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The Case for a Low-Carb, Healthy-Fat Diet

Book Review by Joseph E. Scherger, MD, MPH

To my knowledge, no one knows nutrition history better than Gary Taubes. As a science writer, he has been studying the subject matter full time for over 25 years. Taubes helped launch the modern low-carbohydrate healthy fat understanding with his 2002 cover article in the New York Times Magazine entitled “What If It’s All Been a Big Fat Lie?” He exposed the shoddy science for the low-fat diet recommendations of over 40 years and how those recommendations resulted in the epidemic of overweight, obesity and type 2 diabetes. 

Previous best-selling books by Taubes include The Case Against Sugar (2017), Why We Get Fat (2010) and Good Calories, Bad Calories (2007). In his latest book, The Case for Keto, Taubes updates the science and provides interviews with nutrition physicians and other health care providers that provide low-carbohydrate, healthy-fat (LCHF) nutrition services in the U.S. and Canada. He also provides his personal experience of being overweight and how he has maintained an LCHF lifestyle for many years. 

I have chosen to substitute “healthy fat” in place of “high fat” in this book review. I acknowledge that in this ketogenic eating plan, fat becomes more than 50 percent of your calories. Thus, I emphasize healthy fat since unhealthy fats, as in processed foods, are to be avoided.

Taubes traces the origins of the published history of low-carbohydrate nutrition to two sources: the French physician Jean Anthelme Brillat-Savarin in his 1825 book, The Physiology of Taste, in which he concludes that grains and starches are fattening and that sugar makes it worse, and to a London undertaker, William Banting, who reversed his obesity upon the advice of his doctor, and published the bestselling pamphlet, Letter on Corpulence (1863). Taubes states that all subsequent articles and books on low-carbohydrate nutrition, including the Adkins diet, are simply reiterations of these works.

David Ludwig has led the academic validation of low-carbohydrate nutrition at Harvard, Eric Westman at Duke, Jeff Volek at Ohio State and Steve Phinney at the University of California, Davis. They validate that obesity is an endocrine disorder caused by the fat storage effects of an excess of the hormone insulin induced by carbohydrates. The physics argument of energy in and energy out by calories is not valid, yet it persists. 

Taubes describes how everyone has a different carbohydrate threshold as to what will cause fat storage. There is no universal dietary carb limit (such as 50 grams) that applies to everyone; genetics, a person’s metabolism, and whether a person was previously overweight or obese are all important factors for how few carbohydrates a person can ingest without gaining weight. Since we do not need carbohydrates for our health, Taubes recommends abstinence for many people, especially in the weight loss phase of dietary management.

We live in a carbohydrate culture, and the food industry pushes carbs due to their profitability and addictive tendencies. One academic leader of an obesity clinic said he is in the business of treating carbohydrate addiction more than weight management. 

I have read three of the four books by Gary Taubes and found each filled with science and practical recommendations. He does not treat patients but expresses how many leading clinicians do so in their centers. Many will find parts of his latest book tedious and repetitious, but overall it is well worth reading. Taubes summarizes the main points in the introduction for anyone not wanting to get into the details. The final three chapters: Lessons to Eat By, The Plan and Caution with Children, contain valuable information.

Despite the reluctance of many academic departments and weight loss centers (often funded by the food industry), the nutrition debate has been won by the advocates of low carbohydrates as the best and only truly successful long-term approach to weight loss.

Joseph Scherger, MD, MPH is founder of Restore Health in Indian Wells, a clinic dedicated to weight loss and reversing disease. For more information, visit www.restorehealth.me or call (760) 898.9663.

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