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The Case for Keto: Rethinking Weight Control and the Science and Practice of Low-Carb/High-Fat Eating
The best-selling author of Why We Get Fat and The Case Against Sugar reveals why the established rules about eating healthy might be the wrong approach to weight loss for millions of people, and how low-carbohydrate, high-fat/ketogenic diets can help so many of us achieve and maintain a healthy weight for life.
Based on twenty years of investigative reporting and interviews with 100 practicing physicians who embrace the keto lifetstyle as the best prescription for their patients' health, Taubes's book puts the ketogenic diet movement in the necessary historical and scientific perspective. It makes clear the vital misconceptions in how we've come to think about obesity and diet (no, people do not become fat simply because they eat too much; hormones play the critical role) and uses the collected clinical experience of the medical community to provide essential practical advice. This book sets out to revolutionize how we think about eating healthy, and what foods we can and can't eat to prevent and reverse both obesity and diabetes.
For years, health organizations have preached the same rules for losing restrict your calories, eat less, exercise more. So why doesn't it work for everyone? Gary Taubes, whose seminal book Good Calories, Bad Calories and cover stories for The New York Times Magazine changed the way we look at nutrition and health, sets the record straight, clarifying a century of misunderstanding about the differences between diet, weight control, and health. The Case for Keto gives us a revolutionary manifesto for the twenty-first-century fight against obesity and diabetes.
Based on twenty years of investigative reporting and interviews with 100 practicing physicians who embrace the keto lifetstyle as the best prescription for their patients' health, Taubes's book puts the ketogenic diet movement in the necessary historical and scientific perspective. It makes clear the vital misconceptions in how we've come to think about obesity and diet (no, people do not become fat simply because they eat too much; hormones play the critical role) and uses the collected clinical experience of the medical community to provide essential practical advice. This book sets out to revolutionize how we think about eating healthy, and what foods we can and can't eat to prevent and reverse both obesity and diabetes.
For years, health organizations have preached the same rules for losing restrict your calories, eat less, exercise more. So why doesn't it work for everyone? Gary Taubes, whose seminal book Good Calories, Bad Calories and cover stories for The New York Times Magazine changed the way we look at nutrition and health, sets the record straight, clarifying a century of misunderstanding about the differences between diet, weight control, and health. The Case for Keto gives us a revolutionary manifesto for the twenty-first-century fight against obesity and diabetes.
306 pages, Kindle Edition
First published April 28, 2020
820 people are currently reading
3367 people want to read
About the author
Gary Taubes
25 books770 followersGary Taubes is an American science writer. He is the author of Nobel Dreams (1987), Bad Science: The Short Life and Weird Times of Cold Fusion (1993), and Good Calories, Bad Calories (2007), titled The Diet Delusion (2008) in the UK and Australia. His book Why We Get Fat: And What to Do About It was released in December 2010. In December 2010 Taubes launched a blog at GaryTaubes.com to promote the book's release and to respond to critics. His main hypothesis is based on: Carbohydrates generate insulin, which causes the body to store fat.
Taubes studied applied physics at Harvard University (BS, 1977) and aerospace engineering at Stanford University (MS, 1978). After receiving a master's degree in journalism at Columbia University in 1981, Taubes joined Discover magazine as a staff reporter in 1982. Since then he has written numerous articles for Discover, Science and other magazines. Originally focusing on physics issues, his interests have more recently turned to medicine and nutrition.
Taubes's books have all dealt with scientific controversies. Nobel Dreams takes a critical look at the politics and experimental techniques behind the Nobel Prize-winning work of physicist Carlo Rubbia. Bad Science is a chronicle of the short-lived media frenzy surrounding the Pons-Fleischmann cold fusion experiments of 1989. [wikipedia]
Taubes studied applied physics at Harvard University (BS, 1977) and aerospace engineering at Stanford University (MS, 1978). After receiving a master's degree in journalism at Columbia University in 1981, Taubes joined Discover magazine as a staff reporter in 1982. Since then he has written numerous articles for Discover, Science and other magazines. Originally focusing on physics issues, his interests have more recently turned to medicine and nutrition.
Taubes's books have all dealt with scientific controversies. Nobel Dreams takes a critical look at the politics and experimental techniques behind the Nobel Prize-winning work of physicist Carlo Rubbia. Bad Science is a chronicle of the short-lived media frenzy surrounding the Pons-Fleischmann cold fusion experiments of 1989. [wikipedia]
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January 26, 2021We interviewed Gary Taubes about this book in episode 308 of the "Happier with Gretchen Rubin" podcast. As I write about in my book about habit change, "Better Than Before," Taubes's work changed my life (and my father's life).
October 29, 2020
With his characteristic clarity and persuation, Gary Taubes extrapolates on his previous work that has focused on the correlation between obesity/weight gain and sugars & starches. This isn't a diet book; rather, it is a 101 on how the science behind LCHF ways of eating makes these approaches appropriate for many obese or overweight individuals who have not seen success with conventional wisdom (e.g. eat less, exercise more). I would definitely recommend this as a good place to start for folks who are dipping their toes into the world of keto, paleo, or LCHF, and I appreciate that this focuses on the foundational science concepts rather than a lot of specific praxis
December 29, 2020
I read a lot of health and diet books from all sides and am generally skeptical of most of them. I've been familiar with the keto diet since before it was a weight loss "fad" and recommended it in my health and parenting columns years ago as something to look into for parents of children with uncontrolled epilepsy since that's what doctors at the Mayo Clinic designed it for originally, nearly a hundred years ago now. It was astonishingly effective for those children without the devastating side effects of the drugs they generally were prescribed instead. But I was just never convinced that it was a safe and practical diet for weight loss, especially long term -- until this book.
Taubes' depth of research is remarkable. He goes all the way back, sometimes to the 1800's or earlier, looking at what has worked and what hasn't, what doctors know and what they've just always assumed, and what studies have shown. He explains very succinctly why carbohydrates trigger the release of insulin and the message to quickly store food as fat, and that the threshold is different for different people. He tells the stories of countless formerly obese people who regained their health and got to healthy weights by eating LCHF/keto diets. He does what most keto diet books don't do too, by discussing murkier issues like cholesterol, the effects of this kind of eating on the planet, limits of the diet, what we don't know about long term effects, what further tweaks might be needed, what the studies say, and so on. With other keto books, I always found myself asking things like why the Mediterranean diet works so well for so many. Taubes answers that. He also interviewed over 140 physicians and others who use the diet to treat hundreds of thousands of patients, and he's used the diet himself for decades to stay healthy. He gives practical advice and focuses on doing keto in a healthy way.
My late mother had Cushing's Disease and a brain tumor that caused uncontrolled weight gain. I remember her eating a near-starvation level of calories and still gaining weight. She spent hours jumping on a trampoline and doing aerobics, and still got more and more obese. I remember how people treated her and the assumptions they made about her, and the doctor who fired her because he told her "I don't like fat people." I also watched my disabled husband head to the gym every single day for nearly a year and carefully monitor his eating and still lose just token weight. He and I used to eat roughly the same amount of food, and he was well over 200 pounds while I was barely over 100 (though hitting my 40's helped even out things). The advice of eat less and move more just quite simply doesn't work for many people, and this book helps explain why.
Well recommended, especially for skeptics who need lots of research and science to back up the claims.
I read a temporary digital ARC of this book for review.
Taubes' depth of research is remarkable. He goes all the way back, sometimes to the 1800's or earlier, looking at what has worked and what hasn't, what doctors know and what they've just always assumed, and what studies have shown. He explains very succinctly why carbohydrates trigger the release of insulin and the message to quickly store food as fat, and that the threshold is different for different people. He tells the stories of countless formerly obese people who regained their health and got to healthy weights by eating LCHF/keto diets. He does what most keto diet books don't do too, by discussing murkier issues like cholesterol, the effects of this kind of eating on the planet, limits of the diet, what we don't know about long term effects, what further tweaks might be needed, what the studies say, and so on. With other keto books, I always found myself asking things like why the Mediterranean diet works so well for so many. Taubes answers that. He also interviewed over 140 physicians and others who use the diet to treat hundreds of thousands of patients, and he's used the diet himself for decades to stay healthy. He gives practical advice and focuses on doing keto in a healthy way.
My late mother had Cushing's Disease and a brain tumor that caused uncontrolled weight gain. I remember her eating a near-starvation level of calories and still gaining weight. She spent hours jumping on a trampoline and doing aerobics, and still got more and more obese. I remember how people treated her and the assumptions they made about her, and the doctor who fired her because he told her "I don't like fat people." I also watched my disabled husband head to the gym every single day for nearly a year and carefully monitor his eating and still lose just token weight. He and I used to eat roughly the same amount of food, and he was well over 200 pounds while I was barely over 100 (though hitting my 40's helped even out things). The advice of eat less and move more just quite simply doesn't work for many people, and this book helps explain why.
Well recommended, especially for skeptics who need lots of research and science to back up the claims.
I read a temporary digital ARC of this book for review.
January 25, 2021
I don't read diet books, I read Gary Taubes books.
Taubes is a fantastic journalist and author with a focus over the last 20 years on diet and nutrition. I've read Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease (review), The Case Against Sugar (review), and Bad Science: The Short Life and Weird Times of Cold Fusion (review - this one from 1993 pre-dates his fixation on eating, but sets up his credibility as a great scientific and investigative journalist).
The Case for Keto reads like a more accessible and less technical edition of Good Calories, Bad Calories. It's shorter by half. It's packed full of new info, research and interviews regarding LCHF (low-carb, high-fat) eating and its impacts- Taubes uses the term "LCHF/ketogenic" consistently throughout. As he writes in the intro, this book is a work of journalism masquerading as a self-help book. There are no recipes.
What consistently blows my mind when reading Taubes is how slow the medical establishment is to abandon the "dietary fat is bad" idea, that (Taubes shows) was instantiated in the 1950s with virtually no evidence. Why should we care? This hypothesis, along with the also-unsubstantiated "energy balance" theory of metabolism and dieting (i.e. calories in = calories out) and a non-uncommon perception that "a calorie is a calorie" have caused a terrific amount of misery for eaters, myself included.
How? Why? If the ground rules for "healthy eating" laid out by the medical establishment are valid, why are we in an obesity epidemic? Taubes, nor I, think Frito Lay and Pepsi are solely to blame. Cutting back on dietary fat is a double edged sword: you reduce satiety (fat is the most "filling") and you have to displace fat with something else - usually carbs. As we learned in Good Calories, Bad Calories, carbs (especially refined carbs) are quickly metabolized into the bloodstream as glucose, elevated blood sugar causes the pancreas to secrete insulin, insulin prompts your body to burn carbs for fuel (also causing a hunger response) AND store glucose as glycogen and fat AND hold onto the fat it already has. So "low fat" diets CAN (not always) make it super difficult to lose weight. Low on fat = higher on carbs = body in carb burning, fat-storing mode.
Taubes goes into detail on is what ketosis is (the state where your body switches from storing fat to burning fat) and how one can get into that state. He covers endless studies and interviews endless physicians who have used HCLF/ketogenic diets to treat patients with obesity and type 2 diabetes and related symptoms to see those conditions and their related medications disappear. The second-last chapter on how to start LCHF/ketogenic habits was a bit weak, but the rest of the book was solid.
What's fascinating about LCHF/ketogenic is that these foods are more satiating (think: I can eat a Costco bag of Ruffles All-Dressed Chips, but only a few huge slices of cheddar cheese) AND keep you in the ketogenic, fat-burning state and out of fat-storage mode. This is the SECRET KNOWLEDGE that's been peddled through books like Atkins and Wheat Belly and most diet books, but Taubes backs it up with the science, not the woo-woo bullshit.
I get super worked up reading Taubes (then writing afterwards) because I feel like for most of my life, most health authorities' eating programs are mystical "woo-woo" BS that work for some people, not for others. In doctor's offices and online weight-loss communities, "calories in = calories out" is unquestionable dogma because it works for some people. But imagine we're all biological beings with different trigger levels for entering a ketogenic (fat-burning) state? Imagine a slight imbalance in insulin (or other hormones - sex hormones also affect weight) that makes it a bit harder to exit fat storage and enter fat-burning mode?
So picture me in early 2015, at 250 lbs, over 30 BMI, the definition of obese! I started counting calories under the calories in = calories out dogma and lost over 50 pounds that year. For all of 2016, 17 and 18 I counted calories to maintain that weight loss. Every meal. So counting calories works, but very often I'm feeling hungry, very often not feeling full, and it's really intrusive and time-consuming. In late 2018 I read Good Calories, Bad Calories and the light bulb went off! Here is the SECRET KNOWLEDGE about how your body ACTUALLY METABOLIZES MACRONUTRIENTS! If you know how the system works you can address it with high-level solutions, not band-aids and artificial constraints (like how I now view counting calories). Now I just eat less carbs (not no carbs), way more satiating (high-fat) foods and I've stayed on setpoint with ease since then. Always full, never hungry.
I am not sharing my personal details to humble-brag or get internet points, but because I know there are other analytical thinkers like me who would benefit from this SECRET KNOWLEDGE. If you dive deep and try to understand the scientifically well-understood mechanisms of fat storage and metabolism, Taubes' hypothesis and messages seems not only plausible, but so crystal-clear you'll be as angry as I am for not learning any of this in school, or seeing food guides that recommend 5-7 servings of grains and cereals per day when we KNOW WHAT THOSE DO TO OUR BODIES.
tl;dr recommended reading for husky analytical people (or anyone)
Taubes is a fantastic journalist and author with a focus over the last 20 years on diet and nutrition. I've read Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease (review), The Case Against Sugar (review), and Bad Science: The Short Life and Weird Times of Cold Fusion (review - this one from 1993 pre-dates his fixation on eating, but sets up his credibility as a great scientific and investigative journalist).
The Case for Keto reads like a more accessible and less technical edition of Good Calories, Bad Calories. It's shorter by half. It's packed full of new info, research and interviews regarding LCHF (low-carb, high-fat) eating and its impacts- Taubes uses the term "LCHF/ketogenic" consistently throughout. As he writes in the intro, this book is a work of journalism masquerading as a self-help book. There are no recipes.
What consistently blows my mind when reading Taubes is how slow the medical establishment is to abandon the "dietary fat is bad" idea, that (Taubes shows) was instantiated in the 1950s with virtually no evidence. Why should we care? This hypothesis, along with the also-unsubstantiated "energy balance" theory of metabolism and dieting (i.e. calories in = calories out) and a non-uncommon perception that "a calorie is a calorie" have caused a terrific amount of misery for eaters, myself included.
How? Why? If the ground rules for "healthy eating" laid out by the medical establishment are valid, why are we in an obesity epidemic? Taubes, nor I, think Frito Lay and Pepsi are solely to blame. Cutting back on dietary fat is a double edged sword: you reduce satiety (fat is the most "filling") and you have to displace fat with something else - usually carbs. As we learned in Good Calories, Bad Calories, carbs (especially refined carbs) are quickly metabolized into the bloodstream as glucose, elevated blood sugar causes the pancreas to secrete insulin, insulin prompts your body to burn carbs for fuel (also causing a hunger response) AND store glucose as glycogen and fat AND hold onto the fat it already has. So "low fat" diets CAN (not always) make it super difficult to lose weight. Low on fat = higher on carbs = body in carb burning, fat-storing mode.
Taubes goes into detail on is what ketosis is (the state where your body switches from storing fat to burning fat) and how one can get into that state. He covers endless studies and interviews endless physicians who have used HCLF/ketogenic diets to treat patients with obesity and type 2 diabetes and related symptoms to see those conditions and their related medications disappear. The second-last chapter on how to start LCHF/ketogenic habits was a bit weak, but the rest of the book was solid.
What's fascinating about LCHF/ketogenic is that these foods are more satiating (think: I can eat a Costco bag of Ruffles All-Dressed Chips, but only a few huge slices of cheddar cheese) AND keep you in the ketogenic, fat-burning state and out of fat-storage mode. This is the SECRET KNOWLEDGE that's been peddled through books like Atkins and Wheat Belly and most diet books, but Taubes backs it up with the science, not the woo-woo bullshit.
I get super worked up reading Taubes (then writing afterwards) because I feel like for most of my life, most health authorities' eating programs are mystical "woo-woo" BS that work for some people, not for others. In doctor's offices and online weight-loss communities, "calories in = calories out" is unquestionable dogma because it works for some people. But imagine we're all biological beings with different trigger levels for entering a ketogenic (fat-burning) state? Imagine a slight imbalance in insulin (or other hormones - sex hormones also affect weight) that makes it a bit harder to exit fat storage and enter fat-burning mode?
So picture me in early 2015, at 250 lbs, over 30 BMI, the definition of obese! I started counting calories under the calories in = calories out dogma and lost over 50 pounds that year. For all of 2016, 17 and 18 I counted calories to maintain that weight loss. Every meal. So counting calories works, but very often I'm feeling hungry, very often not feeling full, and it's really intrusive and time-consuming. In late 2018 I read Good Calories, Bad Calories and the light bulb went off! Here is the SECRET KNOWLEDGE about how your body ACTUALLY METABOLIZES MACRONUTRIENTS! If you know how the system works you can address it with high-level solutions, not band-aids and artificial constraints (like how I now view counting calories). Now I just eat less carbs (not no carbs), way more satiating (high-fat) foods and I've stayed on setpoint with ease since then. Always full, never hungry.
I am not sharing my personal details to humble-brag or get internet points, but because I know there are other analytical thinkers like me who would benefit from this SECRET KNOWLEDGE. If you dive deep and try to understand the scientifically well-understood mechanisms of fat storage and metabolism, Taubes' hypothesis and messages seems not only plausible, but so crystal-clear you'll be as angry as I am for not learning any of this in school, or seeing food guides that recommend 5-7 servings of grains and cereals per day when we KNOW WHAT THOSE DO TO OUR BODIES.
tl;dr recommended reading for husky analytical people (or anyone)
March 5, 2021
It's hard to admit your knowledge is imperfect and yet come up with a reasonable plan of action based on the overall weight of the best available evidence. Taubes deserves great credit for traveling that difficult path. This book goes over the same territory as his previous books. The plus-value here is the perspective of twenty years of trying to convince the world about something, and trying to understand why experts, policymakers and the general public reject that something and instead cling to dogma that clearly doesn't work and that seems to be doing tremendous harm. That was fascinating. We're talking about medical science, and what helps people in the real world to lose weight and decrease diabetes, etc. And yet the way that the more effective approach is gaining ground is that individual physicians are having "conversion experiences," which is religious talk. Part of the problem is that despite the billions of dollars we spend on medical research and the trillions on medical care, there's overall not much strong evidence for these key questions about prevention and wellness. But then there's also the problem of the lack of humility and scientific rigor of experts who will just make a pronouncement for the sake of saying something, even when the right answer is "I don't know."
January 3, 2021
More reviews (and no fluff) on the blog http://surrealtalvi.wordpress.com/
The blurb for this book is very accurate: this is a journalist, not a nutritionist or physician, who researched the topic thoroughly, laying out clearly where there wasn't or was evidence in support of theories for and against a keto/low carb diet. Because he is a journalist and not a medical professional, he didn't have a proverbial 'skin in the game' - he was free to explore and really think in a neutral fashion about the topic of diets. He also battled weight gain and was frustrated with dieting and lack of success.I appreciated the candor and also that the author did not go 'all in', looking for reasons to support a low carb/keto diet's justifications that just weren't there. It is a very thought provoking read for that reason. His conclusion throughout is that diets just don't work because we are trying to do a one-size fits all model. The keto diet might be an answer to those who have not had success in other diets - and that it might be in their own physiology that is causing the obesity.
The basis of the book is trying to find why diets just don't work. I.e., it's not about eating less, cutting fats, cutting meats; it isn't just a mental health issue, a racial issue, a problem of willpower, or the other reasons that are non-food related. The evidence Taubes finds relates to each person having different resistances to insulin (caused by carbs) and so what one man can eat in excess another can have just a little and gain weight while experiencing crippling cravings. It is not surprising that most nutritionists are indeed thin but were also born that way - and therefore don't have a perspective on those whose obesity resist diets or longevity. The thin never had to fight the long battle to lose weight.
This isn't a diet book and there are no recipes etc. (you can find plenty of keto recipes on the net or in bookstores). It's just the author laying out what his research has gleaned from the various medical professional and historical figures who have tries to combat or address the obesity issue.
The crux of the book is to knock out carbs/sugars altogether - everything from breads, to pastas, fruits, to even beans. In doing so, the body resets, insulin isn't overloaded, and the cravings begin to wane. It is a hard ask in this modern society but the reason this can work is that it is a lifestyle change (so you can keep the weight off/stay healthy a lifetime), there is no starving, and you can enjoy the things like bacon, eggs, meats, without dealing with constant cravings.
There are so many good discussions and points about other diets and also why keto/low carb isn't a fad (anyone remember the grapefruit diet?) misfire. It's also a great way to understand why so many diets are likely failing. I found a lot of the information fascinating and it was a both a reality check and a new perspective on the obesity issue. Reviewed from an advance reader copy provided by the publisher.
June 10, 2020
I would recommend this for anyone interested in nutrition and curious about ketogenic/low carb diet. There is a lot of scientific discussion regarding the influence of carbs/sugar on our health, discussion of previous studies and the evolution of these studies over the time. Therefore, it is not an easy and fast read but it was very interesting.
Thanks to NetGalley and publisher for the ARC.
Thanks to NetGalley and publisher for the ARC.
June 15, 2020
Thanks to Netgalley for providing a review copy.
I am not sure if this book was necessary. I understand that the author has interviewed many people and he draws a convincing picture why the situation for obese people is at it is: what is causing obesity, what's not working, what a better diet should look like etc.
Unlike the The Case Against Sugar, however, information about the Keto diet is widely available these days and it's in my opinion not necessary to dig so much in the history. Make your point and then move on. Instead all the facts are wrapped in stories and anecdotes that made it hard to extract the important pieces. This is especially true for readers who are not fat or obese. For them the Keto diet is a choice among many and the author has to do better to explain why Keto is more natural even for them.
For people who want to start with Keto this is the wrong book. It explains, justifies and gets lost in politics but fails to motivate properly. I liked The Overfat Pandemic by Phil Maffetone much more. For people who want to learn about the scientific background it doesn't go deep enough AND it doesn't compare the Keto approach with other diets that work as well. I was also astonished that the author didn't understand why Omega-3 fats are promoted over Omega-6 (inflammation is one of the keywords).
The human machinery is complex and it's all about balance. When you are have a problem with your weight then methodically find out what is not working. Going fully Keto will probably work, but it might be enough to leave aside a handful of food especially considering the way how they are produced these days and the high amount of sugar. Keto alone is not the solution anymore.
I am not sure if this book was necessary. I understand that the author has interviewed many people and he draws a convincing picture why the situation for obese people is at it is: what is causing obesity, what's not working, what a better diet should look like etc.
Unlike the The Case Against Sugar, however, information about the Keto diet is widely available these days and it's in my opinion not necessary to dig so much in the history. Make your point and then move on. Instead all the facts are wrapped in stories and anecdotes that made it hard to extract the important pieces. This is especially true for readers who are not fat or obese. For them the Keto diet is a choice among many and the author has to do better to explain why Keto is more natural even for them.
For people who want to start with Keto this is the wrong book. It explains, justifies and gets lost in politics but fails to motivate properly. I liked The Overfat Pandemic by Phil Maffetone much more. For people who want to learn about the scientific background it doesn't go deep enough AND it doesn't compare the Keto approach with other diets that work as well. I was also astonished that the author didn't understand why Omega-3 fats are promoted over Omega-6 (inflammation is one of the keywords).
The human machinery is complex and it's all about balance. When you are have a problem with your weight then methodically find out what is not working. Going fully Keto will probably work, but it might be enough to leave aside a handful of food especially considering the way how they are produced these days and the high amount of sugar. Keto alone is not the solution anymore.
March 23, 2023
NU este o carte de specialitate, ci un compendiu al experiențelor oamenilor și al concluziilor aferente ce se întinde pe mai mult de 20 ani. (Ba chiar aduce în discuție și ceva informații practice din 1800-1900).
Cu alte cuvinte, autorul a adunat nșpe mii de cazuri povestite de doctori, pacienți, persoane care s-au confruntat cu probleme și chiar propriile experimente și le-a aranjat în carte.
Avem contextul tuturor ideilor prezentate, ce a mers/ce n-a mers, de ce s-a întâmplat asta, care e stadiul actual, cum s-au simțit persoanele respective și orice altceva mai poate fi de interes când se monitorizează alimentația.
Acum.. problema e că eu nu văd LCHF/keto ca fiind DOAR o metodă de a slăbi, beneficiile ei se întind mult peste partea asta. Ce-i drept, depinde și de fiecare organism în parte și câtă nevoie este de a subția stratul adipos. (Keto e mână de aur pentru pers ce suferă de obezitate, diabet, pb cu metabolismul).
Mi-a răspuns la câteva întrebări, mai ales la cele legate de colesterol și la bucata lui “rea”: LDL. În continuare rămâne un subiect despre care vreau să mai citesc, aparent nu e totul alb sau negru mereu.
Cartea lămurește care-i treaba cu insulina și ce rol are ea în îngrășarea/slăbirea cuiva. Informațiile astea se tot repetă, dar poate așa intră mai bine în mintea cititorilor.
Poate CEL MAI IMPORTANT ASPECT al cărții este că, încă de la început, explică DIFERENȚA dintre TIPURILE CONSTITUȚIONALE și cum unii pot mânca orice și corpul lor n-are nicio problema, iar alții “se îngrașă chiar și respirând lângă ciocolată” (expresie care este adevărată până la un punct, oricât de aiurea ar suna).
Cartea se concentrează pe persoanele ce au probleme cu obezitatea și tot ce derivă de aici.
Ce nu mi-a plăcut aici este că mi s-a părut ciudos atunci când prezenta diferențele astea dintre tipurile constituționale, mai ales când spunea că “your lean friends….” 😂. Bine, nu strică informațiile din carte cu nimic, dar m-am simțit puțin atacată 😂.
Cu alte cuvinte, autorul a adunat nșpe mii de cazuri povestite de doctori, pacienți, persoane care s-au confruntat cu probleme și chiar propriile experimente și le-a aranjat în carte.
Avem contextul tuturor ideilor prezentate, ce a mers/ce n-a mers, de ce s-a întâmplat asta, care e stadiul actual, cum s-au simțit persoanele respective și orice altceva mai poate fi de interes când se monitorizează alimentația.
Acum.. problema e că eu nu văd LCHF/keto ca fiind DOAR o metodă de a slăbi, beneficiile ei se întind mult peste partea asta. Ce-i drept, depinde și de fiecare organism în parte și câtă nevoie este de a subția stratul adipos. (Keto e mână de aur pentru pers ce suferă de obezitate, diabet, pb cu metabolismul).
Mi-a răspuns la câteva întrebări, mai ales la cele legate de colesterol și la bucata lui “rea”: LDL. În continuare rămâne un subiect despre care vreau să mai citesc, aparent nu e totul alb sau negru mereu.
Cartea lămurește care-i treaba cu insulina și ce rol are ea în îngrășarea/slăbirea cuiva. Informațiile astea se tot repetă, dar poate așa intră mai bine în mintea cititorilor.
Poate CEL MAI IMPORTANT ASPECT al cărții este că, încă de la început, explică DIFERENȚA dintre TIPURILE CONSTITUȚIONALE și cum unii pot mânca orice și corpul lor n-are nicio problema, iar alții “se îngrașă chiar și respirând lângă ciocolată” (expresie care este adevărată până la un punct, oricât de aiurea ar suna).
Cartea se concentrează pe persoanele ce au probleme cu obezitatea și tot ce derivă de aici.
Ce nu mi-a plăcut aici este că mi s-a părut ciudos atunci când prezenta diferențele astea dintre tipurile constituționale, mai ales când spunea că “your lean friends….” 😂. Bine, nu strică informațiile din carte cu nimic, dar m-am simțit puțin atacată 😂.
March 18, 2021
An interesting case for Keto that challenges some of the deep rooted conventional wisdom. While I’ve had my doubts the author manages to explain his case in a convincing manner. The role of insulin and impact on weight and the mechanism of how our body consumes carbs, fat, protein and alcohol are interesting and impactful. While this book will not likely convert anyone who has already decided that eating less is the only solution, it may be eye opening for those with an open mind.
Worth a read for those thinking about losing weight or remaining lean.
Worth a read for those thinking about losing weight or remaining lean.
March 28, 2022
This is Nonfiction/Health. This is the third book by this author that I've read. He is pro Keto. If you want to try this, this gives a lot of the science behind it. I'd recommend this to you, but if you are in the process of researching to find something that fits you, then make sure to include other books in your research...and just know that this isn't the "end all, be all" when it comes to weight loss and controlling insulin levels.
The reason this is 3 stars and not 4 isn't for the writing or anything like that. It is mainly because of how I felt about this. While he laid out the Keto plan given all the new research showing how important controlling insulin levels is when it comes to being successful at losing weight. He really laid everything out so neatly.....it was tidy. I liked that. But what gets me, and I am NOT a doctor, is how he makes it sound like KETO is for everyone. I agree that KETO is certainly beneficial for some people and for some health issues, but bottom line, we are not all the same. It is not, nor will it ever be, a one way street and that is how this author makes it sound. Like everyone on the planet needs to eat like this.
Lately, there has been an emphasis encouraging metabolic testing and gut health testing. This is helpful in getting to know what works best for your body. Some people process carbs better than fats, and others process fats better than carbs. You have to know your body. A close friend of mine chose KETO to lose some weight. She felt awful for the 6 months she was on it. She lost some weight but I don't think it felt worth it to her. We both did our metabolic testing and it turned out that she doesn't process fats well......at all. So she quit KETO, and followed the guidelines given to her and felt so much better and lost a lot more weight and has been able to keep it off. For success, you have to know your body. I guess what I'm trying to say, according to my experiences and those who are close to me, is that we are all different and there is no "one size fits all" approach because if there was, we'd all be doing it and we'd all be successful. So 3 stars.
The reason this is 3 stars and not 4 isn't for the writing or anything like that. It is mainly because of how I felt about this. While he laid out the Keto plan given all the new research showing how important controlling insulin levels is when it comes to being successful at losing weight. He really laid everything out so neatly.....it was tidy. I liked that. But what gets me, and I am NOT a doctor, is how he makes it sound like KETO is for everyone. I agree that KETO is certainly beneficial for some people and for some health issues, but bottom line, we are not all the same. It is not, nor will it ever be, a one way street and that is how this author makes it sound. Like everyone on the planet needs to eat like this.
Lately, there has been an emphasis encouraging metabolic testing and gut health testing. This is helpful in getting to know what works best for your body. Some people process carbs better than fats, and others process fats better than carbs. You have to know your body. A close friend of mine chose KETO to lose some weight. She felt awful for the 6 months she was on it. She lost some weight but I don't think it felt worth it to her. We both did our metabolic testing and it turned out that she doesn't process fats well......at all. So she quit KETO, and followed the guidelines given to her and felt so much better and lost a lot more weight and has been able to keep it off. For success, you have to know your body. I guess what I'm trying to say, according to my experiences and those who are close to me, is that we are all different and there is no "one size fits all" approach because if there was, we'd all be doing it and we'd all be successful. So 3 stars.
March 8, 2023
People who follow me on here are going to think I’m extremely unhinged for reading all the keto books!!! Which may or may not be true. Ultimately I’m trying to understand the benefits of a keto diet (no grains, starches, or sugar - high fat, low carb) as it relates to brain health mostly.
This book was probably the wrong choice as it is focused mostly on using keto as an effective tool for diabetes and obesity, both of which are not currently a concern for me. But the science is still interesting!
I’m still confused though because an article came out today stating that keto puts you at risk for heart disease? Ugh diet culture is exhausting.
This book was probably the wrong choice as it is focused mostly on using keto as an effective tool for diabetes and obesity, both of which are not currently a concern for me. But the science is still interesting!
I’m still confused though because an article came out today stating that keto puts you at risk for heart disease? Ugh diet culture is exhausting.
December 31, 2020
The long-awaited new book by Gary Taubes
Fans of Gary Taubes will already be familiar with a lot of the material in his newest book from having read Good Calories, Bad Calories and The Case Against Sugar. What sets this book apart is the focus on the practical results of a low-carb-high-fat/ketogenic diet. While it's true that we don't know, and may never know, if the LCHF/ketogenic way of eating will add years to our lives, we do know that it makes us healthier right now. The recurring message of this book is that those of us who fatten easily no matter what we eat (except LCHF/keto) need to stop taking dietary advice from lean people who are lean no matter what they eat. We have a metabolic disorder, and they don't, and they can never know what that's like.
I have been following a LCHF/keto way of eating for over a year. I've dropped over 60 pounds, my chronic reflux has stopped, I have energy to burn, and I will happily eat this way for the rest of my life.
Fans of Gary Taubes will already be familiar with a lot of the material in his newest book from having read Good Calories, Bad Calories and The Case Against Sugar. What sets this book apart is the focus on the practical results of a low-carb-high-fat/ketogenic diet. While it's true that we don't know, and may never know, if the LCHF/ketogenic way of eating will add years to our lives, we do know that it makes us healthier right now. The recurring message of this book is that those of us who fatten easily no matter what we eat (except LCHF/keto) need to stop taking dietary advice from lean people who are lean no matter what they eat. We have a metabolic disorder, and they don't, and they can never know what that's like.
I have been following a LCHF/keto way of eating for over a year. I've dropped over 60 pounds, my chronic reflux has stopped, I have energy to burn, and I will happily eat this way for the rest of my life.
January 1, 2021
A very good read (rehashed a lot of the history from Good Calories, Bad Calories and The Case Against Sugar - which I have binge read the last month) promoting a Low Carbohydrate High Fat (LCHF) ketogenic diet.
The best chapter, for me, was Ch. 17 - The Plan. Gary did a great job giving practical advice on how many people work a LCHF/Keto diet into what work for them. The chapter also use the analogy of being addicted to carbs, and treating the lifestyle as you would breaking an addiction. That resonated with me.
Another chapter, Ch. 8 - The Body’s Fuel is a good read for how the body switches between Fat and Glucose for fuel using Insulin levels. How delicate the change over between burning glucose (and therefore storing fat) can become. I can certainly relate to a constant stream of carbs would flip my switch on and make it impossible for my body to burn fat.
On a personal note. I switched to a LCHF/keto diet almost 90 days ago, a few days after being diagnosed with Type 2 diabetes. In that time my blood sugar has normalized (Metformin helped, I’m sure) and I’ve lost 23 pounds.
The best chapter, for me, was Ch. 17 - The Plan. Gary did a great job giving practical advice on how many people work a LCHF/Keto diet into what work for them. The chapter also use the analogy of being addicted to carbs, and treating the lifestyle as you would breaking an addiction. That resonated with me.
Another chapter, Ch. 8 - The Body’s Fuel is a good read for how the body switches between Fat and Glucose for fuel using Insulin levels. How delicate the change over between burning glucose (and therefore storing fat) can become. I can certainly relate to a constant stream of carbs would flip my switch on and make it impossible for my body to burn fat.
On a personal note. I switched to a LCHF/keto diet almost 90 days ago, a few days after being diagnosed with Type 2 diabetes. In that time my blood sugar has normalized (Metformin helped, I’m sure) and I’ve lost 23 pounds.
August 18, 2021
كتاب لطيف ومختلف ويطرح وجهة نظر مغايرة لما تدعو إليه أنظمة الغذاء الصحي الرائجة ويدافع عن قيمة وفائدة الدهون والروتينات.
يعني بإيجاز يستحق أن تلقي عليه نظرة لو مهتم، أو لو دعتك معدتك إلى ذلك.
April 1, 2022
This is in incredible researched book. It is full of great information, but it was too much for me, I couldn't go on more than 20%.
Still, it is SUPER interesting! I just wasn't in the right mindset to read it.
If you like this subject, read it. You'll love it.
Many thanks to the publisher for the complimentary e-copy of this book through NetGalley. Opinions expressed in this review are completely my own.
Still, it is SUPER interesting! I just wasn't in the right mindset to read it.
If you like this subject, read it. You'll love it.
Many thanks to the publisher for the complimentary e-copy of this book through NetGalley. Opinions expressed in this review are completely my own.
March 17, 2021
Taubes reminds us to question the conventional. He credits the medical professionals who took a chance on Keto, with courage: “They believed the truth was obvious, which is always an impediment to making progress in any scientific endeavor.”
He also helped me understand the starting points of many people who struggle with their weight. “Fat people are not lean people who eat too much.” And what it takes to see results... “We have to eat differently because we are different.”
I am thankful for this honest and detailed account of the research and experiences of the LCGF/Ketogenic lifestyle. Definitely worth reading!
He also helped me understand the starting points of many people who struggle with their weight. “Fat people are not lean people who eat too much.” And what it takes to see results... “We have to eat differently because we are different.”
I am thankful for this honest and detailed account of the research and experiences of the LCGF/Ketogenic lifestyle. Definitely worth reading!
January 10, 2021
What I appreciate most about this book, a summary of much of the thinking about keto diets, is rigorously researched. Taubes is not only on top of the scientific literature, finding the fault lines in even textbooks, but interviews hundreds of experts and practitioners to find meaningful, actionable advice.
Perhaps most importantly, this book provides the needed confidence to start or continue a diet (keto) that is so different from conventional nutritional advice.
Highly recommend.
Perhaps most importantly, this book provides the needed confidence to start or continue a diet (keto) that is so different from conventional nutritional advice.
Highly recommend.
February 14, 2021
Selected excerpts (turned into a lot of excerpts as the book was rather well-spoken)...
It (insulin) prompts cells in your lean tissues and organs to take up carbohydrates and use them for fuel; it inhibits them from burning fat and lets that fat escape back into the circulation, where it can be returned to storage. Insulin simultaneously causes the fat tissue to hold on to fat and the muscle cells to do the same with protein. Protein consumption also stimulates secretion of two other hormones, glucagon and growth hormone, the former of which will work to limit fat storage, while the latter will help promote growth and repair.
With insulin decreasing, the fat tissue will eventually experience that negative stimulus of insulin deficiency, and the fat cells will release the fat from storage—they will mobilize it—and we will burn that fat for fuel. This is what happens or should happen between meals; it happens overnight while we’re sleeping, and it will happen for days, weeks, or even longer if we have to survive a lengthy famine or self-imposed period of fasting.
Since we have such limited storage space, our bodies have three options: Use the carbohydrates for energy, which at least puts them to use; turn them into fat, which the liver will do if necessary; or dispose of them in our urine...
Without that negative stimulus of insulin deficiency—if insulin remains elevated above some unknown baseline threshold—we will store fat.
Excess fat, specifically above the waist, is an exceedingly good sign of insulin resistance, in which case insulin is indeed elevated higher than it should be and elevated for longer than it should be.
High blood sugar, which you can have when you either are diabetic or have eaten a carb-rich meal, will prompt your pancreas to secrete insulin, which in turn will prompt you to burn the carbohydrates for fuel, store glucose as glycogen and fat, and prompt your fat cells to store the fat you’ve eaten and the fat made from glucose and hold on to the fat it already has.
Insulin is the signal that the body has been fed carbohydrates. The fat we eat won’t stimulate insulin secretion.
(“The first principle” of science, as the Nobel laureate physicist Richard Feynman put it so aptly, “is that you must not fool yourself and you’re the easiest person to fool.”)
(The reality is that virtually all hormones, with the notable exception of insulin, are technically fat-mobilizing hormones, although they won’t mobilize fat when insulin is elevated. The insulin signal overrides that of these other hormones.)
Ketones are measured in units of millimoles per liter, abbreviated as mmol/l. On a typical carbohydrate-rich diet, your ketone level is likely to be about 0.1 mmol/l, which is the product of the liver’s ketone body synthesis machinery idling in the background state. If you go twelve hours without eating, which you’ll often do in your life—from finishing dinner at seven p.m., say, to having breakfast at a reasonable hour the next morning—your pre-breakfast ketone body levels will have tripled, up to 0.3 mmol/l, as your insulin is low and your liver is synthesizing ketones to help feed your brain, if nothing else. Continue to fast for more than several days, and you’ll be at 5 to 10 mmol/l. † On an Atkins diet—aka nutritional ketosis—your ketones might be as high as 2 or 3 mmol/l. After exercise on the same diet, when insulin is very low, you might even hit 5 mmol/l, all relatively low numbers compared to those in diabetic ketoacidosis, the state that so justifiably worries physicians and diabetes specialists.
In diabetic ketoacidosis, fat cells dump their stored fat into the circulation, the liver wildly synthesizes ketones, and carbohydrates are not being taken up and used for fuel at anything like the rate that’s necessary. Meanwhile the liver is also generating glucose to use for more fuel. All these fuels are accumulating in the bloodstream, and pathological, metabolic hell is clearly breaking out: Ketone body levels in diabetic ketoacidosis are typically well over 20 mmol/l. This is a condition to be rightly feared, but it is an entirely different physiological state than nutritional ketosis.
In other words, as Yalow and Berson pointed out, if you’re actually getting fatter, your fat cells must be responding to insulin regardless of what is happening elsewhere in your body. Your fat cells must still be insulin sensitive. It seems to be a precondition of the fattening process.
It means that fat cells sense and respond to the presence of insulin in the circulation at levels so low that other cells and tissues don’t even know it’s there, and fat cells continue to respond to insulin long after those other cells and tissues become resistant.
Worth noting is that ketones themselves stimulate some insulin secretion, and the insulin secretion in turn inhibits ketone synthesis. This is a naturally occurring negative feedback loop that prevents ketone levels from getting pathologically high merely from changing our diets.
When insulin is below the threshold, when the switch is in the off position, your body is burning the fat you’ve stored. It will continue to burn fat as long as you remain below the threshold. Now your body has access to plenty of fuel. Twenty pounds of body fat provides fuel for well over two months. Even a lean marathoner like Olympic gold medalist Eliud Kipchoge, who in October 2019 ran the first sub-2-hour marathon ever, at 123 pounds, has enough fat stored to fuel his body on his fat stores alone for a week. Your body is being constantly fed on this supply of stored fat, so it’s satisfied. Your appetite will be blunted. The brain has no reason to think more food is necessary. Your body has no need to ingest more food, hence there’s little or no urge to do so. You experience weight loss—the burning of your stored body fat—without hunger.
Above the insulin threshold, you have to replenish frequently. You have a limited supply of carbohydrates, and insulin works to keep the carbohydrates you’ve stored (a maximum of about two thousand calories of glycogen) locked away as well. As your blood sugar drops, you’ll get hungry. And because carbohydrates are your fuel above the threshold, you’ll hunger for carbohydrate-rich foods.
The relative absence of hunger on these LCHF/ketogenic diets is as consistent an observation as can be found in nutrition science. Remove the carbohydrates and replace the calories with fat, and the stimulus for hunger (and for the obsessive thinking about food that goes with calorie-restricted diets) is lessened significantly.
Willpower, however, had little or nothing to do with it. Those who are lean and insulin sensitive cannot imagine the hunger for carbohydrates that will be induced in those predisposed to fatten, in those who are insulin resistant, when confronted by this aroma and the thought of the bun. It is a subjective experience that lies outside their ability to understand because they never experience it.
One reason all diet authorities now agree more or less that we should cut back on our consumption of highly processed grains (white flour) and sugars (sucrose and high-fructose syrups) is that these refined grains and sweet refined sugars are relatively new to human diets.
Recall what the hundred-plus Canadian physicians wrote in HuffPost about their observations, their experiences, when their patients embraced LCHF/ketogenic eating: “What we see in our clinics: blood sugar values go down, blood pressure drops, chronic pain decreases or disappears, lipid profiles improve, inflammatory markers improve, energy increases, weight decreases, sleep is improved, IBS [irritable bowel syndrome] symptoms are lessened, etc. Medication is adjusted downward, or even eliminated, which reduces the side-effects for patients and the costs to society. The results we achieve with our patients are impressive and durable.” Physicians who now prescribe these diets commonly say that they rarely if ever prescribe drugs to their patients for blood sugar control or hypertension; rather, they de-prescribe, they get patients off medications. That’s compelling testimony.
The results of those five studies were consistent. The participants eating the LCHF/ketogenic high-fat diet lost more weight, despite the advice to eat to satiety, than those who ate the American Heart Association and the British Heart Foundation recommended low-fat, low-saturated-fat diet. Moreover, their heart disease risk factors showed greater improvement.
Since then, as of the spring of 2019, close to one hundred, if not more, clinical trials have published results, and they confirm these observations with remarkable consistency. The trials are still incapable of telling us whether embracing LCHF/ketogenic eating will extend our lives (compared to other patterns of eating the authorities might recommend), but they continue to challenge, relentlessly, the conventional thinking on the dangers of high-fat diets, and they tell us that in the short term, this way of eating is safe and beneficial.
In June 2019 Hallberg and Virta Health published a paper on how two years of LCHF/ketogenic eating had influenced heart disease risk factors in its subjects. The bottom line was that twenty-two of twenty-six established risk factors improved (compared to what these physician researchers call “usual care”), three remained unchanged, and only one—LDL cholesterol—on average got worse. When the Virta Health researchers worked out the numbers for what’s called the “aggregate atherosclerotic cardiovascular disease risk score,” a measure of ten-year risk of having a heart attack developed by the American College of Cardiology and the American Heart Association, the Virta Health patients decreased their risk of having a heart attack by over 20 percent, compared to the usual treatment program for diabetes and all the drug therapies typically prescribed. Even with the rise in their LDL cholesterol, these patients got significantly healthier, as did their hearts.
Just as the evidence has inexorably accumulated over the years supporting the observation that LCHF/ketogenic diets make us healthier, the evidence supporting the idea that saturated fat is deadly and that we should all eat low-fat diets has been fading, despite the best efforts of the orthodoxy to prop it up.
Now, thirty years later, the most recent unbiased review of this evidence—from the Cochrane Collaboration, an international organization founded to do such impartial reviews—concluded that clinical trials have failed to demonstrate any meaningful benefit from eating low-fat diets
By the mid-1990s, though, the experts who assembled a seven-hundred-page report on this question for the World Cancer Research Fund and American Institute for Cancer Research— Food, Nutrition and the Prevention of Cancer —could find neither “convincing” nor even “probable” reason to believe that fat-rich diets were carcinogenic.
While LDL does seem to play a role in the atherosclerotic process, it’s not the cholesterol in the particle that’s the active player but rather the LDL particle itself and specifically the number and maybe the size of particles in circulation.
Finally, the medical community has known since 1977 (if not twenty years earlier) that low HDL cholesterol is a far better predictor of heart disease than high LDL cholesterol, many times more likely to be regrettably right, and that high triglycerides are at least as predictive as high LDL.
Both clinical trial data and clinical experience tell us that this body-wide disruption of metabolic syndrome—the disruption that appears to begin with insulin resistance and so elevated levels of insulin and poor blood sugar control—is normalized or corrected by removing the carbohydrates from the diet and replacing them with fat.
Researchers have known, at least since the 1970s, that carbohydrate consumption lowers the apparently beneficial HDL cholesterol compared to eating fats, and that it raises triglycerides as well.
As for blood pressure, insulin induces your kidneys to hold on to sodium. (Salt is sodium chloride, and the sodium is the player here.) This is one of the many things insulin does. When your insulin levels are high, your kidneys retain sodium rather than excreting it in urine.
By then, though, we were all being told that high blood pressure was caused by eating too much salt, another speculative hypothesis that continues to suffer from a dearth of experimental, clinical trial evidence. It was embraced nonetheless. It sounded right, and so the authorities believed it. We believed it because they did, and we never let it go.
Anyone who makes an ironclad guarantee for any way of eating—that one diet will assuredly make you live longer than others—as Gladwell suggested and I tend to agree, is probably selling something (although perhaps with the best of intentions).
A diet that restricts carbohydrates and replaces those calories with fat corrects your weight by lowering it. It corrects your blood pressure by lowering it. It corrects your inability to control your blood sugar. It’s not the equivalent of taking a pill that will make you healthy; rather, it removes what makes you unhealthy, replaces those calories with a benign macronutrient (fat), and in so doing, fixes what ails you.
The message should be straightforward: Carbohydrate-rich foods are fattening. Or to complicate it slightly such that naturally lean people might more likely understand: For those of us who fatten and particularly those who fatten easily, it’s the carbohydrates that we eat—the quantity and the quality—that are responsible. The relevant mechanism appears to be simple, as well: Carbohydrate-rich foods—grains, starchy vegetables, and sugars—work to keep insulin elevated in our circulation, and that traps the fat we eat in our fat cells and inhibits the use of that fat for fuel.
When we consume these sugars, the glucose enters the circulation, becomes blood sugar, and stimulates an insulin response, but the fructose mostly doesn’t. It’s metabolized first in the small intestine and then the liver. These organs, the liver particularly, are then tasked with the job of metabolizing an amount of fructose, day in and day out, which they are apparently ill-equipped to do.
Like any device tasked to do a job it isn’t designed to do, the liver does a poor job of metabolizing this daily flood of fructose. Liver cells use as much of the fructose as they can to generate energy, but they convert the rest, the excess, to fat. Reasonably reliable research suggests that this fat is trapped in liver cells, leading to a condition known as nonalcoholic fatty liver disease, which is associated with obesity and diabetes
Robert Cywes, a pediatric surgeon who now runs bariatric surgery and weight-control programs for adults and adolescents in Florida, said to me, “To cut to the chase, we are a carbohydrate substance abuse program, not a weight
It (insulin) prompts cells in your lean tissues and organs to take up carbohydrates and use them for fuel; it inhibits them from burning fat and lets that fat escape back into the circulation, where it can be returned to storage. Insulin simultaneously causes the fat tissue to hold on to fat and the muscle cells to do the same with protein. Protein consumption also stimulates secretion of two other hormones, glucagon and growth hormone, the former of which will work to limit fat storage, while the latter will help promote growth and repair.
With insulin decreasing, the fat tissue will eventually experience that negative stimulus of insulin deficiency, and the fat cells will release the fat from storage—they will mobilize it—and we will burn that fat for fuel. This is what happens or should happen between meals; it happens overnight while we’re sleeping, and it will happen for days, weeks, or even longer if we have to survive a lengthy famine or self-imposed period of fasting.
Since we have such limited storage space, our bodies have three options: Use the carbohydrates for energy, which at least puts them to use; turn them into fat, which the liver will do if necessary; or dispose of them in our urine...
Without that negative stimulus of insulin deficiency—if insulin remains elevated above some unknown baseline threshold—we will store fat.
Excess fat, specifically above the waist, is an exceedingly good sign of insulin resistance, in which case insulin is indeed elevated higher than it should be and elevated for longer than it should be.
High blood sugar, which you can have when you either are diabetic or have eaten a carb-rich meal, will prompt your pancreas to secrete insulin, which in turn will prompt you to burn the carbohydrates for fuel, store glucose as glycogen and fat, and prompt your fat cells to store the fat you’ve eaten and the fat made from glucose and hold on to the fat it already has.
Insulin is the signal that the body has been fed carbohydrates. The fat we eat won’t stimulate insulin secretion.
(“The first principle” of science, as the Nobel laureate physicist Richard Feynman put it so aptly, “is that you must not fool yourself and you’re the easiest person to fool.”)
(The reality is that virtually all hormones, with the notable exception of insulin, are technically fat-mobilizing hormones, although they won’t mobilize fat when insulin is elevated. The insulin signal overrides that of these other hormones.)
Ketones are measured in units of millimoles per liter, abbreviated as mmol/l. On a typical carbohydrate-rich diet, your ketone level is likely to be about 0.1 mmol/l, which is the product of the liver’s ketone body synthesis machinery idling in the background state. If you go twelve hours without eating, which you’ll often do in your life—from finishing dinner at seven p.m., say, to having breakfast at a reasonable hour the next morning—your pre-breakfast ketone body levels will have tripled, up to 0.3 mmol/l, as your insulin is low and your liver is synthesizing ketones to help feed your brain, if nothing else. Continue to fast for more than several days, and you’ll be at 5 to 10 mmol/l. † On an Atkins diet—aka nutritional ketosis—your ketones might be as high as 2 or 3 mmol/l. After exercise on the same diet, when insulin is very low, you might even hit 5 mmol/l, all relatively low numbers compared to those in diabetic ketoacidosis, the state that so justifiably worries physicians and diabetes specialists.
In diabetic ketoacidosis, fat cells dump their stored fat into the circulation, the liver wildly synthesizes ketones, and carbohydrates are not being taken up and used for fuel at anything like the rate that’s necessary. Meanwhile the liver is also generating glucose to use for more fuel. All these fuels are accumulating in the bloodstream, and pathological, metabolic hell is clearly breaking out: Ketone body levels in diabetic ketoacidosis are typically well over 20 mmol/l. This is a condition to be rightly feared, but it is an entirely different physiological state than nutritional ketosis.
In other words, as Yalow and Berson pointed out, if you’re actually getting fatter, your fat cells must be responding to insulin regardless of what is happening elsewhere in your body. Your fat cells must still be insulin sensitive. It seems to be a precondition of the fattening process.
It means that fat cells sense and respond to the presence of insulin in the circulation at levels so low that other cells and tissues don’t even know it’s there, and fat cells continue to respond to insulin long after those other cells and tissues become resistant.
Worth noting is that ketones themselves stimulate some insulin secretion, and the insulin secretion in turn inhibits ketone synthesis. This is a naturally occurring negative feedback loop that prevents ketone levels from getting pathologically high merely from changing our diets.
When insulin is below the threshold, when the switch is in the off position, your body is burning the fat you’ve stored. It will continue to burn fat as long as you remain below the threshold. Now your body has access to plenty of fuel. Twenty pounds of body fat provides fuel for well over two months. Even a lean marathoner like Olympic gold medalist Eliud Kipchoge, who in October 2019 ran the first sub-2-hour marathon ever, at 123 pounds, has enough fat stored to fuel his body on his fat stores alone for a week. Your body is being constantly fed on this supply of stored fat, so it’s satisfied. Your appetite will be blunted. The brain has no reason to think more food is necessary. Your body has no need to ingest more food, hence there’s little or no urge to do so. You experience weight loss—the burning of your stored body fat—without hunger.
Above the insulin threshold, you have to replenish frequently. You have a limited supply of carbohydrates, and insulin works to keep the carbohydrates you’ve stored (a maximum of about two thousand calories of glycogen) locked away as well. As your blood sugar drops, you’ll get hungry. And because carbohydrates are your fuel above the threshold, you’ll hunger for carbohydrate-rich foods.
The relative absence of hunger on these LCHF/ketogenic diets is as consistent an observation as can be found in nutrition science. Remove the carbohydrates and replace the calories with fat, and the stimulus for hunger (and for the obsessive thinking about food that goes with calorie-restricted diets) is lessened significantly.
Willpower, however, had little or nothing to do with it. Those who are lean and insulin sensitive cannot imagine the hunger for carbohydrates that will be induced in those predisposed to fatten, in those who are insulin resistant, when confronted by this aroma and the thought of the bun. It is a subjective experience that lies outside their ability to understand because they never experience it.
One reason all diet authorities now agree more or less that we should cut back on our consumption of highly processed grains (white flour) and sugars (sucrose and high-fructose syrups) is that these refined grains and sweet refined sugars are relatively new to human diets.
Recall what the hundred-plus Canadian physicians wrote in HuffPost about their observations, their experiences, when their patients embraced LCHF/ketogenic eating: “What we see in our clinics: blood sugar values go down, blood pressure drops, chronic pain decreases or disappears, lipid profiles improve, inflammatory markers improve, energy increases, weight decreases, sleep is improved, IBS [irritable bowel syndrome] symptoms are lessened, etc. Medication is adjusted downward, or even eliminated, which reduces the side-effects for patients and the costs to society. The results we achieve with our patients are impressive and durable.” Physicians who now prescribe these diets commonly say that they rarely if ever prescribe drugs to their patients for blood sugar control or hypertension; rather, they de-prescribe, they get patients off medications. That’s compelling testimony.
The results of those five studies were consistent. The participants eating the LCHF/ketogenic high-fat diet lost more weight, despite the advice to eat to satiety, than those who ate the American Heart Association and the British Heart Foundation recommended low-fat, low-saturated-fat diet. Moreover, their heart disease risk factors showed greater improvement.
Since then, as of the spring of 2019, close to one hundred, if not more, clinical trials have published results, and they confirm these observations with remarkable consistency. The trials are still incapable of telling us whether embracing LCHF/ketogenic eating will extend our lives (compared to other patterns of eating the authorities might recommend), but they continue to challenge, relentlessly, the conventional thinking on the dangers of high-fat diets, and they tell us that in the short term, this way of eating is safe and beneficial.
In June 2019 Hallberg and Virta Health published a paper on how two years of LCHF/ketogenic eating had influenced heart disease risk factors in its subjects. The bottom line was that twenty-two of twenty-six established risk factors improved (compared to what these physician researchers call “usual care”), three remained unchanged, and only one—LDL cholesterol—on average got worse. When the Virta Health researchers worked out the numbers for what’s called the “aggregate atherosclerotic cardiovascular disease risk score,” a measure of ten-year risk of having a heart attack developed by the American College of Cardiology and the American Heart Association, the Virta Health patients decreased their risk of having a heart attack by over 20 percent, compared to the usual treatment program for diabetes and all the drug therapies typically prescribed. Even with the rise in their LDL cholesterol, these patients got significantly healthier, as did their hearts.
Just as the evidence has inexorably accumulated over the years supporting the observation that LCHF/ketogenic diets make us healthier, the evidence supporting the idea that saturated fat is deadly and that we should all eat low-fat diets has been fading, despite the best efforts of the orthodoxy to prop it up.
Now, thirty years later, the most recent unbiased review of this evidence—from the Cochrane Collaboration, an international organization founded to do such impartial reviews—concluded that clinical trials have failed to demonstrate any meaningful benefit from eating low-fat diets
By the mid-1990s, though, the experts who assembled a seven-hundred-page report on this question for the World Cancer Research Fund and American Institute for Cancer Research— Food, Nutrition and the Prevention of Cancer —could find neither “convincing” nor even “probable” reason to believe that fat-rich diets were carcinogenic.
While LDL does seem to play a role in the atherosclerotic process, it’s not the cholesterol in the particle that’s the active player but rather the LDL particle itself and specifically the number and maybe the size of particles in circulation.
Finally, the medical community has known since 1977 (if not twenty years earlier) that low HDL cholesterol is a far better predictor of heart disease than high LDL cholesterol, many times more likely to be regrettably right, and that high triglycerides are at least as predictive as high LDL.
Both clinical trial data and clinical experience tell us that this body-wide disruption of metabolic syndrome—the disruption that appears to begin with insulin resistance and so elevated levels of insulin and poor blood sugar control—is normalized or corrected by removing the carbohydrates from the diet and replacing them with fat.
Researchers have known, at least since the 1970s, that carbohydrate consumption lowers the apparently beneficial HDL cholesterol compared to eating fats, and that it raises triglycerides as well.
As for blood pressure, insulin induces your kidneys to hold on to sodium. (Salt is sodium chloride, and the sodium is the player here.) This is one of the many things insulin does. When your insulin levels are high, your kidneys retain sodium rather than excreting it in urine.
By then, though, we were all being told that high blood pressure was caused by eating too much salt, another speculative hypothesis that continues to suffer from a dearth of experimental, clinical trial evidence. It was embraced nonetheless. It sounded right, and so the authorities believed it. We believed it because they did, and we never let it go.
Anyone who makes an ironclad guarantee for any way of eating—that one diet will assuredly make you live longer than others—as Gladwell suggested and I tend to agree, is probably selling something (although perhaps with the best of intentions).
A diet that restricts carbohydrates and replaces those calories with fat corrects your weight by lowering it. It corrects your blood pressure by lowering it. It corrects your inability to control your blood sugar. It’s not the equivalent of taking a pill that will make you healthy; rather, it removes what makes you unhealthy, replaces those calories with a benign macronutrient (fat), and in so doing, fixes what ails you.
The message should be straightforward: Carbohydrate-rich foods are fattening. Or to complicate it slightly such that naturally lean people might more likely understand: For those of us who fatten and particularly those who fatten easily, it’s the carbohydrates that we eat—the quantity and the quality—that are responsible. The relevant mechanism appears to be simple, as well: Carbohydrate-rich foods—grains, starchy vegetables, and sugars—work to keep insulin elevated in our circulation, and that traps the fat we eat in our fat cells and inhibits the use of that fat for fuel.
When we consume these sugars, the glucose enters the circulation, becomes blood sugar, and stimulates an insulin response, but the fructose mostly doesn’t. It’s metabolized first in the small intestine and then the liver. These organs, the liver particularly, are then tasked with the job of metabolizing an amount of fructose, day in and day out, which they are apparently ill-equipped to do.
Like any device tasked to do a job it isn’t designed to do, the liver does a poor job of metabolizing this daily flood of fructose. Liver cells use as much of the fructose as they can to generate energy, but they convert the rest, the excess, to fat. Reasonably reliable research suggests that this fat is trapped in liver cells, leading to a condition known as nonalcoholic fatty liver disease, which is associated with obesity and diabetes
Robert Cywes, a pediatric surgeon who now runs bariatric surgery and weight-control programs for adults and adolescents in Florida, said to me, “To cut to the chase, we are a carbohydrate substance abuse program, not a weight
March 29, 2021
Although not a scientist, Gary Taubes cites/quotes/mentions a significant amount of doctors, scientists, nutritionists, researchers and most importantly general public that have experienced the benefits of keto/low carb diet first hand (not just for weight loss, but improvements in other health markers as well).
I am sure there are always two sides to all things, and any claim/theory can be challenged on the basis of contradictory material. However, the content of the book and the logic behind how things work with and without the keto diet definitely align with what I personally have experienced when I tried the low carb way of life and when I was away from the lifestyle for brief periods.
I would certainly recommend anyone to give this book a read, as also explore some additional material such as the DietDoctor website and maybe give this way a try, especially if you have chronic health issues including but not limited to diabetes, metabolic syndrome, high blood pressure, obesity, etc.
I am sure there are always two sides to all things, and any claim/theory can be challenged on the basis of contradictory material. However, the content of the book and the logic behind how things work with and without the keto diet definitely align with what I personally have experienced when I tried the low carb way of life and when I was away from the lifestyle for brief periods.
I would certainly recommend anyone to give this book a read, as also explore some additional material such as the DietDoctor website and maybe give this way a try, especially if you have chronic health issues including but not limited to diabetes, metabolic syndrome, high blood pressure, obesity, etc.
January 27, 2021
Probably a good source of basic (although wrapped in a very sciency language) info to get one started on this path. However, the 2 main points are:
1. There isn't enough scientific proof on the success or the long term consequences
2. It fits every individual differently, so... bottom line, it just depends.
I didn't need a whole book for that conclusion (elmo-shrug)
1. There isn't enough scientific proof on the success or the long term consequences
2. It fits every individual differently, so... bottom line, it just depends.
I didn't need a whole book for that conclusion (elmo-shrug)
May 15, 2021
Taubes presents the 'why' to do it (and the physiologybehind it), not the 'how' to do it. I'm already a believer in keto, but this really helped solidify my conviction. He recommends compete abstinence from carbs, but does it in a gentle not fear-inducing tone; and in the end, advises to do whats best for you - that you are your own best clinical trial.
April 24, 2021
For a 300 page book about a very niche way of eating, I actually really enjoyed this book and learned a lot! Based on the title, you might expect that this book is a “diet” book, but it’s really about helping the reader understand the science of how the body works, and how we can work with our bodies to strive for improved health through nutrition. It’s approachable, easy to understand, and explains why low-carb/high-fat keto eating is not a “fad” diet, but rather rooted in nutritional research.
The author dissects decades of obesity research to argue that a lot of modern and historic diet and nutrition advice aimed at weight loss and heart health (i.e. eating low fat diets) has flawed origins, and doesn’t hold up. Taubes also argues that the classic weight loss advice of “burn more calories than you consume” doesn’t work for everybody, and that some bodies are more inclined to hold onto fat than others. Instead, the author unpacks a lot of fat-phobic thinking related to obesity, and explains how hormones, particularly insulin, play a huge role in the obesity epidemic, and how the consumption of sugars and starches impacts the body. This book doesn’t include any recipes or meal plans for keto eating, but does outline some of the core “rules” that guide this way of eating if you’re curious and want to try it out for yourself.
I think it’s important to note that the author is not a doctor, but rather a journalist who writes primarily about topics related to medicine and nutrition. Taubes comes at the topic from a neutral perspective, has been researching and writing about keto eating for over two decades. This book is the product of interviews with 100 doctors who have been prescribing keto eating to their patients for years.
The author dissects decades of obesity research to argue that a lot of modern and historic diet and nutrition advice aimed at weight loss and heart health (i.e. eating low fat diets) has flawed origins, and doesn’t hold up. Taubes also argues that the classic weight loss advice of “burn more calories than you consume” doesn’t work for everybody, and that some bodies are more inclined to hold onto fat than others. Instead, the author unpacks a lot of fat-phobic thinking related to obesity, and explains how hormones, particularly insulin, play a huge role in the obesity epidemic, and how the consumption of sugars and starches impacts the body. This book doesn’t include any recipes or meal plans for keto eating, but does outline some of the core “rules” that guide this way of eating if you’re curious and want to try it out for yourself.
I think it’s important to note that the author is not a doctor, but rather a journalist who writes primarily about topics related to medicine and nutrition. Taubes comes at the topic from a neutral perspective, has been researching and writing about keto eating for over two decades. This book is the product of interviews with 100 doctors who have been prescribing keto eating to their patients for years.
June 16, 2021
Read it under your own risk. I recommend this book as a motivation source for the one with over weight specially. If you want a more scientific approach to keto and metabolism go read “ketones the 4th fuel”
A nice take away from this one tho (for me) was the metabolic syndrome description. You have to watch your parents fat above the waist, blood pressure and triglycerides (so I’m getting a blood pressure device for mines)
In short all the book really says and repeats is: you get fat bc of the insulin telling your fat cells to stay where they are not due to the caloric superávit. So you can have plenty of calories and lose weight every time those calories are not spiking your insulin (this is specially significant when you are getting insulin resistant which happens with time)
There is no current study (RTC) that show us real implications of long term high fat vs long term high carbs food habits but there is more and more clinic evidence that shows short term benefits of controlling insulin spikes by improving the quality or restricting carbs intake. Specially in obese, diabetic, hypertensive patients.
A nice take away from this one tho (for me) was the metabolic syndrome description. You have to watch your parents fat above the waist, blood pressure and triglycerides (so I’m getting a blood pressure device for mines)
In short all the book really says and repeats is: you get fat bc of the insulin telling your fat cells to stay where they are not due to the caloric superávit. So you can have plenty of calories and lose weight every time those calories are not spiking your insulin (this is specially significant when you are getting insulin resistant which happens with time)
There is no current study (RTC) that show us real implications of long term high fat vs long term high carbs food habits but there is more and more clinic evidence that shows short term benefits of controlling insulin spikes by improving the quality or restricting carbs intake. Specially in obese, diabetic, hypertensive patients.
August 15, 2021
⭐⭐⭐⭐⭐Thanks to #netgalley for the ARC in exchange for a fair and honest review. If you read 1 book this year about how to live a healthier life and literally want to change the pathway that your current way of eating is taking you down, read this book. Gary has a way of making a low carb high fat lifestyle make so much sense without getting caught up in the "fanatical" retoric that makes some people shy away from considering this to be a lifestyle worth considering and reading more about. He explains the science and reasoning behind why lchf is the best way to eat, not only for weightloss but to put yourself into the healthiest position you can be in. He talks about the whys and how's it all works and explains things in a very simplistic manner that even the most novice of LCHF people can understand. He also delves into some of the misinformation surrounding this way of eating again whilst remaining factual. I would highly recommend this book for anyone considering a LCHF lifestyle, anyone currently following this lifestyle and even for the eye rollers/nay sayers of this lifestyle. Such an informative read #garytaubes #thecaseforketo #netgalley #lchf #keto #litsy #goodreads #theystorygraph #bookqueen #bookstagram
March 19, 2024
It's a compelling argument for the keto diet, especially as you read about all that insulin does in the body. I have a son with type I diabetes, and I understand just how crucial insulin is for survival. But hyperinsulinemia is also a devastating problem, especially as a result of the standard American diet. So this book argues that in order to take fat-growing insulin off the table as a risk, one should take sugar and other carbohydrates off the table as well. I can see that it would be beneficial to parts of the population who are especially stuck in their weight-loss goals or those who are particularly sensitive to insulin responses in the body. But the keto diet is an extremely intense method for eating, so I don't see it as THE solution to health problems in America.
February 21, 2023
I've always loved Gary Taubes' books, and this one is no different. After researching his topic in-depth, he always manages to summarize the facts (and his conclusions) in a way that is easy to understand.
April 6, 2021
What a book!!
September 30, 2021
4.5 stars
January 28, 2024
An absolutely astonishing and comprehensive counterpoint to all the diet advice crapola out there. Taubes demolishes the eat less, exercise more advice that never works. A must read.
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