Low Carb Diets: If Adopted on a Mass Scale, Could They End the Obesity Epidemic and Wipe Out the Chronic Diseases of Civilization?
If low carb diets DO make us thinner and healthier, we need all hands on deck to clean up the mess caused by the USDA Food Pyramid.
Over the past 150 years, many eminent (but ultimately ignored) researchers have argued that carbohydrate restriction is uniquely effective in battling obesity and diseases like diabetes, cancer, and heart disease.
If the Lipophilia Hypothesis turns out to be correct, then these researchers would be vindicated.
Let's accept for a moment that the Lipophilia Hypothesis about obesity is correct and that the many implications we have discussed on previous pages are also correct. We are left with an enormous mess. By annihilating the Caloric Balance Hypothesis, we've destroyed the foundation upon which all of modern nutrition and health science rests.
That said, if not only obesity but also most chronic diseases -- including cancer, Alzheimer's disease, type 2 diabetes, and heart disease -- all result from eating too many carbohydrates, then we potentially have a fantastic opportunity. If the vast majority of the population went on low carb diets; theoretically, we could eliminate most -- if not all -- of the chronic diseases of western civilization. We could lengthen our life spans by many years, reduce burdens on hospitals and doctors, create a more vibrant economy, and eliminate many enduring sources of human suffering.
Of course, we can't anticipate precisely how such a transition to low carb diets might manifest. No doubt unexpected consequences would arise – and not all of them good. As Nassim Nicholas Taleb points out in his book, The Black Swan, paradigm shifts don't work linearly. By radically altering our diets, sure, we might all be the healthier for it. But we also might inadvertently set off a cascade of other problems -- economic, cultural, moral, environmental, and even military.
For instance, if we all started eating low carb diets, think about what that might mean. It could devastate our argibusinesses; lead to problems as slaughterhouses revved up production to meet increased demand; strain our ecosystems; and set off uncontrollable earthquakes within our culture and our world. In other words, it would be a remarkably destabilizing event.
So where does that leave us? If it is in fact true that carbohydrates make us fat and sick, and if transitioning from low fat diets to low carb diets collectively could help us be healthier and happier, what might enlightened public policy experts do to engineer an effective, moral, environmentally-friendly, economically realistic, and compassionate program to fix our diet and disease related problems?
Obviously, this question can't be answered simply on one page of a random website. The solution will likely require a Manhattan Project-like marshalling of resources. We need the best brains in science, anthropology, economics, marketing, and so forth to come together to brainstorm fixes.
Of course, to create an elaborate battle plan for the de-carbification of America (and, more broadly, the de-hyperinsulinemia-fication of the world) will take tons of time, resources, and creative thinking.
So maybe we can propose some key principles for what a world on low carb diets might look like -- as a starting point for a productive discussion.
1. First and foremost, any change should be predicated on a more literally scientific approach than we have collectively been taking.
As Gary Taubes mentions in the epilogue of Good Calories Bad Calories, many diet and obesity researches have practiced dismayingly bad science. These people became convinced that they already knew the answers to their questions before looking at the real world evidence. As a result, they became blinded to the contradictions of their theories and the benefits of low carb diets. They behaved, in short, more like religious leaders than like scientists.
We need to reverse this. Science needs to return to its humble roots in dispassionate skepticism. We should be relentlessly dedicated to disproving theories that we think are true. In fact, if a consensus emerges to support the Lipophilia Hypothesis, that only means we must subject low carb diets to ever stronger and more critical tests. The skeptics and non-believers should be offered ringside seats and be given the biggest microphones. A good scientific theory should be able to withstand any kind of battering it gets.
We should collect as many criticisms of Lipophilia as possible and organize those criticisms in a constructive way. We don't want the tyranny of democracy to obfuscate those criticisms, either. If the history of science has shown us anything, it's that the minority leads the most important philosophical revolutions. To empower this critical minority – the group that may one day overturn the Lipophilia Hypothesis in favor of something else – we need to make sure that their voices are never drowned out by the consensus. Perhaps we even need to create a new Constitution for science – a blueprint of principles, kind of like a Hippocratic Oath for scientists.
By returning science to its roots in humble critical inquiry, we can hopefully move towards a clearer appreciation of the phenomena of the natural world.
Another critical point: science has become fractured and specialized. This is an enormous problem. People do not communicate between domains; as a result, good information gets lost, and we miss out on lots of opportunities to develop unified theories -- to "see the forest for the trees." An endocrinologist can perhaps influence other endocrinologists. But in the current set up, anthropologists and psychologists will never look at her work. Massive amounts of information flood over us all the time – some of it is junk, some of it is genius. One goal of our new approach should be to corral this information in a more constructive way that allows for better interdisciplinary focus.
To unify the sciences – to create what Edward O. Wilson once dubbed "consilience" – is a must, if we are to progress. Perhaps the internet can help us. Perhaps we could use David Allen's system of workflow mastery – based on the principles of Collect, Process, Organize, Review, and Action – to derive and maintain a process by which our scientific disciplines can interact more effectively with one another.
2. Whatever solutions we adopt, they must be compassionate.
Compassionate not only to the millions of people who suffer from obesity and chronic disease but also to everyone who might be "implicated" in promoting the low fat high carb diet. We must be respectful when debating with the researchers, nutritionists, dietitians, and public health authorities who've urged us to eat low fat all these years. Behaving bitterly towards these individuals serves no one well. Most are passionately dedicated to helping humanity. They must not be punished, ignored, or talked down to. The low carb movement does itself no favors by being unnecessarily divisive or vindictive.
Similarly, we need to address the concerns of vegetarians and vegans. For years, we've been taught that animal meats are particularly unhealthy; and that whole grains and fruit juice are very healthy. But if the Lipophilia Hypothesis is correct, then the reverse is probably true. Advocates of low carb diets must show compassion towards vegetarians and vegans -- not only because it's "the right thing to do" and because it's "useful" to have as many allies as possible – but also because vegetarians raise some valid points. Eric Schlosser's "Fast Food Nation" and Upton Sinclair's "The Jungle" should be required reading for those on low carb diets. Read Michael Pollan's books as well. And definitely read the late David Foster Wallace's fine essay, "Consider The Lobster."
To advocate for low carb diets, it's critical to listen to the arguments thoughtful vegetarians make. Even if Lipophilia is correct, that doesn't necessarily mean that eating meat loaded with pesticides, antibiotics, and other strange substances is what nature intended. Moreover, even if it is uniquely healthy to eat a diet composed mainly of meat, we cannot shirk from our moral responsibility to be humane in the cultivation and procuring of that meat.
That being said, if low carb diets work best, vegetarians and vegans should acknowledge as much. Denial and ignorance about the positive aspects of a meat diet do no one any favors.
In short, the low carb movement needs to find ways to work hand in hand with the vegetarian and vegan movements so that we can collectively lead our society to a good solution that:
1) Reduces/eliminates carbohydrate/hyperinsulinemia disease;
2) Respects core values of the anti-meat movement;
3) Acknowledges that meat and animal foods are far healhier for us than we have been led to believe by the popular media.
In addition to being mindful of the concerns of vegetarians/vegans, advocates of low carb diets must also be mindful of the values and concerns of other groups that might oppose changes to our diet, such as religious groups, etc. 3. Advocates of low carb diets must acknowledge and prepare for the environmental fallout of a transition to a low carb paradigm.
It's vastly more difficult to cultivate a pound of meat than it is to cultivate a pound of flour or corn. Growing and harvesting meat can strain local ecologies. Methane pollution from cows is a problem. Etc. Any pro-low carb policy must strive to acknowledge and mitigate and / or eliminate potential environmental problems.
4. Whatever low carb solution gets implemented must acknowledge and mitigate against economic disasters as well.
It's hard to overstate how fundamentally carbohydrates tie into our nation's (and our world's) economy. Indeed, if we today burned all of the refined carbohydrates on Earth – it would provoke mass starvation and devastate the global economy. You can't eliminate all carbohydrates or even all refined carbohydrates from our diets without a major economic blowback.
5. Along those lines, solutions based on low carb diets must protect people and businesses that rely on the sale or consumption of carbohydrates for their livelihood.
The government told us to eat carbohydrates and eliminate fat. And so manufacturers and agriculturists strove to eliminate fat from our foodstuffs and to pump in replacement carbohydrates. Businesses that invested resources to comply with the government's guidelines shouldn't be punished. They should be supported.
If you think that people who lobby for high fructose corn syrup, for instance, don't care about their health or the health of their families -- think again. No one wants to live a life of suffering, obesity, or disease. People who have invested time, money, and attention into businesses that revolve around carbohydrates should not be left out in the cold. Whatever solution we ultimately derive must be respectful and compassionate to everyone – we are all in this together. 6. Finally, we must be relentlessly self-critical.
What if low carb theory is wrong? What if, despite the seemingly overwhelming evidence to the contrary, it turns out that Lipophilia is flawed and that low carb weight loss plans are somehow bad for us? We must always be on the look out for evidence that contradicts what we think we know. To solve a complicated and intertwined problem like chronic hyperinsulinemia/carbohydrate disease, we need science based on skepticism, and we must perpetually refresh and reinvigorate our process of inquiry so we don't repeat the mistakes of these past 50 years.
With these principles in mind, let's talk solutions.
1) First and foremost, the Lipophilia Hypothesis needs closer scrutiny.
It needs to be scrutinized in the media. It needs to be scrutinized by clinicians and researchers. And the public needs to learn about it. Before we take action based on this theory, we must be quite certain that it's likely the right theory.
In Good Calories Bad Calories, Gary Taubes proposes some experiments that might help us determine whether low carb diets really are better for us than "balanced" diets. But even he admits that these might cost literally billions of dollars and take many years. Given the pressing public health problems we face, we crave ways to speed up the science somehow. But we obviously don't want to speed it up at the risk of forcing results that we "want." Perhaps we could test aspects of the theory. For instance, we could probably quickly nail down whether excess insulin (as opposed to excess calories) makes us fat. We could also model and test the mechanisms by which insulin acts as a lipogenic agent.
2) If the Lipophilia Hypothesis passes muster, and we can generally trust that low carb diets do work to treat/prevent obesity - as well as dozens if not hundreds of other diseases – then a transition to a low carb world should free up massive resources, money, and creative energy.
By tearing down the USDA food pyramid and adopting low carb diets, we thus should be able to staunch the obesity epidemic, slow down rates of chronic diseases, and make people feel more energized and less depressed. These positive results should trickle down and lead to other positive developments. For instance, we could likely solve many aspects of our healthcare crisis, thereby freeing up our government and stimulating the economy. A healthier population – one not over-burdened by obesity, disease, and uncertainty – can aid our collective quest for a healthier, happier planet. 3. We also need not transition to a completely "carb free" economy right away, either, in order to see positive health benefits.
Even just "rolling back" our dietary recommendations from a low fat, high carb diet to the diet that we ate in the 1960s and 70s should yield substantial and rapid results. In other words, we need not jolt our economy. We can likely do this in stages and thus help carb-dependent people and businesses transition.
4. In addition, if Gary Taubes' interpretation of obesity science is correct, eating carbohydrates sets off a string of cause and effect processes that lead us to fatten. We should theoretically be able to stop this biochemical cascade at any number of points.
Thus, theoretically, maybe we can ultimately be able to stop the damage without needing to go on low carb diets at all. For instance, certain medicines called statins seem to reduce triglyceride levels and protect against heart disease. Perhaps we can learn something about the mechanisms of these drugs and apply those lessons broadly. In addition, the medicine Metformin seems to be clinically effective at treating hyperinsulinemia. Maybe this medicine or medicines like it could be used in conjunction with carbohydrate restricted diets to reduce risk -- not only for obesity but also for other diseases associated with chronic elevated insulin levels.
Maybe we can develop technologies to reduce the level of alpha-glycerol phosphate in our fat tissue. Maybe we can find ways to make our fat tissue more insulin resistant and/or our muscle tissue more insulin sensitive. Maybe we can develop technologies to prevent carbohydrates from causing spikes in insulin postprandially. Who knows what kinds of technologies are out there now – or what could be out there – to mitigate all of these problems? By removing the focus from "eat less and exercise more" and by taking obesity out of the domain of psychology and moving it firmly into the domain of physiology, we can direct tons of resources far more effectively.5. Maybe an X-Prize-like contest can motivate research into low carb diets.
Drug companies could fixate on how to stop/mitigate the cascade of biochemical effects that refined carbs and sugars have on our systems. Who knows, maybe one day, we will be able to drink giant glasses of orange juice and bags of candy corn without fear of reactive hypoglycemia or other problems.
6. Drug companies, insurance companies, sugar manufacturers, and other industry participants should be recruited for discussions about how best to impliment society-wide low carb diets.
For instance, maybe smart minds in the juice industry could develop technologies to limit the impact of fructose on the liver. Or health insurance companies might use their statistical models to fashion solutions. By including everyone in the mix – by making everyone a player on the same team against chronic hyperinsulinemia/carbohydrate disease – we can also avoid or at least seriously mitigate some of the cultural trauma that a transition to low carb diets might bring on. Because if you leave players like the sugar industry and the health insurance industry to fend for themselves – to essentially be "fall guys" or "bad guys" – this will just squash progress. We need everyone's help.
7. We need to take a look at other factors outside of low carb diets that might reduce chronic elevated insulin levels.
For instance, the prescription medications millions of us take for depression, anxiety, and other disorders may be responsible for a significant slice of our collective hyperinsulinemia. This doesn't mean obviously that people should stop taking these medications – but it does mean that the medical community needs to acknowledge – or at least determine – what ultimately drives medication-induced hyperinsulinemia. Perhaps different kinds of therapies, such as meditation, could alleviate some of our collective anxiety and depression. Perhaps better organizing of what David Allen would call the "open loops" in our lives could make us feel less anxious and more in control.
Maybe these solutions are all impractical. But choosing between a society sickened by a high carb diet and elevated insulin levels and a society turned topsy-turvy by a crazy transition to a "post carb" world seems to be (in the words of President Obama) a "false choice." We should be able to solve obesity and improve our economy. We should able to go on low carb diets and reduce animal cruelty and reform the meat industry. We should be able to have the best of both worlds. But first we need to be honest about what's really making us fat and sick, and we need to have the patience, the compassion and the discipline to develop a good process and blueprint.
We must look at this challenge opportunistically – as a test of our mettle and pluck as Americans and as citizens of the world. Could a paradigm shift to a low carb world:
- Make people and our pets healthier?
- Generate economic prosperity?
- Reduce suffering?
- Ameliorate environmental crises?
- Help our species become more in balance with nature?
- Lead science back to its roots in the philosophy of skepticism?
If so, wouldn't that be great?
We must keep our eyes peeled for win-win-win solutions. Leave no one out. Be compassionate – both to ourselves and to nature. We can do this. We can make it happen.
Our first step, however, is a key one:
We must choose between the Lipophilia Hypothesis and the Caloric Balance Hypothesis.
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