Real Food Update


Real Food Update

  1. The NYT reports on a new comprehensive scientific review that found optimal protein levels for people over 40 trying to gain muscle mass are roughly twice our federal recommendations. And remember, many women do not even get the recommended level of ~46g/day. 
  2. A concise opinion piece by Ben Greenfield in The Hill on why the dietary guidelines are failing Americans, and why Congress needs to act to change them to align with modern science. Case in point, a retired special ops combat controller asks, in an op-ed in The Dallas Morning News, why so many of our troops struggle with weight? It's not lack of exercise. His answer? It's the food... controlled by our dietary guidelines.
  3. Might this non-invasive continuous blood sugar monitoring wearable help regular people understand that the bagel they are eating is essentially pure glucose after 15 minutes in their digestive tract?


Real Food Update


Real Food Update

  1. A small clinical trial, ongoing in overweight men with recurrent prostate cancer, shows a keto diet leads to significant weight loss. At six months, patients averaged 28 lbs lost on keto versus 0 lbs in control group. BMI was reduced by an average of more than 4pts. Unclear if diet/weight loss deters cancer growth (trial ongoing). Similarly, a small prospective pilot study of patients placed on a 4 week ketogenic diet to prepare for bariatric surgery showed "highly significant decreases in body weight (− 10.3%, p < 0.001, in males; − 8.2%,p < 0.001, in females), left hepatic lobe volume (− 19.8%, p < 0.001)" and a resolution of micronutrient deficiencies.
  2. A clinical report, published in Cell Metabolism, finds that carbohydrate restriction delivers "rapid and dramatic reductions of liver fat and other cardiometabolic risk factors" in patients with nonalcoholic fatty liver disease (NAFLD). No pill can do this for you.
  3. Diabetes, Obesity, and Metabolism published a study that demonstrates how fasting glucose creeps up gradually, often tied to chronic insulin resistance. Authors argue for early detection and intervention to prevent progression. 


Real Food Update


Real Food Update

  1. Is it possible to reverse type-2 diabetes? Virta Health proves the answer is "yes," releasing hands-down stellar one year results, published in JIMR Diabetes. Here's an easy-to-understand animated short that explains how Virta works.  For a longer read, try this interview with Dr. James McCarter, Virta's Head of Research. Separately, the British Journal of Sports Medicine runs the text of Virta Medical Director Dr. Sarah Hallberg's popular (~3 million views) TEDx, "Reversing type 2 diabetes starts with ignoring the guidelines."
  2. Dr. David Ludwig pens a grim reality check on rising obesity rates in kids, published last month in Pediatrics. Ludwig writes: "The second, more fundamental lesson is that our public health approach to the epidemic has largely failed so far." Fortune reports briefly on the same study to which Ludwig was responding, which looks a NHANES data from 1999-2016.
  3. The obesity paradox—the idea that obesity might protect patients with heart disease and help them live longer— has been debunked. The LA Times explains why a new study published in JAMA Cardiology demonstrates that excess weight can mean younger onset of CVD and, thus, fewer years of disease free life.



Real Food Update

This week, we introduce Dinner Ideas, a free online tool that will help you answer that age-old question, "What's for Dinner?" We've got you covered with thousands of easy, everyday meals.

It is a fun, visual experience... with a click-through to basic recipes (in case you need help executing)! Mix-and-match the three sections until your plate looks just right!

Why not give it a go—try Dinner Ideas.


6 Vintage Diet Options


6 Vintage Diet Options

Once you've created your first few Dinner Ideas, you are ready to get started thinking about which Vintage Diet is right for you!

There are 6 to choose from. The flow chart, below, will lead you to the diet that works best for you based on your health and preferences. 

Get started below! 


Now that you know which diet is best for you, click on your Diet below to get started!

Perfect Health


Real Food Update


Real Food Update

  1. Looking for a comprehensive list of over 70 clinical trials that compare lower-carb, higher fat diets to higher-carb, lower-fat diets? This list was put together by Virta Health's Dr. Sarah Hallberg, and in virtually every trial, the lower-carb regimen does as well or better than the lower-fat arm on one or more of the following measured outcomes: weight loss, blood sugar control, and CVD risk factors. So for those who think lower-carb eating is just a fad, think again.
  2. Which comes first? High insulin levels or obesity? A new genetic study from Dr. David Ludwig’s team shows high insulin levels predict weight gain, not the other way around.
  3. Yale News reports on a new study, published in Cell, that “has identified leptin — a hormone made by fat cells — as a key mediator" in the body's switch from burning carbs to burning fat during fasting.


Real Food Update


Real Food Update

  1. JAMA publishes an important summary of the growing interest in ketogenic diets for weight loss and type 2 diabetes in its theme issue, "Reimagining Obesity in 2018."
  2. The Atlantic reports on a new study that illuminates the startling association between high blood sugar—INCLUDING pre-diabetic levels—and cognitive decline. Results suggest “Alzheimer’s is another potential side effect of a sugary, [starchy] Western-style diet.”  Also this month, The BMJ  published a new essay by Gary Taubes: “What if sugar is worse than just empty calories?” It explores the (still ambiguous) science and policy implications.
  3. Time reports on a study that shows obesity shaves almost a year from US life expectancy. "Drug and alcohol abuse are often blamed for reductions in life expectancy... [but] the country faces multiple challenges when it comes to longevity and public health," including record rates of obesity.


Real Food News


Real Food News

  1. Last week in The Globe and Mail, Gary Taubes asks if anecdotal evidence of the efficacy of low-carb diets should be taken more seriously, especially given the unfortunate across-the-board lack of rigorous science in the realm of nutrition.
  2. Life expectancy in the US declined for the second year in a row. Opioid overdoses are behind this year's decline, but the diabetes epidemic's impact may be underestimated.
  3. In The Dallas Morning News, Dr. Jake Kushner asserts "Government is helping to feed the diabetes crisis in Texas," by perpetuating out-of-date, low-fat dietary advice. Kushner writes, "Despite all the new research exonerating fats and implicating carbohydrates, leading nutritionists refuse to reconsider entrenched norms of a healthy diet." Indeed.


Real Food News


Real Food News

  1. Sugar industry deceit is back in the newsThe New York Times reports that "the sugar industry funded animal research in the 1960s that looked into the effects of sugar consumption on cardiovascular health — and then buried the data when it suggested that sugar could be harmful, according to newly released historical documents." Forbes weighs in on the ethics of this intentional obfuscation.
  2. A new study out of Washington University takes aim at ultra-processed food.  "This review shows that ultra-processed foods, in particular products made from substances extracted from whole foods, particularly oils, flours and sugar, were not part of evolutionary diets and may be a main driver of malnutrition" including over-nutrition (obesity). Back to basic whole foods, folks.
  3. Cardiologist John Warner, president of the American Heart Association, suffered a heart attack while at an AHA conference. Thankfully, Dr. Warner is doing well. But is this a sign (from the universe) that there is something terribly wrong with AHA advice?


Real Food News


Real Food News

  1. Understanding the cancer-sugar-obesity link: The LA Times reports that science points to cancer risk resulting not just from eating too much (or weighing too much), but from eating too much refined carbohydrate, especially sugar.  Fortune reports on a curious interaction between a cancer gene and a sugar molecule that may begin to explain how sugary diets contribute to cancer risk. Plus, the CDC reports on the rise of incidence rates for cancers linked to obesity.
  2. The Endocrine Society puts the story of a dangerous imbalance caused by the omega-6-rich vegetable oil in our food supply on the cover of Endocrine News. These processed oils are inflammatory and contribute to obesity... so back to butter.
  3. New obesity statistics were reported by the CDC. It's official— 39.8% of American adults are now obese. And, a new study, published in The Lancet,shows a ten-fold increase, worldwide, in the number of obese children over just four decades.


Real Food News


Real Food News

  1. The CDC releases the latest obesity data and maps, by state and county. All 50 states now have registered a prevalence of at least 20%, and 5 states have an obesity prevalence greater than 35%. 
  2. The National Academy of Sciences releases its congressionally mandated report: Redesigning the Process for Establishing the Dietary Guidelines for Americans. The Nutrition Coalition, an advocacy organization seeking science-based nutrition guidance, applauds the report and summarizes the findings. On a related note, RealClear Health riffs on the importance of basing nutrition policy on science.
  3. CNBC reports on diabetes and prediabetes in America. According to a new CDC report, 33% of American adults have either diabetes or prediabetes—over 100 million people. The vast majority of those with prediabetes are undiagnosed. 


Real Food News


Real Food News

  1. Really. Big. News. Prestigious medical journal, The Lancetpublished the results of the PURE study, showing that high carbohydrate diets are linked to higher rates of mortality. And that fats, including saturated fat, are neutral to slightly protective. Analysis from Larry Husten for MedPagehere. Delightful headlines ensue, like this one in the Telegraph: Low-fat diet could kill you, major study shows. 
  2. Also in The Lancet, Senior Executive Editor Stuart Spencer endorsed Nina Teicholz's 2014 bestseller, The Big Fat Surprise. Better late than never. Spencer writes: "Researchers, clinicians, and health policy advisors should read this provocative book."
  3. Mainstream podcast, Revisionist History's "The Basement Tapes," tells the story of recovering data from an old (1960s and 70s era) study that, when reanalyzed, showed corn oil was worse for health than butter. While working on the story, podcast host, Malcolm Gladwell, read and endorsed Nina Teicholz's book, The Big Fat Surprise


Real Food News


Real Food News

  1. Doctors Demasi, Lustig, and Malhotra put their heads together to write an opinion piece for Clinical Pharmacist entitled, "The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance." Great reading.
  2. Sugar foe Gary Taubes pens another great piece for The New York Times about why sugar and carbs are so hard to quit and how strict limits work best for him. His article: "Are You a Carboholic? Why Cutting Carbs is So Tough.
  3. Nina Teicholz, author of The Big Fat Surprise, and cardiologist Eric Thorn team up with this post to contest the American Heart Association's recent Presidential Advisory which cautions against consuming saturated fats. Teicholz and Thorn observe, "What is striking about the latest AHA Presidential Advisory is that it's such an anomaly." The co-authors demonstrate that most recent analyses find no significant relationship between dietary saturated fat and CVD mortality. More from Teicholz in her op-ed in The LA Times, "Don't believe the American Heart Assn. — butter, steak and coconut oil aren't likely to kill you."


Real Food News


Real Food News

  1. Doubling down, the American Heart Association reaffirms its counterintuitive advice to replace whole, full-fat food with refined, processed seed oils in this Presidential Advisory published in Circulation. Investigative journalist Gary Taubes parses the AHA's Advisory, and the actual science, in a quick but effective takedown. Meanwhile, a new meta-analysis by Hamley, just published in Nutrition Journal, concludes there is no benefit to replacing saturated fats with PUFA's, and adds, "the suggestion of benefits reported in earlier meta-analyses is due to the inclusion of inadequately controlled trials."
  2. Virta Health continues to slay diabetes. The VC funded firm, dedicated to reversing diabetes in 100 million people by 2025, shared some preliminary results. At one year, 82% remained in the trial, and body weight was down an average of 13.6%. WOW. Additionally, 97% reduced or halted insulin use; oral meds, excluding metformin, were reduced by 84%. 👍
  3. “'It’s a disgrace' that so little is known [about diabetes drugs and their efficacy], said Dr. Victor M. Montori, a diabetes expert at the Mayo Clinic." That's The New York Times reporting on the failure of the medical community and pharmaceutical companies to study and understand the affects of diabetes drugs on patient outcomes, especially real endpoints like heart disease mortality. “'Daunting' is how Dr. JoAnn Manson, the chief of preventive medicine at Brigham and Women’s Hospital, describes the situation for patients and their doctors. She explained the options and uncertainties in a recent commentary in JAMA."


Real Food News


Real Food News

  1. The New York Times reports that the American Academy of Pediatrics revised its guidance on fruit juice, now advising NO juice in a child's first year. Finally—this recommendation should have been made years ago. Further, according to the AAP's report, fruit juice “has no role in healthy, balanced diets of children.” Amen. For more on this topic, check out ETB post, "Juiced on Juice" from the archives.
  2. Baylor researchers report a low-carb diet is associated with less weight gain after menopause. Specifically, the analysis showed that post-menopausal women "who consumed the fewest carbohydrates had a significantly reduced risk of gaining 10 percent of their body weight over an eight-year period, whereas those who consumed the least fat had a significantly increased risk of gaining more than 10 percent of their body weight over that time period." Their report was published this month in the British Journal of Nutrition."
  3. Do the 2015 Dietary Guidelines remove the upper limit on dietary fat? It has been widely reported that the current set of guidelines remove the fat limit, but an intrepid RD MPH (repeatedly) asked the USDA to confirm this... and apparently the 35% upper limit still stands. Get the Alternative Fa(c)ts directly from Ms. Hite.



Living Low Carb in a High-Carb World

 "Low-Carb Lifeboat"&nbsp;by  Anne Lopez Studios

"Low-Carb Lifeboat" by Anne Lopez Studios

New on the Eat the Butter blog... a practical guide for sticking with your real food plan while living in the real world! This post first appeared on the awesome low-carb website, Diet Doctor, but was written by ETB! It is perfect for anyone trying to navigate a real food, low-carb life in our mainstream (and often pretty junky) food culture. 

Living Low Carb in a High-Carb World

Ahoy, low-carb eaters! Rough seas lie ahead.

Take a look at your surroundings. Cheap calories are everywhere. Lousy, outdated ideas about diet and health dominate. Clueless doctors and dietitians supervise. Lame government health officials put their heads in the sand. It’s a perfect storm.

The cruise you didn’t choose

America, like most modern nations, is like a bad cruise ship headed into bad weather. The buffets on-board are overflowing with processed food — sugary drinks, starchy snacks, and meals dominated by additives, refined vegetable oils, and more starch. The restaurants are always open and the all-you-can-eat buffets encourage large plates piled high with food.

The cruise director promotes the ever-present food and drink over the ship’s loud speakers, reminding you to head on over to the restaurants, anytime. Whether you are hungry, bored, or lonely, the answer is a visit to the ship’s bars, buffets, and snack stands. Occasionally the Captain ruins the mood — he picks up the microphone and admonishes, “Passengers should eat less and exercise more.”

And so it goes — the endless cycle of heavily marketed and ubiquitous bad food, weight gain, ill health, misguided scolding, and guilt. This is our crazy (dare I say hellish?) world.

Abandon ship

Living low carb means abandoning the cruise before it takes you down. Once off the ship, you can avoid the buffets that set you up for failure.

Your low-carb lifestyle doesn’t just save you from the storm. It can help fix the broken system. The example you set each day matters. If enough people catch on, we can change the world.

Low-carb living requires extra planning and an independent spirit. But we know you can do it. This post is designed to make low-carb living in a high-carb world easier.

Here is your five-part guide to swimming upstream.

  1. Provisioning Your Low-Carb Home
  2. Living Low Carb in a High-Carb Home
  3. Living Low Carb Away from Home
  4. Parenting Low-Carb Kids
  5. Knowing What You Are up Against

1. Provisioning Your Low-Carb Home

low carb fridge

A low-carb home is like a lifeboat bobbing alongside the enormous cruise ship that holds our toxic modern food environment. When you hop off the cruise ship and come home to your lifeboat, you can surround yourself with delicious real food, eliminating the highly processed choices onboard the cruise.

Provision your lifeboat with the best food you can afford. Time well spent in the grocery store is the most crucial step for setting yourself up for low-carb success. Shop wisely. And remember, if you don’t buy it, you won’t eat it.

Build your basic grocery list

You know what to buy — meat, fish, seafood, eggs, full-fat dairy, colorful vegetables, tart fruit, and nuts. Plus butter and olive oil, of course! Here is a more detailed grocery list organized by section of the store. Print it and bring it with you when you shop.

Master online grocery shopping

Some of us live in rough food environments. Your local grocery store may not offer the delicious fresh meats, tantalizing vegetables and the healthy low-carb extras you seek. Fortunately, online grocers are expanding. Here are a few who might deliver in your area:

Amazon for next-morning service
Amazon Fresh offers next morning delivery to many locations.

Instacart and lookalikes for speedy deliveries
If you live in a major metropolitan area, Instacart might provide speedy grocery delivery to your home. Their model is grocery delivery in under an hour. Local players like this one offer similar services in many large or mid-sized cities.

Walmart and regional grocers for curbside pick-up
Walmart offers online ordering and curbside pick-up in many markets. Many regional grocery chains are also offering on-line ordering with curbside pick-up. This saves time and is usually free.

Safeway, etc. for home delivery
National supermarket chains like Safeway will accept online orders, pick out your groceries, and deliver to your door for a fee. See what is available in your area.

Thrive Markets for organic-ish non-perishables at a discount
As Fortune put it, “If Costco and Whole Foods had an online baby, it would look something like startup Thrive…” If you want to stock up on low-carb staples like macadamia nuts, jerky, dark chocolate, coconut products, and lard, all delivered to your door at prices that are better than Amazon’s, Thrive is a good option. Note that there is a membership fee of ~$60/year, but you can try it for a month free of charge.

Postmates delivers from grocers and restaurants
Whether you want groceries or a gourmet meal, Postmates is on duty, 24/7, in many markets. They promise speedy, courteous delivery in under an hour.

Consider a meal delivery service

Cook new recipes with fresh ingredients shipped to your door
Like to cook but hate to shop? Like variety? Upscale meal delivery services are newish and en vogue. They package whole food ingredients for meals, along with a recipe, and mail them to you in an insulated box. You do the cooking.

Perhaps you have heard of the mainstream choices – Hello FreshPlated, and Blue Apron. You could try one of these and simply throw out the starch and add some healthy fat from your refrigerator or pantry.

Better yet, for a meal service that is closer to low carb, check out the options at these three subscription services:

  • Green Chef (scroll down to paleo offerings)
  • Sun Basket (click on paleo tab for offerings)
  • Chef’d (many options — look for low-carb offerings)

Try completely prepared low-carb meals
For ready to serve low-carb meals that you don’t have to cook, delivered to your door, check out these national options:

Search for local Paleo meal services
Many enterprising chefs scattered about our country offer fresh, ready-to-serve Paleo meals that might satisfy your low-carb needs. Although these services may not deliver, multiple pick-up points can make them convenient enough to justify a weekly stop. Even mid-sized cities in the Rust Belt have local options, like Pittsburgh Fresh!

Atkins offers a line of frozen meals that can be purchased at a discount online as the Frozen Foodie Meal Kit, which includes 14 individually packaged low-carb frozen dinners. You also may be able to find Atkins’ frozen dinners in grocers near you.

Take advantage of farmers’ markets

If you have access to a farmers’ market, it can be a terrific place to shop. Most of what farmers sell is real, unprocessed food, so you will not be dodging aisles of processed snacks while picking out locally grown produce, meat, and dairy.

You might pay a little bit more at these markets, but you are supporting both a healthy local foodshed and the local economy with your food dollar – hard to do at most grocery stores.

Assemble meals without (really) cooking

Everyone has busy days and needs an easy meal. And some of us don’t like to cook and need an easy meal every night.

Diet Doctor's guide, “How To Stay Low Carb When You Don’t Want To Cook” can be a great resource for simple, low maintenance meals from items on your grocery list.

Understand organic and other labels

Should you buy organic? It depends. Is it available? Can you afford it? Focus on the food first and the pedigree of the food second. Organic is a nice extra, but it is not required for healthy eating.

For more on prioritizing the potential upgrades such as grass-fed/free range/wild-caught, this page addresses them all and suggests what matters most.

2. Living Low Carb in a High-Carb Home

Consensus is not always possible, even in loving families. Many of us share our homes with —gasp!— higher-carb eaters. Living with people who eat a high-carb diet can be challenging.

Here are six tips that will make it easier:

Control the grocery list

Keeping your refrigerator and pantry stocked with low-carb favorites is an absolute requirement. You must have healthy, full-fat real food on hand to make low carb work.

If your partner buys the groceries, a list of staples that you would like to always have on-hand can help spell out your needs. If cooperation is not enthusiastic, add a stop at a well-stocked market to your weekly routine. Here is a link to an LCHF grocery list for weekly basics.

If possible, eliminate the most tempting carbs

It is really hard to say no to temptation, night after night. Cooperation from family members is a huge bonus. Perhaps you want to discuss your goals and what you’re trying to do, and ask if they would consider supporting you so that you’re able to reach your health goals.

This could mean preferably not eating cookies, chips or ice cream when you’re spending time together. If your family really wants to do everything to support you, perhaps they could even imagine not having that kind of foods at home.

How hard to push depends on how hard it is for you to resist this sort of temptation. If you’re really addicted to sugar or junk food, then it’s an absolute requirement to get it out of your house in order for you to succeed.

Add fat to eliminate the starch

If your family dinner is a classic mix of meat, starch, and vegetables, you know what to do — skip the starch and ask for extra vegetables. But that might leave you feeling a little hungry. Adding fat to your meal is the ticket to great taste and complete satisfaction.

If your refrigerator and pantry are well stocked, you will have lots of options. A drizzle of olive oil. A spoonful of sour cream. Diced bacon. Grated cheese. Melted butter.

For more delicious ideas, check out our guide, The Top 10 Ways to Eat More Fat.

Freeze bread, buns, and treats

Storing sliced loaves of bread, hamburger buns, and dinner rolls in the freezer keeps them on-hand for the high carber in the family but makes them less tempting for you. Frozen bread stays fresh for months, which eliminates waste. Bread can be warmed when needed by others.

Add enjoyable sides to your low-carb meal

If you are doing the cooking and making a low-carb meal, it can be easy and inexpensive to add a starch for a high-carb eater in your midst. Keep it simple, small, and not necessarily too appetizing:

  • A frozen dinner roll or biscuit
  • Single-serve mashed potatoes, stuffing, or mac and cheese
  • Single serve precooked frozen rice

This way, you won’t add much extra work in the kitchen.

An even better way is to cook low-carb sides that your family likes equally well. For example cauliflower mash or cauliflower rice or another delicious low-carb side dish. This way you can cook the same food for everyone – no extra work at all, and everybody is happy.

Generally, you can make low-carb meals so satisfying, they won’t even miss the bread or side of potatoes. The best way to achieve this is to start with a delicious recipe designed with low carb in mind.

Say thank you

If your partner has gone out of his or her way to make a delicious, low-carb recipe like meat piecreamy chicken casserole, or bacon mushroom cheeseburger lettuce wraps (yum!!), a little gratitude goes a long way. Express your appreciation for his or her efforts with lavish thanks and compliments to the chef.

A household with a mix of different dietary preferences really is doable if you work together to keep everyone on-track and satisfied.


3. Living Low Carb Away from Home

travel low carb

You can’t spend your entire life on your lifeboat. You will want to venture back to the cruise ship for work, play, and social engagement. Fear not. Your low-carb habits travel with you like a life jacket. They can protect you from crappy food, anywhere.

Here’s how to survive dangerous food environments:

At Work…

Office environments can wear you down.

Vending machines sell mostly junk; break rooms are full of cookies, crackers, and microwave popcorn. Some companies even offer refrigerators stocked with free soda. Then, there is the classic bowl of candy sitting on the receptionist’s desk, tempting everyone all day long. Ugh.

What is a low-carb worker to do?

Set a firm rule of no carbs at work
Commit to never eating the food at your workplace except in the rare instances that it is something completely safe, like cheese. Nibbling on freebies from the office is a slippery slope. A little bit here — a little bit there. Before long, you have ruined your eating plan for the day. Instead, draw a line in the sand and never cross it. No questionable office food. Period.

Pack your own food
Bring in leftovers from last night’s low-carb dinner for your lunch. Keep low-carb snacks on hand in your desk or in the refrigerator. When hunger strikes, you won’t be tempted by the high-carb offerings. Instead, you can feast on your own delicious food.

For more ideas for snacks, check out Diet Doctor's guide: Low-Carb Snacks — the Best and the Worst.

Choose drinks with care
Often working means finding focus and energy even when you are bored or tired. It is key that you find a way to avoid drinking sugar-sweetened beverages as a mid-day pick-me-up.

Here are a few ideas to make this easier:

Craft your story
Be prepared for curiosity, concern, and perhaps even amusement from your office colleagues who watch you eat. When you are questioned, be ready to share your story.

Think through the basic narrative. What caused you to switch to a low-carb diet? What problems has it solved? Why does it work for you? Here are a couple of example:

“I was always hungry and had to work out constantly to not gain weight. Plus, I had pretty severe acne. As soon as I cut back on carbs, my skin cleared up and my hunger has changed — I’m just so satisfied by the food I eat. And, although I still exercise, I don’t need it to keep my weight stable.”

“I always struggled with my weight, even as a kid. I was ‘officially’ obese for 20 years. When my doctor told me I was diabetic, I knew I had to do something. After finding LCHF, I completely changed my eating habits. I lost 50 pounds and haven’t looked back. And the best part of my story is that my diabetes is in remission — no meds!”

Practice your story a few times. Knowing what you are going to say makes these encounters less awkward. It can be fun to share your path to improved health! Perhaps you will spark an interest and change a life.

When dining out…

You can enjoy a low-carb meal almost anywhere — ethnic restaurants, buffets, or even Aunt Martha’s. Enjoy yourself without a setback by mentally preparing for your meals away from home.

Common sense should rule — say no to bread, and ask for double veggies instead of the starch with your main course. Sometimes a large salad with protein is the easiest way to go; choose olive oil and vinegar dressing. For a boost in fat, melt butter on your cooked vegetables and protein. Choose coffee or decaf instead of dessert.

Drink mostly water — champagne, dry wine, light beer, and straight spirits are okay in moderation. (Diet Doctor's guide to low-carb alcohol is worth consulting.)

For more detailed tips on how to order and enjoy low-carb meals at restaurants, check out our guide: How to Eat Low Carb When Dining Out.

Don’t miss the section in this guide entitled At a Friend’s Place — perfect to consult when you are invited to dinner at a friend’s, colleague’s, or relative’s home. It also works for an invitation from your boss!

When traveling…

Are you headed out of town on vacation or do you have a business trip coming up? Don’t let travel interfere with your commitment to low-carb eating. With a little planning, you can stride through airports and hotel breakfast buffets with confidence.

As always, packing low-carb snacks can be a lifesaver. Eating well before you leave helps, too. In addition, you can use coffee to stave off hunger. You can even pack butter to add to your coffee in this BPA-free soap dish!

For a complete guide to hitting the low-carb road, please read our guide, How to Eat Low Carb When Traveling.

4. Parenting Low-Carb Kids

low carb kids

As a parent, letting your well-fed child venture from your lifeboat into the big, bad high-carb world can be challenging. Sometimes you’ll just have to let go and accept that perfection may be unattainable. Concentrate your energies on the recurring situations that you can control, like the food environment at home.

Almost everywhere they go, sugar and starch will be served. Your children need to learn to make their way in this environment. Fortunately they will have a giant head start, due to the example of their parents and their food situation at home.

Teach your kids to peel back the carbs

For kids, carbs are often layered, one on top of another:

Preschool Snack ⇒ apple juice | animal crackers | pretzels or Goldfish
School Lunch ⇒ submarine sandwich | French fries | lemonade | pie
Birthday Parties ⇒ pizza | cake | ice cream | a bag of candy to bring home
Soccer Games ⇒ Gatorade | Doritos | gummy fruit snacks

This happens everywhere — even at seemingly safe places like public schools. (Especially public schools, actually.)

Consider talking about our bad food environment with your child – especially if he or she is a bit older – and see if there are things to do to avoid excessive bad carbs when away from home.

Can she or he reduce carbs by eliminating the sugar-sweetened drinks and substitute water? That is probably the most effective single thing to do. If it’s not possible, you can always fall back on serving only water at home.

Suggest that she come up with her own plan. Empower your child to figure out what she really wants to eat and how to say “no thanks” to the rest. But remember it has to be her own choice.

Don’t fight every fight. Accept that there will be some bad carbs eaten at birthday parties and other social situations. Try to focus on what gets eaten every day.

Pack lunch for daycare and school

You can minimize the amount of conventional food kids eat by packing lunch for them to take to school. If your child attends a school with unusually good food, this may not be necessary, but in most cases, it is a commitment that really pays off. Packing a lunch gives you greater control and is usually cheaper, too.

Here is a nice guide to 30 kid-friendly low-carb lunches.

Plan for official high-carb advice

To top it all off, your kids are likely to be taught about the dietary guidelines in school, so they will have to endure lessons about the ‘importance’ of drinking skim or low-fat milk and eating only lean meats. They will learn about the ‘importance’ of eating plenty of whole grains and vegetable oils for heart health.

Prepare them for these lectures, explaining that you believe many people still have it wrong; in your family, you see and do some things differently, because it works better.

Remember YOU are your child’s biggest influence

Your kids are watching YOU. What you eat is the best predictor of what they eat. The science backs this up. Eat well for your own health, and your kids will follow your lead, naturally.

Take comfort in the good news

Before you decide to homeschool your children and never let them leave the house (obviously a poor choice!), consider the good news:

For kids, it’s low carb, not no carb

Kids are usually pretty insulin sensitive. Youth is on their side. Although the conventional food they will eat outside your home is not ideal, chances are it will not ruin their health.

Sugar is public enemy #1

One area where you will find common ground is avoiding sugar. Almost all adults agree that sugar is bad for kids, especially sugar-sweetened beverages. Increasingly, even sports drinks are getting called out as unnecessary for most kids. This trend fits well with low-carb objectives.

Many mainstream parents agree that sport team snacks should be reduced

Talk to other parents about eliminating unnecessary snacks and sugar-sweetened drinks at weekly practices and games. Most children do not burn anywhere near the calories in these treats while playing their sport for an hour.

If every parent brings water instead of fruit punch to soccer practice, that is a gift you give to all the families on your child’s team. Here is a thoughtful post about how to start these conversations in your community.

Let teenagers be teenagers

For teens, grabbing a soda and handfuls of potato chips can be part of blending in with the crowd. Or it can be part of the natural rebellion against whatever habits their parents might want them to cultivate. Either way, go easy — too much of a reaction may backfire. Your years of sharing a carefully stocked low-carb home with them were not wasted. It is a phase. They will find their way back to higher-quality food before long.

More on feeding your kids

Low carb is delicious. You can make it fun, too. Here is a family-friendly collection of low-carb recipes.

If you have questions about low carb and kids, consult Diet Doctor's guide, “How to Raise Children on Real Low-Carb Food.

If you are new to low carb and want to transition your children from a conventional diet to a low-carb lifestyle, check out Diet Doctor's guide, How to Help Transition Your Children to Low-Carb Real Food.

5. Knowing What You Are up Against

swim upstream

Look around. Crappy food is everywhere. And with it, we see the crappy results one might expect — raging rates of chronic disease and an always hungry, always snacking, population of over-fed, undernourished citizens.

Knowledge is power. If you concede that mainstream food and ideas about food are deeply flawed, all the appalling junk food and junk science that surrounds you might drive you a little less crazy.

Realize people are woefully misinformed

The problem goes so much deeper than the piles of junk food in every grocery store and every office break room — the very ideas about food and health that dominate public discourse are compromised.

Turn on the news and you will hear our nation’s unconfirmed ideas about diet relayed as established facts. Understandably, your neighbors, colleagues and family members have been swayed by this barrage of misinformation.

Take saturated fats. Almost everyone believes these naturally occurring fats in intact whole foods are bad, while vegetable oils, which are industrially extracted from seeds that aren’t traditional foods (and some of them, like cotton and soy seeds, were actually once considered waste by-products), are healthy. It’s backwards.

Most people in your social circles are likely to have believed in the health benefits of eating a grain-heavy, canola oil infused, low-fat diet for so long that they may think you are a little crazy when you skip the ‘whole-grain goodness’ and drop a tablespoon of butter into your coffee.

Understand that our authorities are dogmatic

It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.
— Mark Twain

Worse, the authorities we trust — our dietitians, doctors, scientists, journalists, and public health officials are stubborn. The abject failure of low-fat dietary guidelines has NOT led to a ‘back to the drawing board’ moment. No.

Instead, bad ideas are tweaked and massaged into slightly less bad ideas. We started, back in 1992, with a recommendation of 6-11 servings of grain each day (in the original Food Pyramid). Today, we dutifully fill slightly more than a quarter of our plate with processed whole grain products (if we are following MyPlate, introduced in 2011).

Terrible results cry out for a food revolution, not minor modifications, but the establishment is so sure its old, bad ideas are correct, it can give us only same-old, same-old advice.

Know that what you do matters

A low-carb lifestyle is your lifeboat. You must navigate next to the cruise ship full of bad food, bad ideas, bad advice, bad science, and sick passengers. Stay out of its wake and set your course. Ride through the storm.

And know that you are a key part of the solution. Your commitment to low carb matters. Grassroots movements like LCHF spread by word of mouth. As you share your success with others, some will come on board.




Real Food News


Real Food News

  1. Three prominent cardiologists contend that saturated fat does NOT clog arteries in an opinion piece in the British Journal of Sports Medicine. Instead of obsessing about the naturally occurring fat in food, the doctors advise us to eat real, whole food and walk 22 minutes each day. The CBC reports on the controversy, here. And we Iove this easy summary of mainstream and alternative reactions from Treehugger. For a more technical look at the controversy, Henderson and Schofield have you covered.
  2. Professor Tim Noakes, a sports medicine doc with expertise in endurance sports and metabolism, ignited a low-carb-high-fat revolution in South Africa, with millions following his lead. He was finally exonerated from a trumped up Twitter incident that was a huge distraction. Hopefully the attention paid to the scientific evidence (during the lengthy trial) will move the conversation forward. Congratulations, Prof!
  3. Forbes reports on a recent study that shows obesity and diabetes are killing even more Americans than our death statistics suggest. Also in Forbes is a report on the association between high sugar consumption and poorer memory and lower brain volume.


Real Food News


Real Food News

  1. Big news out of Silicon Valley. VC funded Virta Health opens it doors to the public. Virta is an online specialty medical clinic that reverses type 2 diabetes without medications or surgery. Forbes reports on Virta's toolbox—a ketogenic diet and a supportive, virtual clinic model ideal for treatment from any location. A preliminary study, documenting 10-week results, shows impressive 48% of subjects achieve HbA1c below 6.5% (no meds or Metformin only) and mean weight reduction of 7.2%. 
  2. In spite of record obesity rates, Time reports fewer Americans are trying to lose weight. Lesson (IMO)—conventional 'eat less, exercise more' advice is failing people. It doesn't work so many are giving up. Time for a new paradigm.
  3. The New York Times reports on a pioneering cookbook author's fight against Alzheimer's disease. Her main therapeutic weapon? A very low-carb diet. For more details on why low-carb eating can help prevent or even reverse cognitive decline, check out this new Chelsea Green release, The Alzheimer's Antidote, by Amy Berger.



Dodging Midlife Death—on Making It to 75

I want to live to be (at least) 75. This may not seem very ambitious. Dave Asprey, nutrition entrepreneur and host of Bulletproof Radio, regularly insists, on air, that he plans to live to 180—a classic overachiever.

Sure, living vibrantly well into my 80s (even 90s, maybe?) is on my wish list. But my first priority, what I absolutely want, is to avoid dying in midlife. I have (perhaps generously) defined this as dying before age 75; before nearing American life expectancy and entering old age. When friends or loved ones die before age 75, it feels like a takedown—like they were robbed of prime years. How to avoid that seems like a worthwhile question.

Let’s take a quick look at what kills Americans in midlife.  What do people die of between age 45 and 74? And what can we learn from that, and specifically, does it tell us anything about what we should be eating?

First, the bad news. In 2014, almost a million 45-74 year-old Americans died. Over 2,700 midlife folks each day… gone. That is a lot of premature death. 

Some good news… Your risk of death during the early part of this age range is quite low.  When you are 45-49, your chance of dying (from any cause) each year is only 0.31%. But by age 70-74, it has crept up to about 2.25% each year, which adds up; overall, you have a 11.25% chance of dying in your early 70s (2.25% each year for 5 years).


Cancer Dominates

Heart disease may be the leading cause of death for all Americans, but not in this group of middle-aged folks. Not even close. Cancer wins easily, causing almost one third of all deaths of 45-74 year-olds. Heart disease causes roughly 21% of middle-aged death, trailing cancer by over 100,000 deaths in 2014.

As you can see from the lead graph at the top of this post, some causes of death, like accidents and suicide, are meaningful contributors at 45-49, but they stay pretty steady or even decline as we age. By 70-74, they have become almost unimportant, dwarfed by the rapid growth of cancer and heart disease deaths. I wish I could say that avoiding risky behaviors like texting while driving moves the needle on middle-aged death, but the numbers suggest otherwise. Of course, in your n=1 life, it only takes one accident, so definitely STOP texting and driving. But can we do more?

Want to make it to 75? Avoid cancer and heart disease, and you double your chances. What can be done, from a diet perspective, to minimize cancer and heart disease?


Avoiding Cancer

Our multi-billion dollar war on cancer has been pretty unimpressive. In spite of a greater than 40% drop in rates of smoking, we now see higher (age adjusted) rates of cancer than we did in 1975.


Other than quitting smoking, what can we do to dodge the cancer bullet? Is there anything diet-related that might help? What does the science tell us about cancer and specific foods? This cleverly conceived figure in the American Journal of Clinical Nutrition shows us that it is all over the map. This explains why newspaper headlines go back and forth, reporting countless observational studies about food and cancer, all showing meaningless associations.

 All foods cause cancer?  American Journal of Clinical Nutrition , November 28, 2012.

All foods cause cancer? American Journal of Clinical Nutrition, November 28, 2012.

So what do we "know" about food and cancer? Turning to clinical trials, we know that low-fat diets do NOT seem to reduce cancer mortality. Large RCTs, like the Women’s Health Initiative (an enormous, expensive trial that had tens of thousands of middle-aged women eating a low-fat diet with more fruits, vegetables and grain) showed no statistically significant reduction of breast cancer and no reduction of colon cancer.

In his 2010 lecture, Dr. Craig Thompson, President of Memorial Sloan Kettering Cancer Center, states that consensus is that overfeeding carbohydrates increases cancer risk, while overfeeding fat does not; protein is halfway in-between. Watch below for about 60 seconds...

UPMC oncologist, Dr. Colin Champ, offers his personal tips, “10 Ways I Cancer-Proof My Life Everyday,” if you subscribe to his newsletter. It is a thoughtful list. I can tell you the top two tips are to cook and eat real, nutrient dense food, low in sugar and simple carbohydrates. Just one cancer researcher’s opinion, and it fits right in with vintage eating.

There is a meaningful amount of speculation in the alternative nutrition world about vegetable oils contributing to cancer. Authority Nutrition, an evidenced-based site, wrote a review article on the many evils of these heavily processed oils, including a section on cancer. One clinical trial showed substituting vegetable oil for saturated fat almost doubled cancer mortality. Vegetable oils are unstable when heated, leading to the release of lots of toxic byproducts like aldehydes. They are not real food... no traditional population could have made them.  We should be suspicious of them; look here for vintage fats to eat instead.

 Of late, I am hearing a lot of rumblings about viewing cancer as a metabolic (versus genetic) disease, and the promise of very low-carb diets as an adjunct therapy to enhance conventional cancer treatments. As a result, there is speculation that keeping blood glucose, insulin, insulin growth factors, and inflammation low, as low-carb diets do, could be a prudent step toward preventing cancer. Unfortunately, it is early, and most of the completed research is in cell lines and rodent studies, not humans. Definitive answers are a long way off. For a nice summary of the state of the emerging and promising science, check out this lecture, Exploiting Cancer Metabolism with Ketosis, by Dr. Angela Poff.

Given incomplete science, what does culture and common sense tell us? Science journalist Gary Taubes talks about the link between sugar and cancer (beginning around p. 253) in his bestselling book, The Case Against Sugar.  He documents how rare cancer was in native populations eating traditional diets, and how, as Western diets (full of sugar and flour) spread, cancer incidence soared.  And he talks about the well-documented links between both obesity and diabetes and cancer, fingering insulin as a potential driver.  So a vintage diet, low in sugar and processed grains and refined oils, one that emphasizes whole foods found in nature (like the foods that our ancestors ate), is an obvious possibility for prevention. It fits as a potential antidote to the standard American diet (SAD) and the Western diseases, including cancer, that travel with it.


Avoiding Heart Disease

But could a low-carb diet, higher in natural fats including saturated fat, lead to more heart disease? Entire books have been written about this question. The Big Fat Surprise by Nina Teicholz is an award-winning one. (Summary article in the WSJ: “The Questionable Link Between Saturated Fat and Heart Disease.”) Evidence exonerating saturated fat continues to emerge, as buried evidence is unearthed, and large data sets show no significant link between dietary saturated fat and cardiovascular disease mortality. It would seem that the war against dietary fat was long adventure on the wrong track.

Perhaps this is why, after 40 years of low-fat advice, the American Heart Association just reported heart disease prevalence among all American adults of 41.5% and rising... Holy moly, think about that!!!! And, for those between 45 and 64, prevalence of heart disease is around 50%. There has to be a better way.

In fact, most people find that heart health markers like blood pressure and cholesterol profiles improve on a low-carb-healthy-fat eating plan. But there are exceptions; every body is different. Carefully monitoring heart health markers and your own, individual response to your diet is always prudent.

To truly assess heart risk, I would consider the CAC (Coronary Artery Calcium) test. It is a non-invasive CT scan that takes about 10 minutes. It is far more predictive of heart risk than typical markers like LDL levels, which are actually quite poor at predicting heart events. The CAC test sees the actual disease, rather than assessing risk with a guess based on blood lipid levels. Learn more about it from this short, 11 minute, informational video.

Finally, note that prominent Canadian cardiologist, Dr. Salim Yusuf, President of the World Heart Federation, presented a new robust (albeit observational) dataset, the PURE study, suggesting the association between saturated fat and heart disease is neutral or even protective. His data suggests that a diet high in carbohydrates is associated with higher rates of CVD. It is really a remarkable 22 minute lecture and worth watching. If you don't have time, a nice summary and balanced analysis (by Alex F. Sigurdsson MD) of the key points of this eye-opening lecture can be found here.


Avoiding (or Resolving) Diabetes

A 2017 study out of Boston University School of Health and the University of Pennsylvania suggests that our national death statistics severely understate the “contribution of diabetes to mortality in the United States.” In the CDC data used for this post’s analysis, diabetes is noted as the cause of only 3.8% of middle-aged death. Yet the study authors write that their analysis of death certificates reveals that diabetes is the underlying cause of approximately 12% of US deaths.

Further, according to the authors, having diabetes more than doubles one’s chance of dying in any given year, especially for women and those younger than 75. The hazard ratios are presented in Figure 2 from their paper:


  Hazard ratios expressing the association between diabetes status and mortality for all participants and by population subgroup. &nbsp;&nbsp;Source: NHIS years 1997–2009 with prospective mortality follow-up through Dec. 2011.&nbsp;&nbsp; &nbsp;(Figure 2)

Hazard ratios expressing the association between diabetes status and mortality for all participants and by population subgroup.  Source: NHIS years 1997–2009 with prospective mortality follow-up through Dec. 2011. (Figure 2)

Beating diabetes can add years to your life and life to your years. Unfortunately, type 2 diabetes is too often treated as a progressive, irreversible condition in our pharmaceutically-heavy health care system. Considerable evidence demonstrates that low-carb diets offer the greatest promise for resolving T2 diabetes and prediabetes. A new VC-funded Silicon Valley startup, Virta Health, is betting on this approach, with a very low-carb diet and a tech-centric ‘virtual clinic’ model in its toolbox . If you have T2 diabetes, consider trying to reverse it with the help of Virta’s coaches and doctors. If you want to learn more about how to use low-carb diets to resolve type 2 diabetes, check out all of the free resources at Diet Doctor.


Making It to 75… and Beyond

Overall, the promise of a vintage diet dominated by whole, full-fat foods, and missing processed carbs and refined oils is tantalizing. Minimizing blood sugar, insulin, and systemic inflammation with a low-sugar, low-processed-starch, low-refined-oils diet is a potential WIN-WIN-WIN.  Less cancer, less heart disease, and less diabetes. Taken together, these wins enhance your chances of surviving middle age. So check out the six lifestyles on this site that can help you accomplish this goal.

One more WIN for low-carb, real food? Less hunger. Not being hangry all the time makes midlife more fun!

And there is one final huge WIN. Brain health. Minimizing sugar and refined carbohydrates is a promising way to avoid the next chapter that none of us want to face — severe cognitive decline in our golden years. Alzheimer’s disease becomes a major cause of death as we exit middle age, and many experts believe that high blood sugar levels play a causal role. Amy Berger documents the emerging science in her new book, The Alzheimer’s Antidote. That should serve as one final motivation to cut out processed carbs and fuel your body with real, full-fat food—because not only do we want to survive midlife, we want to remember it.