Sunday, March 27, 2011

Foster's POUNDS LOST Study

A recurring theme in my career has been this discovery of a little packet of data, just stuffed in an unmarked envelope, left on my desk or slipped under the door, or pushed towards me in a conference room while others aren't paying attention.  Or, colleagues might pass by in a hallway, and furtively motion me over to some quieter place to "just take a look at something."
The challenge, after opening these envelopes and having a look inside, was for me to determine who gave me the secret data.  Surely, they would be wanting some sort of response.
I was reminded of this while I was reading through Dr. Foster's POUNDS LOST study, and wondering which researcher was getting a little packet of the real data hidden in an in-box somewhere.

I promised you all I would get back to the POUNDS LOST study.  Here's Dr. Foster's paper, finally published in 2010.  It's the study said to compare a low carb diet and a low fat diet for two years.  They concluded that there really wasn't much difference between a low carb reducing and a low fat diet except some markers for heart disease (better in the low carb dieters!)

I really wanted to like this study.  Oh well....

I also really wanted to read this one very carefully before commenting on it.  Initially, it didn't seem like it would be as bogus as some of the other studies, but I still had concerns.
The first thing that really popped out for me is that while the participants were overweight, they were excluded if they had diabetes, high blood pressure, were taking lipid-modifying drugs, and other illnesses.  In short, they didn't even include people with metabolic syndrome.
This omission wouldn't have made such a difference if I hadn't read Dr. Gardner's A to Z study and also saw his lecture.  In the lecture, Dr. Gardner showed how the participants in his study did when they had insulin sensitivity issues that are associated with metabolic syndrome.  This information was in his lecture, not in the published paper.  In short, Dr. Gardner discovered that the participants tending towards metabolic syndrome did much better on the low carb diet than they did on a higher carb diet.  When all the data was thrown together, it didn't look like there was much difference between the diets, but when insulin sensitivity was taken into consideration, the low carb diet was the very clear winner for dieters with metabolic syndrome.
I think the American Diabetes Association has been taking a careful look at all of this.  It seems like every year, they relax their admonition against low carb diets a little bit more.  There are so many diabetics that prefer a low carb diet that the group is becoming difficult to ignore, both in terms of numbers and in terms of success.  (Oh yea, in terms of the actual data.)
The second thing I noticed about the POUNDS LOST study is their wonky description of the way they made up missing data.  (I usually don't read studies in order, I tend to jump to certain places first, like what methods of data analysis they use, and then go back and read the intro part more carefully.)  Lots of people dropped out of both groups over the two years.  My guess is that there were many critical reviews of the way data was made up in earlier studies done by Foster, so they made extra sure to explain it this time.  But, I read it, and kept re-reading it, and the BS meter started to move up a bit.  I couldn't figure out what they were talking about.  I am not a huge fan of making up data anyway, I think it is misleading.  This study just modifies the method a bit, but is still just making up data.
The other thing I found odd is that there was no actual data shown.  Instead, they used some statistical model, made up the missing data, and then showed the predictions from THEIR MODEL, not the actual pounds lost by anyone.  Now I am thinking that the only reason that they did this is to try to weasel out of something.  Nowhere in the paper do they talk about the validity of their model in terms of how it actually fits the real data.  All the charts show plots of the predictions, not any actual data.  The BS meter is really up higher now. I hope the actual data shows in somebody's in-box.
Then I went back to the top, and read carefully about the two diets.  One was called "Atkins", but the Atkins book wasn't given to the participants.  The description of the diet doesn't sound like Atkins at all.  This low carb group was on an induction-style diet for three months, and then started adding carbs.  
"After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved."
This isn't Atkins, this is something else.  And that something else is that they seemed to follow Atkins initially, lost lots of weight, and then went into maintenance mode.  The Atkins plan is to start slowly adding carbs back in as the desired weight is achieved.  In this study, the participants rose their carbs after three months, with the result being that of course they didn't lose as much as they would have if they had actually stayed on the Atkins plan.  And maybe its just the I'm-From-Missouri in me, but I'm thinking that if they wanted to test the Atkins diet, they would have actually tested the Atkins diet.  So here's the recap so far:
1.  We put a bunch of people on one of two diets, an Atkins diet and a low fat diet.
2.  After the first three months, the Atkins group looked much better.  Better weight loss.  Better blood lipid factors.
3.  We told the Atkins diet people it was OK to start adding 5 g carb per day every week instead of following the Atkins diet.  
4.  People on the diet that used to be the Atkins diet started gaining weight.
5.  By the end of the study, the weight loss of the two groups wasn't different.
6.  We concluded that the Atkins diet and the low fat diet are the same after 2 years.
The fourth thing I noticed is the reason I decided to call this study a bogus study.  I looked at the plots of the triglycerides.  It didn't make sense that the triglycerides went down so nicely in the low carb group during the first several months, and then went way up, to the point where they were even higher than in the other group that was eating so many carbs on purpose.  This just shouldn't be.  If these people were really following Atkins, their triglycerides would continue to stay low.  This plot is just further proof that these dieters weren't on Atkins anymore.
These researchers and their associates also made sure that the media was alerted to the ho-hum nature of the study.
Here's, slamming reporting on the paper in a scholarly way, minimizing the success of the low carb approach.  The majority of the commentary was not by anyone who actually wrote the paper.  So, even though the low-carb diet was clearly better in weight loss and heart risk factors in the early stages of the study, everything eventually evened out and the early-stage success wasn't mentioned.  The reviewers did want to make sure that we all knew that the low carb people had bad breath, which was also rectified by the end of the study, but they still felt the need to bring it up anyway.  We haven't gotten actual values of actual weights, or any food logs, and yet the bad breath data was quite important?
There's no doubt about this article.  It's a slam for sure. It's by the guy who did the movie "FatHead".  He brings up some of the same concerns I had about the low carb diet not really being an Atkins plan, and how the study is full of made-up data.  The comments on this blog post are pretty interesting, too.
A little while later, Tom Naughton wrote this enlightening blog post:

It seems like Tom Naughton was the recipient of the plain manila envelope, too!
Here's another blog post a bit later:
She says it much better than I could ever do.

Friday, March 25, 2011

The. Most. Shocking. Rose. Ceremony. Ever.

You'all remember my post about Frank Sacks.  If not, here it is:
Here's what Dr. Richard Feinman has to say about another study done by Sacks:
I had been wanting to get back to this important topic.  Even though it was already getting better and better in my last post on the topic, I soon found out it was even more and more better than ever.
A few days after I read about our researcher friend, I was casually looking at a stack of magazines at a friend's house.  I found a Nutrition Action newsletter and skimmed through a couple of articles touting the low fat diet, and just on a lark, I checked to see who the author was.  I went to the info page where they have all the directors and advisory board people listed.  And who was on the list?  Frank Sacks!
As you recall, Frank Sacks is an author of a bogus study, and his study had been published by a journal, The American Journal of Clinical Nutrition, where he served as editor.  Sure, every "researcher" is biased towards the things they study, but there is a big problem when these researchers mis-represent their work and block the flow of information from other researchers who have data that disagrees with them.
Frank Sacks was also on the scientific advisory board of the Center for Science in the Public Interest newsletter, the Nutrition Action Newsletter.  Here's an article by the CSPI about how wonderful the OmniHeart diet is.

This article discusses the famous OmniHeart trial.  They tested three different versions of the OmniHeart diet and guess which diet was the best?  It was a tie between the OmniHeart diet and the OmniHeart diet!!!!!!  (No, this is not a computer glitch.  You read this right.)  Of course, the OmniHeart diet is Frank Sack's.
So, here's the Clif notes:
1.  Unsatisfied with his other bogus studies, Frank Saks designed an even better bogus study, and tested three versions of his own diet, the Omniheart diet, the OmiHeart diet and the OmniHeart diet
2.  The OmniHeart and the OmniHeart diet tied for the best, and beat out the OmniHeart slightly.
3.  The researcher concluded that the OmniHeart is the best healthy diet of all!
4.  The researcher got this crap published in a newsletter where he was on the scientific advisory board.
Wow!  This has been The. Most. Shocking. Rose. Ceremony. Ever.

My Take on Eades' Take on Taubes' take on Tierney's article on Sat Fat

Don't you love blogs?  In one catchy title, I have managed to link myself to several of the weight-loss science journalist titans!   I found this really hilarious blog post by Dr. Mike regarding the controversy over the health effects of saturated fat.  
Here's Dr. Mike's take on things.
Scroll down to the quotes attributed to Dr. Eckel.  Again, Priceless!

In Gary Taubes' reply to Tierney's blog post, he hinted at a new 2-year study that was coming out shortly.  He asked readers to predict what the results would be.  These predictions were made in July of 2008.

1) The study will show (again) that controlled carbohydrate nutrition results in superior cardiovascular health markers as well as weight loss.
2) The medical and scientific community will be “surprised” that such an “unhealthy diet” could have such better results.
3) Dean Ornish and the PCRM crew will publish rebuttals claiming that obviously these results are only because the low-fat diet was not low-fat enough. Various vegan groups will admonish people to read The China Study so they can know just how “dangerous” meat based diets really are. Katie Couric will ask a talking nutritional head on the national nightly news that “this latest study results aside, in the end its really about portion control, right?”. The talking head will nod appropriately and enthusiastically.
4) Various “authorities” will publish statements to the public warning that the long term effects on health of the Atkins diet are not known, so no one should start cutting carbs thinking its actually good for them.
5) The USDA will revise its food pyramid, emphasizing even more whole grains.
6) and once again we’ll inch ever so slowly toward the medical community understanding that eating low-carb is best for optimal health…"
and another:
"Add to your prediction: 6) The AHA will lower its fat recommendation even more."

 (You can read the whole thing here: )

How did they do?
Here's Dr. Foster's paper, finally published in 2010:
They concluded that the diets were pretty much the same as far as weight loss, but that the low-carb people had an improvement in heart disease risk factors.  (I'll be having more to say about this soon....hint:  look under "bogus studies" category.)

Here's a botched report of the study: I can't believe that someone actually posted this article.  I could do a whole blog post just on how many things were wrong here.  Paragraph after paragraph after paragraph.  They couldn't have actually read the study and come up with this.

Well, here's the revised food pyramid!:  Looks like we are in for less fat.

And here's another whine-y Dean Ornish's rebuttal!:

Here's another spin article extolling portion control, and even saying that such a "moderate" diet will improve heart risk factors when the study clearly showed that the low-carb diet resulted in better numbers for heart risk factors. (Although readers here don't care about that minor discretion, because they know that a risk factor is not a cause anyway.)  Note the caption emphasizing the grains, calling them heart-healthy.  This little tale was spun by another Temple University "researcher", the same place that Dr. Foster is from, in a transparent attempt to undercut their own research:|head

Here's another report with repeat warnings.  Even though this website looks research-y, this article contains really old information and was just cut-and-pasted from somewhere else, without the references.

Here's what the AHA wants you to do: The prediction was correct.  They want even lower fat!

Thursday, March 24, 2011

Great Testimonial!

This is a great testimonial on Free The Animal, from a gal who lost a bunch of weight on a paleo-type diet.  Her story is inspiring and provides hope to those of us who have been struggling, especially after having children.  Enjoy!

Sunday, March 20, 2011

How much Exercise do you really have to do to Lose Weight?

I follow Dr. Mike Eades on Twitter and he alerted his fans (that would be me) to a great study on exercise and weight loss that was published last year.  (I read the study, and it is OK except I am not all that thrilled with the way they threw out some data points, but I'll save that rant for another post someday.)  Like Dr. Eades hinted, the conclusion is a bit odd.
Here's the study in a nutshell:
1.  We found a bunch of studies about exercising and weight loss and they didn't show much of a relationship, so we designed a newer, bigger, better, longer study.
2.  We found and measured a bunch of fat, lazy, old women.
3.  We told them to exercise but not to go on a diet.
4.  After a year of exercising at an average of 9256 minutes, they lost an average of 4.4 pounds.
5.  We conclude that exercise helps you lose weight
Now I don't know about you, but that doesn't sound like alot of weight lost for all those hours put in.  That works out to about 1/2 oz. of weight lost per hour of exercise.  I think that I would get better results by skipping the weekly exercise and just shave and trim my nails before the weekly weigh-in.
Dr. Briffa has a great article about this clinical study, with a bunch of links to other studies that showed little to no weight loss associated with exercise.
You might find in some places where folks have analyzed the weight you should expect to lose while exercising.  You know, where you would have to be on the treadmill for another X minutes to burn off that Y amount of strawberry jam on that bagel.   If you assume that you can burn off 100 calories in 10 minutes of intense exercise, that would give you weight loss change of about 100 times better than this new study actually shows.  So, it's even much worse than we thought for weight loss.
Here's the original study:

Saturday, March 19, 2011

Trashing the Experts

This message was recently posted by a coach on a weight loss website:
"Hi everyone
I've been getting reports about a few of your threads here recently because they tend to trash our experts. Here's the deal: You are welcome to follow whatever program you'd like, and to share your experiences. But we have certain recommendations and guidelines we follow on this site, based on years of sound research. You don't have to agree with it, but it really creates a negative situation when a member asks a simple question about pizza dough and gets a lecture about why low carb is the way to go. As you can see from her response, that wasn't anything close to the information she was looking for.
We won't allow members to constantly challenge or talk negatively about our experts. If you can't just share an experience or talk about our staff in a respectful way, then you'll be asked to leave the site.
Any questions, let me know.

Coach Jen"

When I first saw the post on the low carb team, as I started to post a response, I decided to stop.  I'll post my controversial and dangerous thoughts here instead.
This post is still a work-in-progress, but I just wanted to be sure that people had access to it in case it is erased or modified.  This e-mail from the coach was not a message to a particular person who may or may not have crossed the line on a particular thread.  It was a great shot across the bow, and was posted to and meant to be read by an entire low-carb team.  If there was a problem with a post, a message should have been sent to that poster, not to almost 4000 other low carb fans who had nothing to do with it.  Apparently, thousands of other people needed to hear this important warning.
The coach's message was clear.  "If you disagree with our gold-standard recommendations based on years of peer-reviewed data in the gold-standard publications that have been carefully reviewed by our designated experts, we will go after you and kick you out."  While it has always been their policy to ban attack posts, now it is being made very clear that any challenges to their authority on the carbohydrate topic will be considered an attack and will not be tolerated, regardless of whether that challenge has merit based on the data.
Here's my original response:

"I think that the difficulty that some are having is that when some person goes on that board and asks a simple question about low carb, there are some regular "troll" posters who are all over it, telling people they are crazy, that they can't follow it, etc. It can be really discouraging. As far as I know, the [redacted] moderators aren't going over to their [redacted]teams leaving them warnings. And, it is kind of hard to track some of those posters down since they don't have pages and they haven't been on long. (Kind of a dead giveaway that they are trolls.)
Then again, I can certainly see the [redacted] experts' point. It's their site, and they call the shots. If people don't like that then they can go somewhere else."
Here's what else I had to say.  We all have choices.  This weight loss site is free, and we are also free to come and go as we please.  No one is holding a gun to our heads.  While it may be true that our doctor, our family, our society may be holding a gun to our heads with regard to weight loss, there are other sites and tools we can use to get to our goals.  
Honestly, I do not understand why a website that depends on people visiting and clicking on their ads would deliberately try to piss off over 20 percent of their users, so I am going to assume that it is unintentional.  If it is intentional, then it is ill-advised.  Their own poll shows that over 20 percent of the responders prefer low carb over low fat.  If they want to base their business model on attracting visitors who are interested in reaching their goals based a high carb diet, then they can fight with other sites like Weight Watchers or Dr. Oz for their share of that market.  Meanwhile, an ever-increasing group of low carb fans will gravitate towards the low carb and Paleo blogs and sites, click on their ads and buy their books instead.  If I were this weight-loss website's marketing director, I would insist that a good portion of these "expert" blogs, recipes and articles be revised so as to be more welcoming to people who have found a different way of eating to be more suitable.  From a marketing perspective, the only disastrous and dangerous aspect of the low carb diet is that the more people who succeed with it, the less interest people will have in their website.
I started this here blog a while before I started posting on it.  After I received my first letter from the coach ( ), I was concerned that I would get kicked off the site, so I started moving my posts over here more quickly.  After this incident, I am even more comfortable in my decision to wean myself off any of the trackers so I am not beholden to ANY website.  I have already moved my diet tracking onto the Dr. Oz site, and am working on trying to get rid of computer tracking altogether.
I did post information on one message board, which I removed after receiving a warning letter.  I did not post on the cited pizza thread, preferring instead to respond directly to the original poster.  (Yes, I would freeze the pizza dough!)  I trash bogus research studies, researchers and poorly-done studies, not nutritionists.  If they continue to stand behind their data, they may get knocked down from time to time as the avalanche of newer data pushes everything aside.

Refueling the Protein Debate and Questioning Gravity

[I used to blog on a weight loss website, but now I am moving my entries pertaining to low-carb research and other controversial topics over here.  This was originally posted on Jan 28.]

Many thanks to another friend for posting the original information and the link to the article on protein consumption. 
Here's the article that was cited in her blog: 

I hope that you will "like" my blog, even if you don't like or even understand what I am going to say. I think that we need to jump the conversation to a higher level. 
When I first started reading "The Real truth.." and actually tried to tease out the information, I started to get a bit annoyed. The explanations seemed a little murky, so I decided to find the source. I googled a few lines and found that this article, or portions of it, are posted all over the internet, on sites having to do with all sorts of topics. 
My "beef" with this article mostly has to do with the sloppy way that results are reported in the media, and not as much in the way that many of these studies are designed and/or analyzed. Usually a first problem is that the sample sizes may too small to make sweeping generalizations intended to apply to entire populations not included the original study. Or, the study might have applied to a different group, say, young healthy college-age males. I finally found what I think was one of the articles referenced, and while the sample size was small, I learned other facts that were more disturbing. 
The problem with many of these studies is that they are classic mixture experiments. One group (called a treatment) starts out with a mix of carb:protein:fat, and then one of the macronutrients is changed for the second treatment. But then, to supposedly make everything even, the total calories are kept constant. 
(This is because EVERYBODY knows that if you change the number of calories taken, it certainly affects weight loss. This is a diet dogma, CALORIES IN EQUALS CALORIES OUT that cannot be questioned. It is like gravity.) 
But what is REALLY going on with this experiment is that in an attempt to keep things even, two things have been changed. It's sort of like taking a tube of toothpaste with the cap on and pushing down on one side. It just goes higher up on the other side. 
In this experiment, there are two groups: one with a 60:15:30 ratio of carbs:protein:fat and the other with a ratio of 45:30:30. And, while it is true that the second treatment has twice as much protein by percentage of total caloric intake, it is also true that the second treatment also has 25% less carbohydrate by percentage. 
Stellar results were declared for the second treatment. Was it because of the added protein? Maybe. Was it because of the lowered carb? Maybe. The trouble is, you can't tell. 
The writer had no trouble concluding that it was because of the protein. As I was reading this, plus the quotes by the study's main author, I started to think, "Hey, wait a minute...". 
Now I am going to illustrate my point that mixture experiments can be murky by taking what this author says Dr. Layman said and TWIST it around, just cause I like doing that and I can. An equivalent and equally-valid statement based on the experiment would be: 

"Both diets work because, when you restrict calories, you lose weight. But the people on the lower-carbohydrate diet lost more weight," 
"There's an additive, interactive effect when a lower-carbohydrate diet is combined with exercise. The two work together to correct body composition; dieters lose more weight, and they lose fat, not muscle."

And I am still wondering why Dr. Layman made the statements he did about protein but not about carbohydrate. 
So....... I went looking for more info. Eventually I did find the second article discussed. It had the same problems as the first study. In his study, Dr. Layman did mention in the very first part that the the diet was both a change to a higher-protein AND lower-carbohydrate diet and did mention near the end that the experiment had some design problems and he proposed a different way. 
However, the title of the study, "Dietary Protein and Exercise Have Added Effects on Body Composition during Weight Loss in Adult Women" obviously is biased towards the high-protein conclusion rather than the low-carbohydrate conclusion. Possibly a nod to the the people who funded the study, The National Cattlemen's Beef Association? The Beef Board? Just sayin'.   Or, maybe it is just because doing any kind of paper on about the "evil low carb" idea is career suicide.
And here's the original article:
I didn't find the part where Dr. Layman said what was with the quote marks and attributed to him. Perhaps it came from another article he did, or from a seminar, or from another organization, like the Egg Nutrition Center, another organization he works for. Maybe he never even said it, or more likely, it was taken out of context and "spun". 
I'm not even going to comment that much on the third study discussed in the fitness article, only to say that I found the original article and things are even murkier. Explaining what the problem is would make this blog even longer, and as it is, my head already hurts. So, stay tuned for more... And please, hit the "like" button. Thank you for reading this far. 

Friday, March 18, 2011

Paleo Pizza Deconstructed

(this tasty recipe first appeared on another website on March 17)
The only reason I didn't put this into a real recipe for extra points is that I thought it would get rejected. It is a real recipe (OK, parts of it.) Thanks to another poster for the suggestion.

Paleo Pizza Deconstructed

They do it on TOP CHEF, why not in your kitchen? It is easy to deconstruct your favorite foods and remake them the way nature intended!!!


1 large whole red ripe tomato (3"diam), thinly sliced
1 Jalapeno pepper, diced
.25 cup chopped scallions
.5 cup sliced fresh mushrooms
5 jumbo black olives
.125 t oregano powder
10 basil leaves
2 pork sausage links (4 x 7/8 inch)
.5 cup fresh bell pepper strips

You will also need 1/4 cup whole wheat berries for this party dish.


Wash the wheat berries, soak them in cool water for several hours, spread them on a tray with potting soil. After a few days, they will sprout and you can feed the grass to your cat.

You won't be eating any of the wheat yourself.

For the actual pizza you can eat, cut up the sausage and fry in a pan until cooked. Add the peppers, scallions, mushrooms, olives and oregano, stir and turn off the heat.
Let the mixture cool a couple of minutes. Arrange artfully on a round plate with basil leaves and sliced tomato. You can eat it in sections or just dig in and eat the whole pizza all by yourself.

This should be filed under: beef and pork, dinner, Italian, low carb, Paleo, Party, 4 days prep time for the kitty grass, 10 minutes prep time for the part you will eat, 5 minutes cooking time, 5 minutes plating. (You can also save on clean up time if you let your cat lick the plate. After your cat gets rid of the fur ball, he'll be hungry enough for it, even with all that oregano.)

Nutrition Facts
Deconstructed Paleo Pizza

1 Serving

Amount Per Serving

Calories 208.5
Total Fat 12.0 g
Saturated Fat 3.3 g
Polyunsaturated Fat 1.7 g
Monounsaturated Fat 5.8 g
Cholesterol 21.6 mg
Sodium 732.6 mg
Potassium 848.9 mg
Total Carbohydrate 19.7 g
Dietary Fiber 5.6 g
Sugars 4.0 g
Protein 9.6 g
Vitamin A 42.2 %
Vitamin B-12 7.7 %
Vitamin B-6 26.5 %
Vitamin C 137.2 %
Vitamin D 6.7 %
Vitamin E 12.9 %
Calcium 9.4 %
Copper 23.8 %
Folate 17.6 %
Iron 20.7 %
Magnesium 12.1 %
Manganese 23.4 %
Niacin 21.7 %
Pantothenic Acid 12.9 %
Phosphorus 15.2 %
Riboflavin 20.7 %
Selenium 13.4 %
Thiamin 27.3 %
Zinc 9.0 %

Dr. Christopher Gardner

I had been meaning to do a blog about Chris Gardner's Diet study. He compared the Atkins, Zone, Ornish and LEARN diets and found that the people on Atkins lost more weight and had better metabolic effects (like their cholesterol numbers etc.) 
Instead, I found this wonderful blog post by Dr. Mike that explains it much better than what I could have done. 
When I watched the video, I was just amazed at the data that Dr. Gardner had on participants with metabolic syndrome. This data isn't in his paper, originally published in JAMA. Most of the time, Gardner's study is trotted out with his statement that there wasn't that much difference between the diets. This is what the diet "experts" want you to believe. 
The experts rarely quote this study anymore, preferring another 2-year study which show less differences between the low-fat and the low-carb diets. 
I know this video is really long, so read Dr. Mike's article now, bookmark it and watch the video this weekend with all your Syndrome X friends and family.

I'd like to add that Dr. Gardner is a 25-year vegetarian who was quite surprised by the results. 

Thursday, March 17, 2011

And Now For Something Completely Different

Dr. Kurt Harris created quite a stir on his blog recently when he came out as an evil Rice'Crispies-chompin' starch-eater. Unfortunately, I found his blog just as he was closing the comment option and the forum, due to all the hoopla created by his posts.

I am really glad to see this, and his situation addresses one of the concerns I have had about the Paleo diet.  (I'll be posting soon on why I am not really a Paleo.)  And, I can plug his wonderful blog while at the same time showing you that I can be somewhat unbiased by showing you a work extolling the virtues of carbs.

Dr. Harris found that when he was very active he lost too much weight on a very low carb diet.  So he added the starch back in.  Here's the post that started the commotion.
Read Part II, posted next.
His experience mirrors my own in that I find I need more carbohydrate when I am extremely active.

However, it is difficult (at least for me) to ascertain the correct level to eat by reading many of the popular low-carb diet books.  Many, in fact, recommend various levels of nutrients and also say that tons of exercise isn't necessary for weight loss.  And, while it may be true, such recommendations don't adequately apply in the situation of a person who has an extremely active lifestyle.  In my own case, much of my exercise is in the garden, and the work can get pretty intense, especially in the fall.  I'm not about to stop it because some diet doctor says I don't really need all of it.  I work hard in the garden no matter what my weight or diet success.  I work in my garden because I want good veggies and I am obsessed.  (OK, I'm obsessed first, but justify the obsession by talking up the healthy veggie side-effect.)

Oh, Rice Crispies?  What were they doing in the cupboard of a Paleo?  Maybe, like my grandma for sure, he had one of those hand-cranked rice crispers.  I hope he didn't wash them down with a container of chocolate soy milk!

Totally bogus study disguised as real research?

(a version of this post was on another site on Feb 27 of this year.)
You decide! 
"The intent of this analysis was to evaluate the healthfulness of several popular diets and the OmniHeart diets.." 
Oh really? These researchers didn't do a real experiment. They said they wanted to evaluate "healthfulness", so what they did is compare several diet plans to established dietary guidelines (You know, those guidelines that say we are all supposed to reduce saturated fat because it's a "risk factor" for heart disease). 
Amazingly, they found out that the low-carb diet plans, and even the Ornish plan, did not conform to these recommendations. And they used NIH money to figure this out? They had to have a bunch of people with PhD's to get paid for this? 
So, you're probably thinking, what kind of conclusions did all this money get us? They concluded that the other plans were worse because they didn't follow the guidelines as closely. They elevated their own diet. Nice try, Harvard researchers. We expected better from you. 
Not only that, they got their "peers" to publish this crap in a "peer-reviewed journal". And, they tried to weasel-in a statement about how the low-carb diets increased "risk factors" for cardio-vascular disease. "Although the OmniHeart protein and unsaturated fat diets were superior to the carbohydrate diet in improving CVD risk.." (Nice try on the Google Bomb.) (Repeat after me: a risk factor is not a cause, a risk factor is not a cause....) 
So lets recap. The "researchers" attempted to prove that their diet was better by comparing it to some standards. Then they declared their diet the winner, and also implied that they had determined that it reduced CVD. But, they actually offered NOT ONE SINGLE NEW DATA POINT, and only managed to confuse the issue even further. 
I guess that won't keep others from quoting this study as proof that low-carb diets are bad for us.

And, just for fun:

It just gets better and better

(originally posted Feb 27 on another site.)
Well, here I am, interrupting my daily schedule to bring you another blog for the day. I just had to laugh so hard (or cry) that it couldn't wait till tomorrow. 
I had been reading the comments to yesterday's blog about the "bogus" study. 

(See the entry: )
Curious, I decided to look up a few of the authors, to see if I could find any other comments about this study from other prominent diet doctors. 
It was just bugging me when that little phrase, "Peer-reviewed journal" kept tumbling over and over in my brain and I kept waking up at night troubled, wondering about who might be a peer of this lead Harvard researcher. (BTW, for those that don't want to go back to the article, it was in the American Journal of Clinical Nutrition, sounds fancy enough, doesn't it?) 
I started on Frank Sacks, he's the guy the e-mails and comments go to, so he was probably the man in charge. So, I googled him. Interestingly, the "bogus" article didn't show up first, but another article caught my eye. 
It was an article in the American Journal of Clinical Nutrition. When I clicked on it, I came up with the journal's conflict of interest policy, written by the prominent editors of the journal. Guess who wrote it? Yea, you guessed it! Frank Sacks! 
So let's recap: He's the editor, he even writes the conflict of interest policy, and then a year or so later, his bogus article gets approved for publication in the same journal. Sounds like there's no conflict of interest here! 
Sounds just like an old-boy club there at Harvard. They all take turns editing, writing and then approving each other's papers. Now if they want to call that HIGH SCHOOL, that's great. The trouble is when they are calling it SCIENCE and you and I are not only paying for it, we're being scolded for not following the recommendations in such a prestigious journal. 
Anyway, I found this really great article about one of Sack's other papers, over at LivinLaVida LowCarb.  Sacks gets skewered, and justifiably so, IMO.  Here's the link:

Wednesday, March 16, 2011

Are Fad Diets a Passing Fad??

I ran across this wonderful article this week, and so timely.  There has been lots of chatter in the blogosphere and social media sites regarding the numerous new nutritional articles that have been appearing in the journals recently.  This explains the fair amount of pushback, as some nutritional authorities continue to grasp on to their theories.

Dr. Richard D. Feinman has written this journal article about fad diets, and the use of the terms "fad" and "healthy".  Is it time we discontinue such words when describing diets?  Here's some of the intro:

“Fad” is not a scientific term and is clearly contentious.

Conversely, the widely used term “healthy” is also not

scientific. The two terms, like positive and negative

electrical charge, are probably defined by their being

opposites. The real criterion for a fad diet, however, is that

you do not like it. Fad diets are the other guy’s diet. This

may mean everybody, as in the case of the American Heart

Association’s No-Fad Diet, which thinks all other diets are

fads [1]. In practical terms, there are two kinds of fad diets:

1) those that have some quirky feature, which hardly

anybody adheres to (unlike fads in fashion), and 2) the bĂȘte

noire of the nutritional establishment, the Atkins diet. Or

more generally, any form of low-carbohydrate diet. What

rankles researchers is that such diets outperform “healthy”

diets for however long they are compared."

Are we really ready to move beyond all the recent hullabaloo that started with the Atkins program and continues to this day?  I am not so sure.  Some believe that the whole dominant nutritional paradigm is ready to crash down.  Others believe that they will never see such a change in their lifetime.

Maybe the solution is that we could have kinder, gentler nutrition experts?  Maybe a kinder, gentler Dr. Oz, when he goes after guests like Gary Taubes?

I was especially surprised by reading the position of Dr. Robert Eckel concerning a low-carb diet.  Amazing! You can see his alternative plan here:
Here's another quote from Feinman's paper:

"A final example can be found in, a

subsidiary of WebMD. Although is not a

scientific journal, the publication of the statement by

Dr. Robert Eckel (former president of the American Heart

Association)—that he is “vehemently opposed to any such

outcomes study with Atkins” [7]—seems to have crossed

some line in resistance to new information."

Despite what their website promises, I don't think TheHeart can be trusted.  Let's hope they change their message.

Tuesday, March 15, 2011

What is a [redacted]-wit?

Here is a report that is very critical of the US food guidelines.

I found this passionate review on a Paleo diet forum (Mark's Daily Apple) obviously from a fan of a different way of eating than what has been fed to us.

"Its the paper by a committee who has basically said that the US gov's dietary health plans are a load of [redacted] that may have made done more than harm than anything else.

If you want to know how to call people incompetent [redacted]-wits in academic language then I suggest you read this paper. Also, I suggest you send this to everyone you know (especially those people that like to rely on the food pyramid)."

I Did This and I Did That

I know, it sounds egotistical. But, many who read my blogs regularly know that sometimes if people post something that goes against the accepted nutritional "gold standard recommendations based on years of evidence-based medicine by peer-reviewed professionals who are licensed and registered to know more about it than you do", they can get into trouble. But, it is OK if they post their personal experience.

I'd like to tell you about my own personal experience with potassium.

It is in all their books, and the Eades' say that a good way to get more potassium is in salt substitute. The other day I was in the garden, and it was very hot, the first really hot day, and I got dizzy. Remembering the Eades' recommendation, I decided to try some salt substitute. I bought a container of Morton salt substitute and just put one shake on some food. (1/4 teaspoon has 17% of the RDA.) I felt better immediately. Now when I come inside from some heavy-duty exercise in the heat, I have a bit of the potassium in a glass of water.

The Eades recommend it along with a low-carb diet. Here's Dr. Mary Eades take on it:

Dr. Eades also has a great post about pumpkin. She does comment on our usual solution, which is to run to the high-carb banana for potassium and why pumpkin is better for people concerned about their carb intake.

It turns out that most of the potassium I eat comes from jerusalem artichoke, avocado, fish, winter squash, turnips, kale and swiss chard.

Here's a link to a page with potassium content of foods:

I am not as fond of this list because it shows many of my favorite selections cooked or boiled, and this doesn't include the water. I always save and use my cooking water, and it contains lots of the potassium that was contained in the food. I am kind of fond of this list also:

Just as a reminder to all that a certain weight-loss website dietitian says the low carb diet is "disastrous, dangerous and above all-- boring!" and she also does not recommend potassium supplements. I would not recommend such practices anywhere on the Internets, but I hope you enjoyed my anecdote. Just take everything I say with a grain of, um, salt. (Well, I guess that sounded like a recommendation, but it's not.  If you want advice about potassium please see your doctor.)

Sunday, March 13, 2011

Big Fat Funnel Plot?

I received this link from a friend this weekend, a very interesting article by Kristin Wartman:

This article highlights the changes in opinion that some nutrition researchers have had lately, now that better data are starting to come in.  And, it is actually coming from some of the Harvard boys!  Shocking!
Here's a paper by Frank Hu, a prominent Harvard researcher who has been changing the tune lately:
And the clif notes for people who hate to read studies:

1.  We did a study where we looked at a bunch of studies done by other people regarding saturated fat and heart disease risk.
2.  We didn't find anything
3.  Oh, wait, we did find something.  We found publication bias!  We left that tidbit out of the abstract.

What's publication bias????  Well, they showed a fancy funnel plot, and it failed to look like a funnel, but what that really means is that researchers who found a positive correlation between saturated fat and CVD risk were more likely to get their papers published.  Why?  Probably because the biased "peers" who controlled entry into the top journals wouldn't let the other studies in.

It is really interesting to see Dr. Hu changing his position.  He has other studies like this one:
This study was blasted by others, and for the way the media handled it.  This is another one of the observational epidemiological studies some can mis-use when they confuse correlation with cause.  The media picked this up and inaccurately reported that if you eat less meat you will have less disease.

Here's a nice article about the whole messy saturated fat/heart disease debate, and some additional links.  An especially good link is to the Dr. Eades blog, where he uncovers the reporting bias by the media.  Dr. Eades has a number of blog posts describing the widespread incidence of reporting bias. And I think it is pretty interesting stuff to read.  I'd bet that if the media reports could be meta-analyzed, they would show no funnel shape either.  Here's the link:

Saturday, March 12, 2011

Ecological Correlation - It's Not Easy Being Green

As I was reading the linked article from yesterday's posts (see link below) on the widespread practice of sweeping public policy decisions made on the basis of faulty research, I checked out some of the references and I was reminded of one of my favorite topics, ecological correlation.

So, what's ecological correlation?  No, it's not about recycling or reusing your data, and its not all about Al Gore, either.  But, it IS a bit like reducing your data, as in reducing it into a more manageable form so as to make it pretty much meaningless or misleading.  In a nutshell, ecological correlation is a statistical fallacy.
Many reading this probably remember John Robbins' "Diet For a New America".  In his famous book extolling the virtues of vegetarianism, he showed a chart with breast cancer rates plotted against dietary fat intake, with each point coming from a different country.  It had a great caption:  See The Pattern?
Of course, we saw the pattern.  The pattern was clear.  There was impeccable correlation between breast cancer and dietary fat intake.  Both the researchers and Robbins concluded that dietary fat intake causes breast cancer.

But, when researchers actually started to do some of these experiments to test what should have been only theory, they couldn't find such a clear relationship.

What went wrong?  First, researchers confused a correlation with a cause.  Second, they suffered from a bad case of ecological correlation.  I am going to cut some slack for John Robbins.  He is a writer, not a researcher.  His book is peppered, even littered with convincing ecological correlation graphs.  He was just using data that had been published in the "peer reviewed" journals, from people like Carroll and Keys.  (You might remember Keys.  He's the guy who did the starvation experiments with conscientious objectors, and also that bobble-headed cartooned researcher whose data points came crashing down in the movie, Fat Head.)  Data trends that show promise for entire groups oftentimes don't apply to individuals.  The sad part is that the public policy experts and nutritional authorities ran with the original studies and it is only now that some are starting to back-pedal the low-fat recommendations.  I say some, because it doesn't seem like some dietitians want to lose their grip on either their opinions or their control over who even gets to talk about it.

This poor use of data also results in confusion and breeds mistrust amongst the public.  We're told to lower cholesterol, then we're told it doesn't matter.  We're told that high fat causes breast cancer, then we're told it's OK.  We're told that eating lots of veggies will protect us against cancer, and then we are told they don't.  We're told that vitamin D is more important, and then, not so fast.  It IS confusing.  Much of the misleading early research needs to be recycled in the compost heap.  And I don't mean just re-using the same old data points to build newer papers.  I mean going out and getting some more meaningful data.

Here's the link to the original article that got me thinking:
Here's a link for an explanation of ecological correlation.  If you aren't into statistics and just want to cover your eyes and ears, here's the short take-home:  ecological correlation = BAD!!!  When you see a chart plotting averages against rates, run for the hills!

Am I that boring?

I've been reading that some diet "experts" have been saying that a low-carb diet is so boring. It certainly has been a challenge. 
Last night was so dreadful, my husband jumped away from the table after dinner and quickly did something else. (In other words, he wasn't sleepy from too many carbs.) 
We enjoyed fresh haddock fillets with sauted onion, carrot, fennel, thyme, celery, parsley, lemon and anaheim pepper. I served it with a fresh tartar sauce, home-made cole-slaw and some strawberries with whipped cream. All the fruits/veggies were from the garden except for the onion and the strawberries. 
For lunch, we suffered through a vegetable stir-fry with curry powder, garam masala and my own intensly-hot red caribbean pepper sauce. I put a bit of chicken in it, with some basmati rice steamed with vegetable broth and turmeric. (OK, I had a tablespoon of the rice, too!) 
I didn't know how I would be able to get through another day, but since the goal of preparing healthy and satisfying meals is on my action-list, I struggled through breakfast. 
This morning I had a small amount of coffee with a splash of cinnamon and real cream. I made eggs again, with butter, kale and fresh marjoram. At the market yesterday, all the bulk items were on sale so I decided to try some coconut flour. My first trial was to make pancakes. I used an egg, 1/4 cup coconut flour, 1/4 cup ground almonds, 1/4 cup cream, 1/2 cup water and 1/4 t baking powder. The recipe needs some tinkering, but my husband declared the pancakes edible and came into the kitchen for more. He put blackberry jam on his, and I topped mine with sliced strawberries. Boring, I know. We had strawberries for dinner, and I might be stuck with eating them for lunch, too. 
Someone pluck me out of my misery! My diet is boring and none of my clothes fit this week. 

[Note:  a version of this was posted on Feb 26, 2011 on another site.]

Oh, Why do I Keep Doing This?

I know I know, I should know better right? 
I know that very few people read my blogs about clinical studies. Y'all really like artichokes and garden escapades much much better. I get that. But, why do I continue to post about obesity and clinical studies when few people read them or care? 
I have been on a quest to understand what has been happening to me. Last summer I was on a months-long plateau, following my plan the best I could, not losing weight, becoming miserable and depressed, having sleeplessness and lots of night-time cravings. I tried to make up for my cravings by exercising, and then ended up in an increasing eating/exercising spiral that left me exhausted and injured, and more depressed and slug-like. 
The only difference between this response and other times I tried to lose weight is that this time I just didn't give up. I kept tracking my food intake and exercise, encouraged my friends, kept going despite dismal failure. Each day I would wake up with all good intents, but by the evening, I was feeding the cravings, promising myself I'd do better tomorrow. And the next day, I would try the same thing, and get the same results. 
Isn't this the definition of insanity????? 
Then I made a few easy changes (not recommended by the "experts", in fact, they had warned me....) and I started having success. I was astounded. Why hadn't anyone told me about this before? It was always, "eat less, exercise more, use small plates...", all prescribed on the assumption that my problem was one of laziness, will-power and lack of character, lack of planning, and my love of fatty food like coconut and black olives. 
I went to the internet, and searched all the way to the end, to try to make sense of it all. That lead me to many prominent diet doctors, and then to researchers and then to Gary Taubes. 
I read all sorts of books, reports, studies, blogs, position papers, statements. Eventually I think I figured out why certain things started working for me and why certain things did not. But it was what Gary Taubes wrote that really started to make me mad, and to start talking about it. 
In his book, "Good Calories Bad Calories", he described a study that Ancel Keys did during WWII. In the study, he put a number of healthy young men on a "semi-starvation" diet to see what the effects of food shortages (like in Europe) would be. The diet was about 1500 calories and consisted of things like mostly ww bread, potatoes, turnips, cabbage, and a bit of meat or milk. So far, it doesn't sound that bad, except 1500 calories seems a bit low for men. They also followed a walking program. 
The men lost weight, sure enough, but the really interesting thing is that several had to drop out because of psychiatric problems, including depression and self-mutilation. When the diet was over, the men (still monitored) ate more, gained more and ended up fatter than where they started, and they still continued to eat! (And some still continued with the psychological problems for quite some time.) 
But the thing that really made me mad is that Ancel Keys did this study on conscious objectors. These were Quakers, Mennonites and Bretheren who were so into non-violence that they risked quite a bit to not participate in the war. WWII wasn't like Vietnam. It wasn't an unpopular war. People then didn't just escape to Canada for a few years. They had to prove that they had been born into one of these religions (the "birthright" religions) and demonstrate a life-long commitment to non-violence, and then go up against the notion of the times, that the war was justified. They had to follow up their intent with letters, witness statements, church records, etc. in order to be a CO. Many times they were just jailed. (I knew several CO's and their families because many were assigned out West in the forestry agencies, mainly fighting dangerous wildfires. Their families moved to this region with them and many stayed after the war.) Life wasn't as good for these CO's as people might have imagined. They weren't coddled. 
I found it amazing that a reducing diet would have led some of these peace-loving men to self-mutilation. This just doesn't seem to be what you would expect to see from a man who had devoted his life to peace. Their diet led them to later obesity and violence. 
So why is it that we are recommending such a reduced-calorie, low-fat, low-protein diet now? Why is it that when this diet fails, we just tell ourselves that tomorrow will be different? That tomorrow we'll be able to sleep? That tomorrow we refuse to be depressed? That tomorrow we WILL get on that treadmill? 
I read lots of blogs here, probably yours. If you comment on my page or blog, I visit your page and read them all. I know what people are saying about their progress. Many posts indicate frustration, depression, exhaustion, and while many friends have been successful, many have not. That's when I decided to write more about it. 
Friends, I REALLY do care about you. You are real people! I know you aren't weak-willed, or lazy or undisciplined. You have mentioned that you are doing "all the right things", and when you ask for help, the answer is usually to continue to do even more of "all the right things." And I think that's just insanity. 
This "insanity" is what has led several prominent diet researchers to throw up their hands, declare defeat, and recommend lap-band for everyone. And, it led me, a former vegan/vegetarian for 25 years, to start eating some meat again. And that has been surprising and difficult, since I have identified with the vegetarian movement for years and now finding myself a bit ostracized by them, and finding the paleo's to be more welcoming. Gosh, I never thought that would happen!
Anyway, enough rambling. If you read this far, thank you for reading and listening. If you leave a reply, again, I will send you a 5-points-worth goodie that won't make you hungry or raise your insulin level. 

[Note:  a version of this was posted on Feb 26, 2011 on another site.]

Evidence Based Nutritional Guidelines??

Well well well!  Looky what I found?  I'm just not getting around to putting my earlier posts up on this here blog, am I?  I keep finding new interesting things to share.
You know, I thought I was just gonna upchuck the ground-chuck if I heard one more time about "evidence-based" nutritional guidelines.  About a week ago, another post by dietitian on a weight loss website contained this nugget:

"My main concern for this [redacted] site and our members is to keep recommendations evidence based, using published peer-reviewed literature and guidelines that then apply such research and are appropriate for the general population."

Several other posters had remarked that some of the dietary recommendations are either wrong, out-of-date or not universally applicable.  Here's an article that moves the real issue into the light of day.  It calls out the difficulties that the "peers" have stumbled upon when they tried to over-reach their control over food and nutrition policy on the basis of sub-standard studies.  The authors use the dietary fat controversy as an example of how things can go very wrong.
Actually, many of the "peers" haven't stumbled onto it yet.  They are still recommending the same old guidelines.  In the face of increasing uncertainly, some have responded by becoming increasingly rigid.

Thursday, March 10, 2011

Fill 'er up with uh, Ketones?

Recently, I found another interesting article by nutritionist on a weight loss website.  This article had been quoted by others as proof that a low-carb diet is dangerous.  Here's a sentence:
 "In fact, the human brain depends exclusively on carbohydrates for its energy." 
Are carbs the only brain food?????  I wanted to jump into the discussion with a "Hey, wait a minute!", but then remembered that I had better behave myself, at least until I have updated my food tracker to Dr. Oz' new weight loss site.
Here's what Dr. Mary Dan Eades, noted physician and diet expert, has to say about brain food:
Her post contains a dead link, so I found another that speaks of the diabetes-Alzheimer's connection.