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.

Given that my post Low Carb Talibans caused such a stir, I thought it would be appropriate to link Lyle's latest article about low carb diets and the "metabolic advantage" Enjoy, folks.

If you consider buying any of Lyle's books, which you should, make sure you read my reviews.

I subscribe to the idea, that the best diet is the one you can maintain in the long run.

For me personally, this entails intermittent fasting and a cyclic approach of higher/lower carbs, plenty of protein and low/moderate fat. My main focus lies on high quality foods, with nutritious and satiating properties, and not discrimination towards a particular macronutrient.

I don't believe there is any magic to be had when one is excluding fat or carbs from their diet. Both have their place. However, there are people that subscribe to a completely different set of opinions.

After watching the documentary Religulous
(melding of "religion" and "ridiculous) yesterday, it dawned upon me how much some religious fundamentalists have in common with certain nutritional fundamentalists. In recent years, I have seen the rise of one group in particular. I prefer to call them the low carb talibans.

When I am using the term 'fundamentalist' here, I am using it to characterize religious advocates that cling to a stubborn, entrenched position that defies reasoned argument or contradictory evidence - I am not talking about religious people in general, and I don't have anything against them.

1. Religious fundamentalists believe in supernatural beings. Low carb talibans believe you can get fat without a positive energy balance, if you eat carbs.

Similar to the anti-fat proponents 15-20 years ago, we now have one group of people blaming one particular macronutrient as the sole reason for why people are getting fatter.

2. Religious fundamentalists base their beliefs on faith, not empirical evidence. Low carb talibans believe that dietary fat is unimportant for the development of obesity; the most jaded lot believe that you can eat an unlimited amount of fat, without weight gain, as long as carbs are excluded from the diet.

The 'rationale' behind this claim, is that the body can’t store fat without insulin (it can). Carbs equals insulin, and that means ditching carbs must mean no fat storage (wrong). They conveniently ignore that

a) eating protein produce insulin
b) fat stores itself with tremendous efficiency without insulin, due to a nifty little thing called acylation-stimulating protein (ASP).

3. Religious fundamentalists believe that forces of evil hide amongst us, trying to lead us into temptation and wrongdoing. Low carb talibans belive that carbs and insulin are to blame for obesity.

We live in an obesogenic environment; we lead sedentary lives and we are surrounded by easily obtainable foods with high energy density. High carb, high fat foods which taste great, and are extremely easy to overconsume. That people gain weight in such a setting is no great mystery, yet the low carbs talibans likes to make it out to be. It is the carbs specifically that made you fat, not that peanut butter jar you went through watching tv last night. Yes, that seems to make sense.

4. Religious fundamentalists believe there is only one way, and all other faiths are heretic. Low carb talibans tries to push their beliefs on others and will seldom accept alternative views.

More than one time, I have seen the talibans make the most ludicrous claims about their approach, often not accepting the fact that some people actually function better on a higher carb approach, and that people involved in anaerobic sports actually need them to perform better.

5. Religious fundamentalists do not accept current ideas of the creation of earth or human evolution, rather they make up their own stories of how we came to be here. Low carb talibans make up their theories regarding human metabolism.

Here's a quick primer on how it works.

Dietary fat is stored easily as body fat without the presence of carbs or insulin.

Fat metabolism increase when fat intake is increased, but it is primarly dietary fats that are burned off, not fat stored in adipose tissue. For the latter to occur, energy balance needs to be negative. Energy can't just disappear and an excess is stored*

When carbs are consumed, metabolism switches to glucose dependence; that is, while carbs do not get converted to fat**, they do inhibit fat metabolism to a point where dietary fats are more readily stored.

One can say that overconsuming dietary fat leads to fat storage through a direct mechanism, while overconsuming carbs leads to fat storage through an indirect mechanism, through blunting of fat metabolism/lipolysis. Either way you cut it, the key point is that energy balance is the main determinant for fat storage, or fat loss.

* carbs can only be converted to fat by a process called de novo lipogenesis (DNL). This metabolic pathway is very ineffective in humans and in studies it only comes into play during massive carbohydrate overfeeding. How come people still got fat from eating all those low fat foods back when low fat was the craze? Well, the body has the ability to upregulate key enzymes involved in the DNL pathway, making carb to fat conversion more efficient. And this occurs on high carb/low fat diets. So, there is no tricking the body from gaining weight during caloric excess by excluding fat or carbs from the diet.

** metabolism does increase a bit when energy consumption is increased; just a few percentages, nothing drastic (called 'luxusconsumption' or adaptve thermogenesis by some scientists). Ironically, this effect is greatest when the extra energy is provided from carbs, not fat.

Why low carb really works

I have extensive experience with all forms of low carb/ketogenic diets. I’ve done them all, the traditional standard ketogenic diet, the cyclical and the targeted ketogenic diet. I've come to the following conclusions:

1. There is a mild hunger blunting effect on ketogenic diets, which may help intially. This has to be weighed against the deprived feeling you get from not consuming carbs and the decrease in performance during weight training. This can be partially amended by doing a cyclical ketogenic diet (CKD) or a targeted ketogenic diet (TKD), where you either carb load through the weekend or consume carbs in conjunction with workouts.

2. Making the diet highly restrictive, in terms of completely cutting out one macronutrient, may help with adherance. It certainly takes away the hedonic aspect of eating.

Studies actually show that diets which allow ad libitum intake of protein and fat, usually leads to a spontaenous reduction of calorie intake. Cutting out carbs from the equation may be a sound approach for the average joe, who's idea of carbs are in the form of cereal and white bread. IME, you're less likely to binge on egg omelettes and ham, as opposed to chicken and pasta.

3. When people start eating low carb and lose weight, it is partially because they start eating more protein than on their past (failed) diet approaches. Protein leads to better satiety than any other macronutrient. There's also the issue of being forced to make sound food choices overall, such as increasing veggie intake to make up most of your carb intake in order to stay below the threshold (max 50 g carbs/day usually).

4. And of course, there is also the insulin sensitivity/resistance factor to consider. Some people do in fact feel better on ketogenic/low carb diets, for physiological, not behavioral, reasons. No energy dips, hunger pangs and so forth. ***

*** However, as I see it, people have a tendency to draw the conclusion that they need to follow a low carb approach without having visited the middle road. I've had some clients that were convinced they could only do well on low carbs - and it turned out they did just as well, if not better, when I incorporated veggies, fruit and berries as their main carb source. The middle road, with a minimum of refined carbs, is very workable for most people that label themselves as 'insulin resistant'.

Anyway, rant over.

For an unbiased guide to ketogenic diets, free from voodoo science and 'make believe' physiology, I urge you to check out The Ketogenic Diet, by Lyle McDonald. My review is here.