I want to give you a few words of advice right up front. Keep this post close at hand so that you can send it out whenever anyone makes one of the following comments to you:

• The Chinese don’t follow low-carb diets and they’re healthy
• The Chinese eat a lot of carbs and they don’t get fat
• The Chinese follow a low-fat diet and they don’t get fat
• Fruits and vegetables don’t make you fat
• If vegetables really made you fat, the press would be all over it
• Researchers never misstate their findings
• Show me the study!

The current issue (June 2008) of the International Journal of Obesity, published by the Nature Publishing Group (Nature is the most prestigious scientific journal on the planet), contains an article titled Vegetable-rich food pattern is related to obesity in China that is most enlightening and interesting on many levels.

Researchers evaluating the obesity status of the Chinese discovered that

China is facing an obesity epidemic. Between 1992 and 2002, the prevalence of overweight and obesity increased in all gender and age groups and in all geographic areas of the country. Using the World Health Organization body mass index cutoff points, the combined prevalence of overweight and obesity increased from 14.6 to 21.8% during this period. [An increase of about 50%, which pretty much mirrors what has happened in the US, although from a lower starting point.]

What is even more telling is that the prevalence of central obesity, a much more representative measure of overall health, was as follows:

Central obesity was 19.5% in men and 38.2% in women.

In an effort to figure out what is going on researchers evaluated the diets of almost 3000 Chinese men and women (average age 47 yo) from all walks of life and all educational levels living in rural and urban areas. They found the typical Chinese diet to be

characterized by a high intake of vegetables and other plant foods, and thus the intake of carbohydrates and fiber is high.

When these researchers started evaluating the specifics of the Chinese diet, they found themselves ensnared in a thorny thicket of cognitive dissonance. How they hacked their way out shows just how nutritionally biased researchers are today and how they will twist and turn and torture the data (and outright misrepresent it) to make it confirm their biases.

Let’s take a look.

They report early on in the paper that despite the ongoing nutritional transition that the Chinese are going through (brought about by Western influences) that

The average intake of vegetables is still higher than those in the western countries. At a national level, the mean intake of vegetables was 276 g per day in 2002, which is 40 g per day less than 20 years ago.

They then state:

The beneficial association between intake of vegetables and fruits and obesity has been well documented in different populations. In Western populations, high intake of fruits and vegetables is associated with lower intake of energy and a healthy lifestyle and thus a lower risk of obesity. No research has examined the association between obesity and a diet rich in fruits and vegetables in China.

Which they set out to do. It is obvious from the first two sentences of the quote right above what the bias of these researchers is: fruits and vegetables are good for you. And more of them is even better. Problem is that there really isn’t any definitive research showing this, although it is widely believed.

I’m pretty certain that when these people decided to do this study their game plan was to divide the study population into quartiles or quintiles of fruit and vegetable consumption. And I’m sure they figured that those subjects in the quartile or quintile of the highest fruit and vegetable consumption would show the least obesity while those in the lowest fraction would show the most. But it didn’t turn out that way for them.

In fact, it was just the opposite. The researchers did divide the subjects into quartiles (fourths) as a function of fruit and vegetable consumption, and they found that the subjects eating the most fruits and vegetables were the fattest. As they put it:

Increased intake of the vegetable-rich pattern was found to be positively associated with risk of obesity in the study. the prevalence of obesity among women with the highest intake of this pattern was more than double than that of the lowest intake group.

The vegetable-rich food pattern was associated with higher risk of obesity/central obesity in Chinese adults in both genders.

So what do good scientists do when they discover that the data doesn’t conform to their preconceived notions? They change their thinking to fit the data. What do sorry scientists do when the data doesn’t conform to their preconceived notions? They interpret the data so that it does fit with their thinking. Which is just what these researchers did.

The data is pretty clear that those subjects who ate the most vegetables were the most obese. It’s also clear from the data that those subjects who ate the most vegetables also ate the most calories to the tune of about 200 kcal more per day. Now it would be easy and within what the data show to state that those subjects consuming the most calories were the most obese. No one would argue with that. But it flies in the face of the popular idea that you can eat all the calories you want as long as they are fruits and vegetables. Dean Ornish wrote a bestselling book titled Eat More Weigh Less on this very subject.

Our researchers are in a quandary. Their data that they expected to show one thing is not cooperating. And try though they might to legitimately present it, they can’t without somehow contradicting the idea that vegetables (in whatever quantity) are healthful. Where to go? What to do?

What do you think they did?

What all good mainstream researchers do. They blamed it on fat. I’m not kidding.

Here we go right from the paper. As Dave Barry would say: I’M NOT MAKING THIS UP.

The average intake of vegetable oil in China was 33 g per day in 2002, while this figure was only 22 g per day in 1992 and 18 g per day in 1982.

High intake of vegetable-rich food was associated with high energy intake, probably due to the high proportion of energy coming from fat which contributes to a high energy density, which is known to affect obesity prevalence.

In the present study, a positive association between intake of vegetables and vegetable oil was observed.

Stir-fry cooking method in the Chinese population may thus partly explain the positive association between a seemingly vegetable-rich food pattern and obesity…

Thus, when making recommendations on intake of vegetables, the importance of limiting the use of cooking oil as well as cooking method should be emphasized...

You can certainly see where they’re headed with this. And they don’t disappoint.

In conclusion, we found a positive association between intake of vegetable-rich food pattern and obesity. This association can be linked to the high intake of energy due to liberal use of vegetable oil for cooking vegetables.

There you have it. Fat is the culprit. And although vegetable oils have been the darling fats of the mainstream folks for ages, they don’t hesitate to throw them under the bus when their beloved vegetables are challenged.

But hold on. There is a fly in the ointment here.

There is absolutely no difference in the amount of fat consumed in the group that ate the most vegetables as compared to the group who ate the least. In men the grams of fat were exactly the same in both groups; in women their was a slight difference, but it didn’t reach statistical significance. And as a percent of energy intake (the measurement the mainstream loves), fat intake dropped from 32 percent to 31 percent in both males and females as vegetable intake went up.

You think I’m pulling your leg on this? Researchers publishing in a major journal (and the peers who reviewed them) wouldn’t say all this if it weren’t supported by the data. Right?

Well, here is the chart from the article showing all the data.

Click on it to blow it up to readable size and look down to where it lists the fat intake and come to your own conclusion. Then go back up to the quotes from the article that I have put in bold print. Unbelievable. This is why you never want to panic when you read the press report of a new piece of research. Oh, and BTW, have you noticed how the press has ignored this study?

I saw no mainstream press articles when I Googled; the one article I did see from an online publication picked up the misleading conclusion from the paper.

A Chinese study came up with the — to Americans — paradoxical finding that the more vegetables people ate, the fatter they were.

Why? Because the Chinese in this population in Jiangsu Province were stir-frying their vegetables in “generous” amounts of oil, and the more vegetables they ate, the more energy-dense oil they were eating.

If you’re going to draw any conclusions at all from this data in terms of macronutrient consumption and obesity, it’s got to be that carbs make you fat since the data show that carbs are the macrontrient that increased the most in both men and women with increasing obesity.

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Here is how we spent the 4th this year. MD’s singing group, the Santa Barbara Choral Society, always performs with the Santa Barbara Symphony at the free concert in the sunken gardens of the Santa Barbara courthouse. The rest of the fam and friends usually picnic (low-carb, of course) on the grounds and watch. In the above photo the SBCS sings (the symphony is in the back) their hearts out. MD (aka Nanny) is front row, third from the left in the light-colored jeans.

This photo is without telephoto lens back from where our group was sitting. You can click on the picture to enlarge it. The upgrade of my blogging software allows this function, and it’s the first time I’ve used it. Let me know what you think. If the download isn’t too slow, I’ll put all photos like this from now on.

Here is our little patriotic granddaughter sitting on Dad’s (our son Dan) shoulders watching Nanny perform. Our friend Julian Nott is in the white shirt. On the left you can see some of the smoke from the monster Goleta fire burning about 15 miles away on the far end of town.

This is a photo of the sunset taken from our seat on the courthouse lawn just before we left. The only good thing I can think of that comes from these California fires is the spectacular sunsets the smoke provides. It’s hardly a recommendation for starting them, though.

After we had watched the festivities and finished the picnic, we all headed to the Santa Barbara Yacht Club, the best place to watch the fireworks. Here I am sitting on the deck outside with son Dan and granddaughter Emma (all wrapped up in her Princess dress with arms pulled inside to keep warm from the chilly night breeze blowing in off the Pacific) watching the spectacle. In years past this deck was clotted with people. There were only a few this year. I don’t know if the economy or the fire or both kept them away.

The grand finale of the city fireworks display. It was accompanied by a raucous applause of a zillion horns from the boats in the marina below. All in all a fun day. I hope your 4th was as good.

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It would never have occurred to me that Jessica Simpson and I might have something in common, but this photo proves otherwise.

For those readers here in Seppo-land, have a happy and safe 4th of July.

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The Power Protein Plan is an excellent program. The book details every aspect, including cholesterol, triglycerides, heart disease, diabetes…and explains how this protein plan can actually positively affect each.

My husband is diabetic and is on insulin and oral drugs to maintain his out of control blood sugar. I put him on the protein power plan and his blood sugar dropped enough that he could do away with 3 shots and the oral drug. He never felt better, but his self-destructive nature has caused him to forego sticking to the plan entirely-which is why I give it 4 stars instead of 5: If you cheat on this plan, you will gain weight and probably cause your blood levels to rise.

All in all, a healthy, easy plan–the included recipes are really quite good-though time-consuming.

The sentence that I found funny was, of course, this one:

He never felt better, but his self-destructive nature has caused him to forego sticking to the plan entirely-which is why I give it 4 stars instead of 5: If you cheat on this plan, you will gain weight and probably cause your blood levels to rise.

So, her husband’s self-destructive nature cost me a star. Oh well, I suppose that’s a small price to pay.

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The Food Policy Institute at the Consumer Federation of America just published a report showing the amount of carbohydrate and the number of calories in the 26 best selling alcoholic beverages.

The report is in chart form in pdf format. You can download it here.

Put it on your refrigerator or keep it some place handy, so that you’ll at least know how many carbs and cals you throw back when you quaff one or five or your favorite drinks during the hot dog days of summer.

And remember as you’re trying to lose weight the oh-so-true quote (from I don’t know whom - I’ve seen it attributed to several, including Mark Twain):

Will power lasts about two weeks and is soluble in alcohol.

Truer words were never spoken. My will power last night became soluble in the alcohol found in two margaritas. It became way soluble in the Johnny Walker Blue generously provided by my brother in South Carolina at his daughter’s wedding a couple of days ago. Had I had this nifty chart with me, I could have calculated the damages in real time.

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Several years ago I encountered one of the most gifted communicators I’ve ever been around. To watch this guy work was truly amazing. His ability to spread oil on roiling waters and bring people with violently disparate views together was almost magical. Now I’ve found a book that shows how he did it.

MD and I were involved with some other people in a business venture that had kind of blown up and was on the ropes. Interestingly, the business was not struggling - in fact, it was making money hand over fist. Which is strange because most blowups between partners come about when there is great financial strain in the business. In this case it was just the opposite.

We had all agreed on a CEO for the business, but at some point along the way, the other people involved had a falling out with this CEO and wanted to get rid of him. MD and I, on the other hand, really liked him, thought he was doing a good job, and wanted to keep him around. Every conference call and every face-to-face meeting became a sort of angst-ridden nightmare for all concerned. Even the CEO wanted out, but was afraid that his portion of the business would be at risk if simply walked away. He had a couple of people he knew could do the job, but he (and MD and I) figured the other partners would be suspicious of anyone this CEO recommended. We were all at a stalemate, with the distrust among us all growing by the moment.

As MD and I were championing our CEO our partners were, unbeknownst to us, looking for a replacement. They found someone they thought would be acceptable. They sent us this guy’s resume, which was impressive. He had been involved in both large corporate situations and in entrepreneurial ventures that had been monumentally successful. He had recently taken a company from start up to acquisition by a major corporate entity for a healthy sum. Our partners wanted us to talk to the guy on a conference call to see if we liked him. We grudgingly agreed. Grudgingly because we weren’t thrilled to be even giving the appearance of considering someone proposed by the opposition.

We got the guy on the phone and within about 20 minutes we were ready to hire him. We hooked him up with our CEO, who felt the same way. We met the guy and found him to be even more impressive in person. We all - MD and I, the CEO and the other partners - agreed to take him on after checking all his references, which were sterling. People couldn’t say enough good things about him.

He came aboard and, thanks to his communication skills, was able to dissolve a lot of the animosity and mistrust that had become a routine part of all company interactions. It was mesmerizing to watch a pro in action.

Unfortunately, the outcome didn’t have a happy ending. But it wasn’t entirely his fault. He was stuck in big company mode (even his startup was well capitalized) and couldn’t ever get his brain around our specific business model. He ended up pulling a lot of money out of the business for himself and his team (which is the one thing I feared from the get go), and when the funds ran low, he and his team moved on to greener pastures. Sadly, his big corporate outlook and strategies didn’t really work for our bootstrap business.

I did get to witness up close and personal (and at great expense) how a great communicator works, though.

Now I’ve discovered a book titled Crucial Conversations that teaches anyone to become a great communicator.

We all have conversations all the time about all kinds of things with family, friends and co-workers. But most of these conversations are the hum drum, everyday variety of communication that makes up most of our conversations. It’s the not hum drum, everyday conversations that we need to be able to deal with to be effective communicators, however; it is those conversations when the stakes are high and emotions are running strong that separates the real communicators from the rest of us. Those conversations that have large consequences that we constantly replay in our minds, telling ourselves over and over that if only we had said this or that things would have turned out differently. Crucial Conversations teaches us how to handle these conversations on the fly.

Sometimes we initiate these crucial conversations, other times we are sucked into them unawares. And when one is imminent, we have only three choices as to how to deal with them:

• We can avoid them, i.e., run away.
• We can face them and handle them poorly.
• We can face then and handle them well.

As the authors point out, these choices seem simple enough. We can avoid these conversations and suffer the consequences or handle them poorly and suffer the consequences. Or we can handle them well. Seems like an easy choice. Let’s handle them well. But it’s not that easy. Why? Because, typically, during these conversations we’re on our worst behavior. Why? Because of the same reason that makes us do so well on low-carb diets: our Paleolithic physiology. The authors explain:

When talking turns tough, do we pause, take a deep breath, announce to our innerselves, “Uh-oh, this discussion is crucial. I’d better pay close attention” and then trot out our best behavior? Or when we’re anticipating a potentially dangerous discussion, do we step up to it rather than scamper away? Sometimes. Sometimes we boldly step up to hot topics, monitor our behavior, and offer up our best work. We mind our Ps and Qs. Sometimes we’re just flat-out good.

And then we have the rest of our lives. These are the moments when, for whatever reason, we either anticipate a crucial conversation or are in the middle of one and we’re at our absolute worst - we yell: we withdraw; we say things we later regret. When conversations matter the most - that is, when conversations move from casual to crucial - we’re generally on our worst behavior.

Why is that?

We’re designed wrong. When conversations turn from routine to crucial we’re often in trouble. That’s because emotions don’t exactly prepare us to converse effectively. Countless generations of genetic shaping drive humans to handle crucial conversations with flying fists and fleet feet, not intelligent persuasion and gentle attentiveness.

For instance, consider a typical crucial conversation. Someone says something you disagree with about a topic that matters a great deal to you and the hairs on the back of your neck stand up. The hairs you can handle. Unfortunately, your body does more. Two tiny organs seated neatly atop your kidneys pump adrenaline into your bloodstream. You don’t choose to do this. Your adrenal glands do it, and then you have to live with it.

And that’s not all. Your brain then diverts blood from activities it deems nonessential to high-priority tasks such as hitting and running. Unfortunately, as the large muscles of the arms and legs get more blood, the higher-level reasoning sections of your brain get less. As a result, you end up facing challenging conversations with the same equipment available to a rhesus monkey.

We’re under pressure. Let’s add another factor. Crucial conversations are frequently spontaneous. More often than not, they come out of nowhere. And since you’re caught by surprise, you’re forced to conduct an extraordinarily complex human interaction in real time - no books, no coaches, and certainly no short breaks while a team of therapists runs to your aid and pumps you full of nifty ideas.

What do you have to work with. The issue at hand, the other person, and a brain that’s preparing to fight or take flight. It’s little wonder that we often say and do things that make perfect sense in the moment, but later on seem, well, stupid.

“What was I thinking?” you wonder.

The truth is, you were real-time multitasking with a brain that was working another job. You’re lucky you didn’t suffer a stroke.

This book is a well-written, no nonsense guide through the jungle of various crucial conversations we venture or even stumble into. Some of the examples of these kinds of conversations are listed by the authors below:

• Ending a relationship
• Talking to a coworker who behaves offensively or makes suggestive comments
• Asking a friend to repay a loan
• Giving the boss feedback about his/her behavior
• Approaching a boss who is breaking his/her own safety or quality policies
• Critiquing a colleague’s work
• Asking a roommate to move out
• Resolving custody or visitation issues with an ex-spouse
• Dealing with a rebellious teen
• Talking to a team member who isn’t keeping commitments
• Discussing problems of sexual intimacy
• Confronting a loved one about a substance abuse problem
• Talking to a colleague who is hoarding information or resources
• Giving an unfavorable performance review
• Asking in-laws to quit interfering
• Talking to a co-worker about a personal hygiene problem

I’m sure you can think of (and have actually been involved in) many more than this short list. One I can think of that is probably applicable to readers of this blog: Talking to a loved one who needs it about a low-carb diet.

Both MD and I found this book enjoyable and enlightening. It uses a minimum of management-type jargon and is totally devoid of psychobabble. As you read through it you will intuitively feel that the advice the authors give is on the money. Best of all, in my opinion, at least, is that the techniques described require some work and discipline to acquire and become proficient in. (I always mistrust any book that presents X number of easy steps to master some complex skill.) In order to become a virtuoso communicator requires practice in the techniques described. Since you can’t always predict when a crucial conversation will be on you and don’t always know beforehand what’s it’s even about, you’ve got to internalize the methods so that you can use them while on autopilot. Which takes some effort.

The first step in any crucial conversation is the easiest: determine what you want the outcome to be. Being able to skillfully execute the techniques described in this book will get you to that outcome with your emotions and your relationships intact. I can’t recommend Crucial Communications highly enough.

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And even less surprising is the horde of diabetes ‘experts’ who are stampeding over the cliff with the idea that careful glucose control isn’t the panacea they had hoped it would be. Unfortunately, it isn’t they who will be splattered on the rocks below; it will be their patients instead.

Last week’s New England Journal of Medicine published the ACCORD study (full text here), and the authors concluded:

As compared with standard therapy, the use of intensive therapy to target normal glycated hemoglobin levels for 3.5 years increased mortality and did not significantly reduce major cardiovascular events. These findings identify a previously unrecognized harm of intensive glucose lowering in high-risk patients with type 2 diabetes.

The implication of these conclusions is that focusing on blood sugar control is a fool’s errand irrespective of how the blood sugar is controlled.

The low-carb diet is probably the single most effective method known of reducing insulin resistance, hyperinsulinemia and elevated blood sugar, yet it was ignored in the ACCORD study. And, unfortunately, is pretty much ignored throughout the mainstream medical community. Dr. Richard Feinman and the Nutrition & Metabolism society (of which yours truly is a member in good standing) would like to see that rectified. You can help by signing the petition below that will be presented to the NIH and/or other organizations (ADA, for example) and governmental bodies.

Here is the full text of the petition.

NIH must acknowledge existing science!

National Institute of Health re: the ACCORD Diabetes Study: “Intensively targeting blood sugar to near-normal levels … increases risk of death. ”

This statement is untrue. This study lowered blood glucose levels only by aggressive drug treatment.

Preventative measures and proven non-drug treatments are being ignored by the NIH, ADA and many other governing agencies.

There is abundant scientific evidence proving a carbohydrate restricted diet can be as effective as drugs in lowering blood glucose levels safely. Many times diet is more effective than medication in controlling diabetes - all without side effects or increased risk of death.

I ask that the NIH publically retract the above statement. It is misleading the public.

I also request that the NIH acknowledge the existing science and fund more research by the experts who have experience with carbohydrate restriction as a means of treatment for diabetes.

For more info, or to help people with diabetes, please e-mail info@nmsociety.org .

Thank you.

Click here for petition

As always, these things carry much more weight if they are personalized, so take a minute and add a brief comment about your own experience with low-carb diets.

Thanks from all of us at the Nutrition and Metabolism Society in helping us reach our goal of 15,000 signatures.

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One of the reasons this happens is that most of the comments aren’t comments - they’re questions.  If I don’t have the time to answer them, they stay in the awaiting moderation queue.  They stack up until I have some downtime to sit and answer them.  As of late, I haven’t had much time, consequently the questions stack up.

I think I’m going to start doing like everyone else who blogs and simply post the comments as they come in without answering them individually.  Many are asking the same general questions, so they can be answered with one comment from me instead of multiple individual responses.  We’ll see how that works.

Once again, I’m sorry if your comment got zapped.

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Last week a host of reports about a study showing that eating a big breakfast brings about a much greater weight loss than eating a smaller breakfast saturated the media. Predictably, the press was all over this report with varying flavors or reporting depending upon the reporters biases. Some, obviously carb biased, reported from a high-carb perspective; others - more well-balanced, no doubt - reported from that bias. Others simply focused on the ‘big.’ Let’s see what’s going on here.

The first thing one must realize is that this is not a paper published in a peer-reviewed journal, this is a poster presentation at a medical meeting, in this case the annual meeting of the Endocrine Society held in San Francisco last week. A while back I wrote at length on the difference between this type of presentation and a paper that has gone through the peer-review process. Poster presentations such as this one go through a sort of peer review process when they are presented in the sense that attendees ask questions and point out weaknesses. But the public never sees this. The public sees the press reports about these presentations without the peer review. Papers that are published run through the peer-review gauntlet before they see the light of day and are ever reported on.

The authors of this study or the university at which they are employed put out a press release on the results of the study. The press, eager to publish offbeat nutritional news, picks it up and runs with it. The gullible public takes it as gospel.

I tried to find the press release by going to the websites of the universities involved, but couldn’t come up with anything. Maybe some industrious readers will have better luck than I. A number of members of the media secured interviews with Daniela Jakubowicz, the lead author, so we can pretty much see where she’s coming from. Interestingly, she has a diet book out in Spanish titled ¡Ni una Dieta más!, which translates to Not Another Diet! The subtitle translates to: The circadian method that revs up weight loss, controls hunger and sweet addiction, and let’s you keep the weight off forever. It looks like this study is an effort to confirm the ideas in her book.

As I say, I couldn’t find the press release, but I did find the abstract of the poster on the Endocrine Society’s website.

[P3-220] Effect of Diet with High Carbohydrate and Protein Breakfast on Weight Loss and Appetite in Obese Women with Metabolic Syndrome.

D Jakubowicz, D Maman, P Essah, Hosp de Clins Caracas, Caracas, Venezuela; Med Coll of Virginia, Virginia Commonwealth Univ, Richmond, VA

Background: Insulin resistance, common in obesity, promotes weight gain. Weight loss diets for obesity are frequently unsuccessful due to a carbohydrate withdrawal effect that exacerbates carbohydrate craving and hunger. We hypothesized that a diet aimed at reducing hunger and carbohydrate craving would support weight loss in obese individuals.

Objective: The purpose of this study was to determine whether a diet consisting of a high carbohydrate and protein breakfast would promote weight loss, increase satiety, and reduce carbohydrate craving in obese women with metabolic syndrome.

Methods: In this 32-week prospective study, 94 obese sedentary women (age 31.67yrs, BMI 33.84kg/m²) with metabolic syndrome were randomized to one of two diets: 1) a strict low carbohydrate diet (LCH; n=46) consisting of 1085kc/day (carb:protein:fat 17:51:78g) with breakfast 290kc (7:12:24g), lunch 425kc (5:21:28g), and dinner 370 kc (5:18:26g) or 2) a LCH diet with the modification of a high carbohydrate and protein big breakfast (LCH+BB;n=48) consisting of 1240kc, (carb:protein:fat 97:93:46g) with breakfast 610kc (58:47:22g), lunch 395kc, (34:28:13g),and dinner 235kc (5:18:11g). The first 16wks aimed on weight loss and the last 16 weeks on weight maintenance (WM). A 3-h meal tolerance test (MTT) was performed with quantification of glucose, insulin and appetite scores (hunger, satiety, fullness, and desire to eat) using 100-mm visual analog scales (VAS) at 0, 30, 60, 120, and 180 min after LCH or LCH+BB breakfast.

Results: Both groups lost weight at 16 wks (LCH: -12.62kg, LCH+BB: -10.63kg, p=NS). During the WM phase, the LCH+BB group continued to lose weight (-7.52kg, p<0.001 vs. 16 wk) whereas the LCH group gained weight (+8.32kg, p<0.001 vs. 16 wk). At 32 wks, the LCH group lost 4.5% of their baseline weight. In contrast, the LCH+BB group decreased baseline weight by 21.3%. AUC for glucose and insulin responses to MTT improved in line with weight loss (p<0.001, NS between groups). Compared with LCH, LCH+BB reduced hunger (p=0.02), increased satiety (p=0.07), decreased desire to eat (p=0.02), and increased fullness immediately prior to lunch (p<0.001). In contrast to LCH, LCH+BB reduced carbohydrate craving scores (P<0.001).

Conclusion: A diet consisting of a high carbohydrate and protein breakfast facilitates weight loss by reducing hunger and diminishing carbohydrate craving. Effective weight loss strategies for obese individuals should focus on controlling appetite and carbohydrate craving.

By going over this abstract we can learn a lot. What we primarily can learn is what is missing in order for us to get the full and entire picture of what is going on.

We learn that 94 pretty obese sedentary women afflicted with metabolic syndrome were randomized to one of two diets, which is good. This is a prospective, randomized study. There is no mention of how these women were monitored or whether they had food provided for them or were simply instructed to follow specific diets.

After 16 weeks, the weight loss phase of the study, the women on the low-carb arm lost 27.7 pounds (12.6 kg) whereas the women on the higher-carb arm (the big breakfast group) lost 23.3 pounds (10.6 kg). I find it interesting that the lower-carb group lost almost 20 percent more weight than did the higher carb group, yet the researchers reported this difference to be non-significant. I don’t believe this. Not with 46 subjects in one arm and 48 in the other. The numbers simply don’t bear that out.

If you look at the caloric difference between the two diets, it turns out that the low-carb subjects were getting 155 kcal less than the higher-carb subjects, calculating out to about 4.96 pounds difference, which is close to the 4.4 pound difference that actually occurred. We can say that the difference in weight loss didn’t really have anything to do with diet composition, but a lot to do with caloric intake. At these low-caloric intakes, calories are what counts. Not diet composition.

Now comes the interesting part of this study, which is the part that isn’t mentioned. The abstract says that after the first 16 weeks of the weight loss phase of the study, the two groups were put on maintenance diets. There is no mention of calories, macronutrient composition, or meal timing. Presumably the big breakfast group continued to skew most of their calories toward the breakfast meal at the beginning of the day, but the abstract doesn’t tell us. This is one of the things that would never, ever fly through the peer-review process.

All we learn is that after the next 16 weeks on the mystery diet, the higher-carb, big breakfast group continued to lose big time, dropping another 16.5 pounds (7.5 kg) while the poor subjects in the low-carb group actually packed on an extra 18.3 pounds (8.3 kg). There is something fishy going on in Venezuela, and it ain’t just Hugo Chavez. There is no way that these two groups could have had anywhere near the same number of calories and had these results be this divergent. It’s impossible, and (to put it in Samuel Johnson’s favorite words) there’s an end on’t.

I suspect the diets were fiddled with to bring about the results the researchers wanted. That’s the only option.

Having said that, let’s look at another aspect of this study that bears scrutiny. The hunger scores were evaluated using a meal tolerance test at 0, 30, 60, 120, and 180 min after breakfast. Now if I were to do this test anywhere from right after breakfast to 3 hours after breakfast and the only data you had to go on was the fact that one group got a breakfast that contained over twice as many calories as the other, which group do you think would be the least hungry over the next few hours: the group with the little breakfast or the group with the big breakfast? This is the test that was done. And reported. And picked up on by the press. This is one for the having-a-keen-grasp-of-the-obvious award.

I’ve seen a number of studies showing that caloric intake skewed to the first part of the day, i.e., a big breakfast, small dinner, seems to result in more weight loss than the same number of calories skewed later in the day, i.e., small breakfast, big dinner, so I don’t have an argument with this idea. The argument I have is that this is a poorly reported study that doesn’t contain enough information to allow an appropriate understanding of what really went on, yet it’s being used by both the press and it’s author to imply something that isn’t necessarily true: that a big, high-carb breakfast is better for you in terms of weight loss than a low-carb breakfast.

Daniela Jabukowiz herself is not a proponent of the low-carb diet. As she said to one of the reporters covering this travesty:

Most weight loss studies have determined that a very low carbohydrate diet is not a good method to reduce weight.

Oh, really. I would think it is just the opposite. Whenever low-carb diets are compared to low-fat diets, the low-carb diets kicks tail. At the very worst, both diets are about even. But the vast majority of studies show the low-carb diet to be superior.

I can pretty much guarantee you that this study will never see the light of day in a peer-reviewed journal. This is confirmed by one of the press members reporting about this presentation who wrote:

Plans to publish the paper in a journal were not announced.

I’ll bet they weren’t.

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He was so taken with his own self importance that when he read my post saying that calories really do count - even on low-carb diets - he chortled with glee and set about trying to capitalize on my admission of error.

He ran to his computer and pounded out one of his angry interminable posts. The premise of this one being that I had finally come to my senses and admitted that he had been right all along.

He then sent an email blast to all 6 of his readers alerting them to the existence of this post. The subject line of his email in bold print

Famous Diet ‘Guru’ Finally Admits I’m Right!

In the body of the email he writes

In September of last year, I publicly exposed what I considered to
be an extremely misleading blog post by Dr. Michael Eades, author
of the best selling book Protein Power.

In retaliation, Eades has gone to great lengths in an attempt to
portray me as a “clueless young prat” who has it all wrong when it
comes to weight loss.

However, Eades has recently done an about-face. In a recent
blog post, he acknowledges that I was right all along!

Then he refers the recipients of this email to his post. Upon arriving there one reads on an on ad nauseam about how the author of the post is correct and all his detractors are wrong. And how everyone vilifies him but he emerges from it all with everyone (including yours truly) acknowledging his genius.

Let the record show that Eades initially and strenuously resisted my assertions, but is now writing them up on his blog like he always believed and taught them. Let the record show that it was not until well after I made these assertions public, and that the noise between Eades and I [sic] faded somewhat, that he embraced them. Eades has clearly learnt something from our dispute and my book. Obviously he will never publicly admit this, but only the dopiest of his followers (admittedly, they’re a pretty damn dopey bunch) will fail to see what’s going on here. I guess I should be quite proud - getting through to a pigheaded, vituperative old prat like Eades is no small feat! [bold in the original]

And, as if this weren’t enough, a few days later he sends another email blast to the same 6 readers.

In my previous newsletter we learned how after reading my book, famous diet author Dr Michael Eades was finally beginning to acknowledge the real facts about fat loss and shedding some of the erroneous beliefs he had propagated in his best-selling book Protein Power.

Since we’re letting ‘the record show,’ let’s let it show the reality not the fantasy. The reality is that I’ve held this position publicly since long before our friend ever arrived upon the nutritional scene.

Here is what I wrote in The Protein Power LifePlan almost 10 years ago. (PPLP was published in 2000 but was written in 1999.)

…if you want to lose weight you have to watch the calories - even on a low-carbohydrate diet - particularly if you’re a small person. Remember, low-carbohydrate intake means a lower insulin level; and a lower insulin level means that you can easily unload fat from your fat cells. But, if your body has no need to use any of the fat from your fat cells because it has more than enough fat to meet all its needs coming from your diet, it’s not going to go after your stored fat, and you won’t lose weight. To lose weight you’ve got to create an energy deficit. [my bold] For the vast majority of people, simply following a low-carbohydrate diet will easily create enough of a caloric deficit to bring about a reasonable weight loss. (from The Protein Power LifePlan, page 51.)

Doesn’t seem to me to be any different than what I wrote in my post of May 27.

Here is how our friend summarizes his book, of which he is so proud. He leads with my ‘public’ acknowledgment of it.

And yet Eades is now publicly acknowledging that the main contentions of my book are in fact 100% correct!

-Calorie restriction – not carbohydrate restriction – is the key requirement for weight loss;

-The abolition of the initial calorie deficit by subsequently reduced calorie burn is the real cause of weight loss plateaus, and;

-The real reason people lose weight on low-carbohydrate diets is because greater satiety on these diets allows them to eat less and establish a calorie deficit.
[bold in the original]

Looks to me like he is using my alleged conversion to shamelessly promote his own book, parts of which could be said to have been ripped off from my much earlier one. Since the publication of my own ideas predated his by almost a decade, perhaps I should do an email blast to all my readers with the subject line:

Unknown Self-styled Nutritional Expert Finally Admits I’m Right.

Let the record show indeed…

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