Gary Taubes blew the top off the New York Times readership with his carefully researched “What if it’s all been a big fat lie?” about fat and heart disease in 2002 (translation: it’s the type of fat that matters, not total fat).
He’s doing it again with “Is Sugar Toxic? (translation: yes, it’s poisoning you now).
Any of my patients would be proud: (except one thing: the CO2 of 19, which is probably because he’s often ketotic, and has to blow off CO2 to normalize his blood pH).
a. What is the effect of sustained ketosis on heart disease risk?.
Ketosis mimics starvation, pushing the body to burn fats rather than carbs (because there are no carbs!) for fuel. Fatty acids and ketones result.
Ketogenic diets work in about 50% of kids with specific seizure conditions. They reduce appetite but are difficult to sustain (Atkins is a modified ketogenic diet). In a small study in kids, there were worrisome cardiac changes: I don’t know of adult cardiac data.
b. What are the other heart disease risk factors? Smoking, high blood pressure, diabetes and pre-diabetes, sedentariness, family history of early heart disease, high waist-to-hip ratio.
Let’s assume these are not a problem for Mr. Taubes. But not so for everyone else. Some of these have to do with food, and some not. Even if sugar is the problem. And it might be.
c. Is it practical?
To eat without most carbs and sugar, especially fructose, is virtually impossible in the U.S. and even more so abroad.
But Taubes’ idea that “we all respond to the carbohydrate/insulin effect differently”, and for weight loss “getting rid of all the grains and much or most of the fruit, and then eating more of whatever foods they happen to eat or like that provide protein and fat” deserve exploration.
People with celiac disease learn to cook, to read labels, to avoid gluten, because it’s toxic to them. Will we see the same for obesity, heart disease and sugar? Let’s hope so.