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Meet Dave.

7/6/2015

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After graduating college I moved to Florida where I worked in the subprime mortgage industry.  Things started to go bad, I got depressed.  I ate and drank by myself.  I ballooned up to close to 250 lbs.  

Then I moved to DC.  I started exercising again. I tried a number of different diets and exercises but found the most success with the Paleo influenced eating (which was initially kicked off by The Zone Diet and speaking with people from Crossfit).  

AWLR Comment: David has now lost over 60 pounds.

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The new Dave.

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Sugar addict comes clean.

6/29/2015

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Meet Jill.

I had been overweight all my life, then ran into a friend who had dropped 70 pounds after going to Overeaters Anonymous.  She had dropped all sugar and flour from her diet, and had lost her taste for them.  Frustrated by my seeming inability to lose weight, I visited a local meeting, where I had an epiphany about my lifelong addiction to sugar.  

After going abstinent from sugar, starches, and processed food, I quickly lost my excess weight, going from 156 to 122.  At the urging of friends, I recorded my experience in a book called "Farewell, Club Perma-Chub: A Sugar Addict's Guide to Easy Weight Loss," which is a short, friendly girlfriend's guide to overcoming sugar addiction. 
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The new Jill.

CHALLENGES: 
Accepting I was addicted to sugar.  Accepting that I was basically an alcoholic with the white stuff.

ADVICE: 
The biggest obstacle for most people is fear of cravings.  They are accustomed to having the "sweet tooth" and regularly giving into its powerful pull.  But once people confront their chemical addictions, miracles happen with ease, because once we pull that invisible syringe out of our arms, the sky is the limit in terms of improved nutrition and reclaiming our biochemistry.
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Meet Heidi.

6/22/2015

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Meet Heidi.

In December of 2010 I decided that it was long past time for me to do something about my health. After a bout with physical exhaustion and 2 very unforgiving pregnancies I found myself 100+ pounds over the limit. I felt terrible on a daily basis. I was no longer the active, vibrant person I used to be. I wanted to change. I NEEDED to change. So I downloaded a calorie counting program for my iPod, weighed and measured, and made a plan that I thought I could stick to and get results from. 

For 2 months I diligently counted calories, keeping within daily and weekly limits. I also did some mild exercise 3-4 times per week: walking, Wii Fit, DVD workouts. My cardiovascular health began showing some minor improvement, but my weight was not changing and I really wasn't feeling very good. I was hungry ALL the time. Even after just finishing a meal. My results were not great. Heck, they weren't even good. 

Meanwhile, back at the ranch, a good friend of mine was just finishing up a paleo challenge with her CrossFit Box. They started with a Whole30 followed by 60 days of Paleo. She was having amazing results, so I decided to give it a go. 

On February 25, 2010 I started a Whole30 of my own. The first few days I felt a bit anxious and had a pretty bad headache. But by the end of the first week I was feeling wonderful. I no longer had that constant hunger that I had been struggling with on a calorie restricted, yet very high carbohydrate, diet. 30 days flew by and away went the first 10 pounds right along with them. I gave myself a 'reward day' and then immediately started another Whole30. This time I lost another 10 pounds! 

The third month I went straight paleo - allowing for a bit more leniency in the foods I was eating. The fourth month I started running and continued with my paleo eating.  By July of 2010 I had lost 50 pounds. I almost couldn't believe it. All I was doing was eating real food. And as much of it as I wanted to. And that, combined with moderate exercise was giving me the results I was looking for! People were taking notice. I was thrilled!

Over the next few months I continued my running and also went to my local CrossFit Box for a month - which was where my exercise routine went from moderate to more intense. I did another Whole30 concurrent with that month of CrossFit and lost another 10 pounds in 30 days. 

In September I slowed down a bit, continuing to run and doing some CrossFit style working out, but not as intense a schedule as the previous month. And I definitely loosened up the rules a bit about what I could eat. I still lost weight this month, but only a few pounds. 

In October I started the P90X fitness plan and stuck with my paleo way of eating. I let myself make some very high carb choices during the holidays: Halloween, Thanksgiving, and Christmas - the trifecta of high carb incidents; but 95% of the time I was strictly paleo/primal. One of the major changes that I made during this 90 days was that I added cheese, butter, and occasional white potatoes into my diet. My results were not quite what I expected, but were pleasant nonetheless. I only lost a net of 2 pounds in 90 days, but my BODY changed dramatically with a loss of 10" from waist, hips, bust, arms, and legs. 

I whooped it up on New Year's Day and on January 2nd, 2012 I started another Whole30. I needed to 'clean the machine' from all the off plan stuff I had indulged in over the holidays. I am currently 22 days in and 5 pounds down. I feel great every day. I have the energy to keep up with my daughters and my household and still get in a good workout every day. 

All along I was just eating real food: meat, eggs, good fats, vegetables, and a limited amount of fruit, nuts, and seeds. Easy and delicious food that was simple to prepare. 

The results speak for themselves: To date I have lost 72 pounds and more than 50 inches from my body. I am supremely healthy: I have not been sick once since beginning my paleo journey. I feel and look younger. I am vibrant and have energy like I haven't had in years. I would and do recommend a paleo lifestyle to anyone, whether they need to lose weight or not.

Meet the new Heidi.

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CHALLENGES: 
Doing so in a family where I am the only one eating paleo.

ADVICE: 
My biggest obstacle was the mentality that going paleo was a 'diet' wherein when I was finished losing my weight that I would go back to eating a Standard American Diet again. I am over that hump. Paleo is not a diet for me, but rather a complete lifestyle change. My advice to someone who is new to this is to try to embrace paleo as a lifestyle rather than a diet. Paleo teaches you how to eat foods that work with your body instead of against it. Once you feel this good, you never want to go back to feeling like garbage every day. 
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Meet Doug.

6/15/2015

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Meet Doug.

I started on a low-carb transition after Christmas of 2010. I was 255 lbs. I ate and drank (alcohol...I always drank diet sodas) whatever I wanted but during the work week I would actually eat very little. My breakfast many days would consist of a "Fiber One" bar and my lunch would be a "Cup o noodles". I am a soccer player thus I ran quite a bit and due to what I assume was gout my feet hurt all the time. 

I requested the book "The 4-hour body" as a Christmas gift and read most of it within 2 days. It gives many low carb diet recommendations but includes a lot of beans. I followed this diet for about a month and didn't really start losing weight until I removed the beans I was eating at every meal. I stumbled across Gary Taubes's article from the New York Times magazine and then onto the Paleo diet websites where I read and read and read. I couldn't get enough. 

I added more fat to my diet and completely removed any source of carbs that wasn't a green vegetable. I started losing weight immediately and it kept coming off. With almost no effort. I was blown away. I reached 193 lbs sometime in late September 2011 and maintained 195-200 lbs through Christmas and now have resumed losing weight and hope to be down to 185 or so by spring break.
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The new Doug.

CHALLENGES: 
Cooking constantly was the biggest challenge.
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Down 92 pounds.

6/8/2015

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Meet Michael.

Almost 3 years ago I was sick and Obese. My doctor said I was a ticking time bomb with very high blood pressure and high blood sugar, high ldl cholesterol, daily asthma attacks. I was in pretty rough shape. I am 5'7" and I weighed 260lbs. My back ached so bad I could barely walk a block. 

A friend of mine introduced me to LCHF by giving me The Protein Power Life Plan by Drs. Michael and Mary-Dan Eades. I jumped on board immediately. Cleaned out my cupboards, fridge and pantry and started of anything with wheat, grains sugar and vegetable oils. I applied what I learned and went cold turkey, no weaning. The first week I list 7lbs. I continued to lose a pound a day for a month. 

I was down 60lbs in 3 months. I am now down 92lbs and keeping it off. I no long have High blood pressure, my pre-diabetes is gone, asthma gone, haven't been sick in almost 3 years since starting LCHF. I am healthier than I have ever been.

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The new Michael.

CHALLENGES: 
Preparing meals for family members not adhering to lowcarb. Dining out.

ADVICE TO OTHERS: 
Remove all processed foods. Buy and consume only real food from meats, fowl, fish, butter, heavy cream cheese, natural fats, vegetables and occasional berries. Educatoe yourself, read books and blogs about health and nutrition. Good books to start with are: Why we get fat by Gary Taubes, Wheat Belly by Dr. William Davis, The Protein Power Life Plan by Drs. Michael and Mary-Dan Eades, Primal Blueprint by Mark Sisson. Start with these. There is more, many more good books.
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Search and Analyze our Data

6/1/2015

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Thank you.

We have now accrued over 3700 subjects from 71 countries around the world, to our knowledge making us one of the largest - and the only international - weight loss registry. We have struggled for years trying to come up with the best way to use all the data for the largest benefit to all who have registered, and to all that have not.

We will now be opening up our database to you. Doctors, researchers, bloggers, journalists, or any citizen scientist interesting in doing research with our database.

LEARN MORE >>

We have representation from all 50 U.S. states and 70 countries and regions, including:
Argentina 
Asia/Pacific Region 
Australia 
Austria 
Azerbaijan 
Bahamas 
Belgium 
Brazil
Bulgaria 
Canada
China
Colombia 
Costa Rica 
Cyprus 
Czech Republic
Denmark 
Dominican Republic 
Egypt 
Estonia 
Europe 
Finland 
France 
Germany 
Gibraltar 
Greece 
Guam 
Hong Kong 
Hungary 
Iceland 
India
Indonesia 
Ireland 
Israel
Italy 
Japan 
Kuwait
Latvia 
Lithuania 
Luxembourg 
Malaysia Malta 
Mauritius
Mexico
Namibia
Netherlands
New Zealand 
Norway 
Peru 
Philippines 
Poland 
Portugal 
Romania 
Saudi Arabia 
Serbia 
Singapore 
Slovenia 
South Africa 
Spain 
Sweden 
Switzerland 
Thailand 
Trinidad and Tobago 
Turkey 
United Arab Emirates 
United Kingdom 
United States 
Venezuela 
Vietnam 
Zambia 
Zimbabwe 
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You can see our complete results here.

We are very excited to see that our distribution among multiple variables very closely parallels that of the general population. Here is our height distribution:
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The average height was 67.9 inches (5'8") which is almost identical to the average of males and females around the world. The median was 68, with a standard deviation of 4.03.

Male and female representation was nearly identical:
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The average weight loss among all members - regardless of their weight loss goals - was 30.5 pounds, with a median weight loss of 25, and standard deviation of 26.9. 
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Weight change ranged from losing up to 300 pounds all the way to gaining 78. Many of these subjects are eating low carb or paleo for improved athletic performance, improved health etc and did not try to lose weight, which may explain the enormous variation.


Do your own research
"Is there any relationship between weighing yourself and weight loss?"

"How did the Atkins vs Paleo diet compare?" 

"How do eating behaviors in Africa differ from those in the United States?"

"Do people in Alabama eat differently than Massachusetts?"

"Was calorie counting associated with greater weight loss?



Answer questions like these, as well as anything you can possibly think of that may come from our questionnaire. We can do things like descriptive statistics, comparing multiple variables, regressions, etc.

Free response analysis

The most powerful, interesting data we have discovered is through our free response search algorithm that finds every mention of a certain disease/condition among the 1,200 pages worth of text submitted by our members. This is an incredible tool for developing hypotheses. For example, this is a list of what the first 1100 members said about hunger, and a few quotes from that list:
"After a lifetime of being overweight... through childhood, the teen years, my twenties, thirties, and forties,... finally, at the age of 55, I experienced a "normal" appetite on a low carb diet. For all of those decades I "overate" because I was hungry...It certainly is NOT a problem of weak willpower."

"At the age of 48 I easilty lost 40 lbs 9 years ago over 9 months on a carb restricted diet, and a further more gradual (but effortless) 10 lbs one year ago when I stopped eating even small amounts of wheat after figuring out that is was the cause of 25 years of GERD (dyspepsia.)   I have always been active, even when overweight.  I always felt hungry and/or had carb cravings with other diets or even when not dieting (ie, gaining wt)."

"I got most all of my health benefits, getting off blood pressure medicine and such, before I lost any weight at all.  And I didn't lose any weight the first month. But I sure pigged out.  It's amazing I didn't gain weight, that first month. I never went hungry.  I always ate plenty of fatty foods to keep me satisfied.  I stopped losing weight after 6 months, however, and I'm still hovering on my plateau, a year later."

"Many who see my weight loss tell me how hard it must have been, but I tell them it wasn't.  On the reduced carbo diet, I am almost never hungry.  Because of my work schedule, I have no time for exercise and all of the weight loss has been through the change in diet."
Get raw data and analyze it yourself

If you are interested in getting the anonymized raw data, we can license it to you for a reasonable fee. Or if you want all of the above, we can do that too.

LEARN MORE >>

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We want this data to be used by the world, for a better understanding of this way of eating, and we think this is the best way to do it. If you are interested, please fill out this form and we will get back to you shortly.

No go and enjoy this snack.
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Ornish at it again

3/24/2015

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Dean Ornish just published another self righteous Op-Ed, which is essentially word for word from his previous Op-Ed in the New York Times in 2012, touting the benefits of an ultra low-fat, high carbohydrate diet. So instead of writing a new response, here it the one we wrote back then that went viral. In fact, if you google "Ornish response," it is the first thing that pops up. 

Enjoy.

"In 35 years of medical research, conducted at the nonprofit Preventive Medicine Research Institute, which I founded, we have seen that patients who ate mostly plant-based meals, with dishes like black bean vegetarian chili and whole wheat penne pasta with roasted vegetables, achieved reversal of even severe coronary artery disease."

This claim - which is ubiquitous in the medical literature - is based on one study on 35 people, deemed the "landmark heart disease-reversal trial" by US News and World Report. 20 of the 35 people were randomized to receive the intervention which included consuming a low-fat vegetarian diet for at least a year. The diet consisted of fruits, vegetables, grains, legumes, and soybean products without caloric restriction. No animal products were allowed except egg whites and one cup per day of non-fat milk or yoghurt; 10% of calories as fat, 15-20% protein, and 70-75% carbs. Cholesterol intake was limited to 5 mg/day. Subjects were also asked to practice stress management techniques at least 1 hour per day, exercise for at least 3 hours per week, and quit smoking if they were smokers. They also attended group meetings two times per week. The control group was given no guidance besides to continue following their own physician's advice. 

After one and five years, the experimental group had less cardiac events, and a decrease in the size of the plaques in their coronary arteries. 

This is perhaps one the most referenced studies in support of the protective effects of a low-fat diet, cited over 930 times (previous publication cited over 1500) according to Google Scholar, which is unfortunate due to the tremendous amount of confounding interventions. Along with an extremely low fat diet, the experimental group ate more fruits and vegetables, lost 23.9 pounds (control lost no weight), performed relaxation techniques 1 hour each day, exercised at least 3 hours a week, and had group counseling. The control group had none of this. The experimental group contained only 20 subjects (all male), and the control group had 15 (12 men and 3 women). 

The small sample size resulted in an uneven distribution of risk factors between groups. At baseline, the mean age of the control group participants was 4 years higher, mean total cholesterol 8% higher and mean LDL 10% higher than those in the experimental group. Mean BMI was three points higher in the experimental group. 

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Dr. Ornish goes on to say that "in a randomized controlled trial, patients on this lifestyle program lost an average of 24 pounds after one year and maintained a 12-pound weight loss after five years. The more closely the patients followed this program, the more improvement we measured in each category — at any age."

This is a true statement, and a misleading use of the exact same clinical trial cited above twice, to likely add credibility to the argument. While they are two separate links, the linked "reversal of even severe disease" from above and this controlled trial cite the identical article on 35 people: Here and Here.

"Calories do count — fat is much denser in calories, so when you eat less fat, you consume fewer calories, without consuming less food. Also, it’s easy to eat too many calories from sugar and other refined carbs because they are so low in fiber that you can consume large amounts without getting full." 

This argument is made over and over, reducing the complexities of the hormonal control and appetite regulation of the human body to simple arithmetic. The satiating nature of eating high fat, high protein diets cannot be over stated, and will have a much greater effect on subsequent eating behaviors than consciously ignoring our most basic physiological drive to eat when we are hungry, simply because we have reached our daily limit of fat calories mandated by the Ornish diet. 

The satisfying, filling nature which lay the foundations for a Paleo or Atkins diet has been shown in clinical trials, and supported by literally thousands of people who have registered on the Ancestral Weight Loss Registry, from over 35 countries around the world. Based on the first 1,100 people to register, 95% report rarely or never feeling hungry between meals and 88% reported feeling less hungry than on a low-calorie diet (if they had tried it in the past). If you do not believe these stats, then you can read the hundreds of stories from the people themselves:

"After a lifetime of being overweight... through childhood, the teen years, my twenties, thirties, and forties,... finally, at the age of 55, I experienced a "normal" appetite on a low carb diet. For all of those decades I "overate" because I was hungry...It certainly is NOT a problem of weak willpower."

"I was amazed how quickly my body adjusted to the new way of eating. In previous attempts to lose weight I had gone on low-fat, calorie-restricted diets that are based on 'mainstream' advice for weight loss. I would always be hungry and feel fatigued, and could never resist 'cheating' on my diets. On the low-carb diet, I rarely get hungry between meals and never feel fatigued. I weigh myself once a week. By the end of the first full month on the diet, I had lost twenty pounds."

"I ate an extremely low calorie diet for perhaps two years. I didn't follow any particular plan, I just avoided empty calories and counted calories carefully, limiting myself to about 1000 calories per day. I didn't eat an obsessively low-fat diet and I ate a lot of carbs I thought were healthy - rice, whole grain bread, potatoes. I was hungry all the time; I obsessed about food to the point that I planned every meal for several days in advance. I felt cold much of the time, especially at night. In addition, I fasted many weekends. Doing this, I was able to get down to a 34 inch waist."

"I've literally been on a diet all my life.  Lost weight through calorie deprivation and also following the ill-advised low fat/high carb recommended by conventional wisdom and the U.S. government.  I was always hungry with low energy.  Eating that way was completely unsustainable for me."

"I was always hungry and thinking about food.  Now on a low carb diet I eat without worrying about counting calories. It makes life easier."

Read literally hundreds more such quotes here, all of which are variations on a similar theme: Sudden lack of hunger on a diet high in meats, fats, and vegetables.

Dr. Ornish goes on to say:

"But never underestimate the power of telling people what they want to hear — like cheeseburgers and bacon are good for you. People are drawn to Atkins-type diets in part because, as the study showed, they produce a higher metabolic rate. But a low-carb diet increases metabolic rate because it’s stressful to your body. Just because something increases your metabolic rate doesn’t mean it’s good for you."

The cited study is the recent clinical trial done in a metabolic ward, in which the researchers explain: "Among overweight and obese young adults compared with pre-weight-loss energy expenditure, isocaloric feeding following 10% to 15% weight loss resulted in decreases in Resting Energy Expenditure (REE) and Total Energy Expenditure (TEE) that were greatest with the low-fat diet, intermediate with the low-glycemic index diet, and least with the very low-carbohydrate diet." In other words, the fewer carbohydrates in the diet, the higher the resting and overall expenditure, which was exciting news for the proponents of the Alternative hypothesis. 

Dr. Ornish criticizes these results, explaining that "patients on an Atkins diet in this study showed more than double the level of CRP (C-reactive protein), which is a measure of chronic inflammation and also significantly higher levels of cortisol, a key stress hormone. Both of these increase the risk of heart disease and other chronic diseases."

As Dr. Peter Attia explains so eloquently on his blog, this is simply untrue. "Each group experienced a significant decline in both PAI-1 and CRP, and there was no significant difference between the groups for either marker. However, the trend was (barely) significant, favoring the low carbohydrate group for PAI-1 and favoring the low GI group for CRP. Sorry low fat, you didn't win either." As you can see in the graphs below, each group showed a reduction in CRP levels, just the Atkins group had a slightly smaller decrease than the other groups.
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Inconspicuously Absent Evidence

And what about these 14 clinical trials? How can the calorie unlimited, high fat diets keep producing more weight loss as compared to a low fat, calorie-restricted diet (at least in the short term), if they are characterized by high amounts of dietary fat, the vilified cause of obesity according to Dr. Ornish?

Even more striking is the fact that to our knowledge, a low-fat diet has NEVER in dietary clinical trial history produced more weight loss than a calorie unlimited, high fat diet. Many studies have shown no difference, but if it is true that a fat makes you fat, where are the clinical trials supporting this? 

If you can find a randomized control trial in which a calorie restricted low fat diet produces more weight loss than a calorie unlimited high fat diet, please e-mail it to us and we will post it: info@awlr.org.


Saturated Fat is Bad for you

Dr. Ornish says that "It’s not low carb or low fat," and then a few words later explains that an optimal diet is  "low in fat (especially saturated fats and trans fats) as well as in red meat and processed foods."

While we can definitely agree that trans fats and highly processed foods should be limited, the saturated fat argument is an archaic one that is not supported in the literature and has become an academic argument perpetuated by selective citation of supportive trials and variations in inclusion criteria. 

If we were to focus on the largest (i.e. > 100 subjects), randomized, most famous trials ever done lasting longer than 1 year, we are left with very few to assess that meet the following 2 criteria:

1) The only significant intervention involved a reduction in fat and saturated fat and an increase in polyunsaturated fats
2) They ask the question: does this diet reduce heart disease? (defined as heart attacks or death from heart disease)

Listed in reverse chronological order:
Women’s Health initiative (2006) – 48,835 women, 8 years, no significant difference between intervention and control.

Diet and Reinfarction trial (1989) – 2,033 men, 2 years, no significant difference between the groups given and not given fat and fiber advice. No significant differences in ischaemic heart disease between intervention and control (intervention was only advice in this trial)

Minnesota Coronary Survey* (1989) – 4,393 men and 4,664 women, double-blind, 4 years, no significant reduction in cardiovascular events or total deaths from the treatment diet

Finnish Mental Hospital (1972) – 12 years, physicians not blinded, significant decrease in coronary heart disease (CHD) death in men ( 5.7 deaths /1000 person-years vs 13 deaths /1000 person-years in the control. Non-significant decrease in CHD in women. (Not randomized, although included here because this is main experiment cited in support of diet-heart hypothesis)

Los Angeles Veteran’s Trial* (1969) –  846 subjects, up to 8 years, non significant difference in primary endpoints –  sudden cardiac death or myocardial infarction. More non-cardiac deaths in experimental group, resulting in near identical rates of total mortality

Oslo Heart Study (1968) – 412 men, 5 year, slight decrease in CHD with intervention. Many dietary interventions accompanied the low saturated fat diet. When stratified by age, the results were significant only in subjects younger than 60.

* Double blind

A full list of all the trials done supporting and refuting the saturated fat-heart-disease relationship, and a more in depth description of each, can be found here. 

Meta-analyses
If we instead focus on the recent meta-analyses of clinical trials testing this relationship, the majority have failed to elucidate a benefit associated with a low saturated fat diet:
  • In 2010, Ramsden et al. published a meta-analysis of randomized clinical trials, including trials where polyunsaturated fats (PUFAs) were increased in place of saturated fats (SFAs) and/or trans fatty acids (TFA), and non-fatal heart attacks, coronary heart disease related deaths, and/or total deaths were reported.  In the nine studies included, there was a non-significant increased pooled risk of 13% for n-6 PUFA intake (RR=1.13, CI: 0.84, 1.53) and a decreased risk of 22% (RR=0.78, CI: 0.65, 0.93) for mixed n-3/n-6 PUFA diets. In other words, increasing polyunsaturated fats in the diet provides no benefit, and may be harmful according to this study.        
  • Also in 2010, Mozaffarian et al published a systematic review and meta-analysis of randomized clinical trials investigating the effects of increasing PUFAs in place of other nutrients.  Among the seven studies included, an overall pooled risk reduction of 19% (RR= 0.81, CI=0.83-0.97) was observed for each 5% of energy of increased PUFA in the diet.      
  • In 2009, Mente et al. published a systematic review of the randomized clinical trial (RCT) evidence that supports a causal link between various dietary factors and coronary heart disease.  The pooled analysis from 43 RCTs showed that increased consumption of marine omega-3 fatty acids (RR=0.77; 95% CI: 0.62-0.91) and a Mediterranean diet pattern (RR=0.32, 95% CI: 0.15-0.48) were each associated with a significantly lower risk of CHD. Higher intake of polyunsaturated fatty acids or total fats were not significantly associated with CHD, and the link between saturated fats and CHD received a Bradford Hill score of only 2 (out of a maximum score of 4), signifying weak evidence of a causal relationship.
  • Also in 2009, the Cochrane Collaboration, an international not-for-profit organization, published a meta-analysis of clinical trials that either reduced or modified dietary fat for preventing cardiovascular disease. Twenty-seven studies met the inclusion criteria, and no significant effect on total mortality (RR = 0.98, 95% CI: 0.86-1.12) or cardiovascular mortality (RR = 0.91, 95% CI: 0.77-1.07) was found between the intervention and control groups 

The only study above showing a benefit to replacing saturated fats with polyunsaturated fats was the Mozaffarian meta-analysis. The authors of the study claim to have only included randomized clinical trials in their meta-analysis. Surprisingly, the Finnish Mental Hospital Study was included twice – split into separate analytical pools of male and female subjects. It is unclear why this study was even included to begin with, since it was not randomized and contained a disproportionate number of control subjects who were taking cardio-toxic medications and consuming higher levels of trans fats than the experimental group. 

Inclusion of male and female Finnish data separately further raises concern since it clearly exaggerates the apparent cardio-protective effect of PUFAs demonstrated in this meta-analysis. Excluding the Finnish data from their pooled analysis would diminish the observed results and elicit a null finding, since all other included studies apart from the Oslo heart study (RR=0.75, CI 0.57-0.99) were null:    
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Closing Thoughts

In medical school we are taught how to take an HPI (History of present illness) whenever we see a new patient. The importance of this history is stressed in every class, because of how important the patient's story is, and how helpful it can be in coming up with the diagnosis. 

Yet when it comes to figuring out why people are gaining weight, we don't listen. We are absolutely sure that the patient is at fault and we are correct: Just Eat less. 

We don't listen to the fact that people are universally hungry on a calorie-restricted diet. Eat 500 less calories a day than you normally would, then run for an hour each day, then ignore your most basic physiological drive to eat when you get hungry. And repeat this for the rest of your life and our obesity problems will be solved.

What if instead there was a way of eating in which people ate when they were hungry, and stopped when they were satisfied. A way of eating which didn't force you to count calories. A way of eating that, based on our most rigourous scientific data available, produces the most weight loss, reduces triglycerides and increases HDL. 

This way of eating exists, vilified by the medical community as "The Atkins diet", and relegated to a fringe movement and diet fad by the media as the "Caveman diet."

Yet when it comes down to which diet we should eat, the media, physicians and dietitians can make their case, but the final vote should be given to the patient. To the person actually eating the diet. If these patients from all over the world say they are no longer hungry, then maybe we should listen. 
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Tried a paleo or low carb diet? Join Today and contribute to a better understanding of this way of eating!
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Say it ain't so, USDA!?

3/14/2015

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When Good Calories, Bad Calories (GCBC) was published in 2007, it rocked the public health world with a medical-textbook-non-fiction-thriller mashup that made an incredibly powerful argument for the idea that a low fat diet doesn't make you thin or prevent heart disease. I, like many other people interested in health and nutrition, went through the proverbial stages of denial to acceptance to praise..."This is bullsh&%....This research must be cherry picked....This isn't bad....It is incredibly thorough....Great literature cited....Damn, maybe he is onto something?"

I was a senior in college at the time I came across this book. Reading it was shocking. The message was unapoligetically brash and the literature cited was laughably enormous, with the makings of an outrageous David vs Goliath themed hollywood blockbuster. The protagonist, a cocky journalist touting the annoyingly commercial, made-for-late-night-informercial line: "everything you know about nutrition is WRONG." 

But the message was sexy for someone like me. And it made sense.....Using physiology to explain why we lose or gain weight, not simply arithmetic of calories in and out. I was used to journalists writing a nice summary of one new study in the New York Times, a tiny little leaf on the gigantic redwood of dietary research. Along comes Taubes's 447 page tome on the history of medical and dietary research as it relates to human health. I was intrigued. I sent him a cold email as a wide-eyed graduate student looking for some advice, and he graciously replied. Years later, we are still good friends.

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Gary Taubes at my house in Rhode Island, after one of his lectures.

Now, 13 years after What if it's all been a big fat lie? appeared in the NY Times for the first time, people are following suit. Now we see articles like these, which are essentially word for word from 
various chapters of GCBC:

The Government's Bad Dietary Advice - NY Times
Ending the war on fat (PDF) - Time magazine
Butter is back - NY Times
Don't fear the fat: Experts question the saturated fat guidelines - NPR

Now, in what seems like a dream come true for the readers of this blog, the dietary guidelines is listening.
Dr. Krauss, the former chairman of the American Heart Association’s dietary guidelines committee, said that the advisory panel’s emphasis on overall dietary patterns was “a tremendous move in the right direction.” As part of that move, the panel dropped a suggestion from the previous guidelines that Americans restrict their total fat intake to 35 percent of their daily calories.
The panel also dropped a longstanding recommendation that Americans restrict their intake of dietary cholesterol from foods like eggs and shrimp, which we have known doesn't affect blood cholesterol levels since the 1950s. “For many years, the cholesterol recommendation has been carried forward, but the data just doesn’t support it,” said Alice H. Lichtenstein, the vice chairwoman of the advisory panel and a professor of nutrition science and policy at Tufts University.

(Youtube video link)

Now, thanks to Gary's decade of perseverance, we have the Nutrition Science Initiative, co-founded with Dr. Peter Attia, powered by massive funding to run the most rigorous trials we have ever seen in the field of dietary research. 

I look forward to the hollywood ending of this future film.

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Down 70 pounds with no exercise at all

3/12/2015

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Meet the old Robin
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I was born in Romanian, and I grew up as a skinny child/teenager. So skinny in fact, that my parents would literally pay me money to eat. I also remember having to take multi-vitamin supplements and B vitamin shots in the hope that they would stimulate my appetite and make me gain weight. Looking back, I do not believe that I was too skinny. I ate when I was hungry, and until I felt full. My childhood diet consisted of copious amounts of fries and white bread. Despite such a high-carb diet, I remained skinny until the age of 18. I am 5’2”, and I pretty much stayed at 100 pounds no matter what I ate up until that point.

At 18, two things changed. I started eating out more, and I started taking the birth control pill. I might never fully understand the biochemical changes that occurred (or why) in my body after that point, but I slowly began gaining weight. By the age of 21, I was already at 112 pounds. I didn’t feel like I ate a lot, but I could tell something was different because I seemed unable to shed those extra pounds. My first experience with a low carb diet occurred in 2004. I did Atkins’ induction for 2 weeks and lost about 6 pounds. I was stoked, but also still very tempted by starchy foods.

At that point in time, I really did not understand why a restricted carbohydrate diet allowed weight loss, and I couldn’t conceive giving up fries and bread, so I went back to my old eating habits. I promptly gained the lost pounds back, and in 2005, I weighed between 114-116 pounds. After that, I experienced a lot of changes in my personal life and I totally lost myself in carb-rich comfort foods. It was also a matter of money. My income was below poverty level, working in north Florida with animals as a kennel technician; packets of noodles/noodle soups were just so quick, convenient and affordable for me back then. My job was physically very demanding. I had to deal with rambunctious dogs of all sizes as I walked and groomed them, and I also did a lot of cleaning/scrubbing/mopping. I wasn’t losing an ounce, no matter how little I ate.

By 2008, I believe I was already in the mid 140’s. After that, it’s all a blur to me. I remember weighing myself on the dog scale at work, at the beginning of 2009. I was shocked to see that I was now about 155 pounds. I continued to eat pasta until I found myself at 180 pounds, later that same year (2009). I believe the summer of 2009 is when I came across a video called “Adiposity 101, Why we get fat”, by Gary Taubes. As I watched him build his argument I felt so betrayed by life and every well-meaning person that had ever tried to help me, yet only made me feel worse about myself in the process (telling me I had to eat less and exercise more). It was all there, black on white… Women become insulin resistant with age, poverty and obesity form the marriage from hell, and last but not least, carbohydrates and fructose in particular wreck havoc on our bodies. I felt more enlightened, but still nowhere near motivated enough to change the only way of eating I’d known all my life.

During a brief period when I felt ready to change my life, I dropped from 180 to 170 pounds, by reducing the amount of food I ate, and not eating in the evening (November 2009). I remained at 170 pounds until Fall 2010. My “before” picture was taken at the end of August 2010 (170lbs). In October 2010, I met someone who made me feel joy for the first time in many years. I suppose I consider this the only “cheating” element of my “diet”, because I doubt I would’ve found the initial required motivation to lose weight otherwise. Wanting to be with this person gave me all the motivation I needed to finally put Gary Taubes’ knowledge to work. My new friend did not like me fat, and made no secret of it, and I turn took no offense to his preference, because I didn’t like myself fat either. I missed my “old” body that I felt so comfortable in.

By December 16, 2010, I had dropped to about 152 pounds. In March 2011, I was at 145 pounds. May 2011, 130 pounds. I spent the rest of 2011 going from 130 pounds to about 117-120 pounds (December 2011 was the first time I saw 117). Although ideally I would like to reach 100 pounds again, I have remained at 120 until the present day (September 2012). All this weight loss was achieved without doing any exercise whatsoever. I quit my physically demanding jobs in March 2010, and went back to school to get an undergraduate degree in Biology. I am at a point now where I do sometimes indulge in fries and bread products, but the weight gain is instantaneous. They are "gateway foods" for me so I end up falling off the low carb wagon for weeks sometimes if I allow myself to go there once. It is the reason why I’ve spent the last year oscillating between 117 and 123 pounds. I can’t blame anyone but myself for not being at 100 pounds already. By cutting the grains out of my diet, I realized that I am in fact allergic to them. I don’t get a rash or IBS, but their digestion is certainly not pleasant to me. They bloat me, and I generally feel “nasty”/heavy for lack of a better word as soon as they hit my stomach. 

As part of a school project analyzing blood glucose curves, I discovered that mine is abnormal, and even though I am now much healthier by blood work results (lipid profile) than I was at 21 (almost 31 now), this insulin resistance is my biggest hardship right now. It requires a lot of will-power to see results, and I’m not exactly good in that department; this should be motivating to many out there who are certainly a lot more determined than me. If I can do it, a lot more people out there should be able to as well (as long as they can afford a healthy diet – sad but true). Perhaps it is time for me to start exercising if that indeed improves insulin sensitivity. Perhaps that is the next part of my journey towards better health. 

As I started to lose weight, there was a shift in my motivation. I started losing weight for/because of someone else, but after I reached 150 pounds, the weight loss became about myself, and about being good to myself. I feel like I owe my life and health to Gary Taubes, and I am forever grateful that he took the time to expose all that data and research about obesity that most everyone else in the scientific community is hiding under the rug or simply refusing the acknowledge. The second influential person that was part of my weight loss was Wayne Dyer. He said one thing that always resonated in my mind… Something along the lines: “When you truly love yourself and you ‘are’ health, you are unable to make decisions that will cause harm to yourself”. These decisions can range from drinking a regular soda drink, to smoking a cigarette, or eating bread in my case. I now understand (thanks to Adiposity 101) that no matter how “whole-grain”, organic and clean grains are, there is no way around the metabolic reaction they cause upon ingestion. Same goes for any other high-starch containing vegetable or sugar filled drinks. They cause me harm, therefore I must avoid them in order to feel good. When I go to the grocery store and see delicious bread and processed frozen/breaded foods, I hear that statement about “being health” loud and clear in my head, and I feel absolutely no temptation to buy said foods anymore. I generally succumb to temptation when I go out to eat, that is what gets me. :(
Meet Robin Today
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What was the biggest challenge to adopting a carbohydrate-restricted or paleo diet?
Understanding the science behind why we get fat was the biggest obstacle to me. It is so simple and yet its meaning eluded me back in 2004 when I tried Atkins for the first time. The second biggest challenge was to give up my favorite foods, bread and fries, but also sticking to the diet when nobody else in the household was following it. Family members and friends can be huge saboteurs of weight loss success if they subscribe to “eat less, exercise more” dogma.

What advice (if any) would you give to someone interested in trying a carbohydrate-restricted or paleo diet? Were there any obstacles that you overcame that could help future dieters?
I feel sorry for people who try to tell themselves that it’s ok to be “big and beautiful”. As a person who has lived both sides (skinny/obese), I remember feeling so miserable during my “fat years”, that there is no way I will ever “buy” the big and happy concept. My advice is, don’t feed yourself ideas that will only serve to keep you in an unhealthy state. You deserve to be slim/normal and be able to engage in any activity you wish, and you certainly have the ability to get there. There is no magic pill or magic weight loss solution. Weight loss is possible but you must make the required dietary sacrifices if you are like me, and insulin sensitivity is not your best friend anymore. This doesn't mean you will starve yourself, but merely make different dietary choices than what you are used to. Do your best to really understand the science behind what makes us fat. That is the part that helped me the most to stick to this way of eating, because I realized there was no good alternative. It was “low carb for health”, or “die early and be miserable meanwhile”. Stop believing that portion control and exercise will solve all problems. I’m the proof that goes against that. Lost 60 pounds without lifting a finger, and I never starved myself intentionally (I had a couple upsetting moments in my life where I did not eat much for a few days, but other than that, I always ate when I got hungry, even if it was late at night). Giving up addicting foods is much like giving up any other habit forming activity like smoking or drinking (of which I did neither, but I still experienced addiction to other things in life). You don’t tell yourself “I’m NEVER eating bread again”. That sort of thinking will make anyone freak out, and immediately go out to buy the whitest, fluffiest bread one can find! Getting rid of an addiction is a process that you engage in every single day you wake up, as you tell yourself, “I will do my best to avoid bread today”. The next day, you allow the person (inside of you) who went without bread for the previous day to ponder on that choice again. With this “one day at a time” approach, it is certainly possible to rid yourself of addictions you never imagined your life without.
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Tried a paleo or low carb diet? Join Today and contribute to a better understanding of this way of eating!
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Down 60 lbs and counting on atkins

3/12/2015

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Meet the old Kim
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My boss has been on and off the Atkins diet for several years. Two years ago, she asked if I and a co-worker would like to join her in her weight loss efforts. Not wanting to be the odd man out, I agreed. At the time, I knew that I needed to lose weight. I'd been having considerable back pain, and I had no stamina or energy. I'd had two surgeries (1 major) in the year prior to starting a low carb WOE and developed an infection at the surgical site that required 2 months of treatment at a wound care clinic. I had not been diagnosed with diabetes, but it runs in my family and I knew that if I'd continued down that path it would ultimately lead to diabetes.

The weight just seemed to fall off, and I had more energy and no hunger or cravings. I ate 3 meals and 2 snacks daily. I used a tracking program to monitor my carb intake (which also required calorie tracking, but I was not particularly concerned about eating within a certain caloric budget). I immediately noticed an increase in energy and I was in a much better mood. My near-constant GERD is gone.

While I initially followed the Atkins plan and began to research low carb diets and the nutrition behind low carb eating, I realized that a lot of the processed foods that are allowed on the Atkins plan were not healthy and I gradually eliminated processed foods from my diet and transitioned into a primal diet. Currently 90-95% of my diet consists of whole, unprocessed foods. I strive to eat mostly locally-sourced foods, grass-fed meats, and pastured dairy and eggs from a local farm. I now eat 2 meals and 1 snack daily, eating the majority of my calories between the hours of 3:00 p.m. and 10:00 p.m.

I have maintained my weight loss for just under a year. While I would like to continue to lose weight (approx. 100 more lbs), I am more concerned with the quality of foods that I am now eating, rather than the quantity. 


Meet Kim today
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What was the biggest challenge to adopting a carbohydrate-restricted or paleo diet?
I never found the transition to be challenging. It is now second nature to eat this way. My husband and I shop more often so that we can take advantage of the fresher foods, so it has become more time-consuming and it is more expensive to do so.

What advice (if any) would you give to someone interested in trying a carbohydrate-restricted or paleo diet? Were there any obstacles that you overcame that could help future dieters?
Read all you can and research the types of low carb plans that are out there so that you can choose the plan that best works for you. Knowledge is power. Be prepared to face considerable push-back from the majority of the population that insist that the low carb WOE is unhealthy and unsustainable. In reality, this is this a far healthier WOE and it most certainly is sustainable for life.
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Tried a paleo or low carb diet? Join Today and contribute to a better understanding of this way of eating!
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