Paging Gary Taubes: The man behind Good Calories, Bad Calories answers your questions

What  is Gary Taubes  choice as a recommended sweetener for diabetics?

Verdungal

First, I would like to thank you for writing your book. Very few people have the time to sort through the number of research papers you read, not to mention tracking down and interviewing some of the researchers involved. The rest of us have benefited from your work. Thanks.

 

I have a zillion questions, but I don’t want to monopolize your time, so I’ll focus on the main points, breaking them up into several posts so the titles can indicate the topics. To clarify my own position, I have been a lowish-carb diet to control my diabetes for about 9 years, and I support that viewpoint. But I’m also open to new ideas.

 

Your goal was, I think, to show how the currently accepted low-fat dogma came to be accepted, and how the evidence used to promote that dogma was weak. You then present evidence suggesting that limiting carbohydrates, especially high glycemic index carbohydrates, may be healthier. I think your book is aimed at the overall American population, not people with diabetes.

 

In general, I agree with you. But I also support what we on the diabetes lists call YMMV, or “your mileage may vary,” meaning that metabolism is very complex and we all have different genetic makeups. So a diet that works the best for me might not work the best for someone else. Some people find that fat has a bad effect on their blood glucose levels and they do better on low-fat diets. Others find that any carbohydrate makes their blood glucose levels soar, and they do better on low-carb diets that include a lot of fat.

 

Most people who go on low-carb diets find that their fasting lipid profiles improve, despite eating a lot of saturated fat. Others find that their lipid profiles get worse unless they limit the saturated fat and eat more monounsaturated fat instead.

 

We all know people who can eat whatever they want and remain rail thin. Others just look at a carbohydrate and put on pounds.

 

I think that perhaps people fortunate enough to be born very insulin sensitive can eat very high carbohydrate diets without causing harm. Those born with a lot of insulin resistance will quickly put on weight when their carbohydrate intake is high, especially when their activity level is low.

 

Do you have an opinion on this idea of YMMV?

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.

 

In your exhaustive reading, did you come across much that would address this issue?

I understand that the tome you published was actually pared down from an original manuscript of more than 700 pages. Will there be any way that those of us who are interested in this topic will be able to access the information that you left out of this book?

Good Calories, Bad  Calories is a seminal work. It has become a touchstone in both my professional world and personal life. Your book should be reuired reading for all health care professionals, starting with diabetes educators.

My question:

I understand even more clearly now why keeping insulin levels low is primary to optimizing health and how to accomplish this. However, besides carbohydrates, there is another dietary source that also causes insulin resistance: high AGE foods. In researching this book, what did you find re: this subject?

I have been living on a low carb diet since being diagnosed with T2 diabetes 6 years ago. I have lost over 160 lbs & have the disease in very tight control with a usual A1c at 5% or close to it. I am still 30 lbs overweight at 5 ft tall & cannot lose any more no matter how low I cut carbs. I see no way around counting calories to lose these last pounds but my calorie needs are so low that I am intensly hungry all the time which is defeating me. What do you suggest? Thank you for your consideration, cappie

... has no practical utility.

 

Therefore, calories are neither good nor bad...

 

... they are simply useless.

 

Looking forward to Mr. Taubes fielding this comment.

 

In the interim, suggested reading:

 

http://HeartMDPhD.com/EatLess

 

Be hungry... be healthy... be hungrier... be blessed:

 

http://TheWellnessFoundation.com/BeHealthy

 

Andrew (HeartDoc)

--

Andrew B. Chung, MD/PhD

http://EmoryCardiology.com

Dr. Richard K. Bernstein is the diabetes guru of low carb. I notice that you don’t mention him in your book.

 

What do you think of his recommendation that we limit our carb grams to 6 grams of slow-acting carbohydrates at breakfast, 12 grams at lunch and at dinner, plus 12 grams for a snack (Dr. Bernstein's Diabetes Solution, 2007, p.  169 and 172)?

Did you find any research about essential fatty acids affecting insulin sensitivity?

My wife tells me that Overeaters Anonymous used to advocate getting rid of carbs (she still has the old recipe book) but now has allowed a variety of diets, including those that conform to the low-fat guidelines promoted by the government. Is there a story behind this shift?

Also, everything you say about non-Western diets fits with the Paleolithic diet. Any comments on that diet?

In some follow-up reading, I ran into the concept of the insulin index, which purports to index the insulin response of foods.  This index appears to indicate that certain protein rich foods (like beef and fish) may actually have more impact on insulin that certain carbohydrate foods.  This is counter-intuitive based on the science that Gary writes about.  I would be interested to know whether Gary has any comments about this index.

 1. I read somewhere that despite their high-protein, low-carb diet, Eskimos living their traditional lifestyles don't go into ketosis. Do you know if anyone has ever studied this among the Masai, another population with a traditionally low-carb lifestyle?

 

2. You said that the Masai living a traditional lifestyle, despite their low cholesterol levels and lack of coronary heart disease, have extensive atherosclerosis. Is this atherosclerosis more or less extensive than that found among populations living a traditional lifestyle with a high-carb diet?

 

In one of your interviews you said that after the exhaustive research for this book, you only believed about 40% (I may be misremembering the number) of what you wrote in your article What If It’s All Been a Big Fat Lie? Can you indicate what you said in that article that you no longer believe?

 

Some people might not get through this new book and would read the shorter article instead.