Until my late 20s, I was a pretty healthy guy. I’m 6’1”, and when I was 27, I was about 30 pounds over my ideal weight, but I blamed genes for that. Something else I blamed on genes was a seemingly endless battle with irregularity. Since this plagued both of my siblings as well, it earned the nick-name “Kavanaugh-Colon.” On one occasion when the problem was particularly bad, I passed a lot of blood and so I sought the advice of a gastroenterologist. He subjected me to a battery of tests and ruled out the life-threatening possibilities. Ultimately he made the diagnosis of Irritable Bowel Syndrome (IBS). When I asked him what caused it, he told me that there was a strong psychological element to the disease, which frankly seemed insulting. There was no cure. He said I should eat right and exercise, take fiber supplements, and keep stress to a minimum.
Since that day, I’ve learned a lot about Kavanaugh-Colon. IBS is a disruption in the normal communication between the nerves in the gut and the brain, called the brain-gut axis. IBS symptoms are triggered by hypersensitivity to distension in the intestines. Research had shown that this hypersensitivity is related to stress, anxiety, depression, or psychological trauma, hence my doctor’s comment. However, for years I suffered symptoms seemingly at random, with no apparent connection to my mood. As I aged, it was also clear that the symptoms were becoming more frequent and severe.
When I was 37, I had a sudden onset of an illness that was far worse than anything I had ever experienced or imagined. I was hit with unbearable waves of nausea , accompanied by simultaneous vomiting and diarrhea, and I was unable to move my body or to focus my eyes. I felt sure that I was dying and was way too sick to even pick up a phone to call 911. After about 15 of the longest minutes of my life, I recovered my faculties but I was extremely tired. The fatigue lasted for days. In the following months, I often had brief spells where I lost the ability to focus my eyes on my computer screen. Naturally I was terrified. My family physician ran tests but was generally baffled. Aside from high cholesterol, my tests were all normal. Months later I had another attack of severe nausea and very shaky vision. Ultimately it was an Internet search of my symptoms (not my G.P.) that clued me in that this might be an inner ear disorder. It turned out that I had been suffering attacks of vertigo caused by a condition known as endolymphatic hydrops, or in layman’s terms elevated pressure in the inner ear. My otologist could not say what caused the problem. For the next couple of years I suffered vertigo attacks every few months. Gratefully, none were as severe as the first, but they were very unpleasant.
Also during this time I tried to take out a $500,000 policy with USAA Life Insurance Company. After testing my blood, USAA returned my premium and told me that they were unwilling to insure me. These were my numbers:
- Triglycerides 1378 (normal < 150)
- Total Cholesterol 350 (should be between 125-200)
- HDL Cholesterol 29 (should be above 40)
- LDL Cholesterol ?? (test is invalid when triglycerides are higher than 400)
My triglycerides were roughly ten times the normal level and this was the main reason for the denial. Also, my cholesterol was disturbingly high. Both triglycerides and cholesterol are blood lipids so this condition is often called hyperlipidemia. Upon further investigation, I learned that very high levels of triglycerides(above 1,000) are believed to cause pancreatitis (inflamation of the pancreas), and depending on severity, pancreatitis has a mortality rate as high as 30%.
I sought the advice of an internist who put me on medications to lower my triglycerides and cholesterol. She also strongly advised me to lose weight and to get more exercise. I should point out that at this time I was about 50 pounds over weight, but I was very active. I was playing indoor soccer on a regular basis and had taken up jogging. I had also been trying to lose weight for as long as I can remember. I was a salad eating fool. I couldn’t be consistent though. I blamed my failure on weak will.
So by 2002, at age 39, I was taking statins to lower my cholesterol. I took fenofibrate and prescription niacin to lower my triglycerides. My blood lipids were improved but still bad, and my doctor said that a higher dosage would cause liver damage. I also took meclosine and furosemide to treat the hydrops. I spent over $400 per month on medication. However, I wasn’t taking anything for the chronic fatigue and depression I was experiencing, or the IBS. [Interestingly, one scientific paper found that 51% of chronic fatigue syndrome patients also have IBS.] It was then that I encountered my first food heresy: the Dr. Atkins diet.
A friend of mine had lost a lot of weight following the Atkins diet and he raved about it. I was deeply skeptical. Based on everything I knew, a diet that didn’t restrict calories shouldn’t work at all. When I read the book, Atkins New Diet Revolution, I wasn’t swayed. In my opinion, the book reads like a long infomercial, and its explanation of metabolic science seems overly simplistic. However, I couldn’t deny my friend’s success. I finally figured that eating that way was like poisoning yourself, perhaps like chemotherapy. It might make you lose weight, but doing it for any kind of prolonged period would surely wreck your overall health. I talked myself into trying it, thinking that maybe the benefits of weight loss on my hyperlipidemia would offset any damage from the diet.
My experience with the Atkins diet was way different from my friend’s. To begin with, it was very hard to get started. The goal of the diet is to establish and maintain a metabolic condition known as ketosis. The beginning phase of the diet is called induction where you try to avoid all carbs to get ketosis started. I became unbearably fatigued during induction and could barely get out of bed. Also, based on my ketone body test strips (a urine test for Atkins success) I was failing to get ketosis going. I would have given up on Atkins completely if the doctor hadn’t addressed this in his book. He described my reaction as extreme metabolic resistance. He offers a lot of specialized advice to people like me including the suggestion to start by eating nothing but cream cheese, deviled eggs, or macadamia nuts until ketosis kicks in (I’m not kidding). Well I was not ready to go that far. So I did my own personalized version of Atkins for a while. I never really saw much ketosis on the ketone strips,but I did cut my carbohydrate intake dramatically, and over about three months I lost 20 pounds. When I celebrated by eating normally again, I was amazed at how fast I put 10 of them back on.
When my internist talked to me about diet, she shared her opinion that Atkins seemed to work but that no one could sustain it for long. This was my opinion after my first try at it, and I wouldn’t have given it much more thought except for a discovery I made during those three months of low carb eating: my IBS nearly disappeared. When I went back to eating normally, the IBS symptoms returned. After that, I knew that at least for me, there was a connection between carbohydrates and IBS.
Let me digress for a moment and speak directly to readers who suffer from IBS. For many IBS sufferers, symptoms are triggered by the consumption of certain small chain carbohydrates and sugar alcohols (chemicals which are added to a ridiculous number of processed foods.) Researchers in Australia have coined (and copyrighted) a new acronym for the previously unrelated group of dietary substances that were so detrimental to my quality of life: FODMAP (for Fermentable Oligo-, Di- and Mono-saccharides and Polyols). The theory is that in certain people, these FODMAPs disrupt the bacterial ecosystem of the intestines, acting like a fertilizer and causing overgrowth of some types of flora. (There are some 1,500 bacterial species living there). This disruption then leads to the hypersensitivity of the nerve cells lining the intestines. Here is a link to their analysis and dietary recommendations: Gipson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. J. Gastroenterol. Hepatol. 2010; 25: 252-258. Whether or not their theory is correct, it’s easy enough to test their recommendations. Avoid foods that are high in FODMAPs and observe. Then eat some foods high in FODMAPs and observe. I can’t speak to the foods they list that can only be found in Australia, but otherwise their dietary recommendations match my IBS experiences perfectly. You’re welcome.
After learning of a connection between carbs and IBS, for years I tried to eat low carb not so much for weight loss but for IBS management. My diet took on a seesaw pattern. I would avoid carbs for several weeks. My IBS symptoms would disappear. I would usually lose some weight and generally feel great, but then I would lose my will to stick with it. I would give in to some tempting high carb food and then I would spend a month eating whatever I wanted. I’d rapidly gain back whatever weight I had lost. The IBS would come back, and eventually so would headaches and fatigue. I’d then swear off carbs again and the pattern would repeat itself.
In spite of my weak will, my best guess is that once I knew that there was a correlation between IBS and carbs, I cut my carb consumption on average by 30-40%. At the very same time, my vertigo attacks simply stopped occurring. At first, I didn’t see how the two could possibly be connected, but upon further research hydrops can also be triggered by carb consumption. To understand it, here are a few informative paragraphs I lifted from a Chicago otology practice’s website: (http://www.dizziness-and-balance.com/index.html).
The fluid-filled hearing and balance structures of the inner ear normally function independent of the body’s overall fluid/blood system. In a normal inner ear, the fluid is maintained at a constant volume and contains specific concentrations of sodium, potassium, chloride and other electrolytes. This fluid bathes the sensory cells of the inner ear and allows them to function normally.
With injury or degeneration of the inner ear structures, independent control is lost, and the volume and concentration of the inner ear fluid fluctuates with changes in the body’s fluid/blood. This fluctuation causes the symptoms of hydrops.
Your inner ear fluid is influenced by certain substances in your blood and other body fluids. For instance, when you eat foods that are high in salt or sugar, your blood level concentration of salt or sugar increases, and this, in turn, will affect the concentration of substances in your inner ear.
My otologist focused my treatment on salt. He prescribed furosemide to keep the sodium levels in my blood down. If he mentioned that I should try and keep my blood sugar down too, I didn’t hear him say it. Today, I have been symptom free of hydrops for over 5 years. I have also been trying to avoid foods that raise my blood sugar for just over 5 years. And if you think the furosemide might be responsible for the remission, I haven’t taken it for over 4 years. Coincidence? Perhaps. A good test would be for me to switch to a diet of cotton candy for a while and see if my vertigo returns. Sorry, but I’m not willing to do that even for the benefit of science.
My periodic low carb dieting had another surprising effect. While taking drugs for my hyperlipidemia, I had to get blood tests done every six months. A pattern in my test results emerged. If I had been eating low carb for much of the prior six weeks, my lipid levels weren’t too bad. If, on-the-other-hand I had been eating normally during the prior six weeks, my lipids were terrible. The fluctuation was most dramatic with my triglycerides which, while on medication, ranged from the low 200’s to the high 900’s. The differences were sometimes so striking that my internist once falsely accused me of not taking my medicine. I told her that I was beginning to believe that my triglyceride levels were a reflection of the amount of sugar I was getting in my diet. She said that she couldn’t imagine dietary changes alone being responsible for such a wide swing.
It is important to understand that during the time I was being treated by an internist for hyperlipidemia, I was trying to follow her recommendations to the letter. She suggested that I get more exercise and lose weight, and I worked very hard on that. In 2008, for example, I trained for months and ran and completed a marathon. Throughout the marathon training I did lose about 10 pounds, but I was hoping to lose a lot more. And during the month following the marathon I put most of that weight back on. I began to think the only way I could get to my ideal weight would be to exercise all of my waking hours.
A few years ago, as I first started to wonder if excess carbohydrates in my diet were at the root of my illnesses, I stumbled onto a book called The Paleo Diet, by Loren Cordain, a professor of health and exercise science at Colorado State University. In the book, Cordain argues that the diet that human beings evolved eating differed from the modern diet most significantly in the amount of simple carbohydrates. Paleolithic people ate mostly wild game. And they didn’t eat grains at all. Until I read this book, I had been thinking of myself as defective. I thought my obesity, IBS, hydrops, and hyperlipidemia were due to bad genes. But this book made me consider that if I had lived 15,000 years ago, none of these illnesses would have affected me. The dietary causes wouldn’t be present. I realized that if that wasn’t true, the genes in question would have not been passed down to me. My prospective ancestor would have been eaten by a tiger while having a vertigo attack and thereby removed from the gene pool.
I’ll always be grateful to Loren Cordain for providing the basic premise that led to my new understanding of nutrition. There has to be one diet that is the healthiest for the human animal and understanding the environment of our ancestors should logically suggest what that diet is.
About a year ago, I read the book Good Calories, Bad Calories by a New York Times science journalist named Gary Taubes. This book is like a revolutionary manifesto. It challenges conventional wisdom about diet and nutrition on multiple fronts, and it does so with 116 pages of footnotes. Taubes has a physics undergraduate degree and it shows. He writes with an anticipation that his reader will be deeply skeptical. He doesn’t just assert that the vast majority of health professionals are wrong about nutrition science. He provides a detailed history of how this came about. He explains how money and politics have subordinated the peer review process. He explains the inherent shortcomings of observational studies and how biases are often reported by media as fact. In short, he makes a federal case. And that was exactly what I needed.
The message of Taubes’ writing, which carries over to his most recent book Why We Get Fat: And What To Do About It, is that many years ago, our public health system sought to answer the question: ‘Why do Americans suffer from an epidemic of obesity, heart disease, and all kinds of other diet related diseases that were very rare until the twentieth century and are still rare in some third world countries?’ The answer that was embraced by our public health system at the time, was that we consume a large amount of excess calories in the form of fat. The old food pyramid reflected this opinion, and fat became the enemy of American public health. Taubes shows that this hypothesis has been proven wrong, and that the alternative hypothesis: we consume a lot of excess calories in the form of carbohydrates, must be the correct one.
There were two revelations in GCBC that changed my life. Taubes shoots down conventional ideas about the cause of obesity. He makes a compelling case that obesity should be understood as a hormonal disorder and not a defect of character. He points out that the human body self-regulates weight and that worrying about caloric consumption is not just unnecessary to achieve weight loss, in the long run it is counter-productive. Furthermore, Taubes goes into great detail about cholesterol and saturated fat. He made me aware that the same people who were stubbornly clinging to the ‘fat is bad’ hypothesis were the ones villianizing saturated fat. The scientific evidence seems to suggest the very opposite. Saturated fat (natural, not artificial trans fat) is likely good for you and should help prevent heart disease.
After reading the blog of Dr. Peter Attia (who I found through Gary Taubes’ blog) the full implications of this began to soak in. I realized that over the past few years I had been trying to eat low carb and low fat. Hence I was getting too much protein in my diet and not enough fat. I had also been concerned about calories and feeling guilty when I ate too many calorie dense fatty foods in a day. In spite of all my personal experience to the contrary, on one level I still thought low carb dieting was bad for me. I was setting myself up to fail. Taubes and Attia convinced me that trying to avoid saturated fat was not just unnecessary, it probably increased my risk of heart disease.
So in August of 2011, I surrendered. I began low carb dieting with a new attitude. I would embrace saturated fat and I would care less about calories. As an added incentive to stay on the diet, I stopped taking my hyperlipidemia medications. I told my internist that I needed to see what I could achieve in six months with diet alone. She reluctantly agreed as long as I was willing to get my blood tested in 3 months.
It is now 7 months later. I have lost 17 pounds in a very gradual steady manner. I am no longer taking lipid lowering medication and my lipids are the lowest they’ve been in over 12 years. Here are my latest numbers:
- Triglycerides: 197 (normal <150)
- Total Cholesterol: 267 (should be between 125-200)
- HDL Cholesterol: 39 (should be above 40)
- LDL Cholesterol: 189 (should be below 130)
My numbers aren’t perfect, but they are astounding to me. Furthermore, they are way below a level where medication is needed. My internist hasn’t seen these numbers. She moved to another state last Summer. I’ll write about her reaction after I send her a link to this blog. My G.P. ordered the blood test after I told him what I was doing. His skepticism was palpable. When his nurse gave me my test results she said, “The doctor said if what you told him is true, then you don’t need to take your medication any more.”
There is absolutely no doubt in my mind now that my hyperlipidemia is a function of carbohydrate consumption, and so are my IBS symptoms. The endolymphatic hydrops may have been a function of carbohydrate consumption. None of the professionals who I trusted to advise me about my medical condition were able to share the simple bit of advice that I should try eating a low carb diet. The reason they didn’t is that we live in a society that takes for granted that such a diet is generally unhealthy. For years I shared that bias and it sabotaged me, but now, thanks to Gary Taubes and others like him, I know that every serious scientific study that has been conducted along these lines has demonstrated just the opposite.
If you doubt the veracity of what I am saying, then please read Taubes’ Why We Get Fat, but if you aren’t willing to do that, then at the very least watch this:
It is a YouTube video of a Stanford nutrition science researcher releasing the findings of a study he conducted. It is far and away the most compelling report on scientific research I have ever seen because it is obvious that the researcher (a 25-year vegetarian, he admits) ABSOLUTELY HATES his own findings. See if you can spot the point where the presenter contradicts himself and suggests a possible source of bias that may have skewed the results of the study HE DESIGNED. He’d rather have you believe that he’s a bad scientist than have you take to heart his own findings! What are the results that this Stanford professor finds so hard to accept? That following the Atkin’s diet improved the health of his test group in every single criteria that he measured.
But why should this be so shocking? Is it so hard to imagine the environment in which 99% of our evolution as a species took place, the world before the invention of farming? Our ancestors primarily ate animals. Most natural environments don’t provide enough calories for survival any other way. The parts of the animals that early man cherished the most were the fat parts, where many of the essential nutrients are found. The picture at the head of this blog is a 30,000 year old cave painting in Chauvet, France. I don’t see any fruits and vegetables in that painting.
The reason that low carb diets work for weight loss is that we possess the innate ability to self-regulate our body fat in an environment where calories are abundant, provided that the calories are in the form of animal fat and protein. And this makes total sense because this was a common situation throughout our evolutionary history. We do not have that same ability in an environment where abundant calories are present in the form of plant sugars (carbohydrates). That environment never existed until farming was invented.
Don’t get me wrong. People are omnivorous and that is an evolutionary advantage. But we are able to maintain perfect health eating like obligate carnivores. Some societies still do so and they are some of the healthiest ever studied (the Inuit and Masai, for example). And doesn’t that make intuitive sense? If an animal evolves eating other healthy animals, why wouldn’t they get all of the nutrition they would need from that food source? With the invention of farming came generation after generation of sales guys saying people should eat what they are selling because it is good for you. We heard that pitch for thousands of years and somehow came to believe it to be fact. When our nation’s health system decided to set a policy for dietary recommendations back in the 1970s, the politicians didn’t base it on sound science, they gave us agricultural industry sales pitch dressed up as science.
So now, forty years later, it is heresy to question the FDA. And for more than a decade I gave a small fortune to pharmaceutical companies and lost countless productive hours battling diseases that were completely unnecessary. With the threat of pancreatitis, it is not hard at all to imagine that I could be dead today if I’d remained ignorant of the truth for much longer. I now believe that in many circumstances, physicians should be advising their patients to try low carb dieting as a first step in treatment. Of course that won’t happen unless they can point to cases where it has helped, like mine.
In future posts I plan to go into much greater depth regarding how I formed these opinions. I will write more about the scientific research showing how high carbohydrate consumption will cause various diseases. I will write in more detail about the diseases that afflicted me: IBS, hyperlipidemia, and hydrops, and I also plan to write about related things I’ve learned about cancer, heart disease, hypertension, stroke, epilepsy, and ADHD. And finally I want to use this blog to vent about the endless parade of headline grabbing snake oil salesmen that profit by perpetuating myths about health and nutrition. I hope that you’ll get something out of it.