It has to be said that most of these concerns were voiced by people in commerce who stood to lose from such a marked change in diet, but there have been so many scare stories that it is only right that we attempt to dispel these concerns. In this page are typical concerns that have been raised by doctors, nutritionists and sceptics of low-carbohydrate diets recently to show how we are misinformed and misled.

Q: Won't eating more fat raise my cholesterol and triglycerides and increase my risk of heart disease?

A: No, quite the opposite. Of all our nutritional mantras, the one most widely and emphatically proclaimed is the relationship between saturated fats and coronary artery disease. You would think a 'fact' so ingrained in our social psyche would be supported by mountains of evidence.

However, the reality is that the data to support the diet-heart hypothesis lies somewhere between flimsy and non-existent. In an extensive review of existing studies, a Swedish doctor, Uffe Ravnskov, who specialises in the this field of medicine, came to the conclusion that:

In a similar review, Dr Mary Enig, Consulting Editor to the Journal of the American College of Nutrition, President of the Maryland Nutritionists Association, and an expert on fats and oils, was also unable to find a convincing relationship between saturated fat consumption and coronary disease. Dr Enig says:

She came to the conclusion that the causative factor was more likely to be the inordinate increase in trans fatty acid consumption from vegetable margarines and cooking oils. Yet they are the so-called 'healthy' ones.

Conventional wisdom tells us that high levels of blood cholesterol are to blame for the alarming incidence of heart disease throughout the industrialised world, and that animal fats are the cause of that elevated cholesterol. There is now such a strong 'cholesterolphobia' engendered by establishment propaganda in the population over the past several decades that 'fat', once called 'the most valuable food known to Man', by the late Dr John Yudkin, Professor of Nutrition and Dietetics at London University, has now been turned into a four letter word. We have all been brainwashed into believing that eating foods with any type of fat will raise cholesterol in everyone who eats them. However, saturated and mono-unsaturated fats have never been shown to cause heart disease. Only hydrogenated, polyunsaturated vegetable margarines and cooking oils have. Despite this, because they lower cholesterol, they are thought of as 'healthy'!

Q: Will eating more protein increase my risk of heart disease?

A: No, quite the reverse! We should make clear that the way of eating recommended in this video is not high-protein, merely moderate or adequate protein. Having said that, however, researchers at the Harvard School of Public Health answered this question when they studied 80,082 women aged between thirty-four and fifty-nine without any previous indication of heart disease.3 When all other risk factors for heart disease were controlled for, and irrespective of whether the women were on high- or low-fat diets, the results showed that both animal and vegetable proteins contributed to a lower risk of heart disease. The researchers concluded:

Q: Will everyone's blood fats respond the same way to reducing carbohydrates and increasing protein and fat?

A: Why not? Although we do have slightly different reactions to different foodstuffs because of our different evolutionary backgrounds in different parts of the world, we are all one species and all designed to eat essentially the same foods. All the trials of low-carb diets have found dramatic benefits wherever, and on whom, they have been conducted. But if you are concerned about this, have a blood test before you begin this way of eating and another three or four months into it to reassure yourself.

Q: Will eating more protein and less carbohydrate damage my kidneys?

A: Not unless you already have diseased kidneys. The claim that protein intake leads to kidney stones is another popular myth that is not supported by the facts and there is not one study in which such damage has been demonstrated - not one. Although protein restricted diets are helpful for men who already have kidney disease, eating meat does not cause kidney problems.4 With women the situation is different: It doesn't seem to matter whether women have kidney disease or not, protein neither causes nor worsens the condition. Furthermore, the fat-soluble vitamins and saturated fatty acids found in animal foods are necessary for properly functioning kidneys.5 In an Israeli study, the kidney function of a group of healthy individuals consuming an ad libitum high-protein diet was compared to a group of healthy vegetarians eating a low-protein diet. At the end of the study, the authors concluded that protein does not affect kidney function in normal kidneys, and it does not influence the deterioration of kidney function with age.6 They say that 'These results suggest that, in contrast with the important therapeutic effect of low-protein intake on the progressive deterioration of kidney function in diseased kidneys, such a diet does not significantly affect kidney function with "normal aging" in healthy subjects.'

On the other hand, sugar has been implicated in kidney disease.7 So the answer is to give up simple sugars - table sugar, honey and fruits.8
If you're unsure whether your kidneys are healthy, consult your doctor before changing your diet.

Q: Can a reduced-carbohydrate / higher-protein plan lead to osteoporosis?

A: No, a low-carb diet reduces the risk of osteoporosis. In certain sections of the nutritional world, there seems to be a belief that if we eat animal protein this will cause our bones to lose calcium. This question is of particular interest in light of Palaeolithic diet research for two related reasons. The first is because estimates of the levels of animal protein in the hominid diet during at least the last 1.7 million years of human evolution (from the time of Homo erectus) are much higher than considered 'healthy' in some sectors of the nutritional research community today. The second is because the fossil evidence shows that Palaeolithic humans had a higher bone mass that would have been more robust and fracture-resistant than modern Western human's bones.

When studies were done with people eating meat together with its fat, no calcium loss was detected, even over a long period of time.9 Other studies confirmed that meat eating does not adversely affect calcium balance10 and that protein actually promotes stronger bones. 11

Researchers at Tufts University in Boston studied the bone density of 342 elderly men and women who were taking calcium and vitamin D and found that bone density improved most in the participants who ate the most protein, including animal proteins.12 The lead researcher, Dr Bess Dawson-Hughes, said: 'Excess protein intake should be bad for bone, but the results of the study suggest that concerns about protein intake are probably unfounded.' She admitted that the study and other published research 'go a long way toward refuting' concerns that animal protein is bad for bones.

A year later a similar study looked again at this question.13 Researchers at the Bone Metabolism Unit, Creighton University School of Medicine, Omaha, concluded that 'the results of the present study in postmenopausal elderly women suggest that a higher protein intake as a percentage of energy is associated with higher BMD [bone mass density] in the presence of an adequate calcium intake. . . Our results suggest that in the elderly, who are at the highest risk of osteoporosis, a higher protein intake is important for the maintenance of good bone health.'

Recent evidence shows that men and women who ate the most animal protein had better bone mass compared to those who avoided it.14 The evidence also showed that vegan diets containing no foods from animal sources place women at a greater risk for osteoporosis. 15

Protein powders
The studies that purported to show that calcium loss from bone was greater in people who ate lots of protein were not conducted with real, whole foods but with isolated amino acids and fractionated protein powders. The reason why the amino acids and fat-free protein powders caused calcium loss while the fat meat diet did not, is because protein, calcium and other minerals require the fat-soluble vitamins A and D for their assimilation and utilisation by the body. When protein is consumed without these other nutrients, it upsets the normal biochemistry of the body and mineral loss may be the result.16 True vitamin A and full-complex vitamin D are only found in animal fats. Furthermore, saturated fats that are present with meat are essential for proper calcium deposition in the bones.17

To sum up: a high-protein diet is beneficial in osteoporosis. But it must be the right kind of protein. Many popular low-carb plans suggest eating special 'low-carb' foods such as whey powder, soya protein isolates, high-protein smoothies and protein bars. But what the protein-causes-osteoporosis hypothesis really teaches us is avoid these and to eat meat with its fat.

Q: Does the plan in this video contain all the nutrients I need to protect my bones?

A: Yes. This eating plan is high in protein and calcium- and magnesium-rich foods like cheese, dark green leafy vegetables, almonds, Brazil nuts, salmon and sardines.

There is just one caveat: Vitamin D is needed to metabolise calcium and there is very little Vitamin D in any foodstuffs. Our bodies make it from the action of sunlight on the skin. It is also made in other animals the same way. This is why the best foods are animal fats and full-fat dairy products (D is a fat-soluble vitamin) - so long as animals are kept outside. It is also a good idea to get out in the sun as much as possible so that your body can make vitamin D naturally.

Q: I have heard that you can eat more meat on a reduced-carbohydrate plan. I am concerned about eating more meat because I've also heard that there is a link between meat and cancer. Is this true?

A: No. The evidence suggesting that meat-eaters have more cancer came largely from just one study that looked at vegetarian Seventh Day Adventists. 18 They did have less cancer than the average American population. But a similar study among meat-eating Mormons found that, in them, cancer was even lower than that of Seventh Day Adventists.19 It seems that stress plays a large part in cancer and many other conditions. What the various studies show is people who belong to supportive groups, such as tightly knit religious groups, have a lower incidence of these diseases regardless of what they eat.

Q: But doesn't the latest research prove that a high animal fat diet increases the risk of breast cancer?

A: No, it doesn't. In July 2003 two studies were published just two days apart. They both said that animal fats increased breast cancer risk, and that is how they were widely reported by the media.
On 15 July, a New York Times headline proclaimed 'Animal Fats Linked to Increased Breast Cancer Risk, Study Finds'. This story was about a study from Harvard University.20 The researchers had concluded that: 'Intake of animal fat, mainly from red meat and high fat dairy foods, during premenopausal years is associated with an increased risk of breast cancer.' But that's not what their figures showed.

If eating animal fat increased the risk of breast cancer, one would expect that women who ate more animal fat would have more breast cancer. That was clearly not the case in this study. The researchers split the numbers of women in the study into five groups depending on the amounts of animal fat they ate. While the women in the lowest group had the least cancer, their figures show that women in the middle group had more breast cancer than women in the highest group. That is the first sign that something is not quite what it should be. The second is that the range of findings cuts across 1.0 (below 1.0 denotes benefit; above 1.0 denotes harm; and 1.0 means neither benefit nor harm). This indicates that the figures may not be significant. As the researchers gave the total numbers of women in each of the five groups, together with the numbers with breast cancer, what the figures show is that the percentage of women who did not get breast cancer was:

It's hardly something to get excited about. But there is more: This study followed one published only four months earlier from the same study by the same people.21 This time the risk of breast cancer was studied in relation to meat, fish and egg intake. It showed no increase in breast cancer. Strangely, this earlier study finding was not mentioned in the later one.

The second study, published in the Lancet just two days later,22 was also reported as providing 'conclusive proof that a high animal fat diet causes breast cancer' but, again, it is nothing like conclusive! The figures reveal a similar pattern to the American study. Rising breast cancer as animal fats increase a little, then falling again as animal fats are increased more.

What these studies don't tell us is probably more important than what they do. For example, how did the women eat their animal fat? Let's look at a possible scenario. Butter contains conjugated linoleic acid, which prevents cancer. Bread, on the other hand, increases cancer risk. So it could be that those who didn't eat butter or the bread it would have been on had little cancer; those who spread butter thinly on their bread had an increased risk over those who ate no butter, but as butter was spread thicker, the anti-cancer effect of the butter took over and reduced the cancer risk from the bread. Just a thought.

A: Quite the reverse. Fatigue and energy loss are usually signs of low blood sugar. The correct low-carb approach will keep your blood sugar levels stable. Carbs are usually thought of as 'energy foods', and it is true that carbs do provide energy. But they don't provide the best energy. Fats do that. And fat is what you should eat to replace the energy lost from carbs.

The people who experience fatigue at the beginning are those on other plans which cut carbs too low to start with - levels as low as 20 grams are common. This is why we recommend 50-60 grams. At this level these symptoms are avoided. That means cutting down on carbs, but not cutting them down too much.

Q: Does restricting carbohydrates cause headaches?

A: Not if you don't cut down too much. It was thought that the brain used only glucose as an energy source. But recent research from Japan has demonstrated that it can also use fats just as well.23 All the reports of headaches are associated with diets which cut down drastically on carbs at the start. The transition from one kind of fuel to another can cause problems if that change it too drastic. This is another reason not to cut carbs too much to begin with.

Q: Is my breath going to smell funny on this diet?

A: No. The 'badgers' breath' associated with one popular low-carbohydrate diet is not a problem on this plan because the carbs are not so restricted. This video advocates a lower-carb approach by avoiding refined carbohydrates. It is only very severe carb restriction that triggers the 'ketosis' which causes smelly breath.

Q: But doesn't a low-carb diet cause ketosis?

A: Yes and No. Ketones are a class of compounds that are quite normal products of fat metabolism. They can be oxidised in the body to provide a source of energy. However, elevated levels of ketones - which cause overt ketosis - can occur when there is an imbalance in fat metabolism. People unable to use glucose as an energy source - diabetics for example - tend to suffer from this condition. It is also found in people who are starving. Some low-carb approaches for weight loss actively promote ketosis by reducing carbs to extremely low levels: less than 20 grams a day. We do not believe it is desirable, and have not found it necessary, to go to such extremes.

In the case of diabetes, the level of ketones in the blood is very high, often over 3,000 mg per litre. The level of ketones in the blood of someone on the way of recommended in this video is insignificant compared to this, even lower than in a person who is fasting or on a low-calorie diet. In the clinical trials of a high-fat, low-carb diet, ketosis never proved to be a problem.

History tells us that Man, in many parts of the world, has lived, and still does live, healthily on dietary regimes that exclude all carbohydrates except the minute amount that is found in meat. The 60 grams of carbohydrate a day that are included in this plan are more than enough to allay any fears.

Q: Should I expect to be constipated?

A: No. The liberal use of green, leafy vegetables, both cooked and as salads, will ensure that you are not constipated. Drinking at least 2 litres (3 ½ pints) of water will also have a similar effect.

Q: My friend had to have a gallstone operation and was told go on a low-fat diet. I have also been told that eating lots of fat causes gallstones. Will I develop gallstones eating this way?

A: Quite the reverse - a fatty diet actually prevents gallstones. Fair, fat and forty. That is the general perception of someone with gallstones. For this reason gallstones, often found in fat people, are usually attributed to a diet high in fats. In fact this is the opposite of the truth: Gallstones are caused by eating too little fat rather than too much.

Fats are not soluble in water. Before dietary fat can be digested, it has to be emulsified. Bile is used for this purpose. The liver makes bile continuously and stores it in the gall bladder until such time as it is needed - fats in the gut. However, if a low-fat diet is eaten, that bile remains in the gall bladder. Gallstones are formed when the gall bladder is not emptied on a regular basis. In people who continually resort to low-fat diets, bile is stored for long periods in the gall bladder - and it stagnates. In time - and it is really quite a short time - if the gall bladder isn't emptied, a 'sludge' begins to form. This then coagulates to form small stones which then become bigger. The speed with which this happens was dramatically demonstrated in a trial at several American University hospitals.24 None of the subjects had any sign of gallbladder disease at the start of the study. However, after only eight weeks of weight-reduction dieting, more than a quarter had developed gallstones. Where they were fed intravenously, half developed gall bladder sludge after 3 weeks, and all had developed sludge by six weeks. Nearly half of those who developed sludge also developed gallstones.

Missing breakfast may also increase the risk of gallstones. In a study of French women with gallstones, it was found that they fasted on average for two hours longer overnight than women without the disease.25
Eating fat prevents gallstones; low-fat dieting is the cause. If the gall bladder is still intact after the removal of gallstones, then a high fat diet should be eaten to prevent a recurrence. A person with no gall bladder can still eat fats as the liver still produces bile but digestion may be affected. The pain that someone with gallstones gets is when these are passed through the bile duct with the bile in response to a fatty meal and get stuck.

So, it is a low-fat diet which causes the gallstones, but it is eating a high-fat diet that makes them apparent. If you eat a low-fat diet and never eat fat again, then you won't get the pain, even though the stones are there. Thus the doctor who says that the gallstones were caused by high-fat is actually saying that the symptoms were caused by the fat.

If someone suffers from gallstones, a low-fat diet 'prevents' the symptoms, so doctors often suggest such a diet. But it makes the cause of the symptoms (gallstones) worse. Doctors are often loath to operate to remove the stones, so just preventing you knowing about them seems to them to be a good compromise - despite the fact that you will then be miserable and hungry as a result!

Q: But how can a diet that cuts out a whole food group be a balanced diet?

A: Those who complain that this way of eating is not a balanced diet, or that it cuts out a whole food group, don't understand what a balanced diet is. You will realise just how necessary a 'balanced' diet is when you consider that in many parts of the world large groups of hunters live quite healthily on nothing but a small part of one group: meat. And that observation is not confined to those one might call primitives - the Eskimo and Maasai for example. European explorers such as Viljalmur Stefansson and Karsten Anderson found that they remained perfectly healthy over 18 years merely on fat meat and water; the gauchos of Argentina, mainly descendants of European settlers, are near to being pure carnivores, as they live healthily almost exclusively on beef. Obviously, the 'balanced' diet so beloved of dieticians is not so important after all.

The truth is that a balanced diet is any diet that supplies all the nutrients the body requires, in the proportions it requires. A diet of fresh meat alone, if offal and fat are included, can do just that. Liver, for example, contains four times as much vitamin C as either apples or pears; and kidney is nearly as good. This plan, however, goes much further in that carbohydrate intake is not banned, merely reduced. It is, in all respects, a balanced diet.

Q: But eating a lot of fat makes me queasy.

A: Some may say that they find a high-fat diet nauseating. They associate the word 'fat' with blubber or greasy food. It is noticeable, however, that they usually have no difficulty eating fat if it is called 'butter' or 'cream', or served to them as bacon. The person who cannot stand 'greasy food' usually has no problem eating chocolate.

If you really cannot stand the sight of visible fat on a succulent piece of meat, you can avoid offending your palate by choosing foods that are high in invisible fats or the acceptable fats that you eat now. After a while you will find that you will come to relish the crackling on pork, the skin on chicken or the fat on a piece of roast beef and you will be back to the ideal way of eating. At this stage fat will only make you feel nauseous if you try to eat more of it than your body wants. And that is what we want it to do: it's your body's signal that it has had enough. Listen to your body, stop eating when it tells you, and fat will not be a problem.
You may also find that your diet is 'healthier' in the conventional sense. You will see in the video that one of our dieters said that before she started to eat this way she didn't like vegetables. She did eat them because she was told that '5 portions' of vegetables were 'healthy', not because she liked them. Since starting to eat this way, however, now that she can fry vegetables or put olive oil or butter on them, she enjoys vegetables so much that she is actually eating more than she did before. 'It's opened up a whole new world to me' she said.

A: It may actually work out cheaper. Carbohydrate foods such as potato crisps or bread and jam tend to be more readily available for snacks than meat and cheese. It is easier, therefore, to overeat sweet, carbohydrate-rich foods - and it doesn't help that sugar is addictive. This can be a problem when you are eating what you are used to, and when well-meaning friends press such food on you. Sweet and starchy foods are also cheaper to buy as far as bulk is concerned. But anyone prepared to spend good money on unnecessary slimming clubs and magazines would be better advised to spend that money on good, wholesome food. It need cost no more than slimming club membership fees. By eating properly, you will not get hungry and are much less likely to snack on sweets - which will reduce your costs.

And the food itself can actually cost less. For example, at the time of writing, three peppers - one red, one yellow and one green, which is how supermarkets sell them - cost the same as six extra large eggs or six duck eggs. The better value in the eggs is tabled below:

In other words, in energy terms and the length of time you can keep going until you start to get hungry, you would need to spend over three times as much on peppers as you would on eggs. And the eggs will also provide all the other nutrients your body needs with the exception of vitamin C.

Q: But can I be sure it's safe? There are no long-term clinical trials of your diet.

A: There are no such trials of a parachute preventing the death of a person falling due to gravity. But do we need one? Can't we see from mere observation that parachutes slow descent and prevent deaths due to hitting the ground?

Observations over the past century or so have shown that where humans live with a natural diet such as recommended in the video, they get none of the 'diseases of civilisation' we do. Do we really need more evidence? And would a dietary trial, artificially conducted in a clinical environment, be as relevant as looking at the real thing?

In fact there are lots of trials supporting this way of eating. What those who say there are no trials conveniently forget to mention that there are no long-term trials of 'healthy eating' either.

Conclusion
Over the past century or so, many studies have looked at possible adverse effects from eating a low-carb, high-fat diet. Not one has ever demonstrated that such a diet is anything but beneficial.

References

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