Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
18 Jun

Is It Time to Retire the Low-Carb Diet “Fad”?

This is another special guest post from our favorite study-dismantler, Denise Minger. Read all of her previous Mark’s Daily Apple articles here, here, here, here and here, and pay her website a visit. Thanks, Denise, for clearing up the confusion once again!

Sweden is a land of many wonders – most of which put the USA to shame. They’ve got fjords, ABBA, and caviar in a tube. And while Americans get arrested for things like DUIs and stealing socks from Walmart, Swedes get arrested for the more admirable feat of smuggling butter.

Such a delicious felony doesn’t reflect a life of crime so much as a life of fat – the edible kind. For nearly a decade, Sweden has been the unofficial headquarters of the Low Carb High Fat (LCHF) movement, churning out an unprecedented number of lipid lovers. In 2011, a whopping 25% of Sweden’s population was trying to eat more fat and curb their carbohydrate intake, with 5% of Swedes identifying as hardcore LCHF adherents. And those numbers only seem to be growing.

But a new study claims to cast doubt on the safety of Sweden’s fatward trend. In a paper published in Nutrition Journal last week (PDF available here), researchers linked the Swedish low-carb boom to rising cholesterol levels, increased heart disease risk, and failure to maintain long-term weight loss. A cascade of predictable headlines ensued, ranging from “Atkins diet found to be bad for the heart” to the brazen “Time to retire the low-carb diet fad.” The latter article – a well-circulated piece from The Atlantic – gave low-carb fans a particularly snarky flogging:

Low carbohydrate evangelists will almost certainly attack today’s announcement – and perhaps this post – with biblical fury. They’ll make their usual claim: that this is yet another conspiracy of scientists who just don’t get it, scientists who don’t understand nutrition, scientists who somehow made it through their PhD’s and MD’s without knowing the first thing about how the human body works. But let’s face it – most of us know in our hearts that eschewing a breakfast of whole grains and fruit crowned with a dab of yogurt for a greasy pile of sausage, bacon, and eggs is not the road to health.

Ouch! Time to whip out the granola and Yoplait?

If something seems fishy about this study, it’s not just the lutfisk: as usual, there’s more going on (or in this case, less going on) than the alarmist media would suggest. Here’s the real scoop.

No Low Carb, No Heart Disease

First and foremost, this study has nothing to do with low carbers, or even heart disease: it’s an observational study of Swedes Not Further Specified (SNFS). Researchers pulled 25 years’ worth of data from 140,000 folks in the North Sweden Diet Database, averaged everyone’s food intake, averaged everyone’s total cholesterol, and made some pretty graphs.

The findings? Sweden’s fat consumption (as a percent of total energy) dropped between 1986 and 1991, held steady until about 2004, and then started rising; the inverse happened with carbs:

(In those early years, fat kerplunked due to the Vasterbotten Intervention Programme – a project launched in the mid ‘80s to encourage more physical activity, scoot Swedes towards a low-fat Mediterranean diet, improve food labeling, and hopefully knock heart disease off its tyrannous throne.)

And like an ant frantically evading the smoosh of a human thumb, average body mass index skittered wherever the heck it wanted (usually up):

And average total cholesterol – not among low carbers, but among north Sweden’s general populationfollowed a roller-coaster-esque trajectory of its own. It plummeted between 1986 and 1992, crept back up until 1994, rolled downhill again until 2000, stabilized between 2002 and 2008, and then began yet another upward jog until the study ended. A visual for your viewing pleasure:

That’s it. No distinction between HDL and LDL, no reported triglycerides, and – most notably – no mention of how diet or cholesterol changes corresponded with actual heart disease rates. In fact, there’s nary a morbidity or mortality statistic to be found in the whole paper.

So how did the doom-and-gloom warnings about low carbing enter the scene?

Simple: the researchers think Sweden’s recent cholesterol hike might be a result of the LCHF boom – although the design of this study, with dieters of all persuasions stirred together in a giant pot of data-soup, makes it impossible to tell if that’s actually the case. Although the media apparently didn’t get the memo, the researchers even stated in their paper that “our study design does not allow a causal evaluation of the relationship between the increased fat intake since 2004 and the increased cholesterol values after 2007.” Likewise, the media thinks Sweden’s ever-increasing BMI, despite being an average of the general population, means that low-carb adherents fail to maintain their weight loss. (Yeah, I’m scratching my head over that logic too.)

Although it’s possible that saturated-fat-loving, low-carbing Swedes singlehandedly raised the nation’s average cholesterol in 2008, this seems iffy for a few reasons. For one, fat intake and blood cholesterol were hardly mirroring each other for the study’s previous 22 years: cholesterol levels continued to drop even when fat intake remained steady (though this could also be confounded by use of statins and ratios of specific fatty acids). Even more suspiciously, there was a four-to-six-year lag between the rise in fat consumption and the 2008 cholesterol jump – implying that Sweden’s fat-feasting took half a decade to affect blood values. (Usually cholesterol reflects diet changes in a matter of weeks.) And although this particular study tells us nada beyond “total cholesterol,” another paper published just a few months ago – drawing from the same pool of data – shows that after 2008, north Sweden’s triglycerides were frolicking uphill with cholesterol:

If that graph convinces anyone that the Low Carb High Fat movement is spiking triglycerides, I’ve got some oceanfront property in Arizona to sell ‘em, too: the evidence is pretty consistent that low carbing makes triglycerides sink. It seems more likely that other factors are lurking behind Sweden’s shifting blood lipid patterns, especially during the past few years.

Lo and behold, the fine print of our study-du-jour suggests the same. According to the researchers, foods associated with a high fat intake in Sweden were not just the predictable oils and meats, but also pizza, French fries, potato chips, corn chips, cheese-flavored puffed products, and popcorn, as well as “fats used for spreading on bread.” Unless Sweden has a very different definition of “low carb” than the rest of the world, it sounds like their fat intake isn’t coming solely from LCHF-approved fare, but from what most of us affectionately refer to as bona fide junk.

Even when it comes to foods directly associated with high cholesterol, Sweden’s low-carb movement still can’t shoulder all the blame. According to a supplementary table kindly included with the paper (available as a Word document here), boiled potatoes and coffee made bigger statistical contributions to blood cholesterol than saturated fat did! Other foods associated with high cholesterol included not just high-fat foods, but also low-carb no-gos like sweet buns, crisp bread, white bread, and sweet fruit soups.

Dairied Alive

Although this study doesn’t reveal anything very useful about what food does to us (particularly where fat is concerned), fear not: the diet-disease data for northern Sweden is a many splendored thing, and other studies have mined it with much more fruitful results. Or in some cases, milkful.

In 2010, the American Journal of Clinical Nutrition published a paper looking directly at dairy fat and myocardial infarction among some of the same northern Swedes used in last week’s study. The results? Women with high intakes of dairy fat – confirmed both by food-frequency questionnaires and ruminant-milk-fat biomarkers – were less likely to suffer from a first heart attack than their milk-minimizing counterparts. (Cheese and fermented dairy products looked particularly heart-protective.) And just in case you think that one was a fluke, a 2004 study examining the same Swedish population found dairy fat to be negatively associated with cardiovascular risk factors, with zero indication that full-fat milk products contribute to heart attacks. Want more? Yet another study (PDF), again based on those fat-loving northern Swedes, found dairy fat to be beautifully protective against strokes – especially in women.

So much for all that “artery clogging” hoopla!

Are Low Carbers in the Clear?

It’s a mystery why our current study tried to glean anything about low-carb diets from such tight-lipped data – especially since it’d be easy enough to actually untangle those low carbers from the rest of the population and follow them, up close and personal, like the stalkers we all secretly yearn to be. In fact, another north Sweden study published in February attempted that very feat (sans creepiness), and failed to find any increased mortality among the folks it deemed “low carb.” (Unfortunately, that study also used an invariably terrible diet-score design, but that’s a story for another day.)

As for Sweden’s recent cholesterol uppage? Without more detailed data and a look-see at disease rates, it’s virtually meaningless. But even if there’s no legitimate evidence dooming Swedish low carbers to an early grave, it’s possible that the LCHF movement is having some unhappy consequences in the Land of the Midnight Sun. The health climate there is clearly whipping fat-phobia into remission – which, despite the admirable triumph over bad science, could also breed a new species of half-hearted dieters like Low Carb Weekend Warriors, Low Carb As Long as There’s Not a Cookie in Front of Me, and Why Don’t I Just Put Butter on Everything Edible and Buy New Pants When They Get Too Tight. Folks who jump on the “high fat” bandwagon while still living in high-carb land may indeed find themselves gaining weight and frightening their doctors with ominous lipid panels. Whether or not this is happening in Sweden right now remains to be known, but it is a possibility.

Personally, though, I have other theories:

I’m not saying correlation equals causation. I’m just saying maybe we should think about switching to Google Plus.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. OMG, you need some kind of serious award for even contemplating that last graph. Bravo!

    Excellent job on the whole piece. Well done.

    Tim wrote on June 18th, 2012

      Carol L wrote on June 18th, 2012
    • Lool 😀 Jeah that’s true !

      Emina wrote on June 20th, 2012
  2. I love me some caviar in a tube, coincidentally, I think Abba is the most popular brand in Sweden.

    But I think you are confusing Sweden with Norway when it comes to the fjords, Denise.

    Sean wrote on June 18th, 2012
    • Actually, Sweden has one fjord, located in Bohuslän 😉

      Excellent stuff, as always.

      Sean wrote on June 18th, 2012
      • But still Norway is the country famous for its many fjords – the natural habitat for the Norwegian Blue Parrot species made famous in the classical Monty Python scetch.

        Per Wikholm wrote on June 18th, 2012
        • Lovely bird, the Norwegian Blue

          Anders wrote on June 19th, 2012
        • Beau’iful plumage!

          Eric Schmitz wrote on June 27th, 2012
    • I used to eat it all the time, but it has canola oil in it.
      It’s delicious though.

      Lars T. wrote on June 18th, 2012
      • When eaten with soft-boiled eggs, well, I’m willing to take that hit.

        Sean wrote on June 18th, 2012
        • You and me both!

          Lars T. wrote on June 18th, 2012
      • Here we have an interesting divide between the Swedish LCHF-movement and the US LC/Paleo-movement. In general Swedish LCHF-people accept consumtion of canola-oil in moderation. Rape seed is a close relative to mustard.

        After all it is more like olive oil in its fat composition with about 60 % monounsatureted fat and only about 20 % omega 6. But US folks seem to put canola in the same category as sunflower- and corn oil with about 60-70 % omega 6.

        Per Wikholm wrote on June 19th, 2012
        • The real problem with canola is it’s almost always hot-pressed at high temperatures, thus automatically making it rancid. Rancid/oxidized PUFAs can do a lot of damage; gram for gram, they generate more A.G.E.s than glucose or fructose.

          You’d need to find a small business/independent canola oil maker if you want it cold-pressed…

          mm wrote on June 19th, 2012
        • Actually, in Sweden you will find at least one brand of cold pressed Canola oil in every major supermarket.

          Per Wikholm wrote on June 19th, 2012
        • Hmm, cold-press canola oil? I recently wrote a post about Mayo Clinic’s take on canola ( ), but looking at the numbers, I’ve often wondered if canola actually isn’t that bad. Erucic acid isn’t an issue and if it’s not rancid, well…

          Michael B wrote on June 20th, 2012
      • what, the Norwegian Blue Bird?

        Maguerite wrote on January 26th, 2015
  3. I knew that Facebook was somehow responsible for my bad cholesterol readings at the beginning of the year! I’m off to eat some macadamia nuts and plug in my Jusin Bieber mix now….

    Chance Bunger wrote on June 18th, 2012
  4. That last graph is gold. Great article!

    Tashi wrote on June 18th, 2012
    • Really great article but I have to dispute the graph at the end. Pretty sure cholesterol levels declined from Kris Kross making people Jump Jump

      Tony Frezza wrote on June 18th, 2012
      • +1

        Erica wrote on June 27th, 2012
  5. You are an expert in showing how statistic s can be easily twisted and fed to the masses. Unfortunately statistics are challenging even to those looking for the unbiased truth. (there are still some of those right?)

    Groktimus Primal wrote on June 18th, 2012
  6. I just read the headlines and believe everything I read.

    Brian Clasby wrote on June 18th, 2012
  7. “But let’s face it – most of us know in our hearts that eschewing a breakfast of whole grains and fruit crowned with a dab of yogurt for a greasy pile of sausage, bacon, and eggs is not the road to health.”

    It’s stuff like this that makes me think we need a tax on stupid.

    A.Stev wrote on June 18th, 2012
    • Now that is funny! Thanks for the laugh this morning. :)

      Vanessa wrote on June 18th, 2012
    • Well, we all know how much more “knowing something in our hearts” counts than actual data in scientific matters for a large number of people here in the US. *sighs*

      Kris wrote on June 18th, 2012
    • My husband and I were just discussing the same thing–where do you suggest the cutoff be set at?

      Wenchypoo wrote on June 18th, 2012
      • Gee, it’s tough to say. lol

        Stupid is so hard to quantify and it’d be impossible to enforce.

        *Sigh* If only it were actually feasible… 😉

        A.Stev wrote on June 19th, 2012
    • One year ago with a great effort I convinced my mom to switch healthy and wonderful breakfast of oatmeal and dried apricots and prunes for the scary one – eggs, hot smoked fatty pork, coffee with 33% cream. Dinner was in LC style as well. The result – normalization of high blood pressure within days without medication , loss of 23 lb, great improvement in energy level, satiety, GERD. In her heart my mom knew that heavy cream and eggs were a symbol of dangerous living, a thing being next to drinking and smoking. To so many people their guts tell to be afraid of pleasure and good food..

      Galina L. wrote on June 18th, 2012
      • Good for you. My mom has fairly high cholesterol, and when I told her about primal eating and the whole lifestyle she immediately said “I’m not interested in your hokey pseudo-science.”

        I gave up right there. I knew I wasn’t going to win that one.

        Drumroll wrote on June 18th, 2012
        • It’s hardly science when it is based on a lifestyle started by humans before “science” was invented. They somehow mistakenly ate the right foods without scientific intervention. Then we came along and screwed it up with our great “science” because we know better.
          Funny how the dumb caveman got it right while those with the PHD and degrees continue to get it wrong.
          Long live Grok.

          Anthony wrote on June 18th, 2012
        • Cavemen weren’t the only ones to get it right – zookeepers also seem to know what to do when taking care of animals. They must only require Master’s degrees in biology/zoology…

          mm wrote on June 19th, 2012
        • I cut out refined foods and I have been eating mainly meat, veggies and fruit for the past 8 months and have dropped about 22 lbs. I drink full cream in my coffee and eat eggs most days for breakfast. I’m not a strict as I would always like…I have a bit of a penchant for tortilla chips and salsa but I am about 85%. I don’t workout like I should either. I have always loved eating meat – fattier the better – it makes me feel good. I went to the doctor to run my cholesterol which had been climbing year after year despite the Lipitor and shockingly it was a low as it has been in 3 years. Everything was in optimal numbers. So, even though I have experienced the benefits first hand I still have the nagging thought in the back of my mind that this kind of eating cannot be healthy and I should be eating the oatmeal! Don’t be too hard on your mom. We have been literally brainwashed into believing the contrary to what is in our best interest. I still can’t shake it!

          Paz wrote on December 11th, 2013
    • “It’s stuff like this that makes me think we need a tax on stupid.”

      We have one, its called The Lottery.

      Pat wrote on June 19th, 2012
      • I know I’m leaving this comment way too late, but OMG, can’t stop laughing! I knew there was a reason I didn’t play the lottery…..

        Pip wrote on March 12th, 2014
    • My mother and step-father absolutely know in their hearts that this is true! My sibs and I have been low-carbers for more than 12 years and have endured visits to my mother’s house where she accommodates us by fixing eggs and sausage or bacon for breakfast. My step-father makes a huge show of refusing to eat the cooked breakfast and sanctimoniously eats his cereal with skim milk and fruit. They both carry on about how they eat so much fruit. Then my mother mentions that she is worried about her triglycerides (although we’ve told her for years that cutting carbs lowers triglycerides) while she washes down a handful of pills with her OJ (“you’ll never convince me that orange juice isn’t healthy). The punch line of this story is: My stepfather had an emergency quadruple bypass a year ago and is now convinced that it doesn’t matter what you do (diet and exercise) because if you are going to get heart disease, you’re going to get heart disease and there’s nothing you can do to prevent it! (You see, he “did everything right” and still almost had a heart attack – will never consider that it was the wrong diet!)

      Peggy Holloway wrote on June 19th, 2012
      • I feel for you. I sent my parents Mark’s book, and my mom claims she read it, but then goes on about how she “doesn’t really like” the taste of her Ezekiel bread, and how she can only eat cereal for breakfast a couple of days in a row and then it hurts her stomach so she has to “wait a bit before I can eat it again.” I actually facepalmed on the phone when she said that.

        When I told her, no grains at all, all she said was “well then what am I supposed to eat for breakfast?” ><;

        Kris wrote on June 19th, 2012
        • I talked with my mom for 3 years about LCarbing, nothing worked until I came in person for a long visit and actually insisted on her trying my diet for three weeks. She thought that no diet would kill her in three weeks. She was not prepared for almost immediate improvement in her health, looks, energy. Me and my mom have a tendency to feel a very urgent hunger. It is not a problem for me any longer on a LC diet, mom just couldn’t believe me. She spent her whole life being abscessed with the next meal, hunger being an emergency, and all that was gone after her first eggs-cream-bacon without bread breakfast. Her neighbors began to ask why she suddenly started to look younger. For 75 yo lady it was priceless.

          Galina L. wrote on June 19th, 2012
    • Look, the proper thing to eat for breakfast is what you feel like eating that day. You act like people can’t change and have choices, like are they locked into one diet and can never choose for themselves They prefer ham one morning and oatmeal tomorrow morning. What’s the big deal? We develop patterns and invent our own personalized diets. It’s much healthier than dogmatically sticking to someone else’s diet ideas… I don’t see what all the fuss is about…

      Lisa wrote on July 26th, 2013
  8. Nice, but I think there is a causal relationship between the invention of Facebook and higher cholesterol.

    More time spent on facebook = more time sitting on your ass and not engaging in even mild activity = lower general quality of health.

    Now one might say that spending time on this site would do the same, but the happiness it brings cancels out the time spent on my ass, and I read it at work anyway where I don’t have a choice.

    Correlation != causation, but in the case of facebook it might just be true 😉

    ZenBowman wrote on June 18th, 2012
  9. The Carb Wars, they have begun …

    rob wrote on June 18th, 2012
    • They are fun and all but I think a big mistake is demonizing any macronutrient.

      Niether carbs, protein or fat is bad for you.

      It depends on the CONTEXT.

      A cup of plain ole white sugar is bad. Gluten is bad. Soybean oil is bad.

      Fruit, veggies, potatoes are amazing for you. Meat is amazing for you. Butter, avocado, real olive oil, tallow, lard, etc. is amazing for you.

      You see? It really depends on the context folks.

      Oh, and on the individual. One may not be able to digest fructose well at all, even from fruit where as another may thrive on a fair amount of fruit.

      CONTEXT! I think Mark published a post on context not too long ago.

      Primal Toad wrote on June 18th, 2012
      • I agree. I noticed sometimes there are nearly-fanatical low-carbers here, and I’m even friends with one. I just can’t do it. I’ve tried, but averaging a banana a day keeps my energy up. I can do the super-low-carb thing ONLY if I’m not working out. Otherwise, unless I’m going to be a total beeeee-yatch, I end up eating somewhere between 100-150 carbs a day, I think. I probably fall into the “thrives on a fair amount of fruit” category. It kills any cravings I have for bad food.

        Deanna wrote on June 18th, 2012
        • Same here, I can’t do the very low carb thing – I end up slumped in the chair all day if I do. I eat quite a bit of fruit now, probably eating 100-150 carbs a day but this is still low carb compared to most modern diets (and the weight’s still coming off).

          Liz wrote on June 18th, 2012
        • Different strokes for different folks… I’m the complete opposite:

          I had a handful of blueberries on the weekend and it killed any satiety I got from eating fat so I was super hungry, I swelled up like a balloon and had some really unpleasant gut problems (lots of gas, sharp pains, and funny noises).

          I definitely used to be more in the semi-fanatical low-carb camp, but I’ve come to realise that 1) Some people function better with more carbs, and 2) I am absolutely not one of them. If I don’t eat ketogenic or near-ketogenic I’m a physical wreck.

          A.Stev wrote on June 19th, 2012
        • You’re absolutely correct that everyone is different and that we need to find what works for us *beyond* what our doctor recommends because he/she can only tell us what applies to the “average” person. However, I want to make sure that other readers out there understand that you cannot *possibly* know whether or not *you* will be better or worse on a low-carb diet unless you’ve spent at least 4 weeks in ketosis, which means at least 6 weeks of taking in less than 50g of carbs per day (much better to shoot for no carbs to help the process along, drinking bouillon daily, and eating as much fat as comfortably possible). Feeling lazy and hungry 2 weeks into a low-carb “diet” is entirely normal, because you haven’t adapted to turning fat into brain food. Most of you undoubtedly know this because you’re reading MDA, but it bears repeating.

          The “Atkins flu” is not an indication that “you need more carbs”. If you’re still hungry or craving bad foods, you’re almost certainly not in ketosis. Low-carb “dieters” fail primarily because they never actually get to ketosis (they fear fat and thus tend to eat very little at all), but they then conclude that this type of diet is either “bunk” or simply doesn’t work for them. Spend a month in ketosis and *then* decide whether it’s working or not. “Most” people attempting to “diet” while ingesting more than 50g of carbs per day are going to be extremely hungry, lethargic, and miserable. You might be very different, but *try* the full ketogenic diet for a month before drawing any conclusions. If you still feel bad after 6 weeks then by all means try something different. Do this only with your doctor’s approval, of course.

          Rob Allen wrote on June 19th, 2012
      • Yeah… context… everything in moderation…. blah blah blah… that only works if you are not both eating excessive amounts of carbs and suffering from a disease of civilization… most people who find this site/paleo are suffering from a disease of civ. (messed up carb metabolism from the vicious cycel of hyperglycaemia, hyperinsulinaemia & insulin resistance is a neolithic construct)

        Even Weston Price found out of all the healthy tribal peoples the healthiest were NOT high-carb eaters (but coastal herders that ate seafood & meat & dairy, interestingly enough)

        mm wrote on June 19th, 2012
        • Weston A. Price did note on numerous occasions in his book that the high-carb eaters were smaller in stature and not as strong as the low-carb individuals though.

          Brenda wrote on June 21st, 2012
        • Is celiac disease a disease of civilization? Because thats what I have.

          Happy girlfriend wrote on June 26th, 2012
  10. You are HILARIOUS! I heart science only because of graphs like this and bloggers like you. Thank you!

    All joking aside, I think that last big paragraph was VERY important and quite likely the reality for MANY people. Before people jump on the LCHF wagon, they REALLY need to hit the web and get educated. Excellent point.

    Ashley wrote on June 18th, 2012
  11. “I’m not saying correlation equals causation. I’m just saying maybe we should think about switching to Google Plus.”


    Primal Toad wrote on June 18th, 2012
    • The graph absolutely must go with this statement of course.

      Primal Toad wrote on June 18th, 2012
  12. I had much the same reaction when I read the paper last week. Basically, “I don’t think this says what you think it does, and I’m not sure how you could ever have even perceived it as such.” I thought I must be missing something in the design/analysis of the paper, because the media’s description and what the study actually shows are worlds apart.

    Kevin wrote on June 18th, 2012
  13. Excellent, Denise. Thank you. And, actually, Justin Bieber makes my blood pressure go up. But then, I’m just an old fart.

    D.M. Mitchell wrote on June 18th, 2012
  14. Thanks for that clear and comprehensive review! And I have to say that one of the things I love about MDA (and his guest bloggers) is a sense of lightness and fun along with the excellent content. I mean, the serious science articles are great and necessary, but I think this sense of play keeps all coming back…

    Tom Bassett-Dilley wrote on June 18th, 2012
  15. Very funny, and though it is Norway (not Sweden) that have fjords also very informative. I didn’t know that 25 % of us swedes try to cut carbohydrates, but on the other side I am usually sceptical to statistics.

    But not history! 100.000 year of evolution is a good argument for paleo diet – for example eating fruit! And there we might have an explanation to problems with LCHF. Then You should not eat so much fruit. That seems unnatural to me.

    H S Michajlov wrote on June 18th, 2012
    • Well, yeah cavemen ate different levels of fruit based on geography…. but cavemen also wandered around eating basically zero carbs in the ice ages hunting mammoths so we do have some adaptability.

      Interesting fact: average carb consumption of cavemen is estimated at 80g./day. I don,t remember where I got this info

      mm wrote on June 19th, 2012
  16. Here are two major problems with this line of argument:


    What if everything is exactly as they claim it is, only for different reasons?
    I have a total cholesterol of 400+ on a hight fat diet, but the reasons for that figure may have more to do with chronic inflammation, and maybe the types of saturated fats I’ve been using.

    What if high cholesterol is indeed a population-wide reaction to a high fat diet, only for reasons they didn’t look for in the study?

    The number of people getting cranky on a low-carb diet seems to be pretty high, and the Jaminets have pointed out that a healthy immune function needs a certain carb supply.
    I’m having no problems with someone ridiculing VLCers – the other day I read a forum post where someone had switched from cream to butter, because it contains less carbs…this is where ‘fad’ gets to be an apt description.

    Tim wrote on June 18th, 2012
    • I don’t understand what the problems here are?
      “What if high cholesterol is indeed a population-wide reaction to a high fat diet, only for reasons they didn’t look for in the study?”
      They were not looking at any reasons in the study… They just said exactly what you said (plus increasing heart disease) and Denise just explained why this is so wrong.
      They have looked at a high fat diet raising cholesterol numbers in properly done studies and it doesn’t (There is even a link to one in the article).
      Your second problem, which I’m still not sure how it relates to this article, is because you have seen a high number of people who seem to be crabby who are VLC? They are probably tired of people claiming these study’s have something to them and having to explain it again or they are just cranky people. I know people who are racist eating a SAD but i don’t blame their diet for it…
      Unless you are saying that the 5% who are VLC were so cranky and were eating so much butter (instead of cream) that they stressed other people out so much that EVERYONE’S cholesterol started to rise?
      Also switching from cream to butter may make someone extreme in your eyes others would say they are just trying to give themselves every advantage they can. Either way this is in no way an apt description of a ‘fad’.

      Cassidy wrote on June 18th, 2012
      • “were eating so much butter (instead of cream) that they stressed other people out so much that EVERYONE’S cholesterol started to rise?”

        {snicker} Yeah. This. This is why. +1

        Elenor wrote on June 18th, 2012
    • @Tim, from the paper linked to in the article shows the Swedes were generally eating a lot more seed oils and various other poly-unsaturated fats. These are the likely culprits in inflammation, not the saturated fats. For example, one graph showed butter consumption pretty much flat throughout, but some kind of butter+rapeseed oil combo (a faux butter, I suspect) skyrocketed in lock-step with the rise in BMI, cholesterol, and an increase in non sugary snacks. So which one of these caused the other? Of course, no one in the study nor in the reporting of it mentioned any of these other facts in their text. It’s all highly irresponsible and, frankly, malicious.

      Juan wrote on June 22nd, 2012
  17. “A new species of half-hearted dieters like Low Carb Weekend Warriors, Low Carb As Long as There’s Not a Cookie in Front of Me, and Why Don’t I Just Put Butter on Everything Edible and Buy New Pants When They Get Too Tight. Folks who jump on the “high fat” bandwagon while still living in high-carb land may indeed find themselves gaining weight and frightening their doctors with ominous lipid panels.”

    This is the most important thing people need to understand. If you are going to follow a low-carb diet it has to be a lifestyle!

    Vanessa wrote on June 18th, 2012
    • Ugh, I can’t STAND Low Carb As Long as There’s Not a Cookie in Front of Me. Just a few weeks ago, someone said we had to try these stick buns because they were “worth the carbs.” Ummmm… no.

      Deanna wrote on June 18th, 2012
      • Next time ask them if it’ll be worth the diabetes. lol

        A.Stev wrote on June 19th, 2012
    • This is why it might actually be a good idea to summarize/stereotype Paleo as “Meat and veggies only… and go organic if possible”
      Simple to understand….

      Some people stereotyped Atkins as the meat-only/steak diet… ironically if someone eats only steaks believing this they will still get better (but would have to either eat offal/liver & bone broth to get all nutrients or take a multivitamin)

      mm wrote on June 19th, 2012
    • this is the best comment i’ve read on this thread.

      so true!

      ashley wrote on July 24th, 2012
  18. Thank you so much! Great write up.

    Peg wrote on June 18th, 2012
  19. If people are becoming fat and unhealthy on high-fat/low-carb diets, it’s because they’re CHEATING. It’s also because they don’t make the distinction between sweets and grain carbs versus fruit and vegetable carbs.

    Eliminating all carbs isn’t healthy. The body needs the vitamins and minerals it gets from an abundant amount of fresh, preferably low-glycemic veggies. Also, trying to stick with an all-protein diet is just about impossible for most people. Veggies plus a little fresh whole fruit keeps everything moving through the GI tract. The energy level stays high, and so does the sense of well being.

    The body does not need sweets and grain products. That old food pyramid, with it’s 11-or-so daily servings of grains, is just plain bogus. It should be relabeled “Junk Science” and tossed in the trash. Instead it’s still being foisted off on generation after generation by so-called nutritional experts as the healthy way to eat. Fortunately, for those of us who care enough to seek out the facts, we have knowledgeable websites like this one.

    shary wrote on June 18th, 2012
    • “The body needs the vitamins and minerals it gets from an abundant amount of fresh, preferably low-glycemic veggies”

      Stefansson would disagree with you… then again, Stefansson and the Inuits had strange eating habits…

      mm wrote on June 19th, 2012
      • Their eating habits may have been strange (for some value of strange), but they were correct.

        Walter Bushell wrote on June 4th, 2013
    • Cheers!! I concur this has worked for myself and my family. We probably consume 60-% carbs in the form of vegetables, and usually an apple a day (important flavonoids – our eating focus is cancer preventative for personal reasons) – with balance comprised of organic meat,, nuts, Omega3 fats. Simple carbs are avoided as much as possible. This week my husband’s doctor called after hours – of course the immediate thought is she must have bad news. But she was so stoked about his cholesterol numbers that she wanted to know what he did . Several years ago his triglycerides were 5 00 and now they are less 100. He has simply changed his diet, takes a vegan Omega 3 daily, a multi vitamin pack and has vegetable based protein for breakfast with almond milk. I ‘ve never regained the 85 lbs I lost over a year ago, and feel amazing my doc says I am 3 yrs younger – I will take that anyday.

      RitaS wrote on June 21st, 2012
    • Fruit and vegetables do not contain that many vitamins and minerals! It is just CW that you NEED to eat fruit and veg. You can live happily without them if you eat various types of fat, meat and offal.

      Andy wrote on June 26th, 2012
      • As a biologist, I will disagree here; while it is possible to get all necessary nutrients from animal sources, the anti-cancer properties of many as-yet-unquantified phytochemicals in plants are vital to staying healthy in our modern toxin-filled environment.

        hrmm wrote on August 23rd, 2013
  20. That last graph is priceless.

    Russell (PrimalU) wrote on June 18th, 2012
  21. Loved your light-hearted critique of this. You make science fun, Denise!

    Sue Minger wrote on June 18th, 2012
  22. “Why Don’t I Just Put Butter on Everything Edible and Buy New Pants When They Get Too Tight”

    Bhahaha! I think the noise I made at that one counts as a guffaw.

    Lady Grok wrote on June 18th, 2012
  23. Denise, you are an absolute trip!

    Susan wrote on June 18th, 2012
  24. Once again. Thank you. Google plus?! Never!

    gilliebean wrote on June 18th, 2012
  25. This woman’s a genius! That Justin Bieber chart is funniest thing I’ve ever seen!

    OMG so true

    nyckitegirl wrote on June 18th, 2012
  26. Fun fact: the boy on the tube of the most popular caviar (in Swedish, Kaviar) was the son of ABBA’s CEO (not the group!). His name was Carl, Kalle for short and that’s what they named the caviar. Poor Kalle got teased in school and given the nickname “The Tube” (

    Mark, You’re awesome! Love from Sweden,

    Linnéa wrote on June 18th, 2012
    • Another fun fact: Abba the pop-group actually asked for permission from Abba Seafood to use the name Abba and got it.

      Per Wikholm wrote on June 19th, 2012
  27. Ya can print anything as far Conventional Genre “Journalism” goes…and there’s a ton of people who read the headline and take that to the bank….. without …..a …..clue. Did I forget to mention the fact that somebody also gets to play with a graph maker software?>>>BET they are NOT outside doing this…LOLOL

    Dave PAPA GROK Parsons wrote on June 18th, 2012
    • What makes it worse is that so many of the “journalists” don’t even read the studies themselves (or have a science background to understand them), so you have people reading a headline written by someone who could only be bothered to read the abstract of a study that they barely understood that wasn’t even well done in the first place.

      After this though, I’m starting to see why The Atlantic hasn’t been profitable for much of their existence.

      A.Stev wrote on June 19th, 2012
  28. Great post :)

    doghug wrote on June 18th, 2012
  29. Wow– I thought all Swedes were athletic and ate primal! Who knew they liked pizza, Twinkies, and sitcky buns so much.

    Thanks Mark– great article and it’s wonderful to see the “science” that is applied to these studies disected in such a way as to show that much of the junk is in the study as well as the people with high cholesterol.

    Pastor Dave wrote on June 18th, 2012
  30. So Gary Taubes states in his “why we get fat” book that it is completely healthy to have no carbs. He bases this off of diets our of paleolithic ancestors, some who could only find meat to eat day in and day out.

    So are these diets safe and effective? I’d be curious to read some studies on this. We have evolved to a degree though where if we subsist off fat and protein only, our bodies will torment us for god knows how long from what I undestand.

    I imagine it would take a long time for average body to efficiently utilize energy from fat and protein only though. Everyone seems to claim carbs are absolutely necessary, but would like to hear the evidence and science as to why if fat is more energy dense and more sustainable for the long term.

    Brent wrote on June 18th, 2012
    • Have your read the Phinney/Volek books? They do a great job of answering all of these questions.
      Over the past 13 years, I have tweaked my low-carb diet. I recently have reduced my carbs even further and upped the fat intake. This week I am experimenting with eating only the egg yolks to minimize protein consumption as well. (The best scrambled eggs I’ve ever had!) My body does not torment me at all. The fewer carbs, the better I feel (and better I look). I took up cycling a few years ago and this summer attempted my first 7-day 460-mile ride. Hills, winds, nothing phased me (even two days of some sort of water/food borne GI bacterial infection). I have lost body fat and built muscle (thunder thighs), something women my age (59) aren’t supposed to be able to do. My 70-year-old SO/biking partner was so convinced by the Phinney/Volek books that he also converted to ketone-burning and is truly amazed at the results, including dropping his 40 pound “wheat/beer belly” in three months, something that exercise alone wasn’t accomplishing on a moderate-carb diet.

      Peggy Holloway wrote on June 19th, 2012
    • Read up on the arctic explorer Stefansson’s meat-only experiments. (And his analysis of the native Inuit/Eskimos’ health and diet… too bad some of what he observed like rapid aging is probably caused by environmental facts i.e. high ultra-violet exposure from weak ozone layer. Same with artery calcification from lack of vitamin D/sunlight, and random bleeding issues, bad skin from too much Omega-3, lack of Omega-6 in diet)

      mm wrote on June 19th, 2012
  31. Denise – yer picking a great field – like Jon Stuart and the Daily Show, you will never want for material – the absurdities and idiocies just bubble forth waiting for your delightful wit and intelligence to mince them into comedic hash (best with half dozen eggs…)

    ravi wrote on June 18th, 2012
    • True, the ludicrous abounds everywhere.

      But Jon Stewart is a profoundly ignorant man. It is unfair to compare Denise to him.

      Txomin wrote on June 18th, 2012
  32. Thanks for this! I had my doubts as soon as my brother forwarded me an article about this.

    Jesse wrote on June 18th, 2012
  33. Damn facebook, I knew it.

    rkd wrote on June 18th, 2012
  34. That last graph haha… classic Denise, classic

    Burn wrote on June 18th, 2012
  35. Greetings from the Land of the Midnight Sun!
    It’s 10 pm and still light. The suns just set.
    Earlier I had a dinner of spare ribs with broccoli and butter from Åland and some leafy greens (probably from Italy).
    Denise is – as usual – doing a great job dismantling yet another poor study.
    I’d like you all to know that LCHF/Primal/Paleo is indeed getting maintream here now. People are talking about cutting carbs, not only increasing fat, as a (the) way to get better health and body composition.
    More and more of us Swedes have stopped listen to “experts”, instead we look at the amazing success our friends, family, coworkers etc make, switching from a high carb, processed food diet to a more natural human(e) diet. And do the same.
    And thanks to blogs like Marks and others that provide good, scientific articles, it’s not so difficult to spread the word.
    And I guess you know by now, it looks like the increase in obesity has stopped, we’ll see in a year or so if it’s also decreasing.
    Sunny midnight greetings from Sweden.

    Johan wrote on June 18th, 2012
    • Thanks for weighing in, Johann, and giving us a view from a real person! I had spare ribs myself, tonight.

      I’m reading Weston A. Price’s book about his travels, and am thoroughly impressed by his statistics, photos, and humanity.

      The healthy “primitive/isolated from trade foods” people from all around the world that he surveyed definitely had some things in common that showed a strong correlation with healthy teeth and faces. Concentration of nutrient-rich foods being primary. Fats being completely present in all of these diets, and very often front and center.

      This is so not a new fad.

      Joy Beer wrote on June 19th, 2012

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