A Low-Fat Diet is a High-Glucose Diet

They are almost always the same thing

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First Published on my Blog on July 15, 2013

An Open Letter to Dr. Daniela Drake

The other day I received an email from a woman ("C") in some distress. For most of her adult life she has been following an Ornish-style low-fat/high-carb diet, sometimes vegan, sometimes not, with plenty of exercise. Despite her dedication to her health, C's weight cycled, so that by the time she was in her 50's, she was fairly overweight.

She was also taking several blood pressure medications with uncomfortable side effects.

Finally, C found Gary Taubes' book, Why We Get Fat, and started doing some research. She got off wheat, then other grains. She has been following a low-carb paleo approach for the past several months, has lost 30 pounds, and has normal blood pressure with no medications. I hear these lovely stories all the time, and they make me feel so happy!

So what is C's problem? Why the distress? The problem is the media, with the constant cry of "eat low-fat to be healthy!". The problem is her husband and other people around her who freak out when she eats bacon. The problem is coming across articles like this one in the Daily Beast by Dr. Daniela Drake, "Doctors Should Start Advocating Dietary Options to Treat Heart Disease".

Dr. Drake is upset with the medical establishment's reliance on drugs instead of lifestyle changes, and decries the Standard American Diet of processed foods and junk.

So far, so good! People need support to be able to change the way they eat and live, which by and large they are not getting from their doctors. At that point, the medical establishment can collectively throw their hands in the air and cry, "it's too hard for people to change!" The problem is, they have barely tried at all to help their patients to do so.

The major disagreement I have with Dr. Drake's article is that she goes on to advocate one diet, the diet of a Dr. Caldwell Esselstyn, who advocates a vegan diet which is very low in fat (kiss your olive oil and avocados good-bye). It is very similar to the diet Dr. John McDougall recommends. On a recent podcast interview by Jimmy Moore Dr. McDougall said that every single person on the planet would do best eating this diet, and that there "has to be one best diet" for the human species. (Although Dr. Drake mentions the Paleo diet in passing, even linking to a positive study, she immediately says"there isn't enough data", thus neatly dismissing it.)

This diet which Drs. Drake, Esselstyn and McDougall recommend is basically a diet as high in glucose as can possibly be managed while still eating whole foods. Yes, there are lots of nutrients and fiber in the veggies and fruits, although far less in the grains and other starchy foods. But if you look at where the calories come from in this diet, we're talking glucose all the way. Since fruit has fructose and almost all plants have a little protein and a little fat, those will be along for the ride as well, but they are riding the Glucose Express.

(As an example, a "medium" potato (2¼ - 3¼ inches in diameter) has 37 grams of carbohydrate, almost all of which comes from the long strings of glucose which make up the starch in it.)

Now, some people apparently do great on an almost-all-glucose diet, as long as it's whole foods with lots of nutrients (and supplements such as vitamin B12). But guess what? Despite Dr. McDougall's protestations, we are not all the same! For example, I have heard from diabetics who do well on a diet that is low-fat and/or vegan, as long as they are losing weight. But basically the second their weight loss stops, their blood sugar starts going up -- because --- news flash -- they are diabetic, and by definition their bodies do not process glucose well!

Ah, I hear Dr. Drake say, but diabetics are small in number! But the numbers of those on the whole diabetes spectrum (including metabolic syndrome), all of whom probably have some degree of beta-cell damage, is a much larger number - in some groups well over half. When you insist that a high-glucose diet is best for everyone, you will end up with a lot of struggling people like C, who benefit from carbohydrate reduction, but keep getting the message that they are risking their health. I call that irresponsible.

Also, you don't have to be diabetic to not react well to the Esselstyn/McDougall diet - it's become commonplace to find people who became downright sick on this and other vegan diets. In fact,  it seems as though the paleo community is chock-a-block full of them! (I think this makes sense, as both groups have a lot of people willing to make substantial changes to find optimal health.) Take the example of nutrition scientist Dr. Chris Masterjohn. I've written about Chris several times when reporting on his conference talks, and have learned a lot from him. He has written eloquently about how his physical and mental health deteriorated on a vegetarian/vegan diet and was restored with a Weston A. Price type diet. One of the things that gets my attention in Chris's latest update to his story is the addition of genetic testing, which revealed some of the probable reasons for him doing better on a diet with animal foods. I think this is very exciting! I SO look forward to the time when we can all get information from our own DNA that will guide our food choices! Scientists are still just scratching the surface, but the progress is encouraging.

If a vegan diet reverses your heart disease, by all means, go for it, although you of course need to be careful to do it safely (both Chris Masterjohn and Denise Minger have some great tips). But if it is raising your blood glucose or blood pressure, causing anxiety attacks or depression, making you feel sick, or making you fat, stop blaming yourself and find another way. If you HAVE found the best diet for you, congratulations! Stick with it, and be willing to adjust if necessary. Just don't assume that you've found the answer for everyone around you. Their genes may be telling a different story than yours. And if you are a doctor, like Daniela Drake, don't assume there is only one healthy diet for all of your patients.

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