Summary of Low Carb USA

I had the privilege of attending the Low Carb USA conference in San Diego this past weekend.  My brain was (still is) on overload after three full days of excellent, research-based presentations by some of the world’s leading low carb experts.  In this case, an overloaded brain is a good thing because it means I have a lot of reading and processing to do in the next few weeks and months.

You might be wondering why a dietitian is all about a low carb diet.  Because a low carb diet is a high fat diet.  If you eat low carb, low fat, you will be miserable.  (I know I’m holding an ice cream cone in my profile picture…. mostly because I’m so not photogenic and that happens to be a picture I actually like of myself….).  Most dietitians are all about “moderation” and “all foods fit”.  MyPlate (it was the Food Pyramid when I was in school) and the Dietary Guidelines are the dietitians’ Bible and so ingrained into my oatmeal-induced hyperglycemic brain during college that I never thought to question what I was taught in school, even though there were sometimes inconsistencies throughout my nutrition education.

I actually sat next to Gary Taubes (how cool is that!) for a few hours at the conference on Friday morning before he spoke.  During a break I introduced myself and said that I was a dietitian.  His response was, “Oh, you must be opened-minded.”  Seriously!  How crazy is it that the majority of my profession is so opposed to even entertaining the thought of a low carb diet!

In school, I was taught that fat is bad; it will give you heart disease, diabetes, cancer, and make you fat.  Fat will clog your arteries and has too many calories.  I was taught that almost everyone needs to eat a low fat diet.  But the dietary recommendations are for 30% of your calories from fat – well, 30% of calories from fat never exactly seemed low fat to me…especially when they recommend 20% of your calories from protein and 50% from carbohydrates…seems more like a high carb, moderate fat diet.  And what about Europe with their cured meats, cheeses, and butter, the French Paradox…was I just supposed to accept that the French eat a ridiculous amount of saturated fat and have less heart disease – must be genetic or because they walk more than Americans, even with their smoking…. I was taught that egg yolks are the devil reincarnate, limit red meat to never, use margarine, vegetable oils, and that everyone should drink 100% juice with their cereal and skim milk.  I never questioned why it was recommended to avoid whole, natural foods that humans have been eating for thousands of years – just told to eat low fat and not too much protein because it will damage your kidneys, so what can you eat? Carbs…

The reasoning behind a Low Carb, High Fat diet (ketogenic diet) is the Insulin-Obesity Hypothesis.  Maybe you have heard of it? Maybe not… To put it simply, this alternate theory is that a diet high in carbohydrates raises blood glucose (sugar), which raises insulin levels, and leads to insulin storing extra glucose as fat.  Consuming a high carbohydrate diet over time will continually raise blood glucose levels and insulin levels, eventually the pancreas wears out from constantly kicking out insulin to bring down glucose, leading to Type 2 Diabetes.  High blood glucose and high insulin levels damage your arteries. Think of your blood vessels like freeways.  Excessive glucose and insulin in the blood stream cause traffic jams, car accidents, side swipes, damaged barriers. High blood sugars are like having shards of glass in your blood vessels.  Damaged blood vessels equals an increased risk for heart disease.  You don’t want to damage your arteries.

Back to insulin and obesity.  Why do fat people get hungry?  Why can’t someone who is overweight simply use the excess fat from their body for fuel?  There has to be something metabolic going on in their bodies; the idea that overweight people have no self-control, are lazy, essentially that they have some moral flaw that prevents them from saying “No” to one more bite and keeps them on the couch, has run it’s course.  I know there are a lot of critiques of the insulin-obesity theory, and I am in no way saying that I’m an expert, but it makes sense that when the body is constantly using glucose for energy, it can’t burn fat for fuel.  Glucose is easy for the body to burn, but you only have 5 grams, a little more than a teaspoon, of glucose in your blood stream at a time (at a normal blood glucose of 100 mg/dL).   A lunch consisting of a peanut butter and jelly sandwich, crackers, fruit, and celery sticks could easily have 75 grams of carbs, which are broken down into glucose, causing blood sugars to rise.  And blood sugars will rise whether you’re diabetic or not.  Insulin then shuttles glucose into cells for energy, muscle cells have glucose stored as glycogen, but your muscles (and liver) can only store so much, the extra glucose goes into fat cells.  Direct quote from Lehninger Principles of Biochemistry, 4th Edition by David L. Nelson and Michael M. Cox, Chapter 21 – Lipid Biosynthesis, “Whenever carbohydrate is ingested in excess of the organism’s capacity to store glycogen, the excess is converted to triacylglycerols and stored in adipose tissue.”  When there is a constant supply of excess glucose in the blood stream, the body doesn’t need access to the energy stored in fat cells.  Eating a low carb, high fat diet switches your body from a carb burning machine into a fat burning machine.

Okay, now let me back up a little bit and provide some background into my low carb journey.  I’ve been a dietitian for seven years and have been working with outpatients and inpatients my whole career.  I would consider weight management to be my area of interest.  In seven years, I haven’t seen very many people successfully lose weight and keep it off longterm.  Most people will initially lose some weight by reducing their calorie intake, but they’re hungry all the time and complain of low energy.  Working inpatient, I see a fair number of heart attack patients and very often their lipid panels are normal, even low levels of cholesterol sometimes, and they still have heart attacks. And I am frustrated.  The people I see in the hospital keep getting sicker and sicker and heavier and heavier.  My outpatients can’t lose weight even though they’re following all my low calorie, low fat guidelines.  Finally, I just thought, there has to be something else, something I’m missing.

So I started reading and reading and reading.  And listening to talks on YouTube.  And PubMed is bookmarked and permanently has an open tap in my browser.  And you should see my stack of research articles.  And my mom found my biochem text book from college…I’m probably the only person who’s ever got excited about a biochem book…. My reading started with Michael Pollan and cutting processed food out of my diet, which automatically cuts carbs.  Then I found Gary Taubes and all his talks on YouTube, which I listened to on my commute to and from work, then read Good Calories, Bad Calories, and then more YouTube talks on my commute.  I literally just went through my saved YouTube videos to see all the talks I’ve listened to in the past year.  Some of them I’ve listened to multiple times just to wrap my head around the information because it’s so completely opposite everything I learned in school.  The following list is comprised of links to websites and YouTube talks.  I highly recommend you check out at least a few of these talks and websites, if not all of them.  I’ve also indicated who was at Low Carb USA and I had the pleasure of seeing speak in person. (*Full disclosure – we are an Amazon affiliate, and I did include Amazon.com links below.  If you purchase any of the books listed below, we get a small percentage).

• Gary Taubes author of Good Calories, Bad Calories and Why We Get Fat. Link to his YouTube talks here. (spoke at Low Carb USA)
• Peter Attia – link to YouTube Talks, his blog The Eating Academy
• Grain Brain by David Perlmutter
• Jonathan Bailor – YouTube talks, SANESolution, The Calorie Myth
• Nina Teicholz – The Big Fat Surprise 
• The Nutrition Coalition
• Low Carb Down Under
• Malcolm Kendrick – The Great Cholesterol Con, link to YouTube talks
• Jeff Volek – Art and Science of Low Carb Living, published articles, link to YouTube talks, link to his books. (Spoke at Low Carb USA)
• Stephen Phinney – link to books, link to YouTube talks, http://www.artandscienceoflowcarb.com
• Ken Sikaris – link to his YouTube talks
• Tim Noakes – Real Meal Revolution, The Noakes Foundation, link to YouTube talks
• Sarah Hallberg – link to YouTube talks
• Robert Lustig – Institute for Responsible Nutrition, Fat Chance, link to YouTube talks, Sugar Science
• David Ludwig – link to YouTube talks, Always Hungry
• Jason Fung – Intensive Dietary Management Blog, The Obesity Code, link to YouTube talks (spoke at Low Carb USA)
• Jeffry Gerber – Denver’s Diet Doctor, link to YouTube talks, (spoke at Low Carb USA)
• Ivor Cummins – The Fat Emperor, link to YouTube talks, (spoke at Low Carb USA)
• Andreas Eenfeldt – Diet Doctor, link to YouTube talks, (spoke at Low Carb USA)
• Eric Westman – link to YouTube talks, link to his books, (spoke at Low Carb USA)
• Jonny Bowden – link to YouTube talks, link to his books, (spoke at Low Carb USA)
• Franziska Spritzer – The Low Carb Dietitian, link to YouTube talks, The Low Carb Dietitian’s Guide to Health and Beauty, (spoke at Low Carb USA)
• Cate Shanahan – Dr. Cate, link to YouTube talks, Food Rules, Deep Nutrition
• Wendy Pogozelski – link to YouTube talks
• David Diamond – link to YouTube talks
• Richard Bernstein – Dr. Bernstein’s Diabetes Solution, link to YouTube talks
• Rangan Chatterjee – link to YouTube talks
• Michael Eades – link to YouTube talks, link to books, (spoke at Low Carb USA)
• Karen Thomson – The Sugar Free Revolution, link to YouTube talks, Sugar Free (spoke at Low Carb USA)
• Emily McGuire – Low Carb Genesis, link to some of her YouTube talks, (spoke at Low Carb USA)
• Ketogenic Diet Resource
• Dave Dikeman – link to YouTube, RD Dikeman on Facebook, (spoke at Low Carb USA)
• Jackie Eberstein – ControlCarb, link to YouTube talks, (spoke at Low Carb USA)
• Jimmy Moore – LivinLaVidaLowCarb, link to YouTube talks, link to books, (spoke at Low Carb USA)
• Dominic D’Agostino – KetoNutrition (spoke at Low Carb USA)
• Angela Poff – link to research articles, link to YouTube talks, (spoke at Low Carb USA)
• Jacob Wilson -The Muscle PhD, link to BodyBuilding.com articles, link to YouTube talks, link to Facebook page, The Applied Science and Performance Institute (coming soon), (spoke at Low Carb USA)
• Peter Defty – VESPA, link to YouTube talks (spoke at Low Carb USA)
• Alessandro Ferretti – link to a YouTube talk (spoke at Low Carb USA)
• Pete Ballerstedt – Grass Based Health (spoke at Low Carb USA)
• Adam Kosloff – CalorieGate, Why-Low-Carb-Diets-Work, The Low Carb Survival Guide, link to YouTube talks, (spoke at Low Carb USA)

I’m going to leave it to you to make up your own mind about low carb diets but want you to have access to solid research to support a low carb, high fat diet.  My mind has been changed.  I’ve read enough research to confidently say that a high carb diet can be detrimental to your health and that there is no reason to fear fat. I follow a low carb, high fat diet.  Technically, any diet in which 50% or more of your calories come from fat, is a high fat diet.  I do anywhere from 60-70% fat, 20-25% protein, and carbs are generally less than 20%.  I don’t necessarily follow a ketogenic diet.  The majority of the carbs I eat come from vegetables, occasionally a piece of fruit, alcohol (wine mostly).  I do eat bread sometimes; I like my homemade sourdough.  I can’t say that I’m never going to straight carbs again.  I’m a sugar addict for sure, it’s an ongoing battle, in recovery. You’ve seen my posts and recipes, I love food!  But overall, I do try to follow a very low carb diet.  And I feel amazing. I’m not hungry between meals, food cravings are reduced, energy level is stable, less mood swings.  It’s great!  I’m not saying it’s always easy, I really do love eating and think that good food is part of living life to the fullest.  I’m sharing this because I want you to know I struggle too, but that cheesy “knowledge is power” phrase is true.  Having the knowledge to back up why a high carb diet can lead to weight gain and health problems, makes following a low carb diet so much easier.

Finally, I’m posting some slides from Adam Kosloff’s presentation at Low Carb USA.  He was the last speaker and his talk was titled, “Mainstreaming the Low Carb Revolution: A Roadmap for Decisively Defeating the Low-Fat-High-Carb-Diet-for-All Paradigm”.  If you would like to see the US Dietary Guidelines reformed, a petition has been started on Change.org, please consider signing. Here is the link to the petition: Change.org – 11 Ways We Want to Reform the U.S. Dietary Guidelines.