A Choir Of Heretics

In the introduction to this blog, and in my page on The Alternative Hypothesis, I referred to a letter to the editor of the New York Times that was written by Gary Taubes back in January. I reread that letter yesterday and then for the first time read a large portion of the comments written by the letter’s signators. I felt that some were too good to be buried in a list of what is now nearly 1,250 signatures. So with the power of copy and paste I give you:

“My experience as preventive cardiologist and lipidologist confirm insulin-producing foods as the major contributor to weight gain (especially abdominal adiposity), dyslipidemia, insulin resistance and associated metabolic derangements leading to diabetes. 17 million diabetics at present and tens of millions more on their way if we don’t change the way we approach this problem and fast.” Jonathan Fialkow MD, FACC, FAHA, Cardiovascular Center of South Florida

“It is a shame that newspeople do not seek out experienced, learned Bariatricians to comment before the newspeople spout gibberish. Misconceptions permeate this health crisis, including MDs who have not kept up with the changing science regarding obesity and it’s treatment and prevention.” Raymond Gerard Mock, Jr. MD, ASBP.

“I fully support carbohydrate restriction as the principal modality for achieving weight loss and improving cardiovascular health. Obesity is not an incurable condition but knowledge of its key determinants – in particular carbohydrate excess in modern life – is critical to its amelioration and highly effective for doing so.” Daniel Hackam BSc MD PhD FRCPC, Division of Clinical Pharmacology, Department of Medicine, University of Western Ontario

“Mr Taubes has written extensively on this topic and his investigative work clearly supports it is carbohydrates, especially fructose and not fat in the diet that drives obesity.” Thomas Dayspring MD, FACP, FNLA, UMDNJ, NJ Medical School

“Repairing insulin resistance is key to successful long term weight loss. The deluge of refined carbs that we are confronted with daily have made it difficult to stay with a more restricted eating style. A cultural shift needs to take place if we are to really address the obesity crisis. Thanks for your thoughtful article. This is a conversation that needs to be brought to the public. ” Gail Altschuler, MD, ASBP

“Well done. Care for the wonderful people obese by the poison the food industry profits from, as I do, and you would be quick to agree.” Warren Willey DO, ASBP

“As a practicing physician I have used a Paleo style low carbohydrate meal plan and lifestyle with great success to improve cholesterol, reverse hypertension and type 2 diabetes, improve type 1 diabetes, as well as improving autoimmune disorders. And yes, it is the most effective weight loss program available in my clinical opinion.” Ronald Scott Kempton, MD, ASBP

“Well said. I would further add that the glycemic index and glycemic load of a particular food should be required on our nutritional labels.” Debra Ravasia, MD, FACOG, ASBP

“I’m a board certified Lipidologist, and have devoted my career to addressing obesity, pre-diabetes, cardiovascular disease, etc. I strongly concur that Insulin Resistance is the root of most of the evil in our society, caused by excessive carbohydrates/sugars, and especially fructose.” Eric J. Bush, MD, Fairview Hospital

“As a physician who has specialized in obesity for 20 years and who has spent the last ten years focusing my practice on weight maintenance, I fully agree with the points made above. The adoption of a diet that is very low in sugars and starches and which looks a great deal more like our ancient human diet appears to be highly successful in inducing and maintaining weight loss. As hunter-gatherers, our ancestors were not exposed to large loads of sugars, nor to situations in which insulin required frequent and significant production. It seems likely, then, that our insulin system is a fragile one, and that we may be seeing the consequences of continuous overuse. While obesity resolves and people are far less hungry on diets that lower sugar and starch consumption, a problem remains. Foods that ultimately become glucose tend to have an addictive nature. While we can imagine ourselves becoming vegetarian with only minimal pain, the idea of giving up bread, pasta and sugar is anathema to many of us. This is a shame, since those who attempt such a diet are often rewarded not just with good health and weight, but with a feeling of being freed from the control of food.”(www.refusetoregain.com) Barbara E. Berkeley, MD, LakeHealth System, Cleveland, Ohio

“I would like the NY Times to allow Gary Taubes or anyone from the Nutrition and Metabolism Society to respond to this article so as to avoid discouraging would-be dieters from even trying to lose weight, and to avoid encouraging doctors to wrongly blame their patients “lack of willpower”” Dr. Cate Shanahan, Queen Of The Valley Medical Center, Napa Valley, CA

“As a Physician’s Assistant in primary care for thirty five years, I became frustrated with the traditional energy approach to dieting. If I convinced a patient of the power that carbohydrates had over appetite, they could change habits, lose,weight, reduce blood pressure, not to mention normalize blood pressure. It seems criminal that people like the NYT author have been hoodwinked into believing they have no willpower and continue to count calories. More frustrating is the point you make regarding well known facts on the physiology of insulin. Thanks for offering to enlighten the public on this. Good luck. I fear the gods are against you.” Chris Lohry, AAPA

“Below is a key sentence in the article by Tara Parker- Pope: ‘Nutritionists counselled them in person and by phone, promoting regular exercise and urging them to eat more vegetables and less fat.’ Eating less fat typically means eating more carbohydrate-probably of the ‘heart healthy whole grain’ variety typically given by nutritionists. Many obese people, although not all, are insulin resistant. Insulin resistance is in essence a manifestation of carbohydrate intolerance. If those who lost weight in the studies mentioned in the article kept their total carbohydrate consumption to less that 80 to 100 grams per day, they would likely remain free of future weight gain. Those with severe insulin resistance may have less tolerance for carbohydrate, perhaps as little as 50 grams per day.” Jeff Reagan Ph.D., Department of Metabolic Disorders, Amgen, Inc.

“Carbohydrates are inflammatory and fattening. Nutrition guidelines need to change with scientific knowledge. Not only do my patients lose weight and keep it off they treat and prevent disease.” Jeffry N Gerber, MD (http://denversdietdoctor.com/)

“It’s 2012! Science, optimism and a symphony support of techniques WILL change the face of national weight disease.” Thomas R. Schneider, MD, FACS, ASBP

“An excellent response with easily understood logical approaches even for those with their heads in a sand pit.” James L. Bland, MD, JD, ASBP

“Modern biochemical and physiological science does indeed understand much of the underlying cause of the modern obesity epidemic, as well as the solution.” Aaron Blaisdell, PhD, UCLA Psychology and Brain Research Institute

“The fact that obesity is caused by excessive carbohydrate intake and too little fat in the diet has actually been known since William Banting wrote his Letter on Corpulence in 1863. And controlled clinical trials in the first third of the 20th century proved it consistently. Those professionals who insist that weight maintenance is all about calories and exercise have no excuse for not knowing their professed subject. They are incompetent.” Barry Groves

“I absolutely agree with Mr. Taubes as a clinician and as an individual with obesity as a child. To go further, the most significant health benefits are for those who make the most radical changes in their diets. In other words, the “middle road” is almost certain to fail when you are already obese. Saying goodbye to carbs should happen much sooner for some (like when your triglycerides go up). When are we ever going to be scientific? Clearly fewer and fewer of us are “genetically lucky”.” Jerry Suminski, MD

“yes yes yes a thousand times yes, I have been preaching this concept to my patients for years and guess what,,,the patients that follow my no refined sugar diet, less process food loose weight and their lipoprotein profiles thank me…thank you Gary for printing what most of us already know from experience!!! Kathleen Dively, associates in cardiology, lipid specialist

“I have written a book titled, The Tubby Traveler from Topeka. It is a year long case study of being on a low carb diet with 60% fat while doing advanced lipid testing, CAC and CIMT.” Brian Scott Edwards, MD, Diplomate of National Lipid Association

“Because the recent large increase in obesity rates has occurred over such a short time period (i.e., 2-3 generations), it cannot be explained by a change in inherited risk (e.g., genetic drift or natural selection increasing the frequency of adverse alleles for obesity-associated genes). Environmental factors are clearly implicated, and changes in diet would seem to provide the most likely explanation for the obesity epidemic in Western countries.” Robert E. Tarone, International Epidemiology Institute

“I had to relearn the physiology of and effect insulin has on fat metabolism. When I started to apply these concepts to the care of my patients they not only started losing weight but have had a dramatic overall improvement in their health. This is an idea whose time has come…back!” James M Weiss MD (http://www.privatemds.com/)

“Excellent! All my patients who understand insulin and its role in obesity are successfully losing weight. They understand what to eat to prevent those insulin spikes and they are burning fat and dropping pounds. I recommend the “Paleo” diet to everyone. I myself have lost nearly 100 lbs eating this way. I am a type II diabetic and I used to be on 4 diabetes medications and a cholesterol lowering medication. 10 years after my diagnosis I am off all medications and my last a1c was 5.3.” Laura Voss, DO, Cass Regional Medical Center Department of Family Medicine, ASBP

“We have known since Benedict (1917) through Keys (1945), Stunkard & Hume (1959) to Franz (2007) that eat less/do more does not achieve sustained weight loss. Quite the opposite – as Parker-Pope has discovered – it tends to lead to weight gain over time. The definition of madness is doing the same thing and expecting a different result. Stop the madness!” Zoë Harcombe

“If Ms. Parker-Pope is correct, I must be some sort of freak! I struggled with my weight for many years. However, when I started restricting carbohydrates in my diet, especially those derived from grains, I lost weight quickly and kept it off for 6 years. In addition, I lowered my triglycerides, improved my cholesterol ratio, boosted my energy, increased my immune function and stopped having painful kidney stone attacks that I had experienced every 2 years from age 25 to 42. I agree that people who are overweight should not be disparaged for their metabolic condition, particularly when they are encouraged by the USDA to eat precisely those foods that will cause them to gain weight. However, to suggest that people have no control over their weight or wellness is irresponsible. I feel so empowered since I discovered that I CAN influence my health by eating what my body needs – virtually the opposite to what is recommended by the USDA: high fat, low carbohydrate, plenty of salt.“ Adrienne Larocque, PhD, Healthy Nation Coalition

“Ms. Parker-Pope’s article was really excellent in many respects. I applaud her honesty and her citations of some important studies as well as her superb writing style. The insulin-obesity axis is so well-established, however, that the public NEEDS to know about it. While dietary needs can vary from person-to-person, depending on age, sex, lifestyle, etc., and there is not a one-size-fits-all optimum diet, the role of insulin in weight gain is solid science. What is most telling is the fact that so many physicians have switched to advising their patients to restrict carbohydrates and raise fat in the diet, based on positive results in the short-term AND long-term. Also, this approach is backed up by our understanding of the biochemistry of insulin.” Wendy Pogozelski, Professor, Department of Chemistry SUNY Geneseo

“The cause of obesity is well known. It occurs in those with insulin resistance (carbohydrate intolerance) when they eat more than about 80 grams of carbohydrate per day. As one with insulin resistance I have been able to return my body to my adolescent weight, to exercise vigorously and to reverse my pre-diabetic state by rigorously restricting my carbohydrate intake and eating as much fat and protein as I like. This personal experience confirms what Gary Taubes and others have described in their books and scientific works.” Professor Timothy Noakes OMS, MBChB, MD, DSc, PhD (hc), FACSM, (hon) FFSEM (UK) Department of Human Biology, University of Cape Town, South Africa

“The New York Times could help resolve this issue by holding a conference in which the “two worlds” discuss the issues. The NIH, USDA, AHA, etc. have consistently refused to discuss things with those who work in dietary carbohydrate restriction.” Richard David Feinman, State University of New York Downstate Medical Center

“Mr. Taubes provides a persuasive rebuttal to “The Fat Trap,” worthy of our support. In recent decades Americans embraced a diet once reserved for fattening meat pigs and other livestock, placing human health, productivity and our economy in peril. Even prior to 1912 Cornell University reported optimal obesity gains in swine (omnivores, like us) when fed with corn, kafir corn and grain middlings (carbohydrates) plus skim milk (low fat). We must reverse this trend by reducing carbohydrates and increasing natural fats if we are to rescue the health of our nation.” Ann M. Childers, MD

“The majority of health professionals prefer carbohydrates to fats in dealing with obesity and illnesses is because they have forgot that it is blood glucose in excess being converted into fats with the help from insulin. Replacing carbohydrates with fats and proteins helps increase satiety and decrease the calorie intake, thus facilitate weight loss without the need of starvation. It is a shame that these health professionals have forgot what they learned in biochemistry 101.” Robert K. Su, Pharm.B., M.D. (www.carbohydratescankill.com)

“Ms Parker-Pope is herself a classic example of why the obesity epidemic persists and worsens. Even the most intelligent, well educated, and successful members of our society have accepted as truth the misbegotten beliefs and antiquated bad science perpetuated by politicized governmental authorities and profit driven food manufacturers. Our society must change it’s attitude and beliefs before it can change its weight! The public must reject the celebrity “doctors” and glossy magazine propaganda, and seek out the small but growing number of medical experts in the specialty of non-surgical Bariatric Medicine.” Michael D. Kane D.O., ASBP

“Believe it or not. This is the state of the art. Yet most of American Medicine does not yet perceive or understand it.” Geoffrey V Drew M.D. ASBP

“My research confirms that this petition needs to be read by everyone.” Nancy Appleton, PhD, author of Suicide By Sugar.

“While this analysis is clearly a little oversimplified, from my over 15 years of clinical experience with what does, versus does not work to dramatically reduce the problems humans have with obesity, atherosclerosis progression (which, as has been known for decades to begin, on average, in later childhood, about age 7) and eventually clinically obvious cardiovascular disease and cardiovascular disasters, this statement is clearly much closer to reality than many of the myths which have long been promoted by the medical industry. The medical industry largely focuses on symptoms and advanced disease, i.e. failure, not success. I have long found it sadly interesting (demoralizing actually) the extent to which many issues promoted by the medical industry do not promote the best interests and success of the people we are supposed to be helping. Correct understandings of how our clients can best protect their interests and keep down costs for treating end-stage disease complications (often in expensive yet relatively ineffective ways) is relatively rare. Instead, oversimplified and misleading information often seems to dominate.” Milton E. Alvis, Jr., M.D.

“My family has a significant degree of genetic insulin-resistance which has resulted in obesity, “Type II Diabetes” (including my father and grandfather who died from complications), mood, energy and eating disorders (chronic fatigue, ADHD, and bulimia) high blood sugar, and GI issues. My siblings and children have seen near complete reversal of all of these issues with the adoption of low-carb lifestyles over the past 12 years. I hope Tara Parker-Pope and her readers will all benefit from the wisdom of this letter, as my children and I have.” Peggy Holloway

“The 2010 NHANES data just released has the prevalence of adult obesity at over 35% for both sexes. That the prevalence of obesity and diabetes has increased THREE FOLD since Americans were first counseled to eat less calories, eat low-fat and exercise more thirty years ago is surely not a coincidence. Continuing with these ineffective and possibly obesity-causing public health recommendations is, as Einstein would say, the definition of insanity. It is time for the government to swallow its pride and start funding research to examine the best current alternative hypothesis to explain metabolic syndome: that refined carbohydrates, sugars and starches, have caused this epidemic of metabolic syndrome. Our obese and diabetic citizens, many of whom are economically-disadvantaged, deserve better from our government and the public health community.” Robert Wright, University of Georgia, College of Public Health

“After reading Taubes book I read a variety of textbook and articles on fat metabolism and agree with his conclusions. In addition, one friend who used this information to lose and keep off 40 pounds, also got rid of his Non-alcoholic steatohepatitis (NASH), possible another advantage of reducing insulin levels.” Frank McCullar, MD


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