Everything Is Bigger in the US

Philadelphia2-650x408

Here is my morning view from the top floor of my hotel in Philadelphia. The sunrise behind us is mirrored in a skyscraper.

The obesity conference started yesterday and I’ve just finished my two talks. I think they went well.

I’ve also done a couple of interviews – so far with Jeff Volek and Eugene Fine. I’ve put together a very promising studio in my hotel room. If picture and sound don’t turn out well with all this equipment (Canon 5DMkIII, 60D, XA10, Sennheiser microphones and special lighting equipment) I’ve done something wrong. Unfortunately, this may happen when you’re playing camera man, sound technician and interviewer at the same time.

Have a look at the conference program and suggest who you think I should interview and what topics to cover. Please leave your suggestion in the comments below.

On a different note, everything really is bigger in the US. Not just the view, but also the people. It’s obvious that they’re struggling with even worse food and are facing an even worse uphill battle.

I started my first days at the hotel gym. There were (as there usually are in the US) ten times more people using stepper machines and exercise bikes than people lifting weights. When you eat what is common food in this country you have to exercise fat burning for hours to keep thin. It is literally an uphill battle. 

Previous Reports from ASBP Conferences

Greetings from San Diego

“I was Wrong, You Were Right”

Interview: Good Food is Good Medicine

Paleo Interview with Professor Cordain

Hundreds of Low-Carb Doctors

The Obesity Conference in Denver

The Real Cause of Obesity

Eggs & Bacon at the Obesity Conference

What Happens in Vegas…

Toward Las Vegas and the Obesity Symposium

29 Comments

Top Comments

  1. Ward
    Here is my list:

    Richard Feinman on his update on low carbohydrate metabolish

    Steven Phinney on his talks on carb restriction and exercise and on rehabilitation of beta-hydroxybuterate

    In general I would like to hear more about ideas on how some of these experts would describe a
    "well-formulated" ketogenic diet, update on ketosis and exercise, and it is always interesting to also hear Eric Westman and Jay Wortman.

    And of course - interview yourself if that's possible - we always like to keep up with your thinking.

    Thanks for doing this.

    Read more →
  2. Ward
    On a different note, I just started reading Terry Wahls new book "The Wahls Protocol" and (no surprise) she recommends a ketogenic diet and lays out what she considers a "well-formulated" ketogenic diet. I would be interested in you opinion on her recommendations. It looks pretty good to me, but then again I'm not an expert and would value your opinion.
    Reply: #15
    Read more →

All Comments

  1. Ward
    Here is my list:

    Richard Feinman on his update on low carbohydrate metabolish

    Steven Phinney on his talks on carb restriction and exercise and on rehabilitation of beta-hydroxybuterate

    In general I would like to hear more about ideas on how some of these experts would describe a
    "well-formulated" ketogenic diet, update on ketosis and exercise, and it is always interesting to also hear Eric Westman and Jay Wortman.

    And of course - interview yourself if that's possible - we always like to keep up with your thinking.

    Thanks for doing this.

  2. Nate
    I recommend Dariush Mozaffarian. How does one improve their metabolism?
  3. Mike
    What kinds of food are they serving?
  4. Ward
    On a different note, I just started reading Terry Wahls new book "The Wahls Protocol" and (no surprise) she recommends a ketogenic diet and lays out what she considers a "well-formulated" ketogenic diet. I would be interested in you opinion on her recommendations. It looks pretty good to me, but then again I'm not an expert and would value your opinion.
    Reply: #15
  5. Ward
    And....just so I don't forget. Even though I understand he's not at this conference, if you could ever interview Tim Noakes that would be very interesting. He speaks highly of you and I love the way he is mixing it up down in South Africa.
  6. Solomon
    Hi,
    can you interview an expert or practitioner on Resistant Starch, please? A chat with Jimmy Moore will be interesting.
  7. Darren
    Saw there is a talk on the CNS. If "digestible" and Interesting something on that would be good.
  8. Chuck
    You might want to try a real Philly cheese steak and make sure to check out the Mutter Museum of medical oddities
  9. joey callahan
    Welcome to my home town. Hope you enjoy.
  10. Suzanne D.
    1. IF as it relates to women who are pre/post menopausal, the effects on adrenals/thyroid, if any, and what to do to avoid negative hormonal changes - if re-feeds are appropriate or if IF should be avoided altogether.

    2. Resistant starch and what foods and prep thereof to make them the best for weight loss.

    Thanks for asking!

  11. Pam
    What a great collection of minds. Thanks for hauling equipment internationally so that you can interview folks and share it with us.

    Being a post-menopausal woman, I concur with Suzanne D. that anyone that can actually speak to how we are affected differently in the low-carb or nutritional ketosis way of eating is appreciated. I think it was Peter Attia that said generally post-menopausal women are a mystery to the medical community. Ha!

  12. Eric Anderson
    Hunger
    Hunger seems to be the key!
    Look at hungers key and not Ancel Keys!
    Why does only 1 of 100 at best lose weight on starvation diets that reduce calories?
    Why do ketogenic diets work so well?

    When people eat enough fat and protein (either as food or from the body stores) and reduce or eliminate carbohydrates and the insulin response they report 2 things
    A) Lack of hunger (Seems to be universal in calorie reduced carb diets)
    B) Significantweight loss (More and lasting as juxt opposed to starvation diets)

    The comming ability to track insulin levels in the blood and glucose and ketone and other levels should produce wi spread agreement as to metabolic variation and variable response to long term diets at various levels of macronutrients (Fat, Protein, and Carbohydrates.

  13. Ria Schoeman
    Why do nutritionists and anyone that deals with diet are so protective about their food pyramid, following it blindly, just because 'someone in the 1970s' decided it was the right thing to do?
  14. Marina
    Yes, an interview with Tim Noakes. Pity he is not at the conference!
    He has come out with an interesting book "The Real Meal Revolution".
    https://www.facebook.com/timnoakesrevolution
  15. murray
    Nice list, Ward. I have a lot of time for Dr. Wahls.

    I don't know if others have noticed, but I have generally found that physicians who get ill often have the best insights. A good biomedical education is important, but there is nothing like having your own life at stake to sharpen the senses and enhance critical acuity of interpretation.

  16. Katheryne's Michaels
    I suggest talking with Jimmy Moore about wether medicines effect weight loss on hflc, :-)
  17. Triskeliongirl
    Thye state attendees can purchase a tape of all the talks. See if u can get permission to post the tape do the entire low carb symposium for those if us that couldn't be there. Looked like a great day!
  18. Sabine
    I have 2 very specific questions (maybe Eric Westman or yourself can answer these):

    In feeding a ketogenic diet to a person with nephrotic syndrome (not from diabetes or infection, and creatinin normal, but copious protein in urine), are there special precautions or modifications advisable.
    Are there other precautions or modifications which should be implemented for some persons with certain diseases or chronic conditions (just naming a few, and where to get advice)?

  19. paleozeta
    steve phinney: ketogenic diet and sports at anaerobic threshold. is it possible or better rely on glycogen?
  20. Sharon
    What is your feeling on the KE diet (feeding tube)?
  21. Frank Chiarilli
    Fourteen years ago, I'm 74 now, I had clogged arteries and had two stents put in my heart .I started with low carb high protein as recommended by the Eades. I gradually changed and an now on the LCHF diet. I Have never been healthier.

    Here is my dilemma. I haven't told my Primary care Doctor or my Cardiologist. My concern is that if they found out the truth, it would take a lot of courage to change their advice to their patients. Please ask the MD's at the conference how they handled that issue. Remember How they persecuted Dr Atkins.

  22. Mary Baechler
    Everything by Dr Eric Westman, please!
  23. Pamela Forrester
    I would like to know if it is common for Total Cholesterol to go way up on a LCHF diet and if so is it normal and healthy b/c mine did and my Functional Medicine doctor was very insistent that I take a statin. I did not. Would not. I stayed low carb but started eating green smoothies every other day and for the last two months, by functional Dr. Rx took bergamot and berberine. It came down from nearly 397 to 253 after a year of adding green smoothies, no fruit and two months of the supplements.

    I know TC is meaningless and my trigliceride, HDL,
    C-reactive Protien, and A1c were all perfect so the ratios were excellent the whole time.

    Just wondering if anyone knows if "high cholesterol"l is perfectly fine when ketogenic. Despite all that I knew I was a little scared.

    Reply: #27
  24. FrankG
    @Pamela

    Total Cholesterol IS meaningless... one glaring logical flaw is that it includes HDL-C, which is pretty much universally called the "Good" cholesterol (although that is an oversimplification)... so the line of reasoning goes that: an higher HDL-C is "Good" while an higher Total-C-- which includes that higher HDL-C -- is somehow "Bad". What?!?

    How can it be both, simultaneously? :-P

    Total-C also includes the LDL-C which is a calculated (rarely directly measured) volume. It often seems to be represented as if it were a meaningful value but without consideration of the number of LDL particles (higher number seems to be associated with higher risk) or the fact that LDL particles come in different sizes (smaller size seems to be associated with higher risk) it has little value by itself.

    It is akin to someone saying you have a bucketful of balls, without specifying if they are ping-pong balls (riskier) or tennis balls (less risky).. the volume is all they focus on. In this example the volume is the same but the particle count would be lower with tennis balls.

    Just a reminder that "associated risk" does not mean that higher LDL particle count causes a problem. Alternates include that an higher LDL is a result of some other cause such as a response to inflammation... after all Cholesterol (far from being toxic sludge) has an important role in repairing cells; amongst many other jobs.

    I've seen it commonly mentioned that LDL-C can tend to rise at least initially with an LCHF diet... this may be the body getting used to relying more on fat as an energy source, and/or the change in size of LDL particles from small and dense, to large and buoyant (same particle count but larger size increases the volume... which is the number we are given.

    Some people do not even bother with cholesterol testing as it may just cloud the issue. There are many other (better) health markers to show if you are in imminent danger of dropping dead from an heart attack.

    Also worth considering that humans do not come with an operating manual... the "normal" blood values used by hospital labs are based on what is considered an "healthy" sample of the local population... so remember that current cholesterol values are based on a population eating the standard low-fat, high-carb, western, industrial diet. Your normal values on LCHF may differ... we just don't know enough yet.

    Like you, I focus mostly on the HDL-C, Triglycerides and their ratios. There are tests for LDL particle size and count but these are not widely available in all countries... so much easier to keep people confused and sell statins with the version of the story which tells us how "bad" cholesterol clogs up your arteries like sludge in a drainpipe! LOL

    If you want more background on how the guidelines were decided, this is an enlightening blog post by Dr Kendrick...
    http://drmalcolmkendrick.org/2013/08/02/who-shall-guard-the-guardians/

    and you can read about particle size here...
    http://www.centerforpreventivemedicine.com/04114med_messenger.pdf

    Dr Attia also has some interesting posts on his blog...
    http://eatingacademy.com/

    Reply: #25
  25. bill
    FrankG:

    Thanks for that summation.

    Very nice.

    Reply: #26
  26. FrankG
    Thanks Bill.

    Speaking of associated risk and ping pong balls... anyone else see the recent Mythbuster's episode where they accelerate a ping pong ball to around Mach 1.5 (1,100mph) ...?

    http://www.youtube.com/watch?v=qV4xVAYCK8Q

  27. Boundless
    > ... if it is common for Total Cholesterol to go way up on a LCHF diet ...

    During weight loss, yes (and this may not be your case). See:
    http://www.wheatbellyblog.com/2012/06/i-lost-weight-and-my-cholestero...

    As FrankG has pointed out, the standard "lipid" tests are close to worthless (except TG). What you need is a "lipoprotein" test. LDL-C is truly worthless. LDL-P is not.

    It's also worth getting a one time test of your Apo E genotype status. E2 and E4, not common, have special challenges.

  28. Pam Forrester
    Thanks FrankG. I read Peter's Cholesterol series as he was blogging it and I have Dr. Kendricks book but that article about conflicts of interest was enlightening and infuriating. Corruption can always worm its way in eventually. I did have Type A LDL but a lot of it. Dr. Dayspring (Attia and Taubes) says size doesn't matter but only the number of them. So this too was worrisome.

    But as you said we just don't know what "normal" and "Healthy" lab test results really are for healthy LCHF people.

  29. sheryah
    I hope they put all on youtube...

    Also, I agree with Ward, don't know if Prof Tim Noakes is attending, but maybe you two can interview each other :-D

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