This is everyday Wellness, a podcast dedicated to helping you achieve your health and wellness goals and provide practical strategies that you can use in your real life. And now here is your host nurse practitioners. Cynthia, Thurlow
I'm delighted today to have Gary tobes. He's an award-winning science and health journalists co-founder and director of the nutrition science initiative. He is the author of the case against sugar why we get fat and good calories, bad calories. And most recently, the case for Quito, he's a former staff writer for discover and correspondent for science. He has written three cover articles on nutrition and health. For the New York Times magazine, and his writing has been featured in the Atlantic Esquire and numerous best of
Anthologies, including the best of the best American science writing. Welcome Gary. It's a pleasure to connect with you
today. Thank you for having
me. I would love to understand and appreciate how an engineer got from. You know, doing an undergrad and graduate degree in engineering, kind of ending up in science, writing with that, just a natural extension of graduate school or how did that process actually
happen. Well first of all I wasn't very good, you know, be student and physics.
And Engineering. So that was clearly, I even had an advisor who after I got a c-minus in quantum physics and college suggests that, I find another career path. I was always interested in journalism. So I went to journalism School Columbia and then when I got out the jobs I could get were science writing, I wanted to be an investigative reporter as a science writer at Discover magazine. It turned out that there's a lot of very sort of questionable poorly done, science out there and we see this condensed now with the covid debates.
Back then it was a little easier to get a handle on. And so, I started my first two books, her about first physicists and then chemists and nuclear physicist, who discovered non-existent phenomena. I became obsessed with how hard it is to do science, right? So that's sort of the, you know, whatever people think of my nutrition and chronic disease writing, I think it's safe to say I'm one of the world's leading experts on bad science or what physicists would have called pathological.
Logical science. So after my second book we physicists friends said, if you're interested in bad science you should look at the stuff in public health. It's terrible. And so I moved into public health writing mostly for the journal science and the early 90s and by the late 90s, I had stumbled on the nutrition world and did a series of investigative articles first on this question of whether salt causes high blood pressure which is still like just Bedrock conventional nutrition wisdom. And there's just the
Tends to support that belief is just at best ambiguous and then the issue of dietary factor causing heart disease. And again interesting hypothesis that doesn't pan out. It's like they you know kind of man's Hokies in the 50s. Has this idea that dietary fat causes heart disease and the government funds, a few hundred million dollars worth of studies and the studies don't actually confirm the hypothesis, but we're so invested in it. You know, when they have your government spends, 200 million dollars,
Or in this case there was a hundred and fifty million on one study a hundred and twelve million on another. The assumption is, unless the study confirms the hypothesis, you wasted the money, it's a very odd way to think about it anyway, that got me into obesity and what the causes of obesity is and I had this first Infamous New York Times magazine article, and then spent Five Years on my first book, good calories, bad calories, and I have not been able to
Get out. I'm like Al Pacino and Godfather 3 I'll be writing about this until I fall off the stool someday. Hopefully, later, rather than sooner.
Well, I'm so glad that you're doing the due diligence because as a clinician, you know, my whole career was an ER medicine and Cardiology first as a nurse later as a nurse practitioner. And for me so much of what I was telling my patients was what we were conventionally taught in school, which I even attended a top research.
See, on the east coast and even, we weren't getting it right in terms of what we were suggesting to our patients. And I'm so glad that there are people, like, yourself that are doing the due diligence, so that it can help, you know, shift perspectives, because obviously, with escalating rates of obesity, largely tied into the foods that were choosing to eat. It's really of Paramount importance. So let's focus. First on. Why calories are irrelevant? I think that this is probably one of the most common I know.
Smiling, one of the most common questions I get from other women as well. How many calories do you today? And how many calories do you suggest I eat? And I tell them, I don't track any of that. I'm much more focused on Macros, because that's what our body recognizes as opposed to this unit of measurement. So I would love for you, I know dr. Fung dispelled, this also when I interviewed him but I'd love to get your take on it as well.
Yeah, and it's the most, it's so the essence of how we think about obesity writers,
And then fat accumulation is caused by taking in more food than we more energy than we expand. And then we get to know calories of the way we count energy. This idea goes back to the early years of the 20th century back. When the only thing they could measure was how much energy was in foods and how much energy people expended. So they thought the disconnect the difference might explain obesity and again, it was an incredibly naive way to think about it. So that's medical research at the time. And
1920s 1930s was going on in Europe in Germany and Austria and in Germany and Austria. The research saying look we know that obesity fat accumulation is controlled by hormones like men and women fat and differently, you know, we go through puberty, we lose fat and gain muscle. You guys gain fat and you gain fat in very specific places. You know, you get pregnant, you put on fat and you put on fat below the waist. Because if you put on fat above the waist, like men do with the babies, you would be unbalanced. So evolution.
Ocean or nature, whatever designed it, so that you can add fat. So, when the baby's born, you could feed the baby and you've got po, even if there's a famine, when the baby's born, you have fuel available that you've stored, so you can feel and it's, you know, so all this is controlled by hormones. But if you have excess fat the idea, it's got that way. Just because you eat too much. You know, the argument I've been making and the Jason has been making his look clearly. All of this is a hormonal problem and there are other ways to think about it, sort of, and I
This in the case, for Quito to quantify how silly this calorie problem is. So, for instance, you know, if you've gained 30 pounds of fat, between high school and say, 45 years old, and your best friend has remained the lien. The difference is, is that you stored 30 calories, a day and your fat tissue 30 calories a day that they didn't. So, you're overeating, however, much you are supposed to overeat or however much you're supposed to control your caloric intake, the problem.
Is that your fat tissue is holding on to 30 calories everyday too much like a after you eat the fat, you eat gets stored temporarily. So say during the course of the day, maybe we'd 1500 2000 calories and half of that's from Fatso. Your fat tissue will store 750 calories. And at the end of the day, it's only release 720 of them to be used for fuel and the 30. That's left is a difference between you being overweight and your best friend being lean. So, now you can ask the
What controls, whether or not those 30 calories, get out or not, that's a hormonal question. It's not a, how much you weight or exercised or counting your calories question? Because you can count your calories and your fat tissue will still trap that fat. So, if you think about it like that, and it medical community religiously, refuses to do so. And then you're asking what hormones connect, what you eat to, how much fat you accumulate math, that's been known for
Good years, depending on how you want to look at it, and it's primarily the hormone insulin. So, now, we've gone from talking about calories to talking about
hormones. It's absolutely critical. I mean, unfortunately, whether or not people want to, you know, change and shift, the Dogma that they grew up with. I'm a huge disrupter. I am someone that constantly is asking why which sometimes gets me in trouble, but I think it's really critically important that people understand that, you know, a lot.
Out of the fat shaming that we see here, you know, not just in the United States. I know that it was you know really prevalent when we were traveling abroad, but when we're thinking about how that actually takes place, it's not about someone not having enough initiative. It's not about someone being lazy. It's really about this hormonal dysregulation. That goes on in the body and you mentioned insulin. And unfortunately, I think it's one's gotten a bad rap, insulin isn't all bad and so
So you know, when you're talking about your unpacking, this whole concept of what's driving obesity. Let's talk a little bit about insulins roles in the body and how it impacts our ability to, you know, utilize, you know, fat for energy and store fat for energy.
Yeah, I want to get back to one point though. You made a bad fat shaming because one of the problems and this is an argument. I also make in the book once we decided that obesity is caused by eating too much and then you quantify the
Right? So like I said, you're 30 pounds overweight, your best friend's lean, you stored, 30 calories, a day, and your fat tissue that he or she didn't. That's that's like three bites of food. It's to almond stead border of a taste tablespoon of Allah or teaspoon of olive oil. I mean, it's just, it's a tiny amount of food. And so then the natural thing to ask is, why did you store it and somebody else didn't. And so if you think it's cause because you ate too much, then clearly you just don't care enough, right?
Right, to eat less or you're too ignorant to realize. There's no way to explain that without shaming. The person who's got the excess weight and if you think it, you know, there's its counter argument that it's a hormonal issue. Then while some people are predisposed to get fat and other people aren't, there's just no way to get around it. I had a brother. I have a brother who was always lean. I was always thick we were built differently is a wonderful new book out. I'm in a heartbreaking book called what we don't talk about. When we talk about that by a young.
Audrey Gordon. And she suffers with severe obesity and she says, look some people are just built that. It's all there is, it's not the nothing in almost any food environment, any modern food environment, they're going to have excess fat, it's not about. Yeah, as you put it, it's not that they're lazy. It's not that they're gluttons. It's not that they don't pay attention to how much, they'd usually people who suffer with obesity, pay more attention to what they're eating.
And then the rest of us, because they have to Roxane Gay rights about this in her Memoir hunger. When she's going on a plane friend offers her. I says, you want to potato chips, go on the plane and Roxanne weighed over 300 pounds. She said, no, you don't understand. People like me. Can't, we can't be seen eating in public because then people draw conclusions. So the very nature of this idea that obesity is caused by taking too many calories and weeks pain leads to all the fat shaming.
Whereas if we had accepted this idea that it's a hormonal, this regulation, then you, then the job is understand what hormones regulate fat accumulation. Now we're back to insulin, which was your question. So, I think of insulin is the hormone that regulates a hormone that regulates fuel partitioning in the body. So you eat mix meal with fats carbohydrates and proteins and your body wants to maximize utility of all those macronutrients and that's terrific.
For storage because it's a dense as calories. Protein is used for repair and growth of cells and tissues and membranes on carbohydrates have no use in the human body except for energy. And when your carbs are high blood sugar is high, that's sort of toxic State. That's most of the Damage Done and diabetes is done from high blood sugar. So your body is working very hard to keep blood sugar under control, which means the insulin is telling your fat too.
To store the fat, you've consumed? Remember I said that virtually all the most of the fat you eat during the day gets stored for the short-term immediately and then it's telling your the protein to be used for growth and repair, so it's serving sort of as a growth factor and its stimulating, other growth factors like insulin-like growth factor and then it's telling the body to burn carbohydrates. And the problem when it becomes a negative thing is when we have to, and when we become insulin,
Assistant and we have too much insulin elevated in our bloodstream and then it's constantly telling your fat to hold onto fat cells and burn carbs for fuel in a mode where you're storing fat from far more of the day than you normally would. And so it's a you know, it's a hormone that has that we can't live without clearly is in type 1 diabetes, it's extremely beneficial but when it's dysregulated, then it starts to do damage and that damage includes excess fat accumulation. And
Ali manifest his diabetes type 2 diabetes.
Do you think a lot of the shift here in the United States was a direct result to the methodologies of ancel keys? I know that we've had several guests that have touched on ancel Keys, including Nina, take holds, whose podcast will be released tomorrow, but I reflect back on how much his perspectives and policies really have been profoundly.
All to the health of us here in the United States. And so I would love for you to kind of touch on his shift on, not wanting to focus on sugar, being this profoundly inflammatory substance and instead wanting to bastardize fats and let me be very clear to all the listeners. I always feel like I have to say this, you know, I was schooled in the 90s and started practicing as an MP in the 2000. And we were still at that point in time. Especially in cardiology saying fats, bad you have to use all these fake fake.
Fat's, you know, now, I know better, but I think it's really important because those changes, you know, shifting Focus from sugars to that bastardization has forced, you know, the processed food industry and forced, all of us to think of fat is a bad thing. And so, in many ways, when I reflect back on 80's 90's and beyond that start of a lot of these policy changes where they want us eating heart, healthy and Grains, and people are hungry all the time because they're not eating much fat. In their diet is very
Hydrate focused. And so I would love to get your, you know, taken perspective on what you think of ancel keys policy.
This is what got me into obesity. So all I was doing this article on dietary fat which took me the better part of me. It took me a year and effect. I interviewed the a hundred and forty-five researchers and administrators for one magazine article in the journal science and realized. As I was doing this again to learn about the influence of an toki's and others that there was they there again, the, the idea that
Dietary fat caused heart disease and saturated, fat raises LDL cholesterol, and that increases causes atherosclerosis was an interesting hypothesis that had been tested in a numerous trials and, you know, few of the trial suggested that people a lot of saturated fat compared to unsaturated fats, had more heart disease, but they also tended to have more can or less heart disease. Well, the view of anyway, this is some of the studies confirm this idea that saturated
Was bad. And some of them refuted the idea that saturated fat was bad, but the government was so invested. As I was doing that, there was a researcher an administrator at the National Institutes of Health. Who told me we were actually having coffee at the Starbucks at the corner of Falls Road and River Road with home ethnic and then the Washington DC suburbs. And he said, look, you know, we thought when we put the country on a low-fat diet beginning in 1984, we thought if nothing else we would solve the Obesity problem because we're putting them on the least, you know?
The fat is a dentist calories in the diet, their nine calories per gram of fat compared to 4. So if he eats less fat will consume less food and you'll wait less and when we that was, you know, our fallback position. We didn't know what it would do for heart disease. You know, we were clear about the studies being ambiguous but we figured I'll make people leaner and if people get leaner they'll have less heart disease and instead we have an obesity epidemic and people ate more carbs. They replace the fat with carbs and they got fat
So that was when I started this New York Times magazine story. That was my one of my hypotheses. The idea was, what's the cause of the Obesity epidemic. And here, I had this administrator, the National Institutes of Health suggesting to me that it was their policy to tell the whole country. And So what had happened in the US and there's the ancel keys. Story is ancel keys and University of Minnesota nutritionist, comes along in the 1950s with this hypothesis that dietary fat causes heart disease.
He's it's based on, you know, work that he and his wife had done in Naples, sort of very amateurish studied where you look at people with heart disease and people with that, you measure their cholesterol and you get some idea what they're eating and decide this an interesting hypothesis and ancel keys. A very energetic motivated man who wouldn't take no for an answer. He's a kind of man, that would be described as not suffering fools gladly and he would Define a Fool's anyone who disagreed with him and he
Is through force of, will convince the government and the research community that this hypothesis was almost assuredly, right? And they just had to do the right clinical trials, or studies and they could demonstrate that it was right. And it turned out that it inflicted in time with the British hypothesis, which is that. So it's interesting way to look at it in science. I would someday like to write a book about good science and bad science and in
That's the critical thing to do is to ask the right question because the question you asked to terminals. The answer you get. So what ancel keys wanted to know is why was there so much heart disease in the United States and Minnesota where he was practicing medicine as well as being a nutritionist and maybe in Italy why did the rich people have more heart disease in the poor people. And so this is a question he asked and the answer was well, because we too much saturated fat, and dairy, and meat and so and that raises our
Cholesterol. But simultaneously, there was a British hypotheses and the British had the British Empire. So they had Colonial and missionary hospitals all around the world and all around the world. They were seeing the same thing which is regardless of the population that was being served, so it could be agrarian populations in Asia or pastoral populations living on you know panel in Africa or Inuit populations living on whale meat.
And caribou and CEO and wherever it is. They were healthy until they transition to the Western diet and then once they have the Western diet then they start manifesting heart disease, obesity diabetes, cancer. This whole cluster of chronic diseases and the transition to the Western diet was basically you add sugar and white flour, who whatever their Baseline diet was. So their Baseline diet could be very high in saturated fat, like the pastoralists. It could be high in unsaturated fat, like,
And you had said, could be relatively low in fat, like the southeast Asians and you add sugar and white flour and you get the Obesity diabetes, heart disease and a whole cluster of chronic diseases that became known as Western diseases. So the British had this theory that the problem is sugar and flour. Alright so the first by a US Naval Research or named Peter cleave and British Naval Research or and then John Yadkin the most prominent British in European.
- took it up and pushed it as a sugar. Hypothesis sugar only piss cleave off. Because kleber said look, we've said he was testifying to the US Congress. He said I could pick the hundred artists men in a five-block neighborhood of the US Congress and there wouldn't be a sugar either among them they don't be beer drinkers so we can't just blame sugar anyway. So that was it. The British hypothesis pushed by odd can saying. It's sugar and maybe white flour.
Keys in the u.s. is pushing the fat hypothesis. The US had all the money that's Europe was still digging out of the second world war and they had other things to worry about, still in the 1960s. So funding was much lower. So, he's did the biggest studies. It was a political social conflict. There wasn't based on the data and then in the u.s. there was a very active sugar lobbying that Nina, you know, I've written about my books and the sugar
Obby was pushing the fat hypothesis right. You know that clearly if everyone thinks it's fat and sugar must be benign. So by the 1970s, the fat hypothesis had kind of one out and that was it, the sugar hypothesis. Sort of fell into hibernation went into remission for 30 years until people like myself and dr. Robert Ludlum, lustig at the University of California, San Francisco started saying maybe it's sugar and not found, but no.
He will none of us knew this when I was growing up, when I was eating a low fat diet through the 90s, I had no idea about any of this that I, you know, I was consuming an awful lot of sugar on my very healthy mostly plant low-fat diet because like all of us we thought you know the problems saturated fat and salt and as long as we avoid those will be healthy and it's the interesting thing is books. Now come out what happened to what I wrote my investigative articles and the New York Times magazine
In pieces on my first book, this was kind of news. And then Michael Pollan picked up on it a little bit. Even and said, this is, you know, this is important stuff and then Nina took it even further with her book, The Big Fat Surprise and got Accolade that I couldn't get seven years earlier because what I was saying was too controversial, so we've managed to the sort of shift the thinking so nowadays, it conventional wisdom, right is, the problem is processed foods, which means processed grains and vegetable oils.
Sugar's, that's the sort of, you know, the Zeitgeist but the establishment still is pushing low fat. Low saturated fat. Diets is Nina will have said, and the dietary guidelines are still pushing those in the American Heart Association, the public is still afraid of fat, you know, they don't know. But we know, even though they're in books, Nano and multiple books and they said world of low carb and ketogenic diet books that are out there and new ones coming out every month and there.
All saying the same thing but this sort of History, just Fades back into the history and people think this is an interesting opinion but they're still going to worry about the saturated fat in their diet because that's what they've been told their whole life.
Well, there's not a day that goes by that. I don't get a direct message on Twitter or Instagram or Facebook, someone's fearful of my life because I'm eating butter. I'm eating steak, but admittedly I have a house full of all boys, so there's a lot of meat consumption in my home, but I think you
I'm such a great point that it takes a long time for Dogma to shift, and it takes a long time. If we, if the conventional wisdom has been for 20, 30 plus years, that fat is bad, people are afraid of eating fat. And I know this, because I have conversations with my own family members, my mother, whose Italian trying to convince her that she needed to liberalize or avocado use and not be afraid to eat some nuts and not be afraid to use coconut oil or, you know, MCT oil mean it completely blew her mind.
Mind and especially I think women of a certain age in particular, they're already very focused preoccupied with weight gain and so there they fear that if they hate fat they're going to get fat. But let's pivot a little bit and talk about you when we're talking about these carbohydrate Focus diets that have low fat. One of the reasons why people continue to over eat carbohydrates is because they're not satiated. So, let's kind of pivot and talk about, you know, the foods that we know are most satiating and then, you know,
Of jump into talking about ketogenic or lower carbohydrate diets. And some of the health benefits because I think that keto also gets a bad rap because so many people do it wrong, like there's junk food in every nutritional Focus that's out there vegan. Probably not carnivore but just about everything else like they're vegan junk food. There's paleo junk food, there's Primal junk food, there's keto junk food? I mean it's all out there. You know people capitalize on that?
Yeah, a lot of issues wrapped up in that the
When we talk about satiety, well, first I was going to talk about the fear of fat. So I've been doing this right eye first experimented with he do, which in 2000, we still call to Askins, you know, I 20 years ago. So 21 years ago, and I, when I first wrote about this for the New York Times magazine, I describe sitting down at my breakfast, looking at my bacon and eggs, and waiting for the heart attack for the rebound, obesity, or whatever, it was, it was going to and 20 years later. I still worry about.
I'm programmed, it can't possibly the amount of butter IE, and possibly be good for me. Like, bacon. Cannot possibly day and you see this. It's funny. The most uninformed, the nutritionists are, you know, if how can this diet possibly be healthy? They allow you to eat bacon, you know? And it's like I can you actually show me a study a clinical trial with and without bacon in it, where the people not eating bacon are healthier. And at that, I mean,
it's kind of a disingenuous question because nobody's ever going to do that kind of trial. But that's what you actually need to do to know if they can is bad for you. It's just, it seems, it's always been Associated. There are certain foods that became associated with an unhealthy diet. So instead of it being a Coca-Cola and McDonald's french fries, it was always the burger. Whenever you have a picture about unhealthy diets for the American diet being bad for you, they will show you what hamburger photo.
With photos and 400 Pounders in, you know, bad clothes at DisneyWorld taken from the back. The idea being made a hamburger and that's what made them. It would, we are programmed this point and the younger the generation and I've spoken to a lot of Rico, but I talked to a lot of dietitian classes and nutrition classes. And I had the environment growing up my mother and the 60s was believed that, you know, meat fish and fowl our integral to a healthy diet. So that's just what we ate with.
The green vegetable and a starch at every meal and an appetizer and a salad, very lucky to have a mother who was very health conscious but then by the 90s mother's had been convinced that they should be avoiding fat and read me. Now, you have a generation of people who have been taught that from birth, and it's much, much harder to end if you can give that up and eat. Instead, donuts and bagels, and soy, cream cheese. And, you know, McDonald's, french fries, and feel like you're being virtuous, because you're not eating meat. That's
It's a good trade-off. And if you're 50 or a hundred pounds overweight that seems like the best you can do because you're still trying Aid, not too much and you end up with this sort of Perfect Storm of bad dietary advice combined with the physiology. That's now programmed to gain weight. Its entirety is an interesting issue. I don't actually think in terms of satiety and hunger, okay? Part of my research, part of the advantage. I had as a journalist, when I wrote my first book, good calories, bad calories,
Calories. I wasn't locked into a particular discipline and the way obesity researchers have thought about fat accumulation for 50 years is that people get fat because they eat too much. And if they eat too much, that must mean that they're either too hungry or the foods, they're eating aren't satiating enough. So they continue eating after the point that they're full or they don't know that their folder. All these sort of concept that are based on the idea that you get fat because you eat too much as opposed to, you get fat because your body is
Pouring too many calories as fat, there was a field, a discipline known as physiological psychology, which dates back to, you know, Pavlov and Pavlov's dogs, Assumption of that research being that underlying physiological states, that the fundamental behaviors are determined by underlying physiological state. So, if you're hungry, it's not because your brain is being failing to get some satiety hormone or something, it's because your body is not receiving.
Enough. The cells in your body are not receiving enough fuel and if they're receiving enough field and you won't be hungry and you won't go through and that's whether or not your cells, are receiving enough fuel is they hormonal issue in the body. And again, it's the same hormones, insulin and glucagon and growth hormone and these hormones that determine whether you burn calories for fuel or so. The way I think about it is when you're in a condition where you're storing calories as fat, when insulin is
That's going to make you keep eating because your body basically. You're on with the bodybuilders, would call it an anabolic state, where your body is trying to grow. So, the foods that stimulate insulin secretion are going to be the foods that make you hungry and the foods that you can eat without stimulating. Instant, I'm going to be the foods that seen more satiating, but even then it's more complicated. I don't like the term overeating on carbohydrates, because if for the kind of person who fans easily,
he then there may not be almost any amount of carbohydrates that won't trigger that that deposition. So it'll be hard to find the point at which we can eat carbs without our body, still wanting to store fat and if we're not getting enough calories and we'll just be hungry and we'll keep eating. And if we are getting enough calories and our bodies will store the fat and well despite the carbohydrate. So there's a lot of ways. We've been trained to think about this that are based on this initial belief that we get.
Because we had too much. And if the Obesity researchers at gotten that, right? We have been thinking about all of this differently, so wouldn't be that some foods are satiating like protein and fat. It would be that some food to literally make us hungry or like the carbohydrates we consume and
I can be hugely problematic. I think as people if they're open to it, if they're open to shifting, I always say the end of one of experimenting with what works best for your body. I think it can be profoundly interesting. And I know before we started
Recording, we were talking about see GM's or continuous glucose monitors and how surprised I had been despite being you know low-carb bordering on ketogenic how surprised I have been that certain foods that I thought were probably not all that bad for me really spiked my insulin and so you know is it any surprise that yesterday when I tried to eat some berries? That it seemed like my insulin significantly and the whole rest of the day whether it was like a psychosomatic, kind of
Situation. But the whole day I was, you know, the whole rest of the day I was like, wow. I mean I don't normally have cravings and here I am having cravings. And isn't that interesting that we're talking today? Whereas today, I made sure everything I've done, has been protein and fat focused. I'm very fun full, like there's no desire to eat more food and my CGM data completely aligns with
that, you know. And this is part of the problem with the end of one's. It's hard to tell what's kind of a placebo psychological
Effect. I have all kinds of responses to car Bridge foods that I know I can almost get hand. Why do I get sort of the equivalent of hangovers? Now, if I have a car Bridge dinner and the next day, I'll feel awful and I died in all honesty. I mean, I have no idea if that's a real phenomena or if that's somehow psychologically, prompt and an entity been a difference, right between the two. The other thing that happens is as you when you're keeping low carb for a long time, your body loses
Ability right to I mean it doesn't lose you did take your pancreas kind of decides that it doesn't have to secrete insulin every day. It's not going to get carbs so you don't have to worry about it. And then, and this is a common phenomenon, it's been known since the nineteen teens that if you want to test Lupo's Tolerance on a, after a ketogenic diet, you've got a refeed, carbohydrates for a few days, to get the pancreas, used to eating them. And then, so if you were eating the berries,
Aries regularly, your blood sugar might have stayed better under control. You have gotten more insulin secretion by doing the experiment. Like this, you may be seeing a sort of anomalous short-term effect times days. Yeah, everyone's who want to decide the Palio people? Maybe they know what they're talking about. And I should be having sweet, potatoes, or yams everyday. Because whenever I give a conference and somebody I can give a talk and somebody asked me about sweet potatoes. I immediately think that we're in this is a Palio person.
I'll cook dinner for my family. My kids get a sort of healthy conventional American diet, and my wife is mostly vegetarian. So show get what were eating - whatever the, you know, the meat fish or fowl is and every once in a while, I'll make them sweet potatoes. And I'll try these little pieces. We potato. And then after dinner, and we get cleaned up my wife, and I usually watch an hour of Netflix or Amazon Prime video. That's great, great age of television and I will fall asleep on the couch.
Religiously. I will fade just as in high school, Thursday night was pasta night and I used to go in these carb Comas after the pasta meal, my mother would have to almost dragged her, you know, hundred ninety pounds son, from the living room couch to his bedroom. Now the same thing happens from a little piece of sweet potato and I keep thinking if I continue to eat it, maybe my body would adapt but I don't feel well. So I don't want to continue to eat it,
which makes complete sense. Although it's interesting because I feel
Like, there's this kind of conventional Dogma that we need to put ourselves out of ketosis, you know, episodically, if we're doing low carb or ketogenic diets for a period of time. So their bodies aren't, you know they're well, the conventional wisdom that was shared with me was we want to remind our bodies were not starving? We want to, you know, much like anything. It's some variability in our diets. I just don't know where I fall with that right now because I was so surprised at how high, my blood sugar went when it has been in the 70s and 80s coasting along. And
I know when I was talking with Ken Berry he was saying any time, your blood sugar goes over a hundred and forty, you're damaging, you know, the interstitial lining of your blood vessels, you can be damaging your kidneys and your eyes and you know, being the good soldier, you know, being the obligor hear that I'm like okay. Well I know I probably need to be more conscientious. I'm not sure what the right answer is and I know that listeners will be curious if there's any research that's been done on this at all.
Yeah. And the answer is no because what do you want to know, right? Is long-term harm.
You can make the argument that a little damage is a good thing because it keeps your defense mechanisms for our thing. You know, so that that would be. And this is there's a the world is full of hypotheses. One reason, I wrote the case for keto, I kind of want to say look, this is how originally it was called, how to think about how to eat and we had to change that tie it on but that's what I wanted it to. For those of us who are you know who fat uneasily, a term I picked up from the 1950s diet books and we all know who we are, you know, for those of
Us who put on weight easily. We have trouble controlling our weight in our blood sugar and now we're bombarded by information. And this is how I think we should approach this and think about it. And so, you know, and might be right. But even if he's right that you're doing long-term damage, and you're doing this two or three times a week, or once a week, are you shorten your life by five years or you shortening your life by five minutes? And we don't know, right? When these studies were done.
In the late 1980s to test the idea
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ewp. Yeah, we should all keep our cholesterol on our LDL cholesterol low, the answer for that. Assuming that everything that the establishment said about the evils of cholesterol was right? Was that we would live a few weeks to a few months longer by restricting, the saturated fat in our diet significantly. So, all of our fear of fat was about, maybe he word, maybe lengthening our
Life by a few weeks to a few months and one of the researchers who did this and he did this study at the behest of the surgeon general's office, and then that's when he got his results, a surgeon general's office tried to prevent him from publishing. It actually reached out to the editors and Jama the journal that had accepted. And said he couldn't publish this because if he published it, and nobody would eat a low-fat diet when I interviewed him. He was here in San Francisco. He said, you know, aside from sharing with me the letters and went back and forth with the surgeon general's for
I was always grateful. He said you know this you can live two three months longer, it's not on your honeymoon. Okay. It's at the end of your life, right? So somebody who is going to die of 75 years old March who avoids saturated? Fat is whole life. It's like, you know, skinless, chicken breasts and Seed oils or pick your oils, instead of butter and chicken thighs. And you know, instead of eating like the French they eat like the
The Mediterraneans even though we know the French live a very long time. Anyway you make the all these sacrifices you live instead of dying in March, it's 75. You died in late April. And these are the, these, this is the time in the nursing home, okay. It's like another exhales. So, how much of a difference going to possibly make? That's the question. So in this book, you know, I there's a good argument to be made that if you're not, if you're on the borderline of ketosis, maybe your brain isn't getting enough ketones for fuel and that the brains
That people often feel, but they feel this on every diet, just the brain fog, that you might feel in a key. Keto diet might be better if you were. Lidge ously stayed in Quito in ketosis is quite possible. I don't know if it's true or not. It's also like I said, Ken's argument is quite possible and I don't know if that's true but even if it's true, either question is, how much do we met? I often wonder like if you give up if I'm writing you give up sugar and flour and Grains and starches and
And don't even eat legumes because they have a high carb content and you go carnivore, for instance, and then what's going to kill you, okay? Now because I we associate all the chronic diseases that we suffer from with basically overweight and obesity and diabetes and high blood sugar and high blood pressure and those are all carb related. So you're going to minimize the risk of all those chronic diseases including cancer and Alzheimer's. So what do you die of and my theory is if you're 80 years old you're in perfect health you go to your
Son's first birthday party. You have an ice cream cone in your heart blows up and everybody blames it on the ketogenic diet you've been eating for the past 40 years instead of on the ice cream cone that raise your blood sugar and blew up your heart. Lot of complicated either. The one of the problems and I discussed this in the case for Quito is because the Obesity nutrition research establishment completely failed to. You know they came up with this idea that people get fat just because they eat
Too much. So they tell us all we got to eat less and exercise. More, we have obesity and diabetes. Epidemics, the whole nation is getting fatter. They have completely and utterly failed to handle this. So they've left it up to the positions, like yourself, figure it out and over the decades positions did people like, you know, Albert Pennington in the late 1940s, who worked in Pennington Aura, who worked at the DuPont there, Herman talar, what a book called calories, don't count or Robert Adkins and the
Amos Atkins, diet and Micah married, a needs, what protein power and a group of Tulane Physicians, who wrote sugar Busters. And then people like Nina and how you Shelton I came along and we established through our research journalistic research that these diets are healthy, they're not going to kill you. And while we were doing that work, people are actually doing clinical trials, establishing that rigorously. But now you've got this world of theories and hypotheses and diet books, and everyone's got to say something.
In new, you can't write a diet book and say, just do what I had can said, I can because I'm a journalist, but positions can. So, as soon as you decide, I'm going to write a book, you've got to write something different than everyone else. So you've got to have a different hypothesis or timing or, you know. So now you're pushing, you know, I mean, there are all kinds of variations on it, and some of them may be important advances, but there's no way to know and some of them may be important observations, you know,
Be just a little bit of elevated. Blood sugar is going to shorten your life by five years, not five weeks but maybe five years maybe it'll be the difference between you know, a cancer diagnosis or not. I don't know, you know, not one in 10,000 people but one in ten people but there's no way to know because the mainstream establishment has failed at their
job that's important points. I definitely want to at least be remindful of your time but one of the questions that came up with some frequency when I
Mentioned that we were going to be connecting was carbohydrate addiction and obviously I know that there is this is real this is not something that's just contrived, you know, just based on uncertainly, what I have read. So for people who are unable to control their consumption of carbohydrates, meaning they can abstain from eating a cookie or ice cream, but as soon as they have one or a scoop, it puts them in a position where they then.
Slide down the path of, you know, overconsumption and then they're back to this, you know, kind of powerfully. Addictive qualities. What has been your experience? You know, when you're talking and doing research on carbohydrate addiction because I do believe that it's a real entity, you know, much to the point you were making earlier about, you know, the profound hormonal impact of having elevated, insulin levels amongst a myriad of other hormones that get activated.
Well, one of the things I did,
In this latest book, the Case for key to. So I interviewed a hundred and twenty plus Physicians who out of what is tomato is a few tens of thousands in the world who now think like we do and I wanted to understand they what would beginning to see is enough clinical experience that people can start talking about what works from The Physician perspective and what doesn't work in the challenges to the patient and many of these Physicians thought of what they did. Not as you know, prescribing the clinics, not as weight loss, clinics or Family Medicine.
Expert is carbohydrate Addiction Rehab 1 X, how do you get people off carbs. So there's a very good physiological, explanation for the craving and the love, we all have of carbs, which is when you start thinking about eating carbohydrates, your body will secrete insulin in response. That's like a the pavlovian thing I talked about. You start just Pavlov's dogs. Would salivate when he rang a bell, you know. I can say you know, hot warm or hot fresh do.
Donuts and I'll start salivating but it means my pancreas. Also just secreted insulin saying, oh, this guy's about to eat carbs and we got to get insulin in the blood stream in advance, and what insulin does is it tells the lean tissue to take up the blood sugar, the glucose. So your blood sugar is going to start dropping. Once you start thinking about eating and it tells your fat tissue to hold on to the fact, because it's preparing for the food that's coming. Once you're on insulins elevated, it's telling your fat tissue to hold onto fat
Your protein, the protein you consume to be used for cell repair and growth and carbs. It's telling actually the mitochondrion yourselves, the the energy factories in new cells to burn carbs, not fat or protein. And so carbohydrates literally become your fuel. And if you've got this condition called insulin resistance, which if you're you know overweight obese pre-diabetic or diabetic your type 2 diabetic your you are insulin
Distant then for most of the day, probably except for little window while you're asleep, your body is looking to burn carbohydrates and as your blood sugar comes down, you're not getting the access to the fat to replace it because your insolence high, so you're going to crave carbs. And so you drink sodas all day long, right? Because you're basically feeding your body a little bit of carbohydrates and feeding your liver specifically all day long. You snack on
Carbs because the idea of having, you know, cheese and a meat plate at 10:00 in the morning. Two hours after breakfast is like, most people are going to be put off by that. One reason they'll be put off by that is because their body doesn't want to burn, fat and protein and wants to burn, carbs. Give me the crackers, the donuts. So, even, and again, the part of the, the way I think about this now is once your body is dependent on cards for fuel, your brain will respond with these,
Markers of addiction. When you eat carbs, you'll get the reward, the dopamine response that you get from other addictive foods, and we all know who we are. You know, my wife can have, she can go to dinner order, dessert have two bites and then push it aside and not think about it again. I'll go I'm with her, I don't order dessert, right? Because I'm virtuous, I don't eat carbs, then I start staring at her dessert. Then I have a bite of her dessert and then I stare at her dessert and then I just she's pushed it aside. And then I just grab and put it in front.
Man, I'm going to finish it. I that bite makes me crave, it doesn't, there's no way. The sugar satiates me. This is it just when I'm done with that dessert, I don't crave sugar, any less than I did. When I started, I just realized that. I can't have two desserts. That would be foolish, but that kind of herb that kind of craving is magnified, it would be magnified. The heavier I am and be magnified the more insulin resistant. I am. It's hard for a lien.
Healthy person to imagine the carb Cravings of someone who's not and how do you break it? Well, telling people to eat in, moderation is not the solution anymore than is telling an alcoholic to drink in moderation, or cigarette smoke for the smoke in moderation or a heroin addict. Only shoot up and moderation. It's like you need and this is when these people think about rehab, you need to go probably cold turkey and the good thing is, we know, physiologically. If you get rid of the carbs and replace them with fat,
Then your body will switch over to become what's called fat adapted and now you're burning fat for fuel. And you will start craving fat-rich Foods instead of carb rich foods, and this was demonstrated in rats in the 1930s again, in this field physiological psychology, you hear it all the time in the anecdotal. Well, but you have just like it takes you three weeks to get through the worst of alcohol addiction and smoking addiction. That's why alcohol rehab is 28 days because by 28 days
as you're over the worst of it, it probably takes that long for at least, some people to convert in our world, to get rid of the carbon addiction and then it's something you fight for the rest of your life. The only reason I'm not as negative about I'm skeptical of the keto low carb high fat processed food industry, but a lot of people they're going to Foods who workplace the junk, they're eating now. And
Help them get through the carb addiction. So and I know honesty. There are still times. I crave a good candy bar, and Susie's good fats, you know, we'll do it for me, but anyway, that's the issue. So these, these Physicians, I spoke to they often, they said, look, you know, we know we have all these lessons. We learned about, you know, in the addiction World about how to deal with addictions. So if you know, if you're an alcoholic, you don't get a job in a liquor store, right? You don't get a job as a bartender. I mean maybe you want to challenge,
Enjoy yourself, but it's a for most of us. It's a foolhardy thing to do. You don't have alcohol in the house, you know, if you're a smoke or when I used it I was a smoker. I trying to quit smoking. It wasn't enough to just throw out the pack of Marlboro Lights that I ate, or to break it up. Because if I put in the trash and broke it up, three hours later, I would be able to find a half of one that I could still smoke. So I had to put water in it, you know, the dads because otherwise I was going to smoke it and we just you learn those tricks. A lot of this and this is advice I got from
Russians. You it takes practice the longer, you do it, the better you get at it. Things that seem unsustainable quitting. Smoking seemed unsustainable to me for 10 years before I finally succeeded and I learn tricks. Don't go into, don't don't go to a club with my friends Friday night. If they're smoking and think that I can not smoke. So I just can't do that anymore because I don't want to become a smoker. Now I can because no one's allowed to smoke in clubs. Now, I don't go to clubs because I'm a man.
You know 60 year old, 65 year old man. Anyway this is the way, you know again what I'm trying to communicate in the case for Quito is you learn to think like this and you take it one step at a time so it's not as hard as you think and what next thing you know, it's been six months, you're pretty happy living without carbs and you're very happy that you're now healthy that your body of shed. When he 30 or 40 pounds, your blood sugar is under control.
All your blood pressure is if you're a type 2 diabetic, you're off your medications. You know, and these have all been shown in clinical trials. This is you know what happens when you give up these carbs,
slow and steady. Absolutely wins. I want all my listeners to know that case for Quito is the first book. I'm recommending for 20 21, I'd love for you to share with the listeners. What are you doing next? And what's the easiest way to connect with you on social media or on your
website? My next book will be on
On Diabetes specifically. And I have to admit all my, all, my books have taken a historical perspective, I work on the assumption that if you don't know the history of your beliefs, you don't know whether they're true or not. So literally to know what you're talking about. So I'm become obsessed with the history of diabetes. Dietary therapy for diabetes and I hope I don't lose too many readers. I'll apologize in advance, I'm active on Twitter, not active enough at Twitter is another addiction. I'm not sure.
Anyone is healthiest with, and my website is Gary tabs.com and people can reach me through the contacts. Lot of my website in the book is available. Wherever fine folks are sold and if you have a independent local bookstore, that's still open. We buy it there.
Alright. Well, thank you so much. I look forward to having you back when your new book comes out and I do think that, you know, people are curious to understand more about this whole concept of blood sugar dysregulation, largely because so many
Many of us are insulin resistant if not diabetic and unless we start changing our choices more and more of us will end up in that direction. So thank you for your time today,
okay? Thank you very much. Thank
you. Thanks for listening to every day. Wellness, if you loved this episode, please, leave us a rating and review. Subscribe and remember, tell a friend, and if you want to connect with us online, visit the link in the show notes.
