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?

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?

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)?

 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?