Carbs: A Brief History

Some hundreds of millions of years ago, plants developed the ability to take energy from the sun (along with carbon dioxide and water) and make carbohydrates. The process, called photosynthesis, allowed plants to store energy in the form of carbohydrates.

This evolutionary step completely transformed the planet because it allowed the flourishing of organisms that lacked the ability for photosynthesis, since they were now able to obtain energy by eating carbohydrates in plants.

The human body, which does not have the ability to make food from the sun, also happens to use carbohydrates as its main energy source. For example, our brain and red blood cells depend specifically on glucose (a carbohydrate) for normal functioning and energy.

Carbs also serve as an important energy reserve in the form of glycogen in our muscles and liver, allowing us to maintain steady energy levels and also to have energy for sudden strenuous activities (such as sprinting). Thus, carbohydrates enable the body to adapt to a diverse range of situations.

How, then, did we come to vilify carbs? Most plant foods are naturally high in carbohydrates, so if we shun carbs, we’re shunning some of the healthiest foods that exist. We’re also shunning our bodies’ main source of energy. So how did this all come about?

Throwing the Baby Out with the Bath Water

There’s a world of difference between eating fruits, vegetables, and whole grains, and eating doughnuts, candy, and other processed foods.

In this vein, there’s a kernel of truth in the low-carb message: Refined sugars, white bread, and other processed foods high in carbs are unhealthy. Indeed, they are. But it’s not because they are high in carbs; it’s because they are processed foods that have had all of their nutrients stripped out.

However, fruits and other plant foods that are naturally high in carbs (such as vegetables, whole grains, and legumes) contain fiber, phytonutrients, antioxidants, minerals, and vitamins that are critical for good health—from protecting our eyesight by helping prevent macular degeneration to helping fight infections and cancer. Yet in the minds of many, these immensely healthy foods have been grouped with white bread and table sugar.

By telling people to avoid or significantly limit carbs in general, the low-carb movement has erased the crucial distinction between unprocessed and processed foods—creating an entirely new paradigm that goes against everything we know about nutrition and health.

Long-Term vs. Short-Term

If you eliminate carbohydrates from your diet and put your body into a state of ketosis, whereby it’s forced to burn fat to make ketones for energy, it can lead to short-term weight loss. But keeping your body in a state of ketosis is neither sustainable nor healthful, and it does not fulfill the long-term promise of effective weight loss. Indeed, observational population studies show that high-protein, high-fat diets are associated not only with more health problems but also obesity.

When looking at long-term and sustained weight loss without mandated exercise or calorie restriction, the most effective eating pattern has been shown to be a whole-food, plant-based diet (low in fat and high in unprocessed carbohydrates).

The Rise of Atkins

The low-carb idea first became well known in 1972 after Dr. Robert Atkins began publishing his Diet Revolution books, which sold more than 15 million copies and established the Atkins brand and marketing empire.

Atkins is considered the “father” of the low-carb movement. He pushed the remarkable idea that if people ate fat and protein and eliminated (or significantly minimized) carbs, they would be more slender and healthy. Calories were deemed unimportant, allowing people to embrace some of the unhealthiest foods while still following a “diet.”

It’s not hard to see the appeal of this movement, which persists to this day. Gluttony is permitted and encouraged, and people think they are sticking to a diet while loading up on fried chicken, butter, bacon, eggs, steak, and cheese.

The chair of Harvard’s Department of Nutrition said that the Atkins diet was “nonsense” and “dangerous.” The prestigious Medical Letter on Drugs and Therapeutics called the diet “unbalanced, unsound, and unsafe.” But no amount of criticism stopped the diet’s popularity and the newfound fear of carbs it perpetuated.

The Zone and Other Atkins Spin-Offs

Seeing how Atkins hit the financial jackpot, it didn’t take long for a slew of other “low-carb” spin-offs to follow suit.

In the 1990s, we saw the rise of the Zone Diet, which claimed to achieve both weight loss and “hormonal balance” with a so-called “40-30-30” approach, whereby you obtain a relatively low 40 percent of calories from carbs (so still low-carb), 30 percent from protein, and 30 percent from fat. The Protein Power diet was a high-protein/low-carb approach, with significant vitamin and mineral supplementation (perhaps to compensate for the deficiencies of avoiding high-carb fruits and vegetables).

The blood type diet was an even more unusual idea, where people with different blood types would follow dramatically different diets (which is akin to someone recommending different diets based on different eye or hair colors—sounds curious enough, but has no real science behind it). Interestingly, it recommended a meat-free diet for those with blood type A but a meat-heavy low-carb diet for those with blood type O, which is the most common blood type in the U.S.

The 2000s produced even more low-carb variations. The South Beach Diet emphasized “leaner” meats, but still limited carbs to no more than 28 percent of daily calories. The Paleo diet, popularized by an exercise physiologist, is another “high-protein/high-fat/low-carb” diet, but with an emphasis on avoiding processed foods and dairy. It’s based on very subjective assumptions about hunter-gatherer life in Paleolithic times, with provocative and sweeping claims that animal foods comprised up to 75 percent of the human diet (despite evidence to the contrary), and that these questionable estimates should dictate what we eat today (despite being at odds with mainstream medicine).

These diets and their promoters have enjoyed immense commercial success. The author of The South Beach Diet, for example, has sold more than 17 million books and generated large revenues from online services and major licensing deals. The founder of the Paleo diet gained a huge share of the weight-loss market, with cookbooks, Paleo-themed magazines, “Paleo-approved” protein bars, and other products.

These low-carb entrepreneurs tapped into something very powerful: people’s desperation to lose weight. But they have done so by introducing serious confusion about basic nutrition, to the detriment of people’s health.

The Real Skinny on Weight Loss

In short, low-carb/high-fat diets are not good strategies for sustainable or healthy weight management.

One reason is that it’s metabolically a lot easier for our bodies to use carbs for energy, and to store fat as fat. Certainly, if you’re eating too many calories in general, then carbs can and do get metabolized into fat. But it costs our bodies a large percentage of calories to do so: About 28 percent of energy content of carbs is needed to convert them into fat.

In addition, it’s much harder to overeat whole plant foods that are naturally high in carbohydrates (such as fruits and vegetables) because they are typically less calorically dense than high-fat foods and come packaged with lots of fiber, which provides satiety (i.e., you feel full before you eat too much). By contrast, high-fat/low-carb foods can easily trick our brains into overeating because they are more calorically dense and lack fiber.

A Lesson from History?

Low-carb advocates sometimes claim that we’ve tried limiting fat before and it didn’t work—that it actually made Americans fatter. Specifically, they point to a U.S. Senate report published in 1977 that recommended increasing plant foods while cutting back on high-fat meat and dairy.

But the basis for this argument is simply not true.

First of all, the 1977 recommendations specified that no more than 30 percent of calories should come from fat—which is not “low-fat” by any measure. Second, even that modest recommendation was not followed by most Americans; instead, fat and calorie consumption continued to increase.

A Better Lesson From History

It’s no big surprise that Americans are not the healthiest population: We weren’t in the 1970s and we still aren’t today. So, who are the healthiest populations and how do they eat?

The healthiest populations in the world have thrived on carbohydrate-centric diets with corn, wheat, rice, or barley as the main staple, plus lots of vegetables and fruits. These populations are sometimes referred to as “Blue Zones.”

One example is the Okinawans of Japan. Their traditional diet derived close to 85 percent of calories from carbohydrates, with about 60 percent of calories specifically coming from sweet potatoes.

This emphasis on whole unprocessed foods high in carbs served the Okinawans very well. They were not obese, had much lower rates of diseases that plague the West, and were the longest-living people on the planet until they changed their diets. Older Okinawans who continue their traditional way of eating are still among the oldest living people on the planet.

Increased Cardiovascular Risk

Those who follow a low-carb diet have been found to be 50 percent more likely to die of cardiovascular disease and 51 percent more likely to die from cerebrovascular disease.

Cardiovascular disease involves the hardening of the arteries and formation of cholesterol plaques in our vessels, which can cause blockages, blood clots, or tears in our vessels. The disease can manifest in the heart, as it often does; in the brain, where it causes strokes; or in other parts of the body. It’s the world’s leading cause of death, and the only diet that’s been found to stop and reverse it is a whole-food, plant-based vegan diet.

There are numerous factors that help explain the strong association between animal food consumption and cardiovascular risk. For example, eating animal foods in general (including poultry, eggs, dairy, and fish) results in our bodies’ producing higher amounts of a substance called trimethylamine N-oxide (TMAO). TMAO directly injures the lining of our blood vessels and makes them prone to develop atherosclerosis.

That may be why cardiologist Dr. Kim Williams vigorously promoted a plant-based vegan diet during his tenure as president of the American College of Cardiology, and once famously said, “There are two kinds of cardiologists, those who are vegan and those who have not read the evidence.”

Dr. Robert Atkins himself sadly had a history of congestive heart failure and a heart attack, according to a medical report that was accidentally leaked from the New York medical examiner’s office following his death. His widow and the Atkins organization have always denied it.

It’s worth noting that those following a low-carb diet were also found to be 35 percent more likely to die of cancer.

Takeaways

It is extremely important to eat a varied and large amount of whole plant foods every day, something that is exceedingly difficult (if not impossible) to do if you’re displacing plant foods with animal foods in a misplaced effort to avoid carbs.

Yes, refined and processed foods (including processed carbs) are to be avoided. But don’t replace them with meat, eggs, and cheese. Replace them with foods that actually promote good health, such as vegetables, fruits, legumes, whole grains, and, yes (gasp!), potatoes, sweet potatoes, and bananas, too.

It’s easy to get the right proportions of nutrients (plus lots of antioxidants and phytonutrients that promote health and prevent disease) simply by eating a well-balanced and varied diet of whole plant foods. And, as no small added benefit, eating a plant-based vegan diet is also an effective and sustainable way to manage your weight.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

The post How Carbs Became a Dietary Supervillain appeared first on Forks Over Knives.

FOK: What are the most important takeaways from your new book?

AJ: That regardless of how long, or how deeply, you have suffered from a lifestyle-related disease, excess weight, or food addictions, once you get the food right, there is hope for a full recovery. When you truly understand what to eat, you don’t have to worry about how much you eat. And that health food can taste absolutely delicious.

FOK: Understanding the idea of calorie density seems to be the key to unlocking the secrets to weight loss. Can you give us a short lesson on calorie density?

AJ: Calorie density simply means calories per pound of food, and foods range in caloric density from about 100 calories per pound for non-starchy vegetables to 4,000 calories per pound for oil. So there is a 40-fold difference in the caloric density of various foods. A mere tablespoon of olive oil has more calories than 2 pounds of zucchini! Understanding caloric density is not about counting calories, or memorizing how many calories are in a cup of rice or half a cup of blueberries. When you change the average calorie density of the food you eat each day, you can literally consume twice as much food in terms of volume, yet take in half as many calories. So you never have to feel hungry or deprived or count calories, carbs, or points. As luck would have it, the healthiest, most nutrient-dense foods on the planet, the whole plant foods (fruits, vegetables, whole grains, and legumes) and are also the most calorically dilute. By understanding and implementing calorie density, you really can eat more and weigh less.

FOK: Any tips for getting started on a weight loss journey?

AJ: It is essential to sanitize your environment if you want to be successful with any kind of dietary or lifestyle change. As I often say in my Ultimate Weight Loss program: “If it’s in your house, it’s in your mouth.” It’s not a question of if you will eat it, only when. Willpower is only required if you have to make a decision, and you never have to decide to not eat something that isn’t there in the first place. When some people remove all the unhealthy, toxic, trigger foods from their environment their cupboards are completely bare. It’s imperative to shop for healthy food and learn some easy batch cooking techniques because it’s easy to make the right choice when only healthy food is available.

FOK: In the book, you suggest keeping a food journal. Why do you think it’s essential to do so?

AJ: Because what is recorded gets remembered, and you are less likely to eat that Cinnabon if you have to write it down. Keeping a food journal helps keep you accountable, especially if you have someone who will be looking at it. Research shows that people who write down what they eat lose more weight than people who don’t log their food. Old fashioned pen to paper is best.

FOK: I’m obsessed with your idea of “Vegetables for Breakfast” (VFB). Can you explain the habit of VFB and why it’s so crucial for lasting weight loss?

AJ: Pretty much all countries with the exception of the United States eat vegetables as part of a healthy breakfast. Whether it’s the vegetable miso soup in Japan, the kimchi in Korea, or the pickled vegetables in China, most countries eat a savory breakfast. It’s pretty much only the United States that considers sugar, flour, and caffeine breakfast. If you want to lose weight, make sure that at least half your plate at every meal, yes even breakfast, is vegetables. That will dilute the overall caloric density of every meal. In addition, vegetables, especially the dark green leafy ones have compounds called thykaloids, which have been proven to turn off the hunger switch and fight cravings for unhealthy junk food, especially sugar. So whether you want to lose weight, recover from food addiction, or just get healthier, the best thing you can do is to start your day in a savory way with vegetables. But you need to eat them whole, not juiced or blended.

FOK: What is your favorite way to consume “Vegetables for Breakfast”?

AJ: My favorite way to consume any vegetables, besides a delicious chopped salad, is roasted. Whether done in a conventional oven or an air fryer, roasting brings out the natural sweetness in vegetables and caramelizes them so that even people who are vegetable adverse will love them. When you make my recipe for Oven Roasted Balsamic Dijon Glazed Brussels Sprouts, you would swear you’re eating candy!

FOK: What’s your favorite recipe from the book?

AJ: Boy that’s a tough one because I only put my favorite recipes in the book, but I think I would have to say the Creamy Curried Kabocha Squash Soup, Barefoot Dressing, and the C.R.A.M (Carrot, Raisin, Apple and Millet) Muffins.

FOK: Do you have any tips for someone who is already eating a whole-food, plant-based, no-oil diet but is still not losing the weight that they want to lose?

AJ: Immerse yourself in the science of calorie density, which is explained in great detail in my book. If someone is still overweight eating a plant-based diet, then some calorie dense foods are sneaking in somewhere. For some people, it’s because of too many of the high-fat plant foods like nuts, seeds, and avocados, which while healthy, are very calorically dense. It could also be from processed foods like sugar, flour, or alcohol, which for a food addict, is often very hard to moderate their use of. Even eating excessive salt can stimulate the appetite and cause people to overeat. But whether your goal is weight loss, recovering from food addiction, or just to achieve optimal health, the solution is calorie dilution.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

The post Chef AJ Shares Her Secrets for Healthy, Plant-Based Weight Loss appeared first on Forks Over Knives.

People eating high-carb, high-fiber diets enjoy exceptional protection from type 2 diabetes. The Adventist Health Study 2 showed that among nearly 61,000 people, vegans—whose diets are typically high in carbohydrate-rich foods—had half the rate of diabetes compared to non-vegetarians, even after accounting for differences in body weight. It is notable that the non-vegetarians in this study ate red meat and poultry relatively infrequently, suggesting that even small increases in meat consumption disproportionately increase the risk of type 2 diabetes.

Other studies from the Adventist group show similar trends. Among 41,387 Adventists followed for two years, vegans had a 62 percent lower risk of developing diabetes compared to omnivores. And among 8,401 Adventists followed for 17 years, eating meat just once a week was linked to a dramatic 74 percent higher risk of diabetes! Both studies adjusted for body weight and other lifestyle variables.

Moreover, in one of the largest studies of plant-based eating patterns to date, people eating a diet emphasizing whole, unprocessed plant foods had a 34 percent lower chance of developing type 2 diabetes in the long term compared with those whose diets were rich in animal products and/or processed foods. However, those eating a plant-based diet high in less-healthy foods such as fruit juices, sweetened beverages, fried potatoes, chips, refined grains, and desserts experienced a 16 percent increased risk of diabetes, highlighting the importance of choosing healthy plant foods.

A high-carb, high-fiber diet can lower insulin resistance. Insulin resistance is the root problem in prediabetes and type 2 diabetes. In people with insulin resistance, sugar in the blood doesn’t enter our cells as easily it should, and the liver produces too much sugar. Over time, this can result in type 2 diabetes.

The causes of insulin resistance are complex, but the key players are inflammation, excess dietary fats and calories, unhealthy weight gain, and the buildup of fats inside our muscle and liver cells. Here’s where much of the confusion about carbs begins: In people with insulin resistance, carbohydrate-rich foods—such as fruit—can cause spikes in blood sugar because sugar can’t enter the cells properly. This leads people to believe that the fruit is somehow at fault, and that they should limit all carbohydrate-rich foods to keep their blood sugar lower.

Quite the opposite! When we avoid healthy carbs, we are masking the real issue. A whole-foods, plant-based diet actually treats the underlying cause of insulin resistance because it lowers inflammation, promotes a healthy body weight, and reduces the buildup of fats inside our cells. When we become less insulin resistant, our blood sugar doesn’t go up as high when we eat carbohydrate-rich foods. That is a true test of whether a diet reverses insulin resistance instead of simply treating the symptom of high blood sugar.

But what about that piece of fruit? Does fruit cause diabetes? Actually, large studies have linked fruit consumption to lower rates of type 2 diabetes, as well as a reduced risk of diabetes complications and premature death in people who already have diabetes. Overall, whole grains (such as oats, barley, brown rice, and whole wheat) are the type of food that is most consistently protective against type 2 diabetes, while processed meat (which contains almost no carbohydrates) increases diabetes risk the most—just one serving per day raises the risk by 37 percent!

High-carb, plant-based diets are effective for treating, and in some cases reversing, type 2 diabetes. Randomized clinical trials show that a fully plant-based diet that is high in carbohydrates and fiber and low in fat can lower glycosylated hemoglobin (a measure of average blood sugar), reduce the need for medications, help people lose excess weight, and even lower blood cholesterol more than a conventional diet based on American Diabetes Association guidelines. Notably, plant-based patients in these trials were not asked to measure portions, count carbs, or tally their calories. They just ate healthier foods! A 2014 review of vegetarian diets for the treatment of type 2 diabetes confirmed significant reductions in blood sugar compared to standard diets.

Whole-food, plant-based, high-carbohydrate diets typically exclude nutrients and foods that have been associated with diabetes risk, including animal protein, saturated animal fats, refined grains, and sugar-sweetened beverages. They emphasize unprocessed plant foods, which are naturally rich in fiber, antioxidants, and phytonutrients—substances that reduce inflammation and promote a healthy body weight.

A high-carb, plant-based diet can prevent and treat cardiovascular disease and other complications of diabetes. Plant-based diets have been shown to prevent and reverse cardiovascular disease, the leading cause of death in those with type 2 diabetes. They also lower blood cholesterol, blood pressure, and inflammation, major risk factors for cardiovascular disease. A growing body of scientific literature shows that plant-based diets may be helpful in delaying the progression of chronic kidney disease, a common complication of diabetes. A plant-based diet may lessen the pain of diabetic neuropathy, a debilitating nerve-related condition in diabetes. Finally, plant-based diets are effective for weight loss, which further improves diabetes control.

Eating more healthful, carb-rich foods tends to crowd out disease-promoting foods. Added sugars, animal fats, animal protein, and white flour and other refined grains all increase our risk of chronic disease and, in the case of animal protein, even premature death. Animal foods in particular contain higher levels of saturated fat; heme iron; advanced glycation end products; and in the case of processed meats, nitrate and nitrite preservatives. They also stimulate our gut bacteria to make a harmful compound called TMAO. All of these substances promote insulin resistance and other health risks. When you focus on beans, lentils, peas, fruits, vegetables, and whole grains, you not only improve your diabetes or risk of diabetes, but you stack the odds in favor of optimal long-term health.

My patients with prediabetes and diabetes who adopt a high-carbohydrate, high-fiber, WFPB diet typically experience lower blood sugars and lower cholesterol, as well as weight loss if they are overweight. They have been able to reduce medications in many cases. I’ve seen this approach work well, and I’m certainly not the only one recommending it: Mainstream diabetes organizations have recognized the value of a plant-based diet for diabetes. In their 2018 guidelines, the American Association of Clinical Endocrinologists (AACE) recommends a plant-based diet as the preferred eating pattern for patients with type 2 diabetes, and the American Diabetes Association advises that a plant-based diet is a healthful option for patients with type 2 diabetes.

If you have diabetes, be sure to work closely with your health care provider if you change your diet, as any medications you are taking may require adjustment. For practical information on how to adopt a plant-based diet for diabetes, check out resources such as the Physicians Committee for Responsible Medicine and Mastering Diabetes.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

The post Why I Recommend a High-Carb Diet for My Patients with Diabetes appeared first on Forks Over Knives.

But you would not know that if you read the New York Times this weekend. On Sunday, the paper published an opinion piece urging Americans to ditch not only sugars, but wheat, rice, corn, potatoes—even fruit—to fight diabetes and obesity. The article also recommended replacing these foods with meat, eggs, and butter.

Advice like this is dangerous. Another recent study of more than 200,000 participants found that consuming large amounts of animal protein increased diabetes risk by 13 percent. But by simply replacing 5 percent of animal protein with vegetable protein—including carbohydrates like potatoes and grains—participants decreased diabetes risk by 23 percent.

Epidemiological studies tell a similar story. Traditionally, minimally processed and unprocessed carbohydrates, including rice and starchy vegetables, were the main staples in countries like Japan and China—and type 2 diabetes was rare. But as time went on, Western diets filled with meat, cheese, and highly processed foods replaced these traditional carbohydrate-based diets, and diabetes rates soared.

So how does it work? Insulin’s job in our bodies is to move glucose, or sugar, from our blood into our cells. But when there’s too much fat in our diets, fat builds up in our cells. Evidence shows that this cellular fat can actually interfere with insulin’s ability to move glucose into our cells, leading to type 2 diabetes. (Watch this video to learn more.)

At the Physicians Committee, we have been putting this idea into practice for more than a decade. Participants in our clinical studies and nutrition education classes eat as many whole, unprocessed or minimally processed carbohydrates as they want—everything from fruit and sweet potatoes to beans and whole wheat pasta—and they soon see improvements in their blood sugar control.

In 2006, we partnered with the George Washington University and the University of Toronto to put these ideas to the test in a clinical setting by pitting a low-fat, plant-based diet against the standard diabetes diet recommended by the American Diabetes Association. The results were remarkable: Participants in the vegan group lowered hemoglobin A1C by 1.2 points, which was three times greater than the ADA group.

These participants also experienced weight loss, lower cholesterol, lower blood pressure, and improved energy. All the side effects were positive. On the other hand, those who follow low-carbohydrate diets are at increased risk over the long term for weight gain, heart disease, and even premature death.

This article originally appeared on the Physicians Committee for Responsible Medicine website and was reprinted with permission. 

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Can you believe people actually avoid fruit in an attempt to lose weight? There has never been a single credible study showing that fruit consumption leads to weight gain, and yet this concept is as prevalent as any nutrition dogma. I have treated people for obesity for years and I can tell you, nobody is coming to see me because they ate too many apples or grapes. Why do people think fruit leads to weight gain? The quick answer from my patients is because of the carbs.

When I ask my patients what their downfall is, when it comes to weight loss, they unanimously blame carbs. Their diet log will read: eggs-and-bacon breakfast sandwich, Subway sandwich and chips for lunch, and a pork roast with potatoes for dinner. When asked the part of that menu that is causing them to gain weight, they blame the bread from the sandwiches, the chips, and the potatoes. It is always the bun, never the hamburger. Now don’t get me wrong; there is nothing healthy about chips, loaded with fat. The sandwich bread is likely bleached flour with little, to no, nutrient value.

However, the vast majority of the calories are coming from fat and protein. Pizza and donuts are considered carbs despite the fact that they contain as many (or more) calories from fat as carbs.

Here are two examples. The first is for a Pizza Hut six-inch Personal Pan Meat Lover’s Pizza (admittedly one of their more calorically dense and fat-heavy options). Of the 850 total calories, 430 come from fat. That’s 51 percent. Another hundred calories come from protein, leaving 320 calories from carbs.

Second, a Krispy Kreme Original Glazed Donut. According to the company’s website (updated September 2014), a single donut delivers 190 calories, 100 of them from fat. That’s 53 percent. Carbs account for 84 calories (44%), while protein comprises another 6 calories (3%).

Widespread Misconceptions About Protein, Carbs, and Fat

Here’s a recent conversation with a patient, a woman from Ghana, that really highlights the misconceptions about diet and weight loss. She has lived in the United States for many years, and during much of that time, struggled mightily with obesity. She has seen endocrinologists, dietitians, and trainers. She has done the Atkins diet several times and most recently went to a doctor who prescribed Belviq (the newest prescription medication targeting obesity). She sees a registered dietitian and a trainer regularly. Despite the meds, the medical oversight, and her sincere and steadfast efforts, she still has a body mass index (BMI) of 40, which classifies her as morbidly obese.

And as you’ll see, she already knows everything she needs to make smarter decisions. It’s only the proteinaholism that blinds her to the truth:

ME: So what do you typically eat for breakfast?

PATIENT: Usually eggs of some sort and a protein.

ME: What do you mean by “protein”?

PATIENT: Well, it could be chicken or bacon or sausage.

ME: Hmm, those aren’t really protein. I mean, some of those choices have more calories from fat than protein. So really, you could just as well say, “I have eggs and some fat for breakfast.”

PATIENT: (Chuckles) Never thought about it like that.

ME: So what’s for lunch?

PATIENT: Usually salad with a pro-um,

I mean fish or chicken.

ME: OK, do you snack during the day?

PATIENT: No. My issues really are at night, when we eat more carbs from our traditional diet from Ghana. We eat lots of yams and stews. Lots of starches.

ME: Interesting that you view that as your bad meal when to me it’s your best. Have you visited Ghana recently?

PATIENT: Yes. Funny enough, whenever I visit Ghana I lose weight. That is the only place I lose weight.

ME: What do you eat there?

PATIENT: Lots of yams, yam stews, lots of maize (corn), fruit.

ME: Are there lots of obese people in Ghana?

PATIENT: Not at all. In fact, when I am there I am one of the biggest.

ME: So do you see what I’m getting at? In Ghana you eat lots of starches and fruits, and people are thin and you lose weight. But come to America and eat American “health food,” and you gain weight. As I look at your diet history, you have always tried diets that focus on high protein. You told me you try to eat lots of protein and it has never worked long for you. Yet you have completely avoided a diet that you enjoy and have lost weight on.

PATIENT: Well, I thought fruits and starches made you fat, and we need more protein. That is all I hear.

In Ghana, the obesity rate is 5.5 percent, slightly higher for women (7.9%) and slightly lower for men (2.8%), compared to America’s 34.9 percent rate of obesity. Higher rates of obesity were found among those who live in the more Westernized portions of Ghana and eat less fruit. Also, those who had not completed a secondary school education were much less likely to become obese than those who graduated from secondary school, high school, and college. This suggests that with higher earning power came the ability to buy meat and other rich Western fare. The Ghanian traditional diet was the one most closely correlated with normal weight and is high in beans and starches, including maize, yams, fruits, and cassava roots (Biritwum, Gyapong, et al. 2005)[1].

Traditional diets high in fruits, veggies and starches have worked for thousands of years, and continue to keep people slim and healthy. But our obsession with counting fat, carbs, and protein blinds us to this truth.

[1] Biritwum, R., Gyapong, J., & Mensah, G. (2005). The epidemiology of obesity in Ghana. Ghana Med J, 39(3), 82–85.

The post Obesity: It’s Not About the Carbs appeared first on Forks Over Knives.

Whole Grains, Refined Grains, and Pseudo-Grains

The choice becomes clearer once you understand the biology of plants.

• Whole grains are the seeds of certain grasses that store their energy mostly as complex carbohydrates. Wheat, corn, rice, barley, oats, millet, and rye are the most common examples. Whole grain foods contain all parts of the seed: the outer protective skin (bran), the tiny baby plant (the germ), and food to nourish the baby plant until it can produce its own (endosperm).
• Refined grain foods, on the other hand, are generally made only from the endosperm. Most of the healthy bran, germ, and nutrients have been stripped away.
• Pseudo-grains include quinoa, buckwheat, and amaranth. These seeds are similar nutritionally to traditional whole grains, but they are produced by plants that are not grasses. While this difference is important to botanists, it’s less important if you’re simply trying to decide what to cook for dinner. You can use whole grains and pseudo-grains interchangeably.

Many published, peer-reviewed studies on people who eat more whole grains attribute a spectrum of health benefits to these foods. Here are three primary ones:

1. Whole Grains Decrease Your Risk of Obesity

A common myth is that foods high in carbohydrates cause obesity. Yet peer-reviewed research finds quite the opposite among people who consume higher proportions of their carbohydrates in the form of whole grains. Here are some representative findings:

• An eight-year study of American men found that those who ate more whole grains gained less weight. In fact, each additional 1.4 ounces of whole grains eaten per day staved off a pound of weight gain.
• Similarly, a twelve-year study of women in the U.S. discovered that those who consumed more whole grains consistently weighed less than other women.
• An analysis of fifteen research trials with data from 119,829 participants concluded that a higher intake of whole grains was linked to lower BMI and waist size.

2. Whole Grains Reduce Your Risk of Chronic Illness

People who consume whole grains have less chance of developing the chronic degenerative illnesses that pervade the modern world. In fact, eating more whole grains is linked to lower levels of a common inflammatory marker associated with chronic disease. Consider a few of the many consistent results:

• While diabetes is popularly thought to be associated with high carbohydrate foods, an analysis of 16 studies found that 3 servings of whole grains per day reduced the risk of developing diabetes by 32%.
• Another analysis of 66 studies found a similar number: a 26% decrease in the risk of developing diabetes, as well as a 21% lower risk of cardiovascular disease with higher whole-grain consumption. Specific risk markers improved by these foods included fasting glucose, insulin, cholesterol, and blood pressure.
• A Scandinavian study of 108,000 participants discovered that eating more whole-grain products reduced the risk of developing colorectal cancer, with whole wheat having the strongest benefit.

3. Whole Grains Help You Live Longer

In 2015, researchers published an analysis of two large studies of participants followed for a period of about 25 years. They reported that each additional one-ounce daily serving of whole grains reduced the risk of death over the study period by 5%, and the risk of death from cardiovascular disease by 9%. The beneficial effect was seen from the combined effects of many foods, including whole wheat and whole-wheat flour, oats, corn and popcorn, rye, brown rice, and whole-grain breakfast cereals.

Scientists cite a number of reasons that whole grains could have such favorable effects. Their high fiber makes food more satisfying, and whole grains promote beneficial gut microbes, which produce protective short-chain fatty acids. These foods are dense with vitamins, minerals, amino acids, antioxidants, and phytochemicals. Whole grains may also displace less-healthy foods that would otherwise be eaten. The big picture, as it is better understood, is likely to involve numerous, interrelated reasons why whole grains promote health.

Don’t let unsupported claims by those who ignore the consistent science deprive you of the pleasure and benefits of whole grains. These foods are inexpensive, filling, nutritious, and healthful. Enjoy them throughout your day.

Read More:

• The Smoke and Mirrors Behind Wheat Belly and Grain Brain
• The Only Three Food Groups You Need to Remember

_{Sources:
Aune, D., Norat, T., Romundstad, P., & Vatten, L. (2013). Whole grain and refined grain consumption and the risk of type 2 diabetes: A systematic review and dose–response meta-analysis of cohort studies. Eur J Epidemiol, 845-858.
Harland, J., & Garton, L. (2007). Whole-grain intake as a marker of healthy body weight and adiposity. Public Health Nutrition, 554-563.
Koh-Banerjee, P., Franz, M., Sampson, L., Liu, S. Jacobs, D., Spiegelman, D., Willett, W., & Rimm, E. (2004). Changes in whole-grain, bran, and cereal fiber consumption in relation to 8-y weight gain among men. Am J Clin Nutr, 1237-1245.
Kyrø, C., Skeie, G., Loft, S., Landberg, R., Christensen, J., Lund, E., Nilsson, L., Palmqvist, R., Tjonneland, A., & Olsen, A. (2013). Intake of whole grains from different cereal and food sources and incidence of colorectal cancer in the Scandinavian HELGA cohort. Cancer Causes Control, 1363-1374.
Liu, S., Willett, W., Manson, J., Hu, F., Rosner, B.,& Colditz, G. (2003). Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Am J Clin Nutr, 920-927.
Mann, K., Pearce, M., Mckevith, B., Thielecke, F., & Seal, C. (2015). Whole grain intake and its association with intakes of other foods, nutrients and markers of health in the National Diet and Nutrition Survey rolling programme 2008–11. Br J Nutr, 1-8.
Mostad, I., Langaas, M., & Grill, V. (2014). Central obesity is associated with lower intake of whole-grain bread and less frequent breakfast and lunch: Results from the HUNT study, an adult all-population survey. Appl. Physiol. Nutr. Metab., 819-828.
Slavin, J. (2004). Whole grains and human health. Nutrition Research Reviews, 99-110.
Wu, H., Flint, A., Qi, Q., van Dam, R., Sampson, L., Rimm, E., Holmes, M., Willett, W., Hu, F., & Sun, Q. (2015). Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women. JAMA Intern Med, 373-384.
Ye, E., Chacko, S., Chou, E., Kugizaki, M., & Liu, S. (2012). Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. Journal of Nutrition, 1304-1313.}

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I enjoy reminding my patients that their fork can be more powerful than my prescription pad when it comes to preventing and reversing chronic diseases. This conversation usually uncovers some common misconceptions about food and nutrition. Here are five myths that I hear almost every day, among patients and colleagues alike:

1. “I need to eat more protein.”

Many people don’t realize that the average American consumes more than twice the Recommended Dietary Allowance (RDA) of protein, most of it from animal products. ^1,2 Unfortunately, animal-based proteins have been shown to promote faster growth, not only of normal cells but of cancer cells, and have been linked to a variety of cancers as well as heart disease, diabetes, Alzheimer’s disease, and kidney stones.^3,4

Plant foods contain plenty of protein, and a well-planned whole-foods, plant-based diet can easily meet our protein requirements. And unlike animal proteins, plant proteins from whole foods are not associated with cancer or other chronic diseases. In fact, these foods actually prevent many of the diseases we see today!

(RELATED: Do Vegans Eat Enough Protein?)

2. “I need to drink milk to have strong bones.”

Many people equate dairy with calcium, strong bones, and the prevention of osteoporosis (low bone density). Generations of advertising slogans have perpetuated this idea. However, dairy isn’t the answer here. Studies show that dairy products may actually increase the risk of fractures related to osteoporosis!^5-7

The biological purpose of cow’s milk is to support the rapid growth of a calf. Humans have no nutritional or medical need to consume the milk of cows or any other nonhuman species. Cow’s milk naturally contains female hormones, and can contain antibiotics, pesticides, saturated fat, and cholesterol — substances that definitely do NOT do a body good! Dairy has been specifically linked with prostate, ovarian, and uterine cancer, as well as heart disease and early death.^7-13

The best sources of calcium come from the earth, in foods such as kale, broccoli, bok choy, and Brussels sprouts. As a bonus, these vegetables are high in vitamin K, which is also important for strong bones. (Some greens, such as spinach and Swiss chard, are high in calcium but the calcium is not well absorbed due to the high oxalate content of these foods.) Fortified plant milks and calcium-set tofu are other good sources of calcium.

3. “Chicken, turkey, fish, and eggs are healthy sources of protein.”

Chicken, turkey, fish, and eggs contain significant amounts of cholesterol and saturated fat, in many cases as much as beef,¹⁴ so they are not “heart healthy” foods. Plant-based sources of protein contain zero cholesterol and far less saturated fat. Chicken and turkey usually contain antibiotics, pesticides, and fecal contaminants, and have been associated with salmonella, staph, and other infectious disease outbreaks. Chicken, fish, and eggs have been associated with an increased risk of diabetes.^15-23 Almost all fish contain mercury, which can cause neurologic and cognitive problems; many also contain polychlorinated biphenyls (PCBs), a toxin associated with cancer.¹⁴ And a recent study showed that eggs cause intestinal bacteria to make a substance called TMAO, which can trigger heart attacks and other cardiovascular events.²⁴

Whole plant foods can supply plenty of protein, and they don’t come packaged with cholesterol or high levels of saturated fat. Instead, their protein is bundled with fiber and many necessary nutrients! Great plant-based sources of protein include beans, peas, lentils, tofu or tempeh, whole grains, nuts, and seeds.

4. “I can’t eat carbs.”

Many people are mistakenly led to believe they should avoid carbohydrates, particularly for weight management and diabetes control. Instead, they focus on proteins—especially animal proteins—and fats. Sadly, this approach actually increases the risk of chronic disease and death,^25-29 and it deprives people of the numerous nutrients found in carbohydrate-containing foods.

It is true, however, that not all carbohydrate-rich foods are created equal. Refined, highly processed carbohydrates can raise triglycerides, promote weight gain, and drive up blood sugar. On the other hand, starches that come from whole grains bring fiber, essential fatty acids, B vitamins, zinc, and protein, and other essential nutrients into our diets and provide an excellent source of energy. Beans, lentils, peas, starchy vegetables, and fruits are other healthy carbohydrate sources. Balancing these foods with non-starchy vegetables is an optimal way to eat for weight loss, diabetes control, and reversal of heart disease.

(RELATED: Obesity—It’s Not About the Carbs)

5. “Healthy food is too expensive.”

You don’t need to shop at a gourmet health food store to find nutritious foods. Actually, some of the healthiest foods are the least expensive, and they are readily available at most grocery stores and many local farmers’ markets. Beans, lentils, brown rice, and frozen vegetables are usually inexpensive, especially when bought dried and in bulk. (Organic fruits and vegetables can cost more, but eating nonorganic plant-based foods is still more nutritious than eating meat, chicken, fish, eggs, and dairy, organic or otherwise.)

Even when processed foods and animal products are sold cheaply, they are expensive in terms of the cost to your health. What you may save now, you could end up spending later in pharmacy co-payments and medical bills!

(RELATED: 7 Things That Happen When You Stop Eating Meat)

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The post Top 5 Misconceptions About Food: A Doctor’s Daily Experience appeared first on Forks Over Knives.

Robert Atkins, MD, creator of the Atkins Diet, was upfront with his recommendations to eat a diet almost exclusively made up of meat, poultry, cheese, butter, fish, and eggs, with very little plant-foods. The first Atkins Diet book was published in 1972; since then well-informed people have come to understand (through their own readings and personal experiences) that eating an animal-based, high-fat, low-carbohydrate diet is wrong. They have learned that following this eating pattern causes epidemic diseases, including type-2 diabetes, coronary heart disease, and common cancers; and that the livestock industry is at the root of climate change. Many people are also wrestling with their conscience as they deal with the moral issues of animals being killed unnecessarily for food, supporting the horrors of factory farming, and depleting our oceans. Therefore, a diet book titled Eat More Animals to Lose Weight would meet a mostly unfriendly audience.

Wheat Belly and Grain Brain take a backdoor approach to the Atkins low-carbohydrate method. As the titles of these books suggest, wheat causes a big belly and grains damage the brain. Within their pages you learn that all starchy foods, including rice, corn, and potatoes—the traditional foods consumed by billions of people throughout human history—are now unhealthy and must be minimized or, better yet, avoided altogether. If you believe these authors, then what is left to eat in order to meet your energy requirements? Meat, dairy, fish, and eggs (the original Atkins Diet).*

In order for the authors of these two books to pull off the monumental task of luring otherwise intelligent people into inherently dangerous diet plans, they have had to (1) ignore the bulk of the science, (2) exaggerate the truth, and (3) make false associations.

Ignoring the Science: Low-Carbohydrate Diets Contribute to a Higher Risk of Death and Disease
Low-carbohydrate diets can cause weight loss, but weight loss should not be the primary goal of individuals, medical doctors, dietitians, insurance companies, or governments. The goal is to live longer and stay healthy. Three major scientific reviews show that low-carbohydrate diets increase the risk of sickness and death.

Exaggerating the Truth about Inflammation
Promoters of low-carbohydrate diets, those high in meat, dairy, fish, and eggs, claim dietary carbohydrates are packed with inflammatory ingredients, and that inflammation is at the heart of virtually every disorder and disease. The evidence linking carbohydrates to inflammation is convoluted, theoretical, and largely limited to an uncommon condition, Celiac disease.

Inflammation is the consequence of injury, such as from a cut, burn, or infection. The pain, redness, swelling, and heat that follow are natural, necessary processes for healing. These symptoms and signs of inflammation resolve after the single event. However, with repetitive injury, inflammation can become long-standing, referred to as “chronic inflammation.” One common example of chronic inflammation is bronchitis from inhaling cigarette smoke 20 times a day. Stop smoking and the inflammation stops, and the lungs heal (scar tissues and other residuals of the damage can be left behind).

For dietary diseases, including atherosclerosis, primary sources of repetitive injury are meat, cheese, and eggs. Once the injury is stopped, then healing occurs and the inflammation resolves. Reversal of coronary heart disease is seen on follow up examinations.

Research does not support the theory that carbohydrates from wheat, other grains, or starchy vegetables are the source of injury that leads to chronic inflammation. In contrast, scientific research does solidly support that the source of injury leading to chronic inflammation is animal foods.

Several mechanisms have been proposed to explain how animal foods injure our bodies. For example, atherosclerosis (chronic inflammatory artery disease) has been explained by the “cholesterol hypothesis” and by the “TMAO hypothesis.” Another sound mechanism identifies cow’s milk as the culprit. Most important for the consumer to understand is that these mechanisms consistently blame meat, dairy, and/or eggs as the source of the repeated injury and chronic inflammation. No debate here.

Relevant to the argument that inflammation is not the underlying cause of obesity and disease is the fact that treating inflammation with powerful anti-inflammatory medications does not favorably change the course and progression of the disease. To quote respected researchers, “In fact, to our knowledge, no anti-inflammatory therapy cures the majority of patients with a disease in which inflammation plays a major contributory role…” To repeat, inflammation is the result of injury, not the cause of disease.

Making False Associations: Using Celiac Disease to Demonize All Carbohydrates for All People

The main take-away that readers will get from Wheat Belly is that wheat is the major cause of obesity, heart disease, diabetes, and almost all other major health problems that people suffer from. Wheat can be very troublesome for a small percentage of the population. Celiac disease is a condition that affects fewer than one in one hundred people following the Western diet. These people must avoid gluten, found in high concentrations in wheat, barley, and rye. However, to put this real concern into a global, historical perspective, consider the importance of these three grains: they have served to fuel the development of civilizations throughout human history and still are a major source of calories, protein, vitamins, and minerals for billions of people. People without celiac disease, or the few other conditions that warrant elimination of these three specific grains, will find them an excellent source of nutrition.

Even those few people intolerant of gluten (wheat, barley, and rye) can healthfully consume non-gluten rice, corn, oats, and other grains. Low-carbohydrate promoters enthusiastically demonize these grains too.

Making False Associations about Diabetes and Carbohydrates
The main take-away that readers will get from Grain Brain is that grains and other starchy foods are the cause of type-2 diabetes, Alzheimer’s disease, obesity, and most of the other chronic health problems suffered in the Western world. The truth is that people with type-2 diabetes are ill with many disorders of the body and brain. But grains and other starchy vegetables do not cause type-2 diabetes. The Western diet, loaded with meat, fat, and empty calories, makes people overweight and diabetic.

Type-2 diabetes is cured by a starch-based, high-carbohydrate diet. To take this point to the extreme, the Rice Diet, consisting of white rice, fruit, fruit juice, and table sugar (more than 90% of the calories are from carbohydrate) has been shown to cause profound weight losses in the severely obese, cure type-2 diabetes, and reverse heart disease. Dietary fat increases blood sugar levels and causes people with type-1 diabetes to require more insulin.

Regardless of the effects on blood sugar, the underlying animal-based, low-grain, low-starchy-vegetable diet consisting of those very foods recommended in the books Wheat Belly and Grain Brain, is the major reason people with type-2 diabetes are so sick with heart and other diseases.

Looking Beyond the Smoke and Mirrors
The truth is that the rich Western diet makes people fat and sick. Steering people away from the few healthy components of our diet (grains and other starchy vegetables) and toward the unhealthy foods (meat, dairy, fish, and eggs) makes matters worse. People are desperate for a solution to their weight and health problems, and many of them are easily deceived. Especially when told that prime rib and cheddar cheese are good for them—people love to hear good news about their bad habits. Just as important for the rising popularity of low-carbohydrate diets, books like Wheat Belly and Grain Brain enhance the profits of the meat, dairy, egg, and fish industries.

Although these industries spend hundreds of millions of US dollars advertising “their science” and influencing national nutrition and health policies, the truth is simple and easy to understand: All large successful trim healthy populations of people throughout human history have obtained the bulk of their calories from grains and other starchy vegetables. Consumption of meats along with other rich foods in any significant quantity has been limited to the diets of fat, sick aristocrats (kings and queens)—until recently. To regain our lost health and save planet Earth, the smoke and mirrors behind popular diet books must be exposed.

*In an effort to partially compensate for important nutritional deficiencies, like dietary fiber, vitamin C, and thousands of other phytochemicals found only in plants, non-starchy green, red, and yellow vegetables (for example, broccoli, Brussels sprouts, celery, kale, lettuce, parsley, peppers, and zucchini), and a few fruits are commonly added to these low-carbohydrate diets, including newer versions of the Atkins Diet. Only plants make carbohydrates, thus “low-carbohydrate” is in practical terms synonymous with meat, poultry, cheese, butter, fish, and eggs.

**Simple sugars, like glucose and fructose, are refined ingredients found in sodas, cakes, cookies, and table sugar. Starches (sometimes referred to as complex carbohydrates) are foods with “natural sugars,” such as, barley, corn, millet, oats, potatoes, sweet potatoes, rice, and wheat.

Originally published in a McDougall Newsletter and republished with permission. Click here to sign-up for the McDougall Newsletter for free.

The post The Smoke and Mirrors Behind Wheat Belly and Grain Brain appeared first on Forks Over Knives.

The body’s metabolism is genetically encoded to run most efficiently on starch. No amount of willpower, dieting, or wishful thinking will change that fundamental fact. The one simple solution to health and beauty is to eat the diet we were designed for. In addition to being healthful, a diet based on starch offers a multitude of rewards.

Starches Satisfy the Appetite: The hunger drive keeps us alive. You cannot fool hunger by pushing yourself away from the table, putting down your fork between bites, eating from a small plate, or counting calories. You will never train yourself not to experience the discomfort associated with hunger, even if you practice until you are 90 years old.

The control you do have is over the foods that fill your plate. Meat, dairy, animal fats, and vegetable oils lead to excess weight gain and illness. Starches, vegetables, and fruits support a trim, fit body and a lifetime of excellent health.

You may have heard that all calories are the same when it comes to body weight. That’s not true, especially when it comes to satisfying the appetite and accumulating fat. Three components of food provide the fuel we know as calories: protein, fat, and carbohydrate. Starches like corn, beans, potatoes, and rice offer abundant carbohydrates and dietary fiber and are very low in fat.

Satisfying the appetite begins with filling the stomach. Compared to cheese (4 calories per gram), meat (4 calories per gram), and oils (9 calories per gram), starches contribute only about 1 calorie per gram. They help you to feel full for just a quarter of the calories in cheese and meat, and one-ninth of those in oil. Plus, they offer a great deal of satisfaction. Research comparing the way carbohydrates and fats appease the appetite shows that carbohydrates lead to hours of satiety, whereas fats have little impact. In other words, when you fill up on starch you stay full for a long time, whereas when you fill up on fats and oils you still want to eat more.

_{Image via Smart Living Network.}

[Related: Obesity: It’s Not About the Carbs]

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