Atkins vs. China Study diet. Who won? You decide.

hello greetings my name is Wendy de Marquand afraid and I am an associate director of the UAB Comprehensive Cancer Center and also the excuse me the Webb endowed chair of nutrition Sciences at UAB my colleague dr. Elizabeth quali is the director of the supportive care and survivorship program at UAB and she is also a scientist with the Centre for palliative and supportive care and together with the help of doctors christine ricci and rodney tucker as well as Bob Sheppard and beneth Annika and Vicki hearing wherever they are in the sea of fake faces we have been working on scheduling this debate for almost over a year so we're so happy that everybody is here tonight and on behalf of the Center for palliative in support of care and the UAB Comprehensive Cancer Center we are pleased to welcome you to the inaugural Dean corliss lecture we are also pleased to turn the proceedings over to cherry Ellis who is be Metro magazine columnist and creative director for charter media she will be moderating moderating this debate thank you hello everybody it's my pleasure to be with you here tonight I would like to let you all know that this event is made possible through a gift by Dean Corliss and the Corliss family Dean was an attorney and health policy expert whose background in Nursing gave her a special understanding of our health care system and the need to improve the care of individuals with serious illness she was a strong proponent of interprofessional holistic care that included an array of disciplines including nutrition and counseling as well as nursing medicine and Social Work care she was a member of the UAB Center for palliative care Community Advisory Board and a passionate advocate for policy reform to improve patient self-determination of treatment goals and access to palliative care Deen remained committed to improving palliative care even as her cancer became advanced her gift perpetuated by her family is intended to improve the care of seriously ill patients by advancing knowledge of the role of supportive and palliative care for patients and families who are facing serious illness thank you so much for that and now let me tell you a little bit about the two doctors who are going to share with us this evening T Colin Campbell who will be on your left is the Jacob gold Sherman professor of nutritional biochemistry at Cornell and author of nationally best-selling book the China Study startling implications for diet weight loss and long-term health he was trained at Cornell and MIT and nutrition biochemistry and toxicology he spent ten years on the faculty of Virginia Tech's department of biochemistry and nutrition before returning to the division of nutritional sciences at Cornell in 1975 where he presently holds his endowed chair his principal scientific interests which began with his graduate training in the late 50s have been the effects of nutritional status on long-term health particularly on the causation of cancer he has conducted original research both in laboratory experiments and in large-scale human studies has received over 70 grant years of peer-reviewed research funding has served on several grant review panels of multiple funding agency has lectured extensively and has authored over 300 research papers he has served on many national and international expert committees with mandates to develop food and health policy positions he now has completed a second book hole which will be published in May of this year dr. Eric C Weston who will be on your right at this podium is an associate professor of medicine at Duke Health Enterprise and director of the Duke lifestyle Medicine Clinic he is board-certified in internal and obesity medicine his master's degree is from the Duke clinical research training program in clinical research and biometry his work combines clinical research and clinical care regarding lifestyle treatments for obesity diabetes and tobacco dependence and he has over 90 peer-reviewed publications he is currently the president-elect of the American Society of bariatric physicians and a fellow of the obesity society and the Society of general internal medicine he is co-editor of the medical textbook obesity evaluation and treatment essentials and co-author of the popular diet book the new Atkins for a new you now let me tell you a little bit about tonight's rules of engagement each speaker will have 18 minutes to present the merits of the nutrition strategy that they are here to advise dr. Campbell will present evidence on the merits of a low protein diet in preventing and controlling cancer as well as overall health and dr. Westman will present evidence on the merits of a high-protein diet as in Atkins in preventing and controlling illness as well as overall health following the initial presentation of evidence each speaker will have ten minutes to offer a rebuttal of their opponents positions questions may be submitted on the slips of paper that were available at the registration table out front now if you did not get a slip of paper but you would like to submit a question you can raise your hands and attract the attention of one of the facilitators and they will pass you a piece of paper pass your questions to the outside of your oh that's my flight attendant thing there pass your questions to the outside of your row it will be collected now you do not need to wait until the end of the presentations to submit your question in fact you will have a higher likelihood of having your question addressed if you submit it sooner rather than later questions will be reviewed by a panel of scientists and submitted to our distinguished guests for their consideration each speaker will have up to three minutes to address any given question now we're not going to be able to take live questions from the audience during this presentation we encourage you to save those so that you will have a stimulating conversation over your dinner or broccoli or steak depending on how this comes out for you at this point I turn it over to dr. Colin Campbell sir the floor is yours thank you very much I first would like to extend a special thanks to the cordless family for making this possible real honor to be here to do that and also to the palliative care group at University of Alabama uib if I can right here in this discussion debate if you will as was told it's largely focused on protein it essentially however protein is it's not just about protein it's about the total diet and so when we talk about the total diet we talk about the kind of foods are being consumed and in order to generate health prevent disease I would argue that is largely related to protein at least in terms of the way that protein indicates that kind of diet were consuming now we have a just to go back just a little bit I want to just mention where we are with respect to the discussion on protein needs a little bit of history you need to know just a little bit about my own background basically I started out on the other side of the fence I was raised on a dairy farm milking cows supposedly milk being a good source of good quality protein I went away to Cornell University I took up my doctoral dissertation research again that research was focused on the value of protein especially high quality protein animal-based protein so I was all about promoting high protein diets my views today are very different as many of you may know I'm certainly going to make that point here and as my views are entirely based entirely based on the evidence that we got from a large research program that I organized experimental research program over what now turns out to be more than 50 years ago now another comment I just need to kind of fill in the background a little bit about this protein question protein has been revered for a long time and as you can see here it was discovered early on early 1800 1839 to be exact by this Dutch chemist there was when it was discovered there was a component of meat being fed dogs that it was found that was required for sustaining the life of the dog so it took on a special importance right from the very beginning it was named after the Greek board because of his importance life-saving it was named from the Greek word Proteus which means our prime importance as I say proteins started out with a generous baptism right to start with a little bit later Karl boy a very famous German professor during the 1880s in particular later yeah well known to be a mentor very famous nutrition researchers some of whom played major roles in the field of nutrition especially on protein and the reason I mention him here is because he kind of set the stage for we tend to think about protein he also Illustrated he also Illustrated the extraordinary enthusiasm that actually was being generated by scientists in this community about protein for example he established that 32 grams a day was the protein requirement for as he said man I'm not sure that women were invented at that time but in any case he said men 52 grams a day yet on the other hand having established that and I think he was the first to say how much protein is required he then apparently because of his significant significance he recommended nonetheless 120 grams a day 120 grams a day as one of the students again a very famous researcher actually said protein interchange his civilization itself that's the kind of dimension that's the kind of euphoria enthusiasm for protein that has existed for a long time from very beginning and we've been living with it ever since now let's fast-forward to the National Academy of Sciences of recommendation in 1943 this was the time and second world was going on and it was enthusiasm there was interest there was interest in determining how much protein the soldiers actually needed to do their work their important work and it was established at that time in 1943 by the National Academy sizes that 10 to 11 percent of total calories was should be enough protein and that's been reviewed every five years since by the National Academy of Sciences the so called recommended dietary allowance that's the RDA the RDA for protein has been set at somewhere in the neighborhood of about ten to eleven percent protein that's said to be enough but the allowance however is not a requirement the RDA to ten to eleven percent of total calories theoretically exceeds the requirements of at least 98 percent of all people so the ten to eleven percent protein of a typical diet is generous already and as I say that's been established in science it's been it's existed for a long time it's been reviewed repeatedly and that's basically a good solid number now the question is that because 10 to 11 percent dietary protein has long been established as more than enough for virtually everyone what type of diet which I type of food what we be consuming in order to get that 10th 11 percent protein now a hint for me came in my research which lasted for many years as a result of a 27 year long series of studies in particular in laboratory animal studies on a relationship of dietary protein with primary liver cancer another interest of mine at the time now I'm just going to show you just quickly just all that background what that study said in the very beginning and certainly it influenced me namely if we take animals we genetically modified them so that they get cancer if you will then feed them to different levels of protein 20% which is the Jennifers that's their usually recommended levels compared to 5% you can see the 20% protein animals they grew those cancer as well these are animal genetically modified to get liver cancer feed them 20% protein that's what to get feed 5% you can see there's no effect this particular strummin here done in many different ways over the years showed us that what we could find out that 20% level of protein was generous in terms of its ability to turn on cancer so in this experiment for example switching back and forth 10 20 percent on 5 percent 20 percent on and so forth so protein essentially is controlling cancer dead in excess fat in excess it generates and grows cancer in contrast welcome let me say this first the protein that we used at that time was the the prominent protein of cow's milk I'm coming from the dairy farm I found that difficult to digest no pun intended but in any case I found out a difficult proposition but nonetheless there it was we did in so many ways elevate protein up to 20 percent we get cancer but soy and whey protein to plant proteins turned it off it's very clear we did it so many times it's it's quite frankly it's really clear in fact this was so prominent that it turns out that casein the prominent protein accounts milk actually is the most relevant cancer-causing chemical ever identified and I suspect that many of you have not heard that before but this is the result of dozens of experiments over a long period of time published quite frankly they're very in the very best journals now that's the background now I want to turn your attention to what where did that research take us that I want to go back to the question concerning how much protein this was a chart here that also influenced me and grew and more expensive these years pass namely you can see that as you increase protein from four up to 20 instead of getting a trait straight line relationship you know more protein more protein you get more cancer it's not that's not the case only when protein exceeds the 10% do you get the cancer that's very interesting you get that sort of hockey stick effective we say that threshold so protein is a good nutrient obviously we needed that RDA said we need it so we need four kinds of good preferences and it's only in excess of that do we get to cancer now I'm going to extend that narrowly focused study to a broader consideration in the view in the interest of time I can't tell you obviously all the various things to which we can talk about not just cancerous heart disease as many other things and involves different species too so here's the relationship between dietary and multiple health outcomes that's that's basically the structure of the relationship I said before ten to eleven percent is the recommended allowance it's not the requirement the way this was devised actually the minimum daily requirement protein is around six seven percent in humans it's about the same in laboratory animals by the way in rats but in any case the minimum daily requirement around six seven percent when those studies were done and repeated many times since what they did they took those that experimental findings six seven percent and ended two standard deviations to that so that statistically we could assume that 98 percent of all humans basically are getting enough protein so again the RDA standing the test of time is in excess of the theoretical protein needs of at least 98 percent of all humans so then you ask the question well how do we get that 1011 percent protein it turns out if you start looking at plant-based foods as a diet I'm going to make sure the plant-based diets applies all the protein we need without going into excess so we go to benefits of protein without getting the excess but trying to run into that problem of beyond that the animal-based foods in contrast as we start putting that in the theoretical diet we diminish plant foods increase animal foods and therefore we end up with problems and those problems are just about causing cancer the same reflection we can see in fact in the long term for blood cholesterol atherosclerosis is a number of other things too so it asks we can ask the question what's the special about plant-based foods and I want to draw your attention to this because it's not just about protein when you know it we can have we can debate how much protein we ought to consume but when you do that just alone as one nutrient that's not the way to do it we have to take into consideration all the things that come along with with protein for examples that plant-based foods for example they have lodged up antioxidants and they only plant-based foods have really to oxidants a generous supply of an antioxidant power 'fl is a powerful group of nutrients that help us to prevent disease they also have complex carbohydrates plant-based foods do animal foods don't one major distinction differences and I would argue the right amount and kind of fat as well it's provided by plant-based foods in contrast animal-based foods are Pro oxidants what a pro lux let's do pro-oxidant SAR the things that cause rust and so it tendeth generate aging it tends to generate cancer they tends to actually generate and catalyze the development atherosclerosis karate complex that then burst and cause heart disease here's another way of looking at just summarizing quickly the difference between plant and animal based foods here's plants and an ox's complex carbohydrates and vitamins fat and protein as present in both but it turns out that those antioxidant copper complex carbohydrates and vitamins are plants basically only fat and protein they both both boots have that but the plants have the lower levels significantly lower levels there is in fact a third group we've got to pay attention to especially during the last half century and that's the process boost the processed foods quite frankly is made up of all kinds of things whatever you want to put in them processed foods are a problem they tend to be high in fat they tend to be high in refined carbohydrates like flour and sugar and oftentimes salt too it's not that's not a whole food plant-based diet so I I say we got to three groups of food processed foods animal foods and plant-based whole plant-based foods the processed first and the animal-based foods are problematic they're problematic but if we talk about this all day long that's the negative I like to focus on the positive the positive let's talk about the value of whole plant-based foods very simply that basically a diet also is low in fat and so forth so we get to this stage here in Italy in my career they say more than 50 years ago as we went through the years I started seeing things from many from perspectives from many different perspectives the whole plant-based foods are really important in terms of generating health it turns out that in the scientific literature some of this information has been around a long time than ignored because of this bias in favor of believing that we ought to consume as much protein as possible and so here are some of the diseases as you can see here all of which there's evidence for an effect of this so-called whole food plant-based diet actually suppressing preventing and even cure when a treatment is used for for basically blocking the development these serious diseases so this effect suggests something really interesting exciting this kind of diet is very broad in scope it affects lots of lots of diseases that's the first thing I mean there's a variety of decisions there seems to be a almost you can almost say all one-size-fits-all but I don't quite like to say that because the one size involves infinite countless things just happen to be present in plant-based foods also this effect if you take people almost of any persuasion any kind of health condition put them on a whole food plant-based diet we're now seeing remarkable effects unseen ever before in medicine in terms of the ADEA this type of effects that are produced we can generate health in a hurry is fast it's surprising things like angina or thrity kind of condition maybe a little longer and other kinds of pains for example dissipate quickly and finally this what this suggests is something exciting this is about treatment nutrition didn't use the whole food plant-based diet being used as a means of treatment of existing conditions not just the prevention we already know about but actually as treatment now I'm going to mention a couple more things there quickly some of this information is really quite old this for example published in 1941 showed that casein or animal protein if you will generate five times as much disease severity that led to heart disease in this particular study as this soy eventually people started talking about the the soy but when in fact they never thought about that possibility that's always the normal and in fact the animal protein in this particular case causes problems so we see the same that that was a related to heart disease 1941 and we see the same thing with cancer these are just a couple of examples now one just zip two very quickly here my column some results of my colleague dr. Caldwell Esselstyn who many of you know of the famous heart surgeon or surgeon at Cleveland playing happiness to work on heart patients basically dr. Esselstyn had found earlier on that when he took heart patients treatable whole food plant-based diet who was actually able to obliterate the disease cure the disease cured the disease any of you have seen the film for seven nights that features both his work in my work you can see that the effect that that what he reported here's some new data just for those individuals who are concerned about this who got that study bit not being big enough since dr. has to retire he has taken on patients it is in at his claim and in his home as well and something like 220 people of accompanying with heart disease he spends five hours with him only five hours he actually tells him about the whole food plant-based diet that's it he doesn't doesn't get involved with him anymore for that recently he went back and asked him how you doing it's been between two and seven years since he saw them he simply asked him how are they doing what turns out that here's the results actually of the hundred and ninety-six patients he was he could find a hundred and seventy seven stayed with the diet can you believe that eighty nine point three percent of the people stayed for the diet now the reason they do that is because dr. Esselstyn is convinced he knows what it does he's quite a funny convincing when you're talkin to him and he tells you how to do it his wife gets involved too that's pretty spectacular that nine out of ten people if you will so here's a rate of cardiovascular events among those who stayed with the diet eighty nine percent the rate of recurrence for an additional heart event is than 1-percent one individual out of the hundred and seventy seven had a problem not fatal it had a problem and the others the ones who decided not to stay with you go on you know any kind of diet higher and protein higher in the kind of foods that we tend to eat sixty-seven percent had a recurrence that's a huge difference I think you would agree now I want to just to sort of conclude here shortly and talking about some of the confusion that lies in this field because we tend not to understand you know the role of protein not only in an in and of itself but also the type of diet that is actually created here's our on a scale here the combination of fat protein fat and protein which is sort of typical American diet but in the Africans case essentially said to be it's encouraged to be even higher you can see up there that in this if fat and protein someone's around eighty to eighty-five percent of the diet is supposed to be fat and protein I'm saying it should be here at the bottom 20 percent that's a huge difference - what we're seeing the really big benefits when we actually treat people down to 20 percent not the 8 80 to 85 percent in the long term that can be a disaster I admit that you can see what looks like to be beneficial in a short run but not in a long run not in the long run in between there you get vegetarian diets vegan diets the so-called standard American diet and so a lot of those studies have been done that you've heard about if they're also kind of packed together weird little changes and they make big stories and they don't mean anything what I'm talking about here is not the vegan diet I don't support the vegan diet the waist practice not the vegetarian diet because 90% of vegetarians are still consuming dairy and things like that I'm talking about a whole food plant-based diet vegetables fruits grains legumes and whole food form without adding back a lot of fat salt and sugar that's where we get these really huge huge very impressive effects so now I want to finish up you know we've lived in in and with information this country that actually allows us to continue on doing what we're doing hi high protein for example guesses in trouble and now I would argue that there are folks that want to go out and talk about the Africa's night Oh get more of that I don't believe it I simply I think that in the short run that that can be a maybe see some effect but in the meanwhile while we're keeping sick people sick we then encourage them to take vitamin supplements to take vitamin supplements and in this in fact it can be found on the Atkins website your best bet is to get the vitamin supplements we now so then the question arises and my my colleague or dr. Westman has also said too that many medications and nutritional supplements need to be taken I can't read it with food and each meal three times a day so here's the combination do you want a combination with high protein high fat diets most of the animal-based foods you know basically I would argue keeping us sick and then try to make us well by taking some vitamin supplements to me it doesn't really make sense and so here's a quick review of what a vitamin supplements do is this the way to take take the tour here's a review of 67 this is in 2008 67 randomized clinical trials that's a huge amount of research and I followed this industry very closely in fact I was what's the Federal Trade Commission or I was asked to be the chief persons given testimony against the vitamin supplements in the beginning and it turns out to 67 trials have been conducted now almost a quarter million people it's huge they see conclusion no evidence to support antitoxin something to prevent mortality and healthy people were patient with various diseases these vitamins here beta-carotene vitamin A and vitamin A significantly increased mortality I'm sorry to interrupt sir your initial 18 minutes is up thank you so much and at this point we are going to turn the floor over to dr. Westman dr. Westman thank you very much it's a pleasure to be here in a scientific venue University of Alabama Birmingham thank you for the invitation to speak and professor Campbell it's a great pleasure to meet you well we just heard is not the only way to go about things I'm gonna change the discussion a little bit first I'm going to declare that I'm a Mita terian not a vegetarian nothing wrong with that guys gals I'm also a reformed carbohydrate addict and I think the discussion you hear is gonna change because we're no longer under a protein love its a carbohydrate love and in my clinical practice I use what I talk about today just about all the time so I'll give you the science and the clinical side of things and I think if there's anything we've learned is that there's more than one way to achieve excellent health you'll be reassured to know that you don't have to eat carbohydrates to live it's not an essential nutrient so one of the first things we learn in nutrition is what does the body not make and what you have to eat you won't find carbohydrate on this list of essential nutrients I'm going to talk a little about what goes on in the body not just what's on the plate because as an internist as someone who treats metabolic problems I need to go out and know what's going on inside the body so the way the humans use fuel what you eat fuel is that you burn what you eat we're omnivores dietary protein is mainly used for structures so we're not going to talk about that but if you eat carbohydrates and fat then you will use both for fuel and your respiratory quotient will be about 0.85 if you eat only carbohydrates then you burn mainly carbohydrates for fuel and your rest which quotient will be one point out and when you eat only fat you will burn fat mainly for fuel and the respiratory quotient will be about point seven this is tied in basic nutritional classes and when you burn fat fatty acids and ketones become the faint main fuel source and if you haven't heard of fatty acids and ketones as a fuel source I will introduce you to that now here are the popular diets in terms of carbohydrates per day on the y-axis and calories per day on the x axis with the diets in yellow limited in carbohydrates so much that your body has to burn fat so on the far right hand side of this panel you'll see at the top and diets that have lots of carbohydrate in them you burn glucose for fuel and at the bottom right the diets that don't have the carbohydrate you burn fatty acids and ketones for fuel that's just the way we're built there's nothing wrong with it when you don't eat overnight most of you are shifting to fatty acids and ketones for metabolism children are very effective at doing this diabetics are very poor at doing this if you didn't eat for a day because you were sick you're shifting to fatty acids and ketones if you were starving for a protest for 10 days you shifted fatty acids and ketones that's just the way we are made how do you implement a little carbohydrate ketogenic diet in my practice there are many different ways and I say ketogenic because you're shifting to the ketones for fuel you could have eggs and bacon sugar free yogurt with berries chicken Caesar salad a fast food burger without the bun snack for all of cheese stick pepperoni slices chicharones steak with blue cheese broccoli salmon with cream cheese cream sauce for drinks water sugar free drinks coffee with cream individuals choose the foods that they like from a list that I give them is a sheet of about a hundred foods and I say eat what you want off this but you can't eat off this list it's a list of low glycemic foods I'll talk about that in a minute there are vegetarian low-carb options but you don't have to be a meat aryan to be a low carb eater and I wonder if that's the common denominator between we're talking about today that professor Campbell maybe we're just saying the same thing in a different way you can categorize carbs as good carbs and bad carbs and the good ones are the vegetables the bad ones are the refined products the stuff that's made in America today and and I hope you're not eating too much of it the popular diets can be put into different phases there's a weight loss phase and a maintenance phase and so if you're at a maintenance phase of a popular low-carb diet you're basically eating like you're living in the Mediterranean Basin like a French person Spanish person or Italian person you're already at your goal if you're my patient I don't want you eating that way yet if you have weight to lose you know so no wine and and and that gets yet but eventually you can if you're at your goal and there was just a recent study again about the Mediterranean diet out of Spain being a favorable thing to do in in recurrent cardiac events being prevented excuse me that was primary prevention of cardiac events so how how could this relate to cancer and and metabolism well you have to understand that lowering the dietary carbohydrate reduces the serum glucose and insulin levels so sugar which is sucrose glucose and fructose raises serum glucose so the sugar you eat the starches you eat raise your blood sugar sarch is like bread and pasta are digested the glucose having a teaspoon of potato is no different than having a teaspoon of sugar from your body's metabolism I know it looks different on the plate and I know you may have some taste and social aspects to that one food over another but your body sees it in the same way insulin is secreted by the pancreas to lower that glucose level our body does not like an elevated in glucose level we protect very carefully against the higher glucose level but insulin while it lowers the glucose it also is a potent stimulator of lipogenesis or fat storage and then if hibbott soar stops fat burning so lowering insulin levels allows an individual to use their body stored fat and that's the basis of a low carb diet the treatment of obesity insulin goes down the body wakes up to the fact that it has excess energy stored on it in terms of fat it starts burning its own fat so low carb diets reduce the dietary contribution to serum glucose which then lowers the insulin levels this is so elementary it's not even taught anymore it's in the physiology books and it's not emphasized in classes I'm afraid insulin is also an anabolic hormone a growth promoting hormone which is why this relates to cancer so lowering insulin may lead to less cancer growth here's a figure that shows the blood glucose and insulin after meals in one of the best studies looking at a low carb diet in an inpatient setting by Gunther Bowden in the annals of internal medicine of 2005 and if you're not eating carbohydrates these are the circles in white white circles the blood sugar and the insulin doesn't go up after meals so we teach that it's normal to have the blood sugar to go up after a meal but it's normal only if you're eating carbohydrates so I've been eating this way about 10-12 years since the first study that I conducted at Duke and my bullet urja doesn't go up after a meal because I'm not eating much carbohydrate so just because it's normal it doesn't mean it's optimal okay so we want to know what's optimal I was helped out by a patient who gave me a book from her used bookstore from 1923 and she said you might look up you might be like this book and I'd like to what the diet was for diabetes before insulin was discovered and basically it was the diet that I was studying in 1999 and almost getting in trouble for studying this diet that was used by all the doctors in 1920 before insulin was discovered for diabetes it's not new its if there wasn't medication for diabetes we'd all be using this diet oh I use this diet in my practice if there's a growing number of people most ideologists don't go to this level they just don't know yet so here are the facts about low carb diets and I give an hour-long presentation about this I can't go through all of it carbs are not essential nutrients they lead to weight loss without talking about calories you don't have to talk about calories the appetite goes down you eat less and so at the bottom bullet the thing that was most unpredicted is that low-carb diets lower the metabolic cardiometabolic risk by raising the HDL cholesterol and by lowering the triglyceride this is called the metabolic syndrome there's so many studies now there are meta analyses in a few wikipedia medical research related related to low carb diets the top 50 articles will be right there for you these are not hard to find in your grant applications the best study the longest term study is the direct study by shiet out out of Israel there's carotid artery level determinations that carotid artery thickness goes down after 2 years if you're following a low carb a high carb or a Mediterranean diet didn't matter in that study so look that up if you're still wondering if this is a healthy thing to do for your arteries obesity and metabolic syndrome two large meta analyses now by Nordmann published in 2006 and Hessian in 2008 type-2 diabetes the recent systematic review and meta-analysis in 2013 and the American Journal of Clinical Nutrition so times are changing in terms of the science for low carb diets so what about cancer autumn warburg received a Nobel Prize for talking about cancer metabolism being predominantly glucose metabolism being glycolytic being using using the glucose from your body using the glucose that you eat cancer cell glycolysis is the basis of the PET scan a medical imaging procedure that lights up under aggressive cancers when a Eugene fine news a radiation oncologist had an aha moment when he was doing a PET scan and he realized he was feeding glucose to cancers it's hard to look this up and said this is old news most aggressive cancers demonstrated glycolytic phenotype meaning they eat sugar they eat glucose even more so Chen at a Lin Journal of bioenergetics and bio membranes 2001 talks about the Warburg effect and it's cancer therapeutic implications tumor cells have over expression of all of the activity has to do the glucose bringing glucose into the cell and all of the glycolytic enzymes drugs that inhibit or block the glucose transport are now being looked at as therapeutic targets for cancer tumor cells often like the ability to use fatty acids or ketones as an energy source so you may be starving the cancers by not eating this sugar now that's the speculation but it's possible and for some tumors ketone bodies are even toxic for them Wow that's pretty important and this is just food to put this all in context this shocks doctors shocks medical students there's five grams of glucose in the entire adult human metabolite stream if you poured out all your blood and measured the sugar or glucose in it there's five grams and it's so obvious nobody ever looks at it if you check your blood sugar a normal blood glucose is a hundred milligrams per deciliter any diabetic they do it multiple times a day a hundred milligrams per deciliter is normal I just did this for a high school class factor labeling showing that with assuming there's five liters of blood and the adult so imagine in a child it's much lower that there's five grams or a teaspoon of sugar in the entire human bloodstream and now if you're telling someone to eat a hundred grams of carbohydrates per day that's 20 times the amount of sugar in your bloodstream 20 times I'm amazed we're not all diabetic if we're all eating that way your pancreas is on overdrive keeping the blood sugar down animal studies no problem Steve Friedman at Duke has done several studies looking at animal models where you could put people not people animals on ketogenic diet significantly reducing tumor volume another study a non ketogenic low-carb diet rich in canola oil was shown to reduce tumor growth and tumor cell proliferation in an animal model another mouse model of a glioma so if brain cancer seemed to be particularly sensitive to glucose don't quite know why some cancers are more sensitive I think the Warburg effect is going to be refined over time not all cancer cell cells are going to be glucose dependent or or predominately glycolytic they're crafty things that imagine if you just changed the diet in combination with chemotherapy or radiation changing the diet I can keep someone on a low-carb ketogenic diet for five years now in my own clinical practice there's an art to it but it can be done and the mechanisms to appear to go beyond just a reduction in the glucose level there are changes that occur in the metabolism including lowering an inflammation that occurs when you reduce the carbohydrates another study showing a squamous cell and colorectal cancers being injected into mice less growth and 10% diet and even a 15% diet reduced the incidence caloric restriction is being compared to carbohydrate restriction Jon remove morales a student at Duke found out that if he but people put animals I'm the same calorie level the animals on the low-carb ketogenic diet lost weight compared to the other calorie level so calorie is not a calorie inside the animal body or the human body so they in this study found that out and then adjusted the calorie level gaves a low-carb diet animals more calories so that the weight was stable and then even found the same result that there were was a less incidence of tumor in the in this mouse model but you know as you're going to hear in my rebuttal that mouse model and animal model is just ain't good enough for a medical physician and but there are some human pilot studies of low carb diets and cancer so they're at the level of can cancer patients tolerate a low-carb diet even at advanced stages so there are two studies that I could find Schmitt at a landfill Eugene fine ed out and the low-carb ketogenic diet was well tolerated in these cancer patients Geoff Volek is one of the shining star nutrition and an exercise physiologist at the University of Connecticut has known a lot of the low carbohydrate science and in this study he collaborated with an individual to look at what would be the best diet for reducing breast cancer and so basically they were coming up the same idea of reducing insulin insulin related gross factor reducing inflammation these are all in the literature has been correlated with cancer especially breast cancer and so they postulate that the optimal diet dietary strategy that would be one that lowered the serum glucose the serum insulin reduced the adipose tissue increased the HDL and decreased the triglycerides that's that metabolic syndrome that the low-carb diet is really good at fixing and then decreasing inflammation so in this paper they provide the basis and great fodder for grant application backgrounds for the rationale for using a low carbohydrate or a low calorie diet a calorie controlled diet for the treatment of cancer published in 2012 I'd like to wrap up low carbohydrate diets create a fuel metabolism using fatty acids and ketones it's just what happens minimizing glucose utilization low carbohydrate diets are safe and effective to treat obesity metabolic syndrome type 2 diabetes like Professor Campbell I see chronic medical conditions go away I can say the same thing professor Campbell in my practice using my approach all of these diseases go away I think we're against the same same problem which is the typical American diet and there are multiple ways to go about things I wonder it's the common denominator of what we're talking about is this glucose dependency of cancers so avoiding glucose metabolism and lowering insulin levels may be beneficial for the treatment of cancer and preliminary human prospective studies are being done to evaluate low carb diets for the treatment and prevention of cancer AIDS in its infancy up until 10 years ago there was a taboo on studying low-carb high-fat diets nobody could get any grants funded now you can get grants funded there are several studies being done in the US and in Australia the Australian group has has had continuous funding for a long time I would encourage you to look at the mechanism you know what's the mechanism of that's creating the cancer and follow the trail I see studies that correlate high insulin levels with cancer and the scientists aren't thinking about well what raises insulin levels it's the carbohydrates that raise insulin levels so I'm just trying to be here to help you connect the dots between what you observe and and maybe come up with treatments that are even better than what we have today and treating the chronic medical conditions of today including cancer thank you very much at this point each speaker is going to have ten minutes for rebuttal we're going to start with dr. Campbell dr. Campbell you have ten minutes thank you professor Wiseman for your comments let me make it just a general comment and I know this is germane to some understanding of this very complex and complicated field you know in science we have done gosh I can't even think three four million studies probably in the last fifteen or twenty years very technical and done in such a way that for the most part we're studying one thing at a time one day at a time out of context of the whole when we do that when we do that as for example when we consume single nutrient supplements for example they do not work in the way in which they're expected to work single nutrients are not that's not nutrition it should be whole foods really and then the question becomes well what about Whole Foods what what kind of diet is best here and in terms of talking about Whole Foods and sort of getting a big-picture intake if you will this particular presentation of data here I thought was quite relationships from some years ago this show is something that we all heard about more or less 3040 years ago it was studies done by dr. Ken Carroll University of Western Ontario I've actually friend the late Ken Carroll friend of mine he actually observed as did other researchers that when we compared to total fat intake in different countries against breast cancer he saw this impressive relationship here the higher that fat intake the higher the breast cancer risk he left it at that more or less I had a different interpretation of this and in fact discussed it with Ken Carol shortly before his passing namely when you look at this and draw the regression line through those points theoretically the emphasize theoretically it turns out the lowest level of fat crosses the line I mean the lowest level of breast cancer is a place where the fat intake is crossing that line there which suggests I'm theory it's theoretical it suggested we have to have some fat intake and not have to worry about getting breast cancer the same is true for colon cancer and heart disease and so that's that's the threshold that's what it looked like at that point in time nothing surprising yet but then the question arises which kind of food animal food or plant food is best or i should say animal fat or plant fat and so Ken actually had these data they weren't talked about much at the time namely if you look at the relationship between plant fat intake and breast cancer it's all over the map there's no relationship between plant fat and animal fat in turn and contrast look at this here's a relationship between foods that have animal fat 'm namely animal foods it goes right through the origin right there what that's telling us again Tourette eclis that as soon as you put a little animal fat in the diet then the breast cancer risk is going to begin to increase that's quite interesting because it turns out that animal fat when you do the experiments in isolation animal fat does not promote breast cancer this normal animals plant that does a better job at that so here we go to dilemma we're really serious dilemma so therefore you know what what is basically the answer it turns out that the plant fat you know causing increased breast cancer risk when fed at high levels it increases oxidation for one thing the animal fat doesn't what here what really happens here is that it's thatis of interest this fat relationship was breast cancer his correlator almost perfectly with animal protein intake the relationship between total fat and animal protein is almost perfect so all the discussion we've heard in past years high fat more breast cancer high fat more heart disease high fat more colon cancer actually could be attributed easily to consumption of high animal protein intake meaning animal foods so you go back and you look at this think I just showed you a moment ago did this is plant fat representative animal foods I mean plant that represented you know relationship to breast cancer animal fat showing that relationship suggest there's more to it than just fat it really is the totality of animal foods there's not one single nutrient it's not just protein it's not just that it's not just one of anything it's the totality of things working together that's what I find really impressive and it's the kind of thing that actually can be sustained if we look at long term studies like this this over long periods of time people are doing nuts with one year two years or five months of something like this this is the way it turns out over a course of a lifetime to see this kind of relationship I would add one more thing since we're talking about what Whole Foods doing how they relate to disease it turns out and this has been published some of this have been published if you feed a whole food or you can use a whole food plant-based diet among diabetics among diabetics it turns out that the effect is so dramatic so fast that my colleagues who are in clinical medicine doing this kind of thing actually have to monitor really up-close the medications that diabetics have at the time they put on a whole food plant-based diet in fact the dietary effect is so strong to reduce the hazards of diabetes and high blood sugar and high insulin and so forth acts so fast that were they to stave on to medicate stay on their medications they could go into hypoglycemic shock and so once you take a diabetic you put them on a whole food plant-based diet you resolve the diabetic problems and it stays that way you know I have one more slides I didn't show I got right to the end had one slide missing but let's pass on that maybe we can show it later during the Q&A so this effect I'm really quite impressed with the idea that what we ought to be talking about is whole food the questions what kind of whole food should we be talking about I'm arguing that whole food low and protein low in fat high in carbohydrate we heard professor Wiseman say you know ten fifteen percent or so it shows the low-carb diet if there's 10 10 to 15 percent carbohydrate or even 20 percent that means as I say 85 to 90 percent or so or 80 to 85 percent of the rest of the dye is going to have to be protein and fat that is a real danger zone in terms of long term health yes we can see weight loss no question about it professor Wiseman is correct we'll see weight loss in the short term yes we oftentimes see some reduction in serum cholesterol looks good promising that's exciting all because of the ketotic syndrome that occurs as a result of consuming a low carbohydrate diet but to say that carbohydrate is not an essential nutrient that's missing the point because if you say it's not a nutrient ok we don't need it or we need minimal amounts something like as I say 15 10 15 percent or so that means the rest of our diet has to be protein at that it may be not at being a central nutrient in a molecular sense but we have to get energy from someplace and carbohydrate complex carbohydrate comes from plant-based foods I think the whole ask is phenomenon historically has been from the day of dr. Africa's first coined this and some people before him it was an attempt to actually begin to a question in a serious way to consumption of plant-based foods because complex carbohydrates are in plant foods and to say that we don't need to have all that carbohydrate is saying we don't need plant-based suits that's where the genesis of this argument really came from and I dispute that very seriously because if we're going to take that approach with a high protein high fat diet yes we can see some benefits in early because calorie caloric intake goes down and we're straight off some waiters law so they say cholesterol goes down but in reality that's can't be sustained if I could have that life slide this is a chart here showing one of the consequences of consuming a high protein high fat this is a paper that Professor Westman actually was a co-author to and I'm curious about Eric what you have to say about this because here's what happens to people this is published with money from the Atkins organization this is their study showing the consequences of consuming and Aptus type of high protein constipation and if the blue bars are basically the Atkins type diet the high protein high fat diet look at constipation compared to the average American diet yourself look at headaches up halitosis bear breath up muscle cramps diarrhea general weakness and what's the last rash these are results from the study of people consuming an Atkins based diet published with money from the Atkins organization the whole food plant-based diet I can't give you exactly that numbers that publish on this but I can tell you if you talk to anything clinicians in this field doing this this is almost close to zero for all of these things I don't know of a single person who's used a whole food plant-based diet and ends up having constipation headaches tend to go away and all the rest of it so here's one thing we have to take in consideration if we're going to talk about consuming a high protein high fat diet thank you thank you sir your time is up and now dr. Westman has ten minutes for his rebuttal well that's great professor Campbell I don't use I don't use supplements in my practice so what you did there was took one of my papers that I wrote and pulled out a one of the our sentences out of context in that study there were supplements used but I don't use supplements in my practice enough other people now have done studies beyond the Atkins funding using the diet without Atkins supplements that they don't they're not necessary the studies in Australia don't use African supplements so and I don't work for Atkins could you please forward to the blank slide that says rebuttal side effects oh gosh you know sometimes you do a study and you're really honest and then you regret being so honest we asked people if they had any of those side effects at any time throughout the study over a six-month period and if they said yes we category categorize it as a yes all of those are manageable it seemed the feeling of using that slide against the diet felt to me not giving the entire picture if someone's diabetes is gone there are off 180 units of insulin in three days and I can give them some milk of magnesia to handle the constipation they are Happy's clams in my practice so I hope that if that slides ever used that you also bring the positive aspects to the diet as well as the minor side effects that can occur if that slide takes you oh I would never do that then then that trivializes the work that we've done I need to put on my hat as a medical researcher and medical evidence doctor correlation is not causation hypothesis-generating is different than hypothesis testing and this is a field that occurred in the last 20 25 years I've watched it grow separating the medical evidence from the other science that's done observational epidemiological studies are excellent for hypothesis generation for making questions they're excellent but experimental research is humans is required for determining causation and how they how it works in humans I'm very human centric I'm thankful for that and my patients are thankful for that the USDA Food and Drug Administration requires for the drug approval experimental research in humans and they require randomized controlled trials because that is the only way to know if something is really worthy beyond something else okay here are some references for you if you've never heard of that the work that we've seen about protein and health comes from animal studies and observational studies these are hypothesis-generating not hypothesis testing you cannot say today that the studies you did proved causation of cancer from protein you can't say that here are the studies that I that I have read that you've done professor Campbell and others around the country and around the world and we hear this in our news every day and don't listen to it if it comes from hypothesis-generating research we've learned this the hard way in medical research there's been a dramatic reduction in faith in the low-fat diet if you don't know about the low-fat diet fad haven't been paying attention for the last thirty years you can read about it and Gary Talib's his book good calories bad calories it was a life changer for me he did an extensive research of assembling the research on the low-fat diet and it's just not there it's not there dietary intervention study the the had to go so the observational work had to be teed up into a randomized trial we say you know at Duke I had 15 years of people saying oh that's a good idea prove it oh that's a good idea Eric proved it and it had to be some kind of experimental research so when the Women's Health Initiative dietary modification trial finally teed up the low-fat low-calorie diet in women it had no effect this was published in 2006 in the jam in the Journal of the medical journal of the American Medical Association and you don't hear about it you've got to know that the low-fat low-calorie diet didn't work for breast cancer reduction for heart disease reduction it didn't work there's even the new science looking at particle size and cholesterol and all this looking at an orange type diet ultra low fat diet this study by Deborah Marshall showed that in three months that an ultra low fat diet one that you're talking about professor Campbell and many people created what's called the atherogenic profile meaning it raised the triglycerides and lowered the HDL and we know of now that that correlates pretty well with atherosclerosis there aren't prospective studies saying if you treat it you can fix atherosclerosis but those we are waiting for and those are being teed up as if you will so the conclusion of this paper was an ultra low fat diet reduces reductions in the good cholesterol the HDL cholesterol and the emergence of a dislocating lipid profile and aerobic exercise only partially mitigated this effect so if you combined exercise with the ultra low fat diet and some people at work and some people that didn't Cassandra Forsythe works with Geoff Bullock at the University of Connecticut and what they're learning is that saturated fat is processed very differently under different metabolic circumstances and in fact in the top left panel the low fat diet leads to more saturated fat in the blood that's the big bubble on the top and the low carb diet leads to less saturated fat in the blood and you say counterintuitive Eric the more fat you eat the more fat you have now away what's on the right-hand side you're burning the saturated fat you're using fat as fuel so the fat you eat is the fat you burn and there's less saturated fat in the blood on a low-carb high-fat diet we have to get outside this notion that fat in the diet is bad they don't fear it in Europe anyone been to Europe lately they have better outcomes than we do there don't they do these statins like we in America maybe no coincidence I'm gonna summarize with some global grand thoughts my job as a physician is clinical care to improve the productivity the quality and length of your life there are lots of lots of research we can look at here's the slew of stuff we were doing at Duke University a few years ago and while some people use just expert opinion - to push clinical care we don't think that's enough now to just say I'm the expert listen to me that's not enough I was that medical student the guy a grad student who said where's the data you know professor where's the data doctor where's the date I kept asking for it so what you really need in yellow is the clinical trials the meta-analysis cost-effectiveness analyses and then so this is the bar that Medicare Medicaid uses this is why many of my patients are really frustrated that Medicare isn't paying for it but that's because there's no evidence for what they're asking for I think we've agreed on some points and we disagreed on some points and I'd like to see if this was predicted correctly we agree that obesity diabetes cancer are related to nutrition and there's several ways that that can be fixed sugar is harmful I'd like to take the discussion away from protein and focus it onto sugar for the future junk food is harmful that we have to talk about that the the highly processed foods the New York Times had a piece a couple weeks ago and how industry made foods irresistible they avoided all of the satiety factors and so you beware of food that industry created a total agree real real food is healthier totally agree but on a meet that area and and meat is real food as well we disagree that epidemiology can be used I say it cannot be used to determine causation that's evidence-based medicine that's what we know now in medical evidence that we can't use circumstantial correlative evidence anymore adequate protein is not harmful animal products are not harmful and one size does not fit all so here are some predictions that didn't come true Nostradamus predicted the end of the world in 2012 I think there's a world a world market for maybe five computers said the former chairman of IBM that's pretty funny the y2k problem gosh that remember back there the computers would stop it didn't happen that virus is a pussycat a molecular biologist said about HIV before all of the tragedy of HIV I'd like to add to the list the dietary fat or protein or carbohydrate is the only dietary component that contributes to obesity diabetes and heart disease no not one factor is the only component and the low carbohydrate adequate protein diets are harmful these are predictions that did not come true when the data were collected thank you very much thank you so much at this point we are going to have some Q&A we have had so many fabulous questions passed up we are not able to take all of them but we do have some really good ones that we're going to start with this first question is for dr. Campbell and they asked sir is protein really really bad or merely casein since soy and wheat proteins didn't seem to have adverse effects even at a 20% level do we know if even higher protein levels are fine as long as it's not dairy well first off is not just about casein I hope that made it clear I couldn't in this short presentation we were using casein only as an experimental instrument to understand something about protein we were working out principles working out the way in which things work and it turns out as you look back at the literature and I was involved in this in my graduate school days actually animal proteins tend to act as a block very similar one to another in terms of increasing cholesterol levels increased neurogenesis increasing the enzymes involved in actually turning on the activation of carcinogens they work as a block now we worked with casing and I'd had no interest at that time I was exploring all the animal proteins to see if it actually just like casing so this was not a story just about casing it was remarkable because casein have to be the most efficiently utilized so all I can say is that plant proteins and animal-based proteins have been studied for years in many different ways animal proteins tend to do one set of things my proteins tend to do something really very different okay thank you our next question is for dr. Westman and the question reads why are you ignoring all of the EPI studies that show a reduced reduced risk of cancer associated with a higher intake of vegetables particularly cruciferous vegetables and an increased cancer risk with higher meat intake well I'm not ignoring them I'm using them as information to create new questions to be tested in evidence in experimental trials I'm not ignoring it I'm not saying that the research that's observational is not important to do it's just not enough to draw concrete conclusions from this next question is a very funny question to me it says it is for dr. Campbell and it says based on your presentation I assume that exclusive breastfeeding would not be a recommendation what should infants eat plants no absolutely the most perfect things we can do throughout our lives is the breastfeed period there's a time and place for everything for whatever food we happen to be chosen this what I'm talking about does not apply to infants on breast milk in any way shape or form very clearly stated this next question is for dr. Westman and they write I am a member at a local gym that promotes a Paleo diet please discuss the scientific pros and cons of this recent trend diet tied to fitness how it is tied to fitness specifically CrossFit right so the Paleo diet if you haven't heard of it paleo is short for Paleolithic or prehistoric so the idea is for four hundred and ninety thousand years of human history people ate a hundred gather a kind of diet humans did and only the last ten thousand years when agriculture was available oh it's only ten thousand years it's just a blip if you took a whole year of human history it's just the last day when we've been eating plants as humans generally speaking it's been a military in existence so that's the paleo idea now I've talked to a hundred people who espouse paleo diets and they all say a little different thing which is the obvious great ploy if you never want criticism because you never really define what you're talking about so paleo in general means lower and carbohydrates if you're exercising at a gym you're burning the carbs you eat and you what I see is generally it's low carb around a hundred grams of carbs eating foods that your your ancestors you know four hundred thousand years ago would have eaten no no dairy for paleo Loren Cordain who speaks about this frequently shows a picture of a moose and says are you gonna go out and milk that sucker so so paleo is it's interesting it's very popular in exercise programs I'm a fan of it compared to a typical American diet I don't know that it would be strong enough to use clinically in my practice for diabetics or for metabolic syndrome or four massive obesity I just saw a gentleman 25 years old in Durham North Carolina who weighs 770 pounds and he's ambulatory and he doesn't want to eat just vegetables so in that case I have no option but to use an approach that uses something more than a plant-based diet this next question is for dr. Campbell and they write what sir is your view of fish such as salmon that is so high in omega-3s I don't have any really firm view on fish to be honest the better all I can do is interpret what has been published namely if you compare fish protein with all the a but a large number of other proteins animal and plant fish protein fits right in to the animal protein category in terms of its ability to generate higher levels of cholesterol in terms of his ability to generate higher a thorough Genesis furthermore fish also has in addition to the protein problem fish do not have really the antioxidants and our company is called behind rates which I argue are very healthy substances so I'm left in a position of suggesting that that is this questionable really I tend not to eat fish and maybe occasionally but it's maybe a shade better than land animals I don't know but the evidence suggests there is much difference thank you this next question is for dr. Westman and they ask processed foods we all know are generally bad but our protein bars a better choice among the processed options mm-hmm well if I teach if you were my patient and I taught you a low carbohydrate diet I'd say don't eat those things eat real food and then people tell me well but I don't have any time I'm running to the gym I got made my kids I'm doing this and doing that and as a something every now and then fine you know I don't work for the Atkins company and I do know about their products and and I don't really recommend them at first except if someone if it keeps them on track and and they watch the carbohydrate content in them they can be used any of these products can be used in a little carb diet I don't know about it outside that outside the low carb diet though well we have a chance to simply just for a second well we have a chance to it both of the states was the same question on occasion I had that urge to I say it's a free girl go right ahead well I have to correct you Erik turn on a couple of comments first off the quotation that I cited about your use of supplements comes directly from your book that's a direct quote if you're changing your practice nail from what that was okay but that I'd want to say this there's more flexible than the book okay so it's more flexible in the book okay the second point that I also have - you can ask me some questions too by the way so we can have it I will forth okay you talked about the extensive literature has been shown for over the years that summarized by Gary Taubes who incidentally our debater in Hawaii just three four weeks ago I heard yes okay but in any case there's a lot to be there's a lot been made about the fact that low fashion work all right right that I have to say that has nothing to do with what I'm talking about nine to think you know it because the critique I did of your book I pointed this out when you talk about low-fat diets as many others have talked about low-fat and is not working they have nothing to do with what I'm talking about it's a it's a it's a it's a fake it's rubbish well you know because of you is still on the amazon.com it's fascinating the review that you did of our book I know Wow well back to the facts I mean the low-fat diet you know that has been tested as suppose it doesn't work is not what I'm talking about so don't say to me or your colleagues say to me that your low-fat diets don't work therefore what I'm talking about doesn't work we haven't even had that kind of diet and that kind of test this simply doesn't work and that's what if I if things can work for individuals and not turn out to be found in randomized trials I totally understand that people who end up going to randomized trials are different than the people who are generally coming into my clinic they're select out people and so just because the but the biggest study ever on a low-fat diet 40,000 women didn't show any benefit was not a low-fat diet it was not a low-fat diet period horowitz's they didn't follow it it wasn't low enough they didn't find well then it's not practical if people can't follow it hernán Harvard study I'd know quite well I've lectures there number of times especially to begin to that study I know that individual is involved the protein content of that diet ended up being around 17 to 18 percent a large point 80 percent of which 80 percent of which was animal-based so they were consuming largely an animal-based diet so that's not that's not fair to say this I say to you what my professors told me which is brilliant Hey look at that we have another audience question and that's something okay this question reads a boat that you gave great talks but they want to know what is your viewpoint of the importance of body weight is it more or less important than your fuel source we're going to have both of you answer this and we're going to start with dr. Westman body weight is a phenotype it's your hat you have your showing extra fat accumulation obesity is actually defined as extra fat accumulation not muscle accumulation Arnold Schwarzenegger has a height well he used to have a high BMI because of the protein on the muscles so but excess body fat is harmful in most but not all people there are people who are metabolically normal and overweight and these tend to be the women who have the shaped more like a pair than an apple shape so it's the central adiposity that confers the negative health consequences but not in everyone but obesity is such a huge problem in the US and either of these approaches that work and are proven to work are really necessary to listen to and to and to incorporate into your practice or into your lives agreed by the way you know the the problem was from my perspective of consuming a high protein high fat diet generated in a ketogenic response if you will that you're talking about yes of course I acknowledged that when I first spoke you know weight can come down but the real question is can this be sustained over a long period of time without consequence without the DEP that without the difficulties arise 12 years here does that count my personal experience my personal experience has been what is it now about 25 years and he another high protein diet come to this so where we have it that's it featuring the same message I believe but so I have there's a support group online with 80,000 members doing low carb diets they've done it for they say we surveyed one of these low carb reform groups and 2,000 people responded they've done this for 10 20 years without adverse consequences by self-report I agreed that that's not good enough but but to say that this is harmful when we don't know that's just not right I don't want you to say that well I'm afraid of going to say it because I think that's what the other says what's the evidence what do you mean what is the evidence of protein I didn't have a chance to get any even closer to the argument concerning the role of high animal protein diets above the RDA you know of causing these kind of problems I'm not convinced I am convinced and with those statements we will need to wrap up this evening's activities like all great debates this event has left us all with plenty to think about it is this exact push and poll that has moved science along throughout the ages we are again privileged to be part of this evening we are so grateful to the gift from the Corliss family they are right over here it is their gift that allowed this evening to happen thank you again as a as a cancer patient I think we are so grateful that this happened and this public forum and we wish you all safe travels in your journeys home thank you and good night you

Channel: University of Alabama at Birmingham

Views: 117,289

Keywords: obesity, atkins diet, china diet, fat, debate

Id: dIwEmgV8Wdg

Length: 80min 2sec (4802 seconds)

Published: Wed Apr 17 2013