On Good Calories, Bad Calories: Your questions answered Part I

Do you have an opinion on this idea of YMMV?

My problem with YMMV is it avoids the question of what causes weight gain and diabetes to begin with. This was the question that I set out to answer and my conclusion is that the evidence is compelling that we get fat and become diabetic because we eat refined and easily digestible carbohydrates and, perhaps, sugars in particular. In this sense, I use cigarettes again as a metaphor. Not everyone who smokes gets lung cancer, but 90 to 95 percent of people who get lung cancer do so because they smoked. So we can say with certainty that cigarettes cause lung cancer. The same is true here. Not everyone who eats these carbohydrates gets fat and diabetic, but those who do get fat and diabetic, do so because they eat these carbs. There is certainly a genetic component to obesity and diabetes, but those genes seem to determine how we respond to the carbohydrates in the diet. I also note in the book that physical inactivity is likely a result of this predisposition to fatten when we eat carbohydrates, rather than a cause. Thus telling someone who is fat to exercise misses the point. If you tell them to avoid carbs, they will free up fuel from their fat tissue and this will give them the energy they need to be physically active. Ultimately, if the conclusions i came to in my research are correct, than obesity, diabetes, heart disease, some cancers and even the tendency to be physically inactive are all caused by the quality and quantity of carbohydrates in our diet. If we want to maximize our likelihood of remaining lean, active and healthy, the way to do it is to avoid these carbohydrates. Just as if we want to avoid lung cancer, the best way to do it is to avoid cigarettes.

Most people who go on low-carb diets find that their fasting lipid profiles improve, by which I mean their triglycerides go way down, their LDL levels go down (although most aren't tested for small, dense vs light and fluffy), and their HDL levels go up.

However, there is some evidence that postprandial lipid levels are strong predictors of heart disease. And if you eat a low-carb, high-fat diet, your postprandial lipid levels may increase. I actually measured my own triglyceride levels with a home meter after a low-fat day and a low-carb day, taking readings every hour when I was awake. The results are shown in the second edition of my book The First Year: Type 2 Diabetes. Of course, this was a sample size of one and hence not definitive.

What I found was that with the extremely high fat breakfast that I used as a test (much more fat than I normally eat), my triglyceride levels after breakfast were off the charts. But by the next morning, my fasting triglyceride levels were lower than they had been the day before. With the low-fat, high-carb (pasta) breakfast, my triglyceride levels first started going down but after about 6 hours started rising, and by the next morning, they were higher than they had been the day before.In other words, if I'd had the standard fasting test, it would have said my lipid profile improved on the low-carb diet (lower fasting triglycerides), but that improvement would have been at the cost of extremely high postprandial levels.