Diet is just one letter away from die.
For most of man’s existence it was all about staying alive long enough to have kids and keep the species alive. You ate what you could, when you could. We come from a long line of hunter-gatherers.
At some point things shifted (at different times around the world) and we began settling down, growing crops and raising animals. And then a couple of hundred years ago we figured out how to mass produce staples such as flour and sugar and changed everything.
The big question is, from an evolutionary standpoint, how long does it take for man to adapt to changes like this? Are our systems still fine-tuned for hunting and gathering, or are they fine-tuned to allow us to adapt to whatever circumstances we find ourselves in? That is the conundrum we face when we look at today’s landscape of dietary advice. And it’s confusing as hell to the average person who doesn’t have a degree in evolutionary biology or nutrition or any sort of scientific field. I’m basically trying to sort through all of this myself, and this article is me just writing it down. Maybe it will turn out to be helpful – we’ll see.
As it currently stands, there are a few basic viewpoints that today’s dietary advice proceeds from. Here are the main ones, as I see it:
- Conventional Wisdom. This view generally ignores evolution and proceeds from there. Think ‘Food Pyramid.’ Obesity is caused by too many calories and too much fat. Calories in, calories out.
- Low Carb. Gary Taubes’ book popularized it. Carbohydrates, mainly processed sugars and flours, wreak havoc on our endocrine systems and are responsible for obesity and Type II diabetes, etc. Paleo diets are an offshoot of this, adding in a cave-man exercise concept.
I grew up as the medical community was adding a low-fat component to conventional wisdom. But obesity grew, and the answers as to why seem elusive. Here are the valid observations, as I see them.
- Segregated native populations world-wide historically suffered very rarely from gallstones, kidney stones, cardiovascular disease, obesity and cancer, the so-called diseases of modern (Western) civilization.
- These populations had very diverse diets, from the high-fat Inuits to fruit and veggie tropical populations to high-carb Indonesians.
- All of these populations get the diseases of Western civilization after being exposed to the Western diet, especially processed flours and sugars.
- At the same time, modern agriculture and medicine have allowed our population and life expectancy to mushroom.
Many of these problems stem directly from obesity, so most of the focus has gone toward solving that problem. And therein lies the rub, because while there are dozens of proven ways to lose weight the general population just keeps getting fatter. For many years, most dietary methods were variations on the same theme - eat less, lose weight. Unfortunately this rarely lasted, in part due to food manufacturers doing everything they could to keep your hunger and cravings ramped up.
Gary Taubes’ writing on this topic proposed a radical variation. His premise was that different types of calories produced different types of processes in the body. His conclusion was that carbohydrates should be minimized, and indeed multitudes have successfully lost weight using this general concept. But why? Is it really because a shift in macronutrient percentages triggers your body to store less fat, or is it something else? What, exactly, is the underlying mechanism?
For the longest time I believed Taubes’ theories. The wife and I are long-time low-carbers, and by that I mean that we’ve generally adhered to the concept while not always actively eating that way. Our first real success with any form of sustained weight loss was on Atkins (the original book) around 1998-99. I still haven’t revisited my low weight from that time period, although I’m currently within 10 pounds of it. [UPDATE: I have now been below 200 for several months] For most of the last decade we’ve hovered in a range closer to our max weights than our low weights.
After reverting from our original Atkins success, we just assumed we could lose back down easily by restarting Atkins, but time has proven otherwise. Taubes’ writing reinforced our beliefs re: carbs over the years, and we even spent awhile doing zero-carb, meat-only, which ‘worked’ but was expensive to maintain.
A couple of years ago my wife was diagnosed as a Type II diabetic. Her blood sugar levels were very high. Regular testing has shown that carbohydrates do, indeed, spike her post-meal blood sugar levels. But what are the underlying mechanisms at work here? Conventional wisdom would say that her pancreas and/or liver are simply failing to produce enough insulin - a genetic flaw, in her case, as she is not obese. Taubes, et al, would say that a lifetime of processed foods has damaged her body’s ability to produce insulin. Carbs has caused her diabetes, in other words.
Until recently I was resigned to this line of thinking. My wife was destined to watch her carbs closely and eventually she would have to start taking insulin as her Type II slowly, inevitably morphed into full insulin dependency.
But then science stepped in and upset the apple cart.
One way of treating obesity that has proven successful is bariatric surgery. The fact that it is an invasive surgery has limited its use to only those patients who are morbidly obese. I always thought it a very inelegant solution to the problem, but it definitely helped people lose weight and extended their lives. And it had a very surprising result for diabetic patients.
Many morbidly obese candidates for this surgery are also Type II (adult-onset) diabetics on some form of medication. After bariatric surgery most of them experienced a normalization of their blood sugar levels and many were eventually off their meds and experiencing complete remission. One study showed that as many as 1⁄3 maintained this state for five years or more. The fact is that their pancreas and livers had not lost their ability to produce insulin, as some had speculated.
These results tore a bit of a hole in Taubes’ theories. His writing indicated that it was a lifelong overload of carbohydrates that permanently damaged the ability of the pancreas and liver to produce insulin, eventually leading to a diabetic state. But bariatric patients with a 10-year or longer history of diabetes were experiencing normal insulin levels without the aid of any medication - technical remission! But while this disproved Taubes’ mechanism theories, it did not directly prove any other mechanism. Subsequent theories have targeted chemicals in gut flora somehow being triggered by the severe diet restriction in and around the surgery, but the details are not clear.
One group at Newcastle University in the U.K. came up with a different concept, something they refer to as the Twin Cycle Hypothesis. To test it they decided to skip the actual mechanism and simply attempt to mimic the results. Since insulin recovery often occurred in bariatric patients long before any weight loss, it was theorized that perhaps it was simply the caloric restriction that set things in motion, resulting in a removal of fat around the pancreas and liver. To test this they put patients on an 800-calorie diet for 8 weeks. The results were very similar to those observed in the bariatric patients! This line of thinking/testing has resulted in some very clear guidance, at least on Newcastle University’s web site.
So Dixie basically thought “Hey, why not?” So she spent eight weeks eating an average of around 700 calories per day, mostly veggies combined with shakes from GNC. And no, not ‘protein’ shakes. Her diet ended up being around 50% carbohydrates. I can’t begin to tell you how amazed I am at her willpower. She even stuck with it when she was hit by some sort of amoebic or parasitic intestinal invasion. Her bowels recovered. She lost quite a bit of weight too! She is definitely more thin than she has been for the last 20 years or so. But the real question is, what about her Type II Diabetes?
She took her blood glucose readings all during the diet. The numbers all dropped, but the real test was what would happen when she went off of her Metformin. So she stopped taking it the day after her diet ended.
Amazingly, her blood glucose levels are all still in the normal range, both when she first wakes up in the morning and after meals. So far, it appears to have done the trick. No more medicine, no more fear that her longevity might be in danger. Technically, she’s not diabetic any more!
UPDATE: It has now been about a year since Dixie started her 2-month diet. She still occasionally tests her glucose levels – sometimes first thing in the morning, sometimes after meals. All readings are still in the ‘normal’ non-diabetic range. Her HBA1C bloodwork from the lab confirms the same.