The Science of Low Carb

After 150 years of on-off popularity, low carb diets are finally getting the scientific support they need to be taken seriously.

Dr Eric C. Westman, MD and president elect of the American Society of Bariatric Physicians (weight loss doctors), has 15 years of experience helping patients lose weight and improve their health using low carb. He has also helped do several high-quality scientific studies on low carb.

In this interview I did with him at the last ASBP meeting he talks about the science and the practicalities of using real low carb food for improving your weight and health.

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48 Comments

  1. Moreporkplease
    Love love love Dr. Westman! The.Best. Ty, Andreas.
  2. Sandy Z.
    "We were taught the wrong thing..."

    It brought tears to my eyes to hear Dr. Westman confirm what I have been saying to myself since starting to eat LCHF 3½ years ago. It makes me so sad to think about all of the wasted time for so many people, myself included.

  3. kitty
    Unfortunately millions of people will get sick and die before most doctors accept LCHF here in America. Only those of us who are bold enough to go against doctors orders are going to be saved. Right now I know people who are morbidly obese (by 100 pounds or more) are losing their health and vision because of hypertension and diabetes but they won't give up their high carb diets because their doctors have advised them not to. They are told to just keep eating high carb, low fat and take their medication. I don't understand why doctors are so evil. They know what they are doing is not helpful, but they are fighting to keep doing it and leading people straight to their graves.
  4. aviator1945
    This was a great video! Also, the fact that as soon as a study was mentioned, it appeared on-screen; a very innovative and nice touch.
  5. Debra from Aus
    A really excellent interview. This doctor gives great hope for a better future....if only the right people would listen to him. Hopefully Australia will take notice too. Agree with comment above re references. I have already looked at a couple I didn't know of. Great work .Keep at it.
  6. Your production skills are really improving!

    If Dr. Westman is the president of ASBP now, is it safe to assume that if he has the ear of the bariatric physicians, there's more chance of support for low carb dieting to spread to other specialties and general practitioners? Is the tide beginning to turn?

  7. Alexandra
    I enjoyed this interview. Like you Andreas, he is a real doctor doing real work with lots of successes... It is becoming harder and harder for your peers to ignore the reality that LCHF works, and is healthy.
  8. Becky
    Are dairy products Included in this LCHF? Why is this different than the Paleo that does not allow yogurt or cream?
  9. Funderaren
    Becky, diary is allowed in LCHF as long as them are low in carb and high in fat. Milk has alot of carbs and should be avoided, were cream butter and cheese is better alternatives.

    Paleo aimes to eat like we did in early human history. LCHF is more aiming to eat a paleo ratio of fat/protein/carbs. LCHF also mimic the early scandinavian diet that existed for thousands of years, were diary was a huge part of the diet.

  10. Alexandra M
    This is fantastic! Thank you very much.
  11. Becky, I think that Paleo is not necessarily low carb, as larger amounts of starchy veggies (i.e. potatoes, winter squash, etc.) and fruit are permitted--even honey sometimes, but it is possible to do low carb while following Paleo/Primal principles.

    People who do not need to lose weight and who are not insulin resistant can certainly tolerate higher levels of carbs.

  12. moreporkplease
    "Becky, I think That Paleo is not Necessarily low carb"

    Indeed as Janknitz says, the majority of Paleo people are not low carb at all. For example, in his recent speech in New Paltz, Robb Wolf called low-carb Paleo "a fringe" and said Taubes was not part of the Paleo movement, arguing that the CIH was disproven, and implied low-carb should be ignored. Paleo is now a high-carb, high-fat, high-protein movement with a focus on exercise such as Crossfit. Calories still don't seem to count tho' for most following the Paleo path.

    Certainly the majority opinion now appears to be (altho' this shifts from group to group somewhat) that low carb has no place in Paleo, that people should follow the high-carb Kitavan diet - Robb Wolf seems to imply in his recent speech that smoking is also acceptable and not harmful when following such an ancestral diet, as he deliberately called out the Kitavans' smoking habits and seeming lack of cancer.

  13. eddie watts
    please tell me robb wolf did not suggest smoking was not harmful when eating paleo...
  14. Alexandra M
    Quite a few years ago I heard a story on the radio about how it seemed that people who had large fluffy LDL-C (which they then thought was genetically determined) seemed to be protected from a host of diseases, including those caused by smoking. The interviewer asked the doctor, "So what if it turned out that people could smoke without getting sick?" There was a pause while the doctor spluttered with outrage before practically shouting, "That would be TERRIBLE!!"

    Which makes no sense when you think about it. ;-)

  15. SharonV
    If people could smoke without any damage, let them. As long as they are not exposing others to second hand smoke damage. Personally, it still won't happen in my house, it stinks, and I won't expose my pets to it. If I had children, I wouldn't risk their exposure either.
  16. JAUS
    I not only find smoking disgusting but I also have asthma. It is usally is not a problem for me unless I encounter tobacco smoke or arificial smells (like perfumes, hairspray and similar) because then I get trouble breathing.

    All my life I have avoided smokey places so that has limited my life quite a bit. Now there is a ban here for smoking, wich is great but I think that It's to late for me to start going to places that I couldn't go before, I'm just not used to doing it. I also don't drink alcohol so I have even less reason to go out to those kind of places.

    The "paleo people" just want to eat their fruit and don't care if it's nutritional value is in reality useless. They have highjacked the term "paleo" even though our ancestor didn't eat the amounts of fruit that they do. They still belive in the myth that plants are essential for humans.

  17. JAUS
    I just wanted to add the oldest group of people that lived in the same way for at least 100 000 years is the Kalahari bushmen. The way that they lived is closest to the way that our ancestors lived and they worship animal fat.

    Their diet is very low carb and the plants that ate was eaten by them was eaten only for the water content since water is rare in the desert. They have wild melons that doesn't taste anything near as sweet as the melon we can buy in our stores. If I remember correctly then the amount of carbs in their diet was below 5% of the total energy.

  18. moreporkplease
    "please tell me robb wolf did not suggest smoking was not harmful when eating paleo..."

    Eddie, watch the entire video yourself. His statement about the Kitavans low cancer rates despite smoking are ambiguous at best. The video is very very slow to load, so be patient:

    http://mediasite.suny.edu/mediasite/SilverlightPlayer/Default.aspx?pe...

    I must frankly say this talk made me lose most of my respect for Wolf - from the second he starts talking about Moore's Law, it's all downhill for me from there. But I understand he's using a metaphor and like most people probably doesn't really keep current with technology. I also found the insult to Taubes unnecessary in the context of explaining paleo to college students.

  19. Margaretrc
    Moreporkplease, Robb Wolfe is friends with Stephan Guyenet. I disagree with them totally on CIH and Taubes. Their definition of Paleo is not only incorrect, it's definitely not something anyone with diabetes or insulin resistance can handle. Kitavans, though apparently healthy, aren't like our Paleo ancestors, who i'm pretty sure ate mostly meat and fat. If they're trying to emulate the Kitavans, Wolfe and Guyenet should stop calling themselves Paleo!
  20. kitty
    Robb Wolf is a former vegetarian. Many paleo people are former vegetarians/vegans.They ruined their health following a plant based diet but can't bring themselves to give up plant foods. So they rationalize that grains and legumes are the only bad carbs because of the lectins, phytates, gluten and other anti-nutrients. Most Americans are still so afraid of LCHF that the paleo/primal people would not sell many books if they advocated low carb. LCHF is already associated with Dr Atkins. Paleo is basically the Zone diet which was 40% carbs, 30% protein and 30% fat.
  21. Jaus has it right! Most tribal societies studied in the 19th & 20th Centuries were less like the Kitavans and more like our ancestors who were hunter-gatherers. The Bushmen certainly have an extremely low carb diet, in part because they live in dry plains/desert environment; the Kitavans are islanders which would indicate plenty of seafood that doesn't get much press from people who want to call them a primarily vegetarian culture.
  22. aviator1945
    Tom Naughton's latest video from a recent presentation at a conference of the Office of Research Integrity on why more and more people are ignoring doctors, nutritionists and government health agencies and turning to blogs and social media for health and nutrition advice. DietDoctor.com appears in one of the slides. 

    http://www.youtube.com/watch?v=6-oP34xXFWM. 

  23. aviator1945
    Sorry, the link above should have been

    http://www.youtube.com/watch?v=6-oP34xXFWM

  24. AM
    Hi, I've been doing this diet for over 2 weeks and I am loving it!
    just wondering what do you think about Dr. Jan Kwasniewski's book "Optimal Diet" as I have been recommended it.

    Thanks.
    AM

  25. Galina L.
    I achieved a great relieve from allergies and infections on a LC diet. I don't need a prescription for my asthma inhaler from my doctor since I went LC more than 4 years ago. I wonder ,because it is an autoimmune in origin, at what degree an asthma is a Western civilization decease? I am sure smoking damages lungs anyway, but probably people in primitive societies didn't get an asthma from it?
  26. Ray
    I was somewhat surprised at moreporkplease's criticism of Robb Wolf, so I followed the link provided to his presentation. I suggest that if you have an interest in evolutionary biology as a sort of "physics" for understanding nutrition that you listen carefully to this presentation. It is excellent.

    If you do this, you will discover that the criticisms made by moreporkplease are basically unfounded. First Robb himself is low carb and his position is that the more you exercise, the more you should include non-grain carbohydrates. Furthermore he in no way endorses smoking. His reference is to the Kitavans who have a high carb diet (of a specific type) and SMOKE yet have little to no cardiovascular disease. Mentioning a FACT is not an endorsement. Finally, he did not disrespect Taubes. He merely pointed out that insulin resistance FOLLOWS leptin resistance. Seriously, not one person in a hundred would interpret Robbs words the way moreporkplease has done. One thing the paleo community certainly needs is less infighting over trivial points

  27. Margaretrc
    @AM, I checked that book out. From the comments, it seems that it leans low fat and/or vegan. If so, I would not bother. Neither is in any way "The Optimal Diet."

    @Ray, thanks. I do hope you're right. I will have to listen to this presentation myself and form my own opinion and will. I do consult Robb's site and I think I've noticed a trend away from LC and toward reward, but I could be wrong.

  28. Zepp
    Dr Kwasniewsky is a long time lowcarb guru whith his one clinic.

    http://homodiet.netfirms.com/diet/optimaldiet1.htm

  29. Margaretrc
    In that case, Zepp, sounds like his book might be a good read. I was just going by the comments on the Amazon site for his book.
  30. Jeff
    I've been looking for some links to the studies that were shown in the video. Some places charge to view so I'm posting some links to a few that are free.

    A Very Low-carbohydrate Diet Improves Symptoms and Quality of Life in Diarrhea-Predominant Irritable Bowel Syndrome.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693479/pdf/nihms101786.pdf

    Dietary Intervention to Reverse Carotid Atherosclerosis
    http://circ.ahajournals.org/content/121/10/1200.full.pdf

    The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
    http://www.biomedcentral.com/content/pdf/1743-7075-5-36.pdf

  31. JAUS
    For those smokers who wants to quit, but find nicotine gum useless, I'll recommend the Swedish product "snus". Snus is not completely harmless, but it's way better than cigarettes.

    CBS 60 minutes did a story about snus: http://youtu.be/mr_tuvbUCLo

    Read also the Wikipedia article about snus: http://en.wikipedia.org/wiki/Snus

  32. Jen
    "Paleo" opinion is driven by politics and back-scratching. ie, exactly what's responsible for the food pyramid.

    If Richard Nikoley's discovered that potatoes and beer make him feel better than ever, awesome for him.

    I'm sticking with Banting.

  33. I'm so thin, I can eat all the carbs I want. It's nice I know. :)
  34. This is the result I got with LC-HF diet for 1 year combined with strength training.
    http://functionalphysique.net/wp-content/uploads/2012/01/Front_all.png
    This is my empirical science.
  35. Alexandra M
    What is it with the nasty vegan spammers (on Dr. Westman's other video)? You'd think they had a personal grievance against anyone who isn't a vegan.

    http://www.youtube.com/watch?v=toLvGpk3HLE

  36. Rachel
    I found some elements of Robb Wolf's talk less than convincing, certainly not uniformly "excellent".

    And I did think his reference to Taubes was somewhat derogatory.

    Paleo can INCLUDE low carb eating, and I fear this backlash against it is alienating people. Me for instance! Not sure how or why the insulin theory has been declared dead all of a sudden. Apparently in favour of a new, untested hypothesis that, to me, makes little coherent sense at this point, although there's probably something in it.

    Pretty dismayed by the state of the playing field at the moment.

  37. Zepp
    Paleo can include low carb eating, low carb eating should include paleo!

    I personaly dont give a damn about whats happen if insulin is injected to the brain!

    As I can see it, its only hapens in two ways.. 1. a stupid scientist inject it, 2. or you have a high blood sugar!

    High levels of insulin in the brain causes you to stop eating those sugary things.. att least the brain tryes to stop you!

    Its not realy about insulin anyway, its about metabolic syndrom.. and insulin is a major part of that!

    The roll of insulin in this is that its do save you from toxic levels of blood sugar.

    And its about incidens.. with a low nutrient status in a population, high carb do inflict more damages, than in a population with better nutrient status.

  38. Alexandra M
    Anyone who has the time/energy and admires Dr.Westman and the late Dr.Atkins might want to put a word in on Westman's video that I linked above. First of all, the video really should have many more views than it does, but second, it's being spammed by the nasty little (probably vegan) troll I mentioned. You don't need to engage the troll, maybe just put in a good word for Drs. Westman and Atkins.
  39. Alexandra M
    Holy sh*t Galina! As I said, there was no need to engage the troll, but you did it in spades! Well done. What an idiot, huh? And what's his agenda, anyway?

    BTW, I'm drascatha.

  40. Galina L.
    It took me 3 years to gather the courage to try a LC diet because I thought it was the last resort crazy food regiment. I wish I knew better. Such idiotic rhetoric keeps people who could be helped from the help. However, the LC diet is often not enough to get a person who is already too obese into perfect weight. Things are more complicated, than just lowering carbs.
  41. Alexandra M
    It sure sounds like you did a lot of hard work and diligent research, Galina. I love hearing stories like that.

    Meanwhile, the little toerag troll is still at it. I should never have poked him. I feel bad because it won't be long before Dr. Westman's video has more trolling comments than it does views.

    I thought his latest were pretty funny, actually. "I never said he [Atkins] died from heart disease, but died riddled with heart disease."

    These people will say anything - absolutely anything. Apparently Campbell, Esselstyn, Ornish, et. al., have been promoted from individuals to "recognised scientific organisations." Duke University, however does not qualify!

  42. Alexandra M
    "There's no doubt that the Atkins diet will lower your cholesterol, weight and blood pressure and get rid of your diabetes, but then what?" asked Dr. Robert Rosati, the cardiologist who runs The Rice Diet Program Clinic, granddaddy of Durham's diet centers.

    ROTFL!

    http://www.newsobserver.com/2011/01/03/896012/irresponsible-doctor-sa...

  43. @AlexandraM: Trashng Dr. Atkins diet like this especially irks me for it is plain the person never read his diet book at all. Leaving aside the use of faux sweeteners, which we all should avoid, Atkins laid out a good diet (as lc was then understood) of protein, fats, vegetables, a small amount fruit and whole grains; it was important for the maintenance dieters to learn what their carb tolerance was that would prevent weight gain. You still had to think low/lower carb for life. Any other diet expects you have to make life-time modifications to keep weight loss permanent. While I've moved on to a stricter LCHF than Atkins taught, I still have to watch the carbs in veg/fruit. There's no magic.
  44. Alexandra M
    Me, too, Nan. What amazes me is the visceral (no pun intended!) rage that these "critics" can barely contain. If nothing else, why can't they just leave people alone with what works for them?

    Rosati's remark left me speechless. "And then what?" What? What else could you want besides healthier cholesterol, healthier weight, healthier blood pressure and no diabetes?? Straighter teeth, fewer wrinkles, no ingrown toenails?

  45. Galina L.
    @Alexandra M,
    More and more people don't buy a low-fat-whole-grain diet advise. My list of alignments that got better or disappeared is unbelievably long. My doctor asked me recently why I don't request asthma and migraine medications any longer, and a water-pill for swollen ankles. He also noticed that I didn't regain lost weight and stopped having my usual ones-a year flue for last 4 years, yest and urinary track infections also became a distant memory. How cool is it to have a completely symptom-free pre-menopause and no PMS, disappearing joints pain? What about countless times when other ladies commented on my youthful appearance and good condition of my skin? Often I hesitate to mention all that because indeed it sounds unbelievable.
  46. Alexandra M
    I'd forgotten, but you're right about all those things! I went through menopause symptom free as well and people often comment on what good skin I've got for 57. Meanwhile my younger female friends are constantly complaining of hot flashes and spending a fortune on wrinkle creams.

    I had one bout of flu in the past few years (and I picked that up at a Christmas party where everybody got it - though I recovered faster) while a vegan friend seems to be posting every week on Facebook that he's feeling run down, coming down with something, is laid up with the flu, has some sniffles coming on, etc. I pointed this out to some mutual friends, and their reaction was, "He's always been like that. He's a hypochondriac."

    Would you be a hypochondriac if you felt good?

  47. Former GERD sufferer here. Re: patients' acid reflux getting worse on a high-fat diet, if you have acid reflux, a fatty meal will make it worse. My thinking is that the fat makes the stomach acid stickier. Someone who wants have a carb indulgence should do it without fat. Also, people can have acid rebound for months after going off proton pump inhibitors. For the first few months of my low-carb diet, I got horse-whipped with acid reflux whenever I too much carb. One of the worst triggers for me was fruit; others have trouble with wheat and milk.
  48. I think itsi dangeroust to eat only carbs. this diet is not balanced.
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