates the most powerful response. Heavy training and fasting are both stressors to which the body responds with increased catecholamine output; in combination it seems the effect is synergistic. How can we combine everything mentioned up to this point and heavy weight training to facilitate stubborn fat loss? Like I've said in the past, I'm not a fan of using weight training as a means to create a calorie deficit. I also do not recommend training completely fasted, since that would be highly counterproductive to the anabolic response. But I've found a way around all this.

Protocol needed: Fasted Training (see the Leangains Guide for details).

We're going to assume that you're at the gym at 10 AM and break your fast at 12-1 PM.

10 AM: Training is initiated on an empty stomach and after ingestion of 10 g BCAA or similar amino acid mixture. This "pre-workout" meal is not counted towards the feeding phase.

10-11 AM: Weight Training: I suggest using a setup similar to reverse pyramid training, which is my favored approach. This is a high intensity, low volume setup. Keeping intensity high is key in order to reap the catecholamine-related benefits. Do 2-3 sets of 4-8 reps for compound movements and 1-2 sets of 8-10 reps for assistance movements (curls, triceps work, etc). Do no more than 5 movements per session.

11-12 AM: When you're done, which should be in no more than an hour, insulin (which was temporarily elevated by the pre-workout BCAAs) will be back to fasted baseline again. Immediately take 0.2 mg yohimbine and do 30-45 min of steady state cardio; cycling, treadmill walking at 3-3.5 mph (slight incline optional), brisk walking outside, etc. The yohimbine will rapidly take effect.

12-1 PM: Eat.

5. Carb refeeds. Refeeding on high carb meals, with a low fat content, will boost leptin and kick up hormonal output and metabolic rate a notch. It may sound counter intuitive for those not familiar with this concept, but it may in fact be just what you need to get past a fat loss plateau, or to see fat loss in stubborn areas. Much can be written about this, but Mark Sisson recently wrote an easy layman's guide to carb refeeds that you might want to check out if you need a quick summary of the benefits.

For a more thorough explanation of refeeds and leptin, I urge you to check out Lyle McDonald's excellent series on body weight regulation. There's plenty more on this topic on Lyle's site; just do a search for "refeeds", or "refeeding", and you'll be busy for hours.

If you follow my approach, as I've laid out in the Leangains Guide, you will refeed after every weight training-session.


Keep it simple

As a final note, keep in mind that none of the above mentioned strategies are essential in order to get to your desired level of leanness, assuming that entails a ripped six-pack. I've gotten myself and several clients very lean without supplementation, cardio, and with fed state training.

In the end, getting rid of stubborn fat comes down to patience. There's no "quick fix" solution. Only various strategies that may present some hard-to-define benefits in theory.

When determining what strategies you can use (and this goes for any diet), first look at what you can implement into your daily routine with a minimum of added effort. Don't go out of your way to find advanced strategies that increase the perceived challenge of your diet. That's always a recipe for failure in the long term.

Following up on my article about the fat fallacy and anti-fat propaganda of the 80s and 90s, I thought it would be fitting to cover the carbophobia of more recent times. The origins of carbophobia can be traced back to the late '90s. Just about the same time that the public was starting to realize that dietary fat was not to blame for our steadily increasing waistlines and failed diet attempts.

In this case there's not a single researcher or study that started it all. Our fear of carbs started as a consequence of looking for a new scapegoat to blame. Luckily, Heller, Sears and Atkins were there to satisfy our needs with "The Carbohydrate Addict's Diet" (1993), "The Zone Diet" (1995), "Dr Atkins' New Diet Revolution" (1997).

Let's approach this topic through an outside observer that had some strikingly accurate thoughts about low carb diets at the time they were starting to take off.

Malcolm Gladwell: straight talk about low carb diets



Twelve years ago, Gladwell hit the nail on the head in his analysis of low carb diets.

I found this incredibly insightful article by Malcolm Gladwell, who has written many great books, such as "The Tipping Point" and "Outliers: The Story Of Success". All of which I have read and strongly recommend if you have a remote interest in social phenomenons.

This article is called "The Pima Paradox" but touches on the popularity of diets that were becoming popular at that time (1998). He discusses "The Zone Diet", Atkins and "The Carbohydrate Addict's Diet" and I was really surprised to see how well Gladwell understood the underlying issues with these diets. They were all based on the hypothesis that lowering carbs and controlling insulin was what successful weight loss was all about.

Let me cite a few good passages. About The Zone Diet, Gladwell wrote:

"Does the Zone exist? Yes and no. Certainly, if people start eating a more healthful diet they'll feel better about themselves. But the idea that there is something magical about keeping insulin within a specific range is a little strange. Insulin is simply a hormone that regulates the storage of energy.

"...High levels of insulin are the result of obesity. They aren't the cause of obesity. "

Comment: He's right on the money. Studies show similar weight loss with widely varying levels of insulin and there is no evidence for high insulin causing weight gain. Weight gain and overeating causes high insulin, not the other way around. Some people in the low carb camp seems to believe otherwise, despite no evidence.

"What Sears would have us believe is that when it comes to weight loss your body treats some kinds of calories differently from others--that the combination of the food we eat is more critical than the amount. To this end, he cites what he calls an "amazing" and "landmark" study published in 1956 in the British medical journal Lancet. (It should be a tipoff that the best corroborating research he can come up with here is more than forty years old.)

"...Sears concludes from the study that if you want to lose weight you should eat protein and shun carbohydrates. Actually, it shows nothing of the sort. Carbohydrates promote water retention; protein acts like a diuretic. Over a week or so, someone on a high-protein diet will always look better than someone on a high-carbohydrate diet, simply because of dehydration. When a similar study was conducted several years later, researchers found that after about three weeks--when the effects of dehydration had evened out--the weight loss on the two diets was virtually identical. "

Comment: Again, right on point. Even today, 12 years after Gladwell's article was published, there's no compelling evidence that shows the superioriy of low carb diets in the long-term. Calorie-controlled studies always show similar weight loss when participants are followed up after 12 months (click here, here and here for examples).

"The key isn't how you eat, in other words; it's how much you eat. Calories, not carbohydrates, are still what matters.

"...The dirty little secret of the Zone system is that, despite Sears's expostulations about insulin, all he has done is come up with another low-calorie diet. He doesn't do the math for his readers, but some nutritionists have calculated that if you follow Sears's prescriptions religiously you'll take in at most seventeen hundred calories a day, and at seventeen hundred calories a day virtually anyone can lose weight."

Comment: This is key. A similar thing happens on ad libitum low carb diets. People reduce calories spontaneously if they're told to cut carbs out of their diet.

"Food in America has become a recreational activity. It is divorced from nutritional need and hunger. We eat to kill time, to stimulate ourselves, to alter our mood."

This is the main reason people are getting fatter all over the world. We can't isolate one single factor. Not fat, carbs or sedentariness. Our environment does everything to encourage weight gain by presenting us with an unnaturally palatable assortment of different foods that completely screw up our natural appetite regulation. And we don't have to expend an iota of energy in obtaining these foods. The pattern is similar in every area of the world where refined foods are introduced.

There are a few more interesting things being discussed in that article. If you're not keen on reading everything, at least hit "ctrl + F" and do a search for "The Photocopier Effect" and "Fat Mobilizing Substance". Malcolm Gladwell had more insight than the great majority of diet gurus and health experts out there at the time.


Note: While Gladwell discusses The Zone Diet above, I wouldn't really want to classify that as a low carb diet unless you compare it with the Standard American Diet. With 40% carbs, The Zone Diet should be considered a moderate carb diet. Besides that, the points made in the article are still valid (with the exception of his remarks about ketosis as potentially harmful, which is far-fetched and alarmist in this context).


My thoughts

Many years ago, when I was a broke student, I would eat tuna with almost every meal. Tuna on whole grain bread, tuna with rice, tuna in salad, etc. Since I was on a generic bodybuildingesque diet with 5-6 meals a day, I ate a whole lot of tuna. I did that for a few weeks and then one day found out that I couldn't eat a single bite of tuna anymore. I developed an aversion to tuna that persisted for many years.

That's how I feel about the low carb/insulin/metabolic advantage-hoopla. But in this case the aversion seems to be severe and permanent. That's why I prefer to let Gladwell speak for me. The topic has been beaten to death so many times over that I simply refuse to debate it any longer.

Why this aversion? I've done my part on this issue in the past. With more than 200 comments, "Low Carb Talibans" is still the most commented article on this site, with guest appearances by Tom Venuto, Alan Aragon and Lyle McDonald among others. Don't bother to resurrect the debate. Ain't happening.

Let me state my position on the issue of high carb diets versus low carb diets one last time.

1. Most people get better results from low carb diets for the simple fact that their diets improve when they make the switch. Protein and veggie intakes tend to go up a lot and this leads to much better satiety and diet compliance compared to a generic high carb diet. The latter also tends to be compromised of a greater amount of refined and high calorie density foods. When people think "high carb" they associate it with rice cakes, pasta and bread. When people think "low carb" they associate it with meat, eggs and veggies.

2. Is there a metabolic advantage to low carb diets? Of course there is. As protein intake makes up a larger percentage of calories consumed, diet induced thermogenesis (DIT) increases. A 2000-calorie diet compromised of 40% protein is superior to a 2000-calorie diet compromised of 20% protein. The difference would roughly be on the order of 95 calories in favor of the first diet. A small difference (small enough to not be detected in studies), but a difference nonetheless. However, the metabolic advantage is due to protein and not specifically related to the carb content of the diet like some people want to believe. If we compare a high carb, high protein (40%), low fat diet to low carb, high protein (40%), high fat diet we wouldn't see a detectable difference in DIT.

3. Some people do in fact feel better on low carb diets and it has nothing to do with the greater satiety from increased protein or veggie intakes. Just like some people feel better on higher carb diets. Problem is a lot of people tend to place themselves in the low carb-category without really having tried the middle ground. My experience is that a lot of people who readily label themselves as "carb-sensitive" do very well on a moderate carb-approach with the great majority of carbs coming from tubers, fruit, veggies and the occasional starch source.



My post-workout meal today: large grilled chicken breast, a pound of fried potato wedges and Ajvar on the side. Pound of slightly thawed strawberries, swimming in vanilla protein powder, as a treat. It's just a matter of time now before the insulin shock and fructose-overload sends me into coma and fries my liver.

Today, actually in the last year or so, I have noticed that the low carb-hysteria has waned a bit. It's gradually being replaced by the paleo-movement. While the paleo-movement has its fair share of extremists, it's still a shift towards a more productive attitude towards diets, as the focus lies more on unrefined foods rather than a specific macronutrient.

I was a carbophobe many years ago. Trust me when I say that it's ultimately a highly counterproductive mindset if you're looking to maintain leanness, performance and your sanity in the long-term. I'm lucky that I got out of it. Since a few years back, at the same time I started using intermittent fasting and developed the Leangains method, I have occupied the middle ground.

There is a place for both higher fat and higher carb intakes depending on occasion. The exclusion of either one macronutrient breeds a longing for the other. Eating sufficient amounts of each one on a regular basis is key. That's why Leangains is a cyclical diet. Low carbs, higher fat on rest days, higher carbs and lower fat on training days. In my experience this is just perfect.


Bonus material

* In Gladwell's article, I found one comment about leptin that really piqued my interest. Gladwell writes:

"There is also some evidence that if you can keep weight off for an extensive period--three years, say--a lower setpoint can be established."

I'm very curious about what research he refers to here. It would be great news for anyone looking to reach and maintain low body fat even though they might not have the genetic setup for it. I've maintained single digit body fat for the last ten years, despite being fat throughout my teens. Even though I have proven it possible for a former fat boy like myself to get lean and stay there, I haven't come across any hard scientific evidence for the possibility of lowering your setpoint. Very interesting.

* If you want to read more about low carb versus high carb, check out Anthony Colpo's dissection of the topic. The exchange between him and Michael Eades also makes for some entertaining reading if you have the time.

* Some people in the low carb camp claim that carb intakes have increased the last few decades while dietary fat hasn't. Which simply isn't true. On average, we're eating 600 calories more compared to the 1970s, with a higher added intake of fat than any other macronutrient. Adding to that, physical activity has decreased by 10%. Alan Aragon covers this in his latest Research Review. Some good reading.

* Lessons from "Low Carb Talibans":

- Trying to convince someone who doesn't really want to be convinced is a complete waste of time. Using studies to back up your point when your opponent doesn't care for it is even worse.

- Placing "Talibans" in the headline of an article is a good way to get tons of hate mail and alienate a large part of your readership.

- ...It's also a great way to boost traffic to your site dramatically.

P.S. Don't bother trying to resurrect the low versus high carb debate - I'm seriously through with discussing it. It bores me to tears.

Bad science breeds diet mythology. Somewhere along the way someone screws up. The screw-ups can range from borderline deception and outright idiocy to a more subtle kind that is not apparent upon closer scrutiny and careful reflection by a third party. Sometimes the devil is in the details.

In many cases the mass media is to blame. Dumbed down translations of results, coupled with soundbites taken out of context and comments from "experts," can easily distort the true meaning of a study. Sensationalistic headlines like "fruit is fattening" sells more papers than "HFCS in refined foods may cause weight gain".

Sometimes we are to blame. When looking for the next cutting edge diet strategy or pill to optimize fat loss and muscle gain, we tend to look for stuff that validates our theories or fantasies. We are prone to readily accept any evidence, however weak and vaguely presented, as long as it jibes with our own thinking.


Diet mythology

In this article series I am going to track the origin of diet myths and pinpoint where things got wrong. I thought it would be fitting to kick off with an old school myth that in some circles is still alive and kicking today. Even if it's old news to most of you, I hope you will find the origins of the myth interesting. It's an excellent example of how bias may warp the minds of scientists. Personally I find this stuff fascinating.

Future articles will reveal how people came to believe that breakfast is healthy, delve into the "30 g protein in one sitting"-myth, carbs and growth hormone, late night eating, among other things.


Fat, cholesterol and heart disease

I still see dietitians in the press media and television warning against the dangers of saturated fat. You have to wonder how long it's going to take until this myth finally dies completely.

The most notorious example of research gone wrong in the field of nutrition has to be that of Ancel Keys and his "Seven Countries" studies. I've mentioned Keys' groundbreaking work on starvation in the past: "The Minnesota Starvation Experiment", which resulted in the two-volume Biology of Human Starvation. Perhaps it was those impressive credentials that bought him so much trust and good will in the scientific community. As history would come to prove, even a brilliant mind like Keys's is susceptible to bias and error.

The birth of the fat fallacy goes back to the 1960's, when Keys started promoting a low fat diet to lower cholesterol levels. At that time he was in the process of finishing up the first study on cholesterol and heart disease. At this point he had convinced himself that there was a connection between fat intake, cholesterol and heart disease. He changed his stance slightly in the early 1970s , when he discovered that death in heart disease was best predicted by the intake of saturated fat specifically.

Keys needed stronger evidence for his hypothesis. Since he had already seen the connection in the "Seven Countries" study, it made sense to him that he would continue his work on the study over a longer time period. His findings were published in the 1980s and it was concluded that there was a connection between deaths from heart disease and serum cholesterol. Populations with a high saturated fat intake (U.S, Finland) had more deaths from heart disease, while populations with a low saturated fat intake (Greece, Italy) had fewer.

The fear of saturated fat had gradually been building up and reached its peak after the results of that study was made public. It was further compounded by studies showing a positive link between dietary fat, obesity and cancers in the early 1990s. By this time there seems to have been a mind shift in the public perception of fat - all fat was basically considered bad.






I wonder what Keys would think of the meal I had today: 1.2 lbs of fatty grilled pork rib goodness.


The mistake: Ancel Keys cherry picked his data to support a pre-existing notion he had about a connection between saturated fat, cholesterol and heart disease. Instead of choosing to continue his work in the seven countries from his original study, he should have selected other populations. When more and different data is added into the mix, the connection disappears. Keys seems to have been blinded by his own bias and wanted to validate, not investigate.

The consequences: Keys's findings resulted in the crusade against dietary fat in the 1980s and '90s. The message to the public was that dietary fat should be minimized and replaced with grains, and saturated fat replaced by unsaturated fat. Everyone started doing low fat, high-carb diets. On a related note, Keys's study also gave birth to the Mediterranean diet and the notion that people should adopt a diet rich in monounsaturated fat.

The truth: Many of the old theories about dietary fat and disease have now been contradicted by more rigorous studies that dispute the results, but it wasn't until about ten years ago the tide started to turn. It is now quite clearly established that there is no clear connection between fat intake, weight gain and many of the aforementioned disease states. Unfortunately Average Joes and Janes, especially those 40 years and older that don't spend their time debating nutrition on Internet forums, still think fat is "unhealthy". At least those I converse with.

Note: There are many nuances to Keys's story and I've only given a brief summary of the events which lead to the fear of cholesterol and fat. One book that covers the topic in great detail is Anthony Colpo's "The Great Cholesterol Con". It's an impressive piece of work and an excellent read.


Thoughts on dietary fat and diet

Fat gain, heart disease and other modern maladies has everything to do with caloric excess and much less to do with dietary fat or any other macronutrient. For those of you who spend time nitpicking about what fat sources to eat for optimal health, consider this.


1. Reach and maintain the lean state first and foremost

Because for health, everything else is secondary. Lean people nearly always have excellent health markers. If you focus primarily on reaching and maintaining a lean state, your metabolic profile will be much better than if you had focused on perfecting the fat composition of your diet. Unfortunately, I know many people for whom the priorities seem reversed. Barring extremes it's an indisputable fact that fat loss does more for your blood lipids than weight maintenance with better fat sources.

Use whatever means you want to reach the lean state; whether you use a low-fat or high-fat diet is secondary to you reaching that objective. Then, maintain the lean state by adding weight slowly. An added bonus of that approach is that more of it will be muscle and less of it will be fat.

Adopting a whole foods approach helps in this endeavour. As it happens, the fat composition of a whole-foods diet is also favorable for health.

Everything is a go if it's an unprocessed food. Dairy is also fine. But eat only food you like and can live with in the long term. Is it not self-evident why am I telling you this? It seems not, because I often hear about how people force oil down their throat even if they hate it. So, if you don't like fish, eat beef. Can't stand avocados, eat eggs. You get the point.

Refined foods with a high fat content should not be an everyday diet staple. Besides diet compliance, there's the issue with trans fats and industrially processed oils present in these foods (which is what people should be concerned about).

My ideas on how to best approach maintenance of the lean state has been outlined in this article.

2. Eat fish or add fish oil to your diet

Even if you get your fats from unprocessed foods for the most part, your omega-6/omega-3-ratio is likely to be skewed towards omega-6. Unless you eat fatty fish on a regular basis, I would advise to add 3 g of fish oil per day. Doing so is prudent and may have modest health benefits in the long term.