Retrospective #402: IGNORANCE is the biggest problem…

A few years ago I was having a tête-a-tête with Dr. Eric C. Westman, co-founder and medical director of the now defunct, unfortunately, Heal Clinics. I have now been a diagnosed Type 2 diabetic for 34 years, eating Very Low Carb for the last 18, and writing about it here for the last 10, so when Dr. Westman asked me what I thought was the biggest problem in Type 2 diabetes today, I replied, simply, “Ignorance.” He nodded his head in agreement.

I told Dr. Westman that I started this Way of Eating after my doctor had read Gary Taubes’ July 7, 2002, New York Times Sunday magazine cover story, “What If It’s All Been a Big Fat Lie?” My doctor wanted me to lose weight, so he tried the diet, described by Taubes, first to see if it would be safe and effective. When he lost 17 pounds, he suggested that I try it too, to lose weight! Then, as he walked me down the hall to schedule my next appointment, he said, “It might even help your diabetes.” He had no more than a vague notion about that. Turns out, he was spot on!

My doctor told me to start on Atkins Induction (20g of carbs a day), and he monitored me closely. He had my blood sugar what he called “under control” (FBG: 155mg/dl!!!) with me taking 3 classes of oral hyperglycemic meds. He knew, however, that by this standard he would soon have to refer me to an endocrinologist to start me on an insulin regimen, probably a basal injection once a day and maybe mealtime bolus injections, 3 times a day, as well.

Like so many other clinicians, my doctor believed that my morbid obesity (I weighed 375 pounds) was a CAUSE (frequently hedged as a “risk factor”) of Type 2 diabetes. But Taubes had not yet written his ground-breaking magnum opus “Good Calories – Bad Calories” (2007), in which he totally dispels that notion. In fact, in the Epilogue he says, “As I emerge from this research,” 10 “certain conclusions seem inescapable to me.” Today, having read them ten years later, every one of his conclusions is still right on point – as true today as they were on the day that he wrote them.

In #5 Taubes says, “Obesity is a disorder of excess fat accumulation, not overeating, and not sedentary behavior.” If this first part sounds like a tautology, it is not. It is fully explained in #6 thru #10. You really should read all 10 “certain conclusions.”  Google: “Type 2 Nutrition: The Nutrition Debate #5.”

6.      “Consuming excess calories does not cause us to grow fatter, any more than it causes a child to grow taller. Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger.

7.      Fattening and obesity are caused by an imbalance – a disequilibrium – in the hormonal regulation of adipose tissue and fat metabolism. Fat synthesis and storage exceed the mobilization of fat from the adipose tissue and its subsequent oxidation. We become leaner when the hormonal regulation of the fat tissue reverses the balance.

8.      Insulin is the primary regulator of fat storage. When insulin levels are elevated – either chronically or after a meal – we accumulate fat in our fat tissue. When insulin levels fall, we release fat from our fat tissue and use it for fuel.

9.      By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity. The fewer carbohydrates we consume, the leaner we will be.

10.   By driving fat accumulation, carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity.”

Gary Taubes’ hormonal explanation of the metabolic science of fat synthesis and breakdown totally refutes the “calories-in, calories-out” (CICO) hypothesis. CICO sounds so logical that it is now “accepted wisdom” without evidence. It’s like that other “truism” of establishment dietary thinking: “Eating fat makes you fat.”

Taubes’s “certain conclusion” #1, “Dietary fat, whether saturated or not, is not the cause of obesity, heart disease, or any other chronic disease of civilization,” deals with that. Of course, he backs up this statement, and all his other conclusions, with 460 pages of convincing research and analysis, 45 pages of links to his sources, and a 66-page bibliography. His seminal book, “Good Calories – Bad Calories” is a bit of a slog, but it’s well worth it.