What's a Healthy Diet?

Over at the GCBC post on weightology.net, Fred Hahn weighed in with statements about low carb diets being the most healthy.  He also repeatedly mentioned speed of weight loss regarding the health of a weight loss diet.  He also seemingly mocks adherence as a factor to consider.

I really believe that in the long run, a healthy diet is one that allows you to maintain a healthy weight.  That need not necessarily be super lean or buff either.   What REALLY gets lipids, blood sugar and hormones out of whack???  Being in chronic positive energy balance, OR being in chronic negative energy balance.  Catabolism is a stressful state, so a case could be made for taking expediency into account.  But the more extreme the caloric restriction (and LC works by creating this spontaneously in most people) the more stress.

Blogger Jimmy Moore, having regained roughly 1/3rd of his 180 lb weight loss over the past couple of years recently went on an "eggfest".  Actually if one looked at his menus for his month long experiment, this could probably have been called a butter fest, but that's not the point.  This was a very high fat, very low carb diet, but something else also happened, Jimmy cut calories.  Jimmy doesn't always post portion info over at his menus blog, but given the amount of added fats he was probably consuming double that prior to going on this diet.  He lost around 30 lbs in a month.  Then he added back meat and very few carbs from veggies and started to see a stall and small gains.  But what else did he add?  Around 4-500 cal/day on average.  Yet to this day he cannot bring himself to recognize the plain truth right there in front of him.  It's the calories stupid!  (And if Jimmy should happen to read this, no I'm not calling you stupid)  -- I've followed his blog for a little over a year now.  When intake went down so did the weight and vice versa.  Jimmy also had blood lipids done after the eggfest, and they were horrible.  I'm not trying to pick on Jimmy here, but this version of LC, at least in the short run, is not reaping improvements in those lipids.  He's been assured by LC experts that this is perfectly normal for someone who has lost significant weight as quickly as he did.  Normal and healthy are not the same thing.  It is normal (aka expected) for lipids to go awry during rapid weight loss and/or drastic dietary change.  So I leave the question out there -- is the most expeditious reducing diet necessarily the healthiest?  Is it better in the long run to lose weight as fast as possible to have the shortest period of haywire lipids, or would it be healthier to lose weight more slowly while stressing the body less?

So what about adherence.  Study after study after survey after survey demonstrates that the single best predictor of success in losing and maintaining weight, is COMPLIANCE.  There are some that can remain on a VLC diet for all eternity.  More power to them.  But what of those who can't?  Read any LC discussion board or various blogs and such and one will find a ton of postings by folks who go up and down the scale and almost invariably the ups were periods of "falling off the wagon".  Myself, my first LC stint I lost 40 lbs.  But when I went off, and couldn't find a way to get back on the wagon, I not only gained 40 but tacked another 60 lbs on top of that!!!  Then you have those who slowly regain as the appetite suppression or whatever wears off.  LC is my chosen WOE because it requires the least amount of attention.  Eat low carb foods and it is difficult to get the count up too high.  But after a while it is easy to consume too many calories.  This is usually blamed on carb creep, but everyone who has re-gained on LC can't all be lying.  Jimmy's foods weren't always perfect, but he was pretty consistently LC but packed on 20 pounds last year.  Thing for LC is that long term compliance may require added effort for some -- carb restriction may not be sufficient to maintain energy balance.  Bottom line, lifestyle change is what works, and it has to be something that can be kept up for the long term.

The web abounds with examples of folks eating LC diets without losing weight and even gaining.  Is low carb healthy in this context?  This is my biggest concern, especially where elevated NEFA's are concerned.

I hear a lot that "low fat made me fat", but I don't believe this.  Low fat reducing diets, especially for women, tend to be too low in protein for adequate satiety.  Therefore they can be difficult to adhere to.  Going off a low fat diet can make you fat.  For me going off a low carb diet made me truly fat.  And no, I didn't binge my way up 100 lbs either.

In any case, Atkins probably didn't intend the super rapid losses on Induction to be the primary goal of that phase as much as getting into ketosis to kickstart the appetite suppression, etc.  But so many long time low carbers do induction for a while then fall off and go on carb binges, and repeat the cycle.  Studies have shown that regardless of diet type, yo yo dieting is HORRIBLE for your health.  With LC I think it is even worse.  Consider that long term low carbing induces an insulin resistant state that essentially makes us semi-diabetic.  Low carbers are advised to "carb up" for several days before taking a glucose tolerance test because insulin response and/or sensitivity is likely impaired.

Whatever level of carbs someone considers "healthy", if  a person can't adhere to that fairly consistently, especially if they binge and gain in between so that their body is essentially perpetually in flux, that can't be healthy.  This is why, although I still weigh more than I would like, I am most satisfied with the fact that I have never back-slid in the past three years (more than a few pounds on vacation).  I think our bodies can handle the occasional indulgence ... severe obesity is unhealthy, yes, but so is chronic energy imbalance.

I think Fred is trying to argue that LC is "intellectually" the healthiest diet.  I'm not sure I would agree with that, but I guess I wonder in the end if that matters much.  If low carbers think they'll gain "converts" or do anything for the "cause" by peddling flawed theories and trashing anyone who disagrees with them for "not getting it" they're sadly mistaken.  If the absolutism that permeated the low fat contingency permeates LC it will be counter productive.  There really aren't examples of longevity amongst cultures consuming VLC diets.  Anyone pointing to the Inuit and the Masai as relevant to their diets is fooling themselves.  There are examples of longevity in cultures consuming moderate and even high carb diets.

I leave you with this graphic from the Shai study commonly cited for the superiority of LC diets.

Which is healthier?  Mediterranean where most of the losses were achieved in ~6 months and then maintained on average for 18 months, or LC where greater losses were achieved in that time but the difference was regained over the next year?

Do these lipid changes make a difference in the long run?

This study was published roughly 2 years ago.  A "where are they now" would be interesting to see.  


Jordan said…
Great stuff. I was the one that Fred was haranguing for losing weight quickly, and losing weight while- gasp- eating carbs! lol. He just can't stand the thought that someone had success with an approach other than his own.

I haven't followed Jimmy's story closely, but every time I hear about it, it makes me sad. I don't mean it as an insult towards him, it's just sad.
CarbSane said…
Hey Jordan, thanks for stopping by and commenting. I think some of the advice those like Jimmy receive from LC "experts" can be downright dangerous.

Don't sweat Fred ;) We all know he's right about everything [/tongue in cheek]

I'm one who believes we tend to wear our health outwardly. Are there people who look healthy but are unhealthy on the inside? No doubt. But do people healthy on the inside look unhealthy? I'm thinking not so much. Fred does not make a good ambassador for healthy LC eating IMHO.

I think Dr. Eades, Gary Taubes and Fred Hahn are all too caught up financially with low carb advocacy to acknowledge even the slightest error in their ways.

Congrats on your weight loss and my best wishes on maintaining (or losing more if needed).
Jordan said…
Thank you. And congrats on yours, as well. I'm 195 right now, so I'd like to lose another 20 pounds or so. 60 down, 20 to go. Almost there! :-)
James Krieger said…
Hey, guys, congrats to you BOTH on your weight loss!

You are so RIGHT ON with the adherence factor. No matter how superior something seems "in theory", it's completely useless if it can't work out in real life.

I would agree that the financial issues cloud these guys' judgement. Interesting how Taubes criticizes Bray for his vested financial interests, when he has some of his own (I will eventually address this in my critique)

I think that's also part of the reason Fred goes all over the internet doing what he does. I think he just wants to bring people to his site. You guys should check this out where he tries proselytizing to a bunch of diabetics...they get sick of him too:

CarbSane said…
Thanks -- as I chug towards 50 I've finally conquered this demon!!

I'm surprised more of the shout down crowd hasn't chimed in on your thread yet.
James Krieger said…
A guy named Rick Santos (has gone by Razwell also in the past) has tried to chime in but I've blocked him. He spams me under different aliases and type in all caps and sounds like a raving lunatic. I've gotten a bunch of personal emails from him under different aliases as well. People like that I just don't want to even bother with.
LynMarie Daye said…
Can't say I blame you blocking Rick Santos, James. He seems emotionally unstable, as in the "I wouldn't want to meet him in a dark alley" variety.
CarbSane said…
I've seen this unhinged Razwell fellow around the net. Hopefully he won't bother me!
James Krieger said…
Razwell is continuing his unhinged behavior:



I'm still getting emails from him too, and he still tries to post messages to my site
CarbSane said…
Interesting website there James! Don't you just love when someone questions your credentials then posts such supposedly "informed" statements as "dieting increases fat storage enzymes". Sheesh.

As to Dr. Linda Bacon, I do find it ironic this renegade will reference a "classically trained" nutritionist (or does UC Davis have some unique dietary philosophy of which I am not aware?) whose main focus seems to be on size acceptance, body image and how to be a healthier fat person, rather than weight loss of any magnitude (let alone maintaining it). Raz chides you for citing a 40 lb loss saying he needs proof of decades of maintenance, then cites someone who doesn't even seem to be all that interested in weight loss. While I have no doubt eating disorders contribute greatly to why more people are becoming obese, she loses cred with me when she takes a swipe at the hard core research being done to understand human metabolism more fully.

The obesity epidemic is no mystery. Neither is, IMO, preventing childhood obesity from ever manifesting itself. Reversing the obese state is another issue entirely. There's only one way to do that, and that is to maintain a chronic sustained energy deficit. Anyone who denies this is kidding themselves.

And what of Zoe's background anyway?? I see no listing of advanced degrees there.

Eat real, whole foods. Well DUH!!!!!!!

To be fair, my first (seriously low calorie crash variety) diet did precipitate my eating disorder. But this is not because energy balance and caloric restriction = weight loss are invalid premises. It was because I was trying to maintain too low a bodyweight that required starving myself. Even had I discovered LC and protein's satiety back then, I'm quite sure I would have gained back around 10 lbs or so were I to have adopted the diet -- but I never would have gotten that far because the first one or two would have sent me into a "purge" mode.

I've been the first to advise others, based on my own experiences, not trying to diet -- any diet -- if their head is not in the right place. And anyone who has let themselves attain a certain degree of obesity (I'm not talking an extra 10, 20 or even 40 lbs for most because that's not necessarily obese for many) has psychological issues they need to address, if not before, then while losing weight. Otherwise they are doomed to failure in the long haul.

The big secret, if there is one, is to find the best way for YOU to restrict intake and/or burn a few more calories each day to reduce fat mass. Take responsibility for gaining the weight in the first place. Adopt a strategy you can implement consistently for the long haul.

This Zoe Harcombe seems to be just another peddler of the easy solution to an extremely complex problem. If eating real whole foods were such an easy answer, we'd all be doing it 100% of the time. Problem solved. And don't give me any of that nonsense that the government food pyramid recommendations and the various weight loss plans advocated by doctors and nutritionists are preventing any of us from doing just that. People desperate to lose weight have been known to try desperate measures. If this were the panacea, it sure would have caught on by now! Yet, I've seen several cases of extremely neurotic folks on Paleo-based discussion forums and blogs who go off on non-Paleo binges. Wouldn't it be grand if every anorexic and bulimic and obese person could be freed from their chains simply by eating meat and eggs. I'm sorry if that sounds flippant, but that's the attitude I get from Zoe Harcombe. It WOULD be wonderful, but it's just not reality!

Sorry for the mini rant.
James Krieger said…
Don't you just love when someone questions your credentials then posts such supposedly "informed" statements as "dieting increases fat storage enzymes". Sheesh.

Yeah, it was also funny how she criticized my website and constructed a bunch of strawmen, I respond to her critiques, and then she turns around and says I'm being rude for responding to the critiques!

Raz chides you for citing a 40 lb loss saying he needs proof of decades of maintenance,

What's funny is Raz obviously doesn't understand that someone's long-term success has little relevance to a person's weight loss expertise. Over the long-term, weight loss requires permanent lifestyle change which is ultimately up to the individual, not the expert who gave that person information. An expert cannot control what someone does with the information provided.

What's also funny is that the experts he refers to don't have any long-term success stories over decades, so by his own standards, he shouldn't be paying attention to these people.
Mike said…
Great post, Carbsane! I have to thank James for pointing out your blog to me. I'll definitely be following it regularly now.

Keep up the great work!
CarbSane said…
Thanks Mike! Welcome to my blog, I'm happy to have you as a reader. My thanks to James as well for sending you my way.
LynMarie Daye said…
LOL!! Have you all seen this:

"James Krieger WRONG about insulin not being needed by cells for glucose uptake"


His "proof" that James is wrong? A couple of barely coherent replies by anonymous people on Yahoo Answers. Hilarious!
CarbSane said…
What a jerk. I'm sure he'll get much back patting nonetheless.

Also, the more I learn about Zoe Harcombe the less I like her "personally". She commented on James then called him rude for setting the record straight. She's clearly the latest Taubes drone looking to make a buck selling books. If I buy her new one by Oct 1 she'll autograph it! LOL I am considering buying it just to see the reference list ;)
James Krieger said…
Razwell/Rick Santos has a history of this unstable behavior, including multiple aliases. For example, check out this thread on sciencebasedmedicine.org:


He goes under the name LisaR in the comments.

Anthony Colpo, Lyle McDonald, and Jamie Hale have had, and continue to have, similar experiences with him (spamming under multiple aliases, rants in all caps, abusive behavior, etc). What is interesting is Razwell was at first a big Colpo supporter, then Colpo was a bit slow (according to Razwell's standards; it was only about 12 hours) in responding to one of Raz's emails, and Razwell suddenly went bonkers and turned on him and then suddenly became Colpo's biggest detractor.

He definitely has serious mental issues.
Anonymous said…
The problem is with the advice NOT compliance as my blog has shown.

The studies actually show that people will REGAIN DESPITE rigorous adhering tot heir low calorie diets and exercise.

The body has compensatory mechanisms. You are not smarter. BIOLOGY dictates we regain .( at least some)

72% of the most elite of the elite are now regaining as the NWCR reports.

We need to MOVE ON from the ineffective nostrum to eat less and move more as TOP EXPERT Dr. Jeffery Friedman says.
Anonymous said…
This comment has been removed by a blog administrator.
CarbSane said…
Razwell, I let one post stand because, even though you keep repeating the same thing over and over, it was relevant to the thread. The second one referenced some thread and discussion apparently on other sites w/o links as an excuse to call people names. So I deleted that and would ask you to refrain from using this blog as a platform to attack others in that manner.

The problem with your repeated thesis that we somehow can't outsmart our bodies, is that it can't explain why we've gotten fatter. I do believe the obesity "epidemic" is somewhat overstated, but we are on the whole a fatter country here in the US. How did that happen?

Our bodies do have compensatory mechanisms that make the IN and OUT sides of energy balance dependent. But these cannot compensate entirely. If that were true we would never get fat in the first place either b/c our bodies would fight to burn off excesses. Just as it fights to maintain reserves in times of fasting or minimal caloric intake.
Anonymous said…
All I can say is watch all Dr. Jeffrey Friedman's lectures of Google. There are several. There are also question and answer segments at the end of the video.

Obesity has always been around CarbSane. All generations THINK "there has never been a time when obesity was worse" They thought this in the 1700's. Thomas Short.

We are only 7 pounds heavier now on average CarbSane than in 1990.

Read my blog again. Compliance is NOT the problem. "Eat less, move more " is FAULTY advice for the morbidly obese like Mauel Uribe.

To say we do NOT understand fat cell receptors chemically is an understatement. Krieger will never admit this. This is the TRUTH.

I hope you can see this.

P.S. Now you know the sorry about Colpo and Hale. Google my name and Colpo on yahoo snasers and other forums. I have helped him a lot. That is proof.
Anonymous said…
Until we understand fat cell receptors chemically ( and not just what disrupts them) we will NOT sove morbid obesity.

Obesity is NOT a simple condition of eating too many calories.
CarbSane said…
So Razwell, forget that obesity label, why are we 7 pounds heavier now than a few decades ago? This is something that cannot be explained by any sort of set-point auto-regulatory homeostatic theory as it would require something changed that and that something is the part that IS within our control.

What several have tried to explain to you here and elsewhere is that we CAN change our weight permanently by changing lifestyle. The body can and does compensate to both overeating, caloric restriction, high and low activity. But these compensations are not sufficient to completely counteract the perturbation. I can tell you that while I did not keep accurate records of intake and such, I've been within ~15 lbs more than I weigh now and my current weight for 2-1/2 years. Every now and then during this time I have felt like my body had finally re-adjusted to the new size. I do feel my metabolism has come back a bit as my intake maintains my size and my body no longer senses it as a deficit or period of "famine" that it no doubt did while I was drawing on the fat stores. This has taken a while and required a bit of self-experimentation. Back when I first weighed myself in April 2009, I was doing the same thing I had done for almost 2 years and worried about regaining b/c I was plateaued and if I did now gain a pound or two even doing VLC. BUT, I didn't give in or give up. I stuck to it, and after some experimentation and attempts to lose more I've been pretty effortlessly weight stable for a year now, perhaps with some tiny losses (though not evidenced much on the scale, my size has gotten a bit smaller somehow).

Part of the problem I think is that (1) many never get to goal, lose motivation, revert to previous habits and regain, or (2) fail to realize that as difficult as it is to lose weight, it will be at least as difficult to maintain it at least in the short run.
Anonymous said…
Let's see where you are in a decade or more from now Carb Sane. We do not have control over our own body fat conciously as much as you think. Caloric restriction conciously and significantly is an attemtp to cheat biology. Working against the body will never work long term.

We are moving on from eat less move more and my blog has even more links.

Dr. Stephan Guyenet and Dr. Jeffrey Friedman and Dr Linda Bacon know this.

I think it is a shame Colpo and Krieger do not.

The caloric bank account model of obesity is not valid. Anyone carefully tracking the research of scientists in this field already knows this.

We do not understyand fat cell receptors chemically. That is a MASSIVE understatement to say the least.
Anonymous said…
Did you really watch Dr. Jeffrey Friedman's lecture, Carb Sane? Honestly.

Here it is. Your question is addressed from the 30: 20 minute mark and on.


James Krieger and Anthony Colpo are NOT reputable, credible sources of information. THey are NOT obesity experts.Why do you cling to them and rely on them fpr information?

Dr. Friedman knows more than them AND Gary Taubes. ( I do respect Gary though for pointing out the fact that the caloric bank acoount model has many black swans against it)

Dr. Jeffrey Friedman and others at his level ARE.

Did you REALLY read this article. Our body fat is NOT empty storage deposists of calories. it is a hormonally active endocrine organ and is regulated largely beyond out concious control.

Any neurobiologist will tell yout this.

I leave you with this GREAT article from the research of Dr. Friedman and colleagues.


The caloric bank account model of obesity is DOGMA NOT scientific knowledge.
CarbSane said…
So you didn't answer my question. Why are we even 7 pounds heavier today? What happened to reset our controls en masse as would be the only explanation for this?

I follow Stephan's work quite closely and to say he believes we have no control over weight misrepresents his position quite a bit. His focus seems to be that we do have a set-point, but behavior can change that probably due to leptin resistance. That's a bit simplistic.

Seems you're rooting against me. Too bad.
Anonymous said…
Start WATCHING the video at the 20: 30 mark for the next 8 minutes or so. Your question WAS answered in that video.

I know you have not.

Stephan DOES feel MUCH of our body fat regulation is NOT under concious control.

I am not rooting against you. I am being a realist about what science has shwon. The odds are overwhelmingly not in your favor especially if you are starting out obese. ( which I do not know)
Anonymous said…
Whoops 30: 20 and on
Anonymous said…
Some people like to disregard science in favor of what Anthony Colpo has to say.

My sources on my blog are all real genuine scientists. NOT Internet gurus.
CarbSane said…
Razwell: If you don't know my weight history, then you haven't really read here. I also may have linked to James' site, but I don't think I've ever even linked to Anthony Colpo let alone used EITHER as a primary *reference*.

I'll make a deal with you. I'll listen to Friedman and make an entire blog post on my thoughts if you'll refrain from bashing people I have no affiliation with on my blog. Deal?