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Fat And Glycemic Index: The Myth Of "Complex Carbohydrates"
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January 4, 2011
2:03 am
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(This article is Part III of a series on carbohydrate addiction. Each part stands alone, but I recommend starting with Part I, "Why You're Addicted To Bread", as it explains the fundamentals. Part II is here.)

The Mystery of the Flour Tortilla

This article started when I asked a simple question: "Why do flour tortillas have such a low glycemic index?"

The humble flour tortilla tops any list of low glycemic index grain products, with a GI of only 30. Yet whole-wheat bread has a GI of 71! (Source.)

Why is that?

"Complex Carbohydrates"...Not So Complex After All

Most low-fat diet pushers (from Pritikin,…

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January 10, 2011
9:52 am
David H. Freedman
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Yes, adding fat to flour lowers the glycemic index of whatever it is you're eating. Here's what else it does: It sends the calorie count through the roof. The ultra-low-carb crowd says, Oh, that's OK, don't worry about all those extra calories, they're GOOD calories, they'll give you energy and muscle instead of fat! Yeah, sure. I don't want to get bogged down in the argument that has played out over and over again based on conflicting studies, data and theories that support low-carb vs. low-fat vs. high- or low-whatever. But if you find yourself falling for the ultra-low-carb argument, here are three things to think about:

1) In spite of all this apparent "evidence" that going ultra-low-carb is the best and really only way to lose weight and that calories don't matter, the vast majority of scientists involved in any aspect in weight loss continue to recommend focusing on calorie reduction over carb reduction. What might they see and understand that ultra-low-carb fanatics don't?

2) Websites and books are full of arguments and evidence that back up other points of view. Don't make your decision based only on what seems like convincing arguments from one crowd.

3) The next time you're in a pizza place, look at the people who are ordering veggie pizzas, and look at the people who are ordering supremos. Still think adding a bunch of fat to your food is a great way to be fit and trim? In general, use your own two eyes to see if people who eat certain types of food over others really end up thinner in the long run. Tens of millions of people have tried very-low-carb diets, and the vast, vast majority of them eventually gained the lost weight back, usually within two years, and in many cases in just a few months. Yes, it has worked for some people, but every diet out there has people who have done well on it. They just don't work for most people.

I'm not a low-fat or low-anything proponent, none of these cut-out-a-major-food-group diets work well for most people over the long term. What we need are ways of getting us to eat more reasonable amounts of less-calorie-dense foods and to be more active, over the courses of our entire lives. That means establishing relatively healthy habits that are easy to live with forever. For most people, cutting out fat or carbs doesn't come close to filling that prescription.

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January 11, 2011
3:14 am
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David:

"The vast majority of scientists involved in any aspect in weight loss continue to recommend focusing on calorie reduction over carb reduction."

Really? If so, they're in error. The peer-reviewed science says otherwise:

JAMA. 2007 Mar 7;297(9):969-77. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC.

CONCLUSIONS: In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake [and highest fat intake], lost more weight at 12 months than women assigned to follow the Zone diet, and had experienced comparable or more favorable metabolic effects than those assigned to the Zone, Ornish [= low-fat, high-carb], or LEARN diets.

[I must mention once again that paleo is not Atkins! I do not recommend Atkins because of its endorsement of processed meats, grain oils, sugar alcohols, and other unhealthy industrial food simulations.]

"Tens of millions of people have tried very-low-carb diets, and the vast, vast majority of them eventually gained the lost weight back, usually within two years, and in many cases in just a few months...They just don’t work for most people."

False, and already addressed by the study. They work more consistently, and for longer, than any other diet:

"Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up.

MAIN OUTCOME MEASURES: Weight loss at 12 months was the primary outcome." [Note: This is 10 months after instruction ceased.]

"What we need are ways of getting us to eat more reasonable amounts of less-calorie-dense foods and to be more active, over the courses of our entire lives."

Calorie density is a red herring. Yes, fat is denser in calories than sugar ('carbohydrates'): it also satiates, and sugar does not. If calorie density were significant, all anyone would need to lose weight is a huge jar of sugar-free Metamucil.

The easiest way to eat less is by eating more fat and less 'carbohydrates' (sugars). This is consistent with basic human metabolism (fat satiates, slows digestion, and slows absorption), peer-reviewed science (see above JAMA study), and common sense (Jamba Juice vs. Quarter Pounder).

"That means establishing relatively healthy habits that are easy to live with forever."

It's a lot easier to live with meat, eggs, butter, fresh greens, fresh fruits, olive oil, and avocado slices than tofu, lentils, and brown rice. We are humans, not birds or rodents.

"For most people, cutting out fat or carbs doesn’t come close to filling that prescription."

This article is Part 3 of a series. Part 1 clearly states that paleo is not zero-carb: you should read it, because it lays the theoretical foundation for this one.

"Don’t make your decision based only on what seems like convincing arguments from one crowd."

Please don't patronize a fellow author. I came to my views because of the evidence I found while researching diet and glycemic index, and because I've been happier, healthier, and more productive since I've put these principles into practice. I wrote these articles to explain my learning process.

Maybe you should try it! I have a few delicious recipes to share: contact me through the "Contact" page if you're interested.

Live in freedom, live in beauty.

JS

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January 17, 2011
9:51 am
Links, Quick Hits &a
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[...] ~ Pretty telling chart that J. Stanton of GNOLLS.ORG put together right here: The Lipid Hypothesis Has Officially Failed. Lot's of other great insight on that blog so have a look around. Here's a suggestion: Fat And Glycemic Index: The Myth Of “Complex Carbohydrates” [...]

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January 17, 2011
2:23 pm
Elenor Snow
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I recommended recently to Tom Naughton of Fat Head fame that instead of calling them simple and complex carbs (since everyone gets those all mixed up) we should start calling them: sugar carbs, fruit carbs, and veg carbs -- as in: "avoid sugar carbs and fruit carbs, go easy on the veg carbs." Much clearer, and more people might understand... if they want to! {sigh}

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January 17, 2011
5:15 pm
Andy Newport
Guest

Hi J,

First off I love the site and agree wholeheartedly. However the arguments you're presenting are incomplete. While somewhat useful, the GI rating on foods doesn't tell the whole story regarding carbohydrate.

Table sugar is 50% Fructose. The metabolism of fructose hardly budges blood sugar at all but causes untold issues in the liver both directly (implicated in non-alcoholic fatty liver disease when high PUFA in diet) and indirectly (damaging liver insulin sensitivity, again when PUFA is high). To say the effect on blood sugar of oatmeal and skittles is the same is accurate (hence the similar GI scores). To say the effects on long term metabolism are equal is true for the wrong reasons. Grains are deadly not primarily because of their carb load but because of the damage they do to our gi tract and metabolism via lectins, gluten and wga etc.

Recently Robb Wolf commented on the difference between the Kativans and the Tarahumara indians, both eat relatively high carb diets, one (90% calories) in the form of tubers and the other in corn (80% ). The ones eating tubers don't display metabolic or cardiovascular disease in old age while the grain based ones do, with bone and tooth issues to boot. There's something more than carbs and GI in play as people groups with undamaged metabolisms (the key factor) seem to deal with carbohydrate just fine for their long, healthy lives.

Total carb level is part of the puzzle, but it's not the be all and end all. Stopping metabolic damage (eliminating Fructose, grains and Omega-6 fats) does more for longevity than eating lower GI, there's plenty of low GI "food" out there.

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January 17, 2011
8:26 pm
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Andy:

Thank you for your perceptive feedback: I hope you'll subscribe and keep contributing!

You are absolutely correct that sugar intake and glycemic index is only one piece of the health puzzle, and that all the other issues you mentioned are very important.  (I may write about them someday, but only if I can provide a unique synthesis of the knowledge.  I don't pretend to be Dr. Guyenet or Dr. Harris, or even Dr. B.G.)

However, I can't address them all in three short articles.  I wrote this series to address the specific question: "Why is it so hard to stop eating bread?"  (And cereal, and other starchy foods.)  In other words, "Why am I addicted to carbohydrates, and what can I do about it?"

I agree with you: kicking your addiction to 'carbs' (sugars) is only one part of a long journey towards better health.  But it's the biggest obstacle I see between most people and a healthy diet: they just can't give up their bread, crackers, and cereal.  Treating bread as a chemical addiction helps some people get through their transition to a fat-burning metabolism...once they've done that, the rest is much, much easier.

And yes, WGA, lectins, and gliaden/glutenin have terrible long-term consequences...but I've found that when you start talking about them to someone who hasn't been exposed to anything but the food pyramid and Weight Watchers, their minds snap shut immediately because they think you're a nutcase.  "Wait.  You're saying wheat, the STAFF OF LIFE, is a slow poison?"  And the conversation is over.

Anyone in the paleo community already knows all this stuff.  My intention with this series is to create something you can forward to your Aunt Blanche or Uncle Ted who's never heard of 'paleo', and who's been struggling with her weight for decades because she can't stick to the standard low-fat diet.  Once they understand why they've been yo-yo dieting for so long, then you can start introducing the deeper paleo concepts.

JS

Elenor:

That's an interesting take on it...here's mine.  Let me know what you think:

There are no special nutrition terms for simple vs. complex proteins.  Until nutrition people start referring to 'peptides', 'prolamins', and other technical terms for the myriad dietary proteins and their breakdown products, I'm going to call all carbohydrates "sugar", because that's what they are.

JS

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January 18, 2011
5:07 pm
Paula
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"Yes, adding fat to flour lowers the glycemic index of whatever it is you’re eating. Here’s what else it does: It sends the calorie count through the roof. "

Yes, it does if you eat the same mass of food. I could eat 2 cups of spaghetti, but there's no way I'd eat anywhere near that volume of cooked meat.

"The next time you’re in a pizza place, look at the people who are ordering veggie pizzas, and look at the people who are ordering supremos."

Two words: confounding factors. People who choose vegetarian tend to be more health-conscious than people who eat a lot of everything, especially if we are talking about people eating out in a fast-food restaurant. A supremo pizza slice still has about 36 grams of carb in the crust, so a low carber wouldn't eat it unless they wanted an indulgence. At my workplace the women who eat Lean Cuisine, Weight Watchers, and other diet frozen entrees are all substantially overweight or obese.

In my informal observation, low carbers who remain overweight include cheese and supposedly low carb versions of high carb foods like bread, tortillas, and cookies. Diabetics who test their blood sugars have reported that some foods labeled low carb caused their blood sugars to rise more than expected for the amount of net cards. Offhand, I cannot think of any paleo low carber who remains overweight after months of eating that way. There may be a black swan yet undiscovered.

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January 19, 2011
11:24 am
Bodhi
Guest

Just writing to say I enjoyed this article and your website. Keep up the good work.

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January 19, 2011
5:29 pm
js290
Guest

How do calories affect hormones?

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January 20, 2011
11:40 am
Check the links̷
Guest

[...] The lipid hypothesis has failed and the myth of complex carbs. [...]

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January 21, 2011
3:04 am
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Paula: "Two words: confounding factors."

I don't like to even respond to anecdotal evidence, because it's irrefutable.  But I think your main argument is most important: no one in a pizza place is on a low-carb diet, so it's not a relevant data point.

Bodhi: "Keep up the good work."

Thank you!

js290 said: "How do calories affect hormones?"

That question would require an entire book to answer it, and I'm not qualified to write that book.  But there is some fascinating data on how different dietary proteins affect serotonin, as well as some interesting data on macronutrients vs. anabolic hormones.  I may try to write an article about what I know someday.

 

Thanks to all of you for contributing!  There's much more good stuff to come, and I'm on a regular update schedule now (Tuesdays), so please continue to share your thoughts.

JS

 

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January 22, 2011
11:54 pm
Cornelius
Guest

I will agree with some of the earlier posts here that there is a difference between low calorie and low carb diets.

As I have done both, please allow me to recount some of my own experiences. First, many years ago, I believed in the low fat, low-cal diet. This was back in the days when Susan Powter was starting the insanity with her oversimplified take on "you are what you eat." For those of you who don't remember, her whole thing was basically "Don't eat fat, don't get fat." It sounded plausible, back in those days, but from an actual scientific standpoint, it is complete and utter hogwash. Your body does not turn ingested fat into stored fat. Ever. Just can't happen.

Anyway, I ate low fat, and limited my caloric intake. And, yes, I lost weight, but, much of the weight I lost was muscle mass. I went from wearing an extra-large shirt to a medium, and not just because of my gut. There is no way now that my shoulders would fit into a medium, or even a large shirt, for that matter. And, there was no way that diet was sustainable. I was hungry all the time, I was quite noticeably weaker, and I was cold. Always. Sorry, ladies, but I felt like I had turned into a little girl. Not a bad thing if you really are a little girl, but a horrible thing if you are used to being a fairly big guy. :)

So, of course, eventually I gave up, and gained the weight back. Along with the muscle, the strength, the lack of hunger, and the warmth. I was once again comfortable, even if my gut was a bit larger than I would have liked. And I said to myself "Screw it, this is where my body wants to be." So I gave my medium shirts to a little guy I knew, and decided to be happy.

Then, eventually, I did some reading, and I discovered the low-carb thing. And then I did some more reading, and learned how and why the body really makes fat. This was the key for me. I then started eating low carb, and discovered that calories and dietary fat were really not the issue. I ate as much as I wanted, lost the fat, but retained the muscle and the strength. And the warmth. And, of course, I never felt like I was starving, because if I was hungry, I ate. The low carb diet is not really a "diet" as in "I am on a diet." It is a satisfying and sustainable way of life.

I discovered I could pork out on fats and protein, and still lose weight. And, by the way, for those of you who say "Yeah, but..." I am much healthier than I was in the old days. No pills or prescriptions for this old man. I can't actually remember the last time I even had a cold, much less anything more serious. The last time I was physically ill was about ten years ago, but that was from too much alcohol. :)

These days, as I said, I am older, and I can't eat as much as I used to, but if I could, I could, know what I mean? And I have kept the weight off. Easily. Don't eat carbs, and you will not crave them. Feel hungry? Go grab a chicken leg out of the fridge. Heck, go grab half a chicken. Or a big, juicy steak. And a big glass of whole milk. Don't worry if it is almost bedtime, even if you pork out on protein and fat and go right to bed, you will not gain weight. (What causes you to gain weight in such cases is the serum glucose you don't burn. Protein and fat don't cause an excess.)

I know a lot of people out there really want to hang onto the idea that calories and dietary fat are the true culprits for overweight. Heck, I was one of them. I really didn't want to be wrong in what I had believed for years, either. But I was, and now I am glad I learned this. If I had not, I would still be fat, and I would probably be experiencing a lot of other troubles that go with this, like joint pain. Forget the cardiovascular stuff; even if you never have that problem, just the sheer weight will wear out your other parts.

Many people say "If you burn less calories than you consume, you get fat." While this sounds logical, and can indeed be true, it is as big an oversimplification as Susan Powter's schtick. It depends on where you get the calories. Most people will agree there are nutritious calories and empty calories. Think of it this way: what I am saying is just one tiny step beyond this concept.

If you are not convinced, read the studies, and keep an open mind. JS provides links in many of his articles. Or, just try it. What do you have to lose, but the weight? If you are obese, you are already unhealthy. Give it a shot.

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January 25, 2011
11:47 am
Mark
Guest

Heres a GI bomb for ya:
The potato is commonly identified as complex carbs however...

White potato, backed without skin = scores a whopping 96!
(according to the HQ of glycemic index: glycemicindex.com; The University of Sydney)

Here's another interesting slap in the face to the "sugar is bad" brigade:

Fructose scores a surprisingly GI of 15 (ave); which implies that the amount consumed will not trigger an insulin spike and thus will not cause you to pack on fat unlike scoffing down on triple fudgy chocolate donuts with sugar on top.

All other carbs are converted to glucose after digestion and then enter the blood stream - but fructose needs to go to the liver FIRST - hence it takes longer to get to the blood stream, hence the low GI score.

The surprise here is that a very small amount of fructose is converted to glucose - the remainder is stored as fat.

The reason why it goes to the liver is because fructose is 4x more efficient in replenishing liver glycogen stores compared to glucose. If the liver is low on glycogen, it replenishes itself and the rest finds a home on your ass/thighs/back/gut!

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January 26, 2011
12:11 am
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Mark:

The GI of a potato depends on how it's cooked, with baking producing the highest GI...just like pasta, which goes up the longer you boil it. But who eats a dry baked potato? Generally it's filled with butter and sour cream, dropping its GI dramatically.  

You're correct about the fructose pathway, which is different: eating lots of fructose is most certainly not a healthy substitute for glucose, and is probably far worse due to glycation as well as the issues you mentioned.  I have to simplify the issue somewhat to chop it down to article size: otherwise I'd just end up rewriting Good Calories, Bad Calories.

Thanks for the helpful dialogue!

Cornelius:

I'm glad you shared your experience.  It helps people to know that there is light at the end of the tunnel.

JS

 

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January 26, 2011
5:44 am
Sean
Guest

When we were visiting my folks in Albuquerque last summer I couldn't actually find any tortillas made with lard at the huge local grocery store. 50 brands of tortillas, none made with lard. And they didn't have any lard itself for sale, just the hydrogenated stuff. I suppose I could've gone down to the valley and have hunted some up (or gone to a butcher and rendered my own) but it was still surprising.

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February 8, 2011
12:35 pm
David H. Freedman
Guest

Ultra-low-carb supporters love to cite the study you mention, and other mostly out-of-date, one-year-long-or-shorter studies. I do agree that if you want to have the best chance of losing the most weight possible over a period of several months, and don't care about long-term results, the Atkins diet seems like a pretty good choice. I tried it, and lost a bunch of weight in just three weeks. Sadly, I, like the vast majority of people who try Atkins, fell off it and gained the weight back. In fact, in the study you cite, the weight-loss gap between the Atkins diet and the other diets was quickly closing in the latter months of the study. There haven't been many long-term studies of the Atkins diet vs. other diets. One of the very few very-long-term studies done seems to suggest that meat-eating Atkinites have an alarming habit of dying early, as written up, for example, here:

http://health.usnews.com/health-news/diet-fitness/heart/articles/2010/09/10/the-best-low-carbohydrate-diet-one-thats-plant-based

The next-longest-term study suggests that when we extend the time period to two years, Atkins loses all its advantages, with other diets fully catching up, as for example written up here:
http://www.nytimes.com/2010/08/10/health/research/10diet.html

Since Atkins seems to start out strong and then peter out, one might infer that Atkins is actually weaker than other diets over the very long term. But as scientists like to point out (or should), further study is needed.

What really interests me, though, about the way you folks cite these weak studies, is that you ignore the fact that even these studies that you yourselves cite clearly indicate that there are serious problems with the theory on which you base all your claims. Your basic claim is that if you eat carbs, you turn into a walking insulin-spurting, fat-accumulating machine of uncontrollable appetite, whereas if you cut out carbs, your body very neatly and comfortably turns your calories into energy and muscle, burning away fat. But when we look at this study that you cite and other studies, do we see people on higher-carb diets piling on flab, while the Atkins folks become all sleek and fit? Hardly. What we see, over the relatively short-term, is that the Atkins folks lose a modest amount of weight, and the non-Atkins, carb-eating folks lose a modest amount of weight, too, if somewhat less, and as time goes on the gap narrows. I know how you folks try to explain away this massive, sharp contradiction with what your theory predicts: You claim that people on other diets are actually reducing their carbs, too. Please. The fact is, the theory just doesn't even come close to holding up in these studies, even if it offers a short-term advantage in rate of weight loss.

But where Atkins really fails is in the real world. If you step outside the world of Atkinites and start randomly asking overweight people what their experiences have been with the Atkins diet, you pretty much always hear the same thing: Tried it, lost weight, fell off it, gained the weight back. Of course, if most of your information comes from sites like this one, you'll hear nothing but good things about ultra-low-carb approaches, and will be oblivious to the serious shortcomings of the diet's claims.

Too bad it doesn't work for most people. It's a very seductive idea. And it seems to work long-term for some tiny minority of people--as do many other kinds of extreme diets backed by wonderful-sounding theories. I'm happy for everyone who achieves a healthy weight over the long term, however they do it. I really wish, though, that the Atkinites and other proponents of extreme diets weren't distracting the public from what really works in weight loss for most people.

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March 6, 2011
10:43 pm
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David:

The AIM study you cite (original http://www.annals.org/content/153/5/289.abstract

http://wholehealthsource.blogspot.com/2008/10/pale.....-part.html

 

'Paleo' is the endpoint of about five years of dietary research for me, during which I purchased no diet books, 'paleo' or otherwise.  My research comes entirely from PubMed, Google Scholar, and other peer-reviewed papers.  So I believe your confident dismissals to be somewhat misplaced, and I would appreciate a modicum of professional courtesy when discussing the subject.

JS

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March 17, 2011
9:52 am
Angelo Coppola
Guest

Excellent discussion here. On episode 7 of Latest in Paleo, I played the following clip by Dr. Marc Bessler. He is an obesity expert at New York Presbytarian hospital: http://bigthink.com/ideas/16494. For many people, fat is more satiating -- especially vs. carbs -- this is key.

The tide is swinging on the low-fat fad diet, with nutritionists, doctors, and researchers finding that natural saturated fats are an important part of a good diet.

One of the reasons I have been a fan of David Freedman's work is that it shines a light on some of the reasons why the research on both sides can be, and often is: WRONG. Much of the research from Ansel Keys on forward has been dishonest, corporate- and agenda-driven, and dubious.

That being the case, what's left? How about the evolutionary clues? What did our ancestors eat? Heck, even our great grandmothers wouldn't recognize half the packaged crap in a grocery store as food...

"Whenever you find yourself on the side of the majority, it is time to pause and reflect." - Mark Twain

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April 15, 2011
10:18 am
TruthandJustice
Guest

Of course you're going to gain weight if you go back to eating a high sugar/starch diet. Duh. That's not Atkins' fault. addictions can be tough, but the key is to take is slow. It took me a year or so to get to the point where I only drank water and milk. I used to cringe at the thought of drinking plain water, but eventually I got over it and now I like drinking water.

The reason people give up is they don't want to put in the required effort, AKA they're lazy. Fat loss is not magic, it takes time. It has taken me two years to go from 30% bodyfat, to 15% bodyfat. Along the way I made small changes. No soda, then no sugar, then no grains, then exercising. I fell of the wagon a few times, but I got back up and put in the effort and I got the results.

In the past three months I've really been hitting the weights and putting on muscle. As a result the fat has really started dropping off. I lost 12 lbs in the past 5 weeks, while at the same time repeatedly setting personal records for all my lifts. I recently reached a 300lb bench press, and 400lb deadlift.

I've had no problem sticking to my diet of steak (fatty cuts), fish, whole milk, eggs, and broccoli. Steak topped with butter and spices is way better than any donut, ice-cream, bread, or soda. It's also not that expensive. My daily food costs are only ~$8, which is less than a single meal at a sit-down restaurant, and only a little bit more than a single meal from a fast food restaurant.

I don't know if my diet would be considered Atkins or not, but saying a diet is bad because people are unwilling to stick to it is horrible logic. As others have previously mentioned, the science proves that high-fat diets are much healthier than high-carb diets. If people are too lazy to change their diet, that's their own fault, not nutrition's fault.

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