Oh, I strongly disagree with Dr. Eades
on this one and I told him so. Here's why:
It all started innocently enough with this e-mail:
I’m a 47 year old woman, and I’ve been overweight for the past 20 years or so. I was normal sized most of my life, but after I had my third baby at age 27, I started gaining and haven’t really been able to lose much weight. At least not until I started a low-carb diet about 6 months ago. When I started your Protein Power diet I lost almost 16 pounds the first month. I continued to lose for the next 4 months, but not at the rate I did in the first month. Over the last month, though, I haven’t lost any weight at all. I’m really dedicated to this WOL, and I religiously keep my carbs below 30 grams a day. I’ll admit that I occasionally (maybe once every 10 days) have something I shouldn’t have, a small bowl of ice cream maybe, but the next day I buckle down and cut my carbs to below 15 grams to make up for it. This falling off the wagon doesn’t seem to make me gain any weight especially since I cut my carbs the next day, but I just can’t seem to lose any more. I’m still about 20 pounds from my goal. Any suggestions?
Dr. Eades Wrote:We get a lot of letters like this one from people who did well early on with their low-carb diets, but have run into a brick wall. Or, I guess, a brick plateau. What’s going on with these people? Are they lying through their teeth and in reality going face down in the carbs? Or is it something else? How can people diligently keep their carbs below 20 or 30 grams per day and fail to lose weight?
Of course, we get this every single day on our forum, so I feel his and his wife's pain. So what do we do about it? First, Dr. Eades explains the process:
Dr. Eades Wrote:Let’s look at what happens when we cut carbohydrates in the diet. First, we don’t get enough carbs to replenish our blood sugar, so the body has to convert protein to glucose to make up the difference. The signal to do this comes from a rising level of glucagon, a hormone made in and released by the pancreas. In order for glucagon to do its job, the level of insulin in the blood has to go down, which it does. A low level of insulin and a high level of glucagon send a signal to the fat cells telling them to release their fat. You can think of it as opening the doors to the fat cells so that fat can easily get out. The body burns this fat for energy. As the body burns more, the fat cells release more. When the fat cells dump their fat, they become smaller. When your fat cells or adipose tissue becomes smaller, you become smaller. And you lose weight. Which is how it’s supposed to work.
I agree with all of this for most part, but it's important to understand that fatty acids constantly and freely roam throughout our bodies in our circulation. Fatty acids do not just sit in fat tissue. Our fat tissue is not some big garbage can waiting for glucagon to come and unlock the door. They are always on the move responding to energy requests unless they are prevented from flowing; which they are for relatively short periods in normal persons.
Dr. Eades Wrote:But there is a little glitch in all of this.
Yes, there is. However, we don't agree on what this little glitch is:
Dr. Eades Wrote:Although the lowered insulin and elevated glucagon open the doors to the fat cells allowing fat to come out to be burned, the fat comes out only if it’s needed. If you are meeting all your body’s energy needs with the food you eat, the body doesn’t need the fat in the fat cells. On a low-carb diet your body burns fat for energy.
If you've been paying attention, you know why I disagree with this and you shouldn't either. Our bodies burn fat for energy on any diet. This must be understood. Fat is never "locked away", it's dynamic. Yallow and Berson proved this in the 1960s with their radioimmunoassay. They put a tracer on a fat molecule and followed it throughout the body and saw what happened to it.
Not only that, but Hans Krebs taught us as well as all physicians concerning the digestion cycle and what happens when we consume carbohydrates and fat. We'll look at that cycle briefly momentarily.
Dr. Eades Wrote:But [the body] doesn’t care where this fat comes from; it can come from the diet or it can come from the fat cells or it can come from both. If you are consuming enough fat to meet all your body’s requirements, your body won’t go after the fat in the fat cells no matter how severely you restrict your carbs. You will burn dietary fat only and no body fat. And you won’t lose weight. It’s that simple.
(Emphasis mine.)
It’s true that the body does not care whether the fatty acids come from the diet or the fat tissue, but
this is because the two are combined in our long term fuel supply that flows throughout the bloodstream and the body. Therefore, the new fatty acids are indistinguishable from fatty acids that were there from yesterday or last week.
Insulin disrupts the free flow of fatty acids by clearing the bloodstream of all fatty acids, amino acids, all nutrients and anything that could be used for fuel prior to a meal and during digestion to deal with dietary carbohydrate and to provoke hunger. As the meal is digested, the fatty acids return under normal conditions unless something keeps them out of circulation longer than they’re supposed to be.
Since that’s the case as the Krebs cycle says it is, then our investigation has to start and stop with reasons why these lipids are delayed from flowing freely longer than they should be.
Dr. Eades Wrote:It has been shown countless times that when people go on low-carb diets they spontaneously reduce their caloric intake. Most foods available on low-carbohydrate diets are satiating and those following these diets get full quickly. They just don’t eat that many calories. In most studies of low-carb diets people drop their caloric intake down to the 1500-1700 kcal range and are quite satisfied. At that level of caloric intake, they need a fair amount of their own body fat to make up the difference between their dietary intake and the 2400-2600 kcal (or more) that they burn every day. As they consume this body fat, they lose weight.
Once people settle in to low-carb diets, a couple of things happen.
First, they lose some weight, which reduces their energy expenditure. A smaller body doesn’t burn as many calories as a larger body, so the gap between what they consume and what they need gets smaller. And as it does, their weight loss slows down a little.
Now, we're starting to get into the premise behind this post. Do all people actually reduce their energy expenditure when they lose weight? For myself, I became far more active as my body dropped the excess weight. I used to be a regular couch potato like anyone else. I also still have this same sedentary job. I still play XBox 360 whenever I can get my teenager to play with me!
What's wrong, you don't like my anecdotal evidence? Fine. Francis Benedict performed semi-starvation studies on lean people in 1917-18 and Frank Evans and Margret Ohlson made the same observation that when inviduals eat less (a low-calorie diet) they decrease their energy expenditure.
However, many people on low-carbohydrate diets go on to run marathons, hit the gym, and many other things that they never did before. How is this possible?
That the tissues of lean people are semi-starved on calorie-restricted diets is not hard to imagine. But why would this happen to obese people who do eat a lot of calories? We'll get to this in a moment.
Dr. Eades Wrote:Second, they start fiddling with the diet. At first, the luxury of eating steak, bacon, whole eggs, real butter and all the rest of the high-fat foods that go along with low-carbing is enough to keep most people satisfied…for a while. They eat until they’re full, then they quit. And they don’t consume all that many calories.
Again, we're back to the calories. Which has more calories, steak, bacon, whole eggs, real butter, or low carbohydrate foods like Atkins bars, cheese and nuts? I would argue that steak has far more calories than nuts. A can of nuts might give you 350 calories, but a good sized steak can easily be 600 or more calories. So what's really going on here?
Dr. Eades Wrote:But then a different aspect of eating kicks in: eating for fun instead of simply for nourishment. People eat for two reasons. They eat because they have to in order to provide the energy and the nutrients required for life. This basic level of eating is driven by hunger. And people eat because it is an enjoyable endeavor, a hedonistic endeavor even. If people only ate when they were hungry and quit when they were no longer hungry, there wouldn’t be much of an obesity epidemic. Problem is people confuse the hedonistic urge to eat with hunger. People want a food because it appeals to them hedonistically, and they read this urge to eat as hunger, which it usually isn’t.
After folks have been low-carbing for a while, they typically start to range out a little, looking for new and different foods that they can make a part of their low-carb diet. The foods they find that fit the bill are either low in everything - celery, zucchini, asparagus, cucumbers, all kinds of green leafys, and certain fruits - or are high in fat (and calories) and low in carbohydrate. The latter include cheese, nuts, nut butters and all kinds of processed low-carb junk foods. The former don’t contain many calories, but also don’t provide much hedonistic bang for the buck, so are typically consumed fairly sparingly.
Dr. John Yudkin once did a survey asking overweight women what foods appealed to them the most, what tempted them the most to overeat. The results are not surprising and are listed below in descending order.
Cakes and biscuits (cookies)
Chocolates and confectionery
Bread with or without spread
Cheese
Fruit
Potatoes
Other foods
Remember, these were the foods that most tempted overweight women to overeat. I suspect that if overweight men had been surveyed the list would have been much the same. In any case, most of these foods are high in carbs and high in fat, the taste combo that most everyone loves. These are the foods that trip our hedonistic triggers.
Most of you going through a stall should probably be pretty outraged at this point because you probably haven't eaten any of the foods that are listed here. You might have had too many nuts, too much cheese or something, but come on!
Dr. Eades is a follower of the famous John Yudkin. Yudkin was the most prominent advocate of carbohydrate-restricted diets among nutritionists through the 1970s. He also had unconditional faith in the popular misinterpretation of the law of conservation of energy.
John Yudkin Wrote:"The irrefutable, inarguable fact is that overweight comes from taking in more calories than you need."
In 1960, he asked four women and two men to consume a carbohydrate-restricted diet for two weeks. They all lost weight by consumming significantly less carbohydrates and no more fat than they typically ate on a balanced diet. The two men ate roughly 2900 and 3500 calories normally but reported consuming only 1500 to 1600 when they abstained from carbohydrates. Their fat consumption dropped by two hundred calories a day as well. This led Yudkin to the "unequivocal" conclusion that "the high-fat diet leads to weight-loss because, in spite of its unrestricted allowance of fat and protein, it is in fact, a low-calorie diet.
John Yudkin Wrote:"Weight is lost by restricting calories, even if calorie restriction is not required by the diet."
Today, Dr. Eades follows through with this idea. When you read his work, you must keep this in mind and it will explain the apparent inconsistencies found in his writings.
However, Yudkin and Eades confuse an association with cause and effect. Even if Yudkin's subjects reduced their calorie consumption on the carbohydrate-restricted diet, which is a common finding in these studies, it does not mean that the reduction in calories
caused the weight loss; only that the diet was
associated with a reduction in calories as well as a reduction in weight. The diet could have worked by some other mechanism entirely, but both weight loss and decreased appetite were consequences.
Before Yudkin published his magnum opus,
This Slimming Business, Weldon Walker and Columbia University physician Sidney Werner both reported that their subjects lost significant weight while consuming at least 2700 and 2800 calories a day respectively. In 1954, Swiss clinician B. Rilliet reported weight loss in his subjects on both 2200 and 3000 calorie versions of the diet.
It's hard to avoid the observation (such as my own) that individuals lose weight on carbohydrate-restricted diets while consuming considerably more calories than they would on calorie-restricted diets.
Based on this, even Werner speculated that perhaps his obese subjects must have typically been consuming 4,000 to 5,000 calories per day before he started his experiment. But if that's true, why don't obese patients regularly lose weight on 2700 and 2800 calorie-balanced diets and why have clinicians always believed it necessary to semi-starve them with 1200 to 1500 calories or even feed them very low-calorie diets of 800 or less to achieve any significant weight loss?
Something else is going on here and it has nothing to do with calories!
When the insulin-level is high, this causes lipids to become trapped in the fat tissue and there they stay until insulin ebbs. Hyperinsulinemia combined with the effect of those nuts and possibly cheese on insulin cause this. It has nothing to do with the number of calories. The change in the fat stores (due to insulin) affects energy-in and therefore people consume too many carbohydrates.
The other problem is hyperinsulinemia which doesn’t seem to get enough attention and press. Those with this condition not only secrete insulin in anticipation of and in response to meals, they also may secrete between meals and this contributes to the high insulin condition.
That the effect of calories has been overstated has been known to some since the 1960s when Yalow and Berson’s technology was used on the VMH-lesioned rats. Obesity could be prevented by short-changing the exaggerated insulin response by severing the vagus nerve. Similarly, the hypersecretion of insulin was reported to be the earliest detectable abnormality in genetic strains of obesity-prone mice and rats. Some ate more and others ate less. When the lesion was administered, obesity followed regardless of the number of calories.
What is important to know is that the fat cells of adipose tissue are exquisitely sensitive to insulin, far more so than other tissues in the body. This means that even low levels of insulin, far below those considered the clinical symptom of hyperinsulinemia, will shut down the free flow of fatty acids from the fat cells. Elevating insulin even slightly will increase the accumulation of fat in the cells. The longer insulin is elevated, the longer the fat cells will accumulate fat and the longer they’ll go without releasing it.
Dr. Eades Wrote:The low-carb diet is a wonderful, healthful way to lose weight quickly, but you do have to watch your calories as well to a certain extent. If your plugging along losing away, keep doing what you’re doing. But if you quit losing, take a look at your cheese and/or nut consumption. Cut those out, and I’ll just about guarantee that your weight loss will pick up again.
Let’s not confuse an association with cause as your hero John Yudkin did. He couldn’t imagine a world where calories did not matter due to his construal of the law of conservation of energy and unfortunately was unable to convince his counterparts of his position. We can’t have it both ways. Calories matter or they don’t. The science says they don’t. I lost 66 pounds by avoiding carbohydrates, plain and simple. If I eat them, I gain weight. If I avoid them, I effortlessly remain lean regardless of calories.
If weight is not being lost, the carbohydrates have to be dropped even further to the point of zero if necessary. This is all that is possible from a dietary perspective. If there is some hormonal issue, then that must be solved first.
I find it amusing that Dr. Eades also provided this advice in the comments section:
Hi Vesna–
I can’t really say what’s going on without looking at food diaries and knowing a little more about you and your health. I’m assuming that the “butter, cream cheese, sour cream” are accounted for in your daily caloric measuring. One thing you can try that almost never fails is to go on an all-meat diet for a week or two. That always seems to get things moving. Eat meat only morning, noon and night. Drink non-caloric beverages. It works like a charm.
Once your weight is where you want it to be, go back on a regular low-carb multi food diet. As I’ll point out in a future post, it’s almost impossible to gain weight on a diligently-followed low-carb diet, so once you get to where you want to be, you should be able to stay there. The meat diet is just a temporary therapy to get you there quickly.
Cheers–
MRE
Need I say more?
Regards,
Charles
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