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Danielle

Wow, you articulated that better than I could have ever hoped to! It's so hard trying to explain to others how... wholly... being Insulin Resistant affects a person's physiology. I always feel like a demented hypochondriac when I do! There's nothing I can do or show to validate - for lack of a better term - the fact that I suffer from insulin resistance. It's not like I can show a cut on my finger and say, "this is why I hurt." I'm going to send a link to this post to my boyfriend. It will answer most of his questions!

Good luck on the induction phase of Atkins. I recently fell off the wagon myself and quickly packed on 25 pounds. It's amazing how much bloat fell off in the first week once I cut way back on the sugar and the refined carbs again!

Tava

ITA with your post. People who do not have insulin resistance do not understand what it is like to try to get through the day with constant hypoglycemic attacks, which is what happens when I eat a "regular" diet. Either I have to be shoveling sugar into my mouth all day by the truckload just to keep puttering along (and, as you said, forget about strenuous exercise), or I literally can't function. When I go hypoglycemic I go into a "brain fog", I can't think, I feel nauseous, my legs are like cement.
I have to eat semi-low-carb, and balance carbs carefully with proteins and fats, just to feel halfway normal and get through my day OK. But I really need something like the Atkins induction phase to actually lose weight...if I eat any carbs at all it seems to thwart me. But, gearing up to do it is HARD. I will miss my normal foods. 14 days seems like a very long time to do without fruit. But if it jumpstarts the weightloss, I will do it.

wavybrains

Great post. My endocrinologist once used the metaphor "carb intolerant" to describe what PCOS/insulin resistance does to your metabolism. The glycemic index (and they have a good PCOS book) is a great starting point, but many people have to limit their intake of even lower-glyemic carbs to achieve maximum health.

I use stevia for most of my sweetening--including baked goods. If you're looking for a flavored water buzz--stevia + lemon juice + sparkling water = really good. Our health food store now has flavored stevia drops with natural oils like lemon, orange, and other flavors. It's in the supplements aisle.

Jo

wavybrains, I saw Vanilla and English Toffee (!) flavored stevia at the health food store!

Carb intolerant. I like that.

Craphead

I'm reading this all with great interest as I just went to a naturopath and he is testing my insulin, hormones, and thyroid. I have no problem with Atkins if that is what works and what he suggests, but I am also a vegetarian. I'm really not sure how the hell that would work (but maybe I just don't know enough about Atkins?).

I'm hoping my insulin and glucose stuff is all good, but given my family history I'm not all that hopeful. :)

Jody

Jo, I have PCOS and insulin resistance myself, so you know I'm all over your points about carbs.

I just cannot get onboard with claims about any diet that arise from arguments about prior eras of human dietary behavior. First, because until the last 100 years, people died young. Second, because until the last 75 years, people ate seasonally. Third, because it was carbs (first rice, oats, barley, and wheat -- later potatoes, manioc, and corn {go American food staples}) that allowed the world's population to grow at all. It was those three American staples, the foundation of the Columbian exchange, that created the conditions for Europe's demographic explosion and all the world consequences that follow thereon.

Also sugar (farmed by slaves) played a huge role in the industrial revolution. Coffee and tea with sugar -- the stimulants that made factory work possible.

What's my point? Yes, it's true, carbs are bad for many, many people. But historically, they were good for many, many people (all that factory work notwithstanding, people weren't as hungry once they could get adequate carbs). Honestly, throughout human history, near-starvation has been a periodic and repeated fact of life, and they didn't have regular access to what we now know are the gold standards of dietary consumption. For example, none of the leafy green veggies stores that well, so people only had access when they ripened, and then they tended to eat spinach in cream sauce or sauteed over pasta.

And of course, they died young.

I guess what I'm failing to say very coherently is that the historian in me twitches a little when we talk about best dietary practices in terms of human history. There are plenty of good arguments against high-carb (or any-carb) diets for specific groups of individuals today, in today's environment, with access to today's varied diet, without invoking the paleolithic period.

Bluntly, I wouldn't want a paleothic human's lifestyle, diet, or life span. But I know I feel better when I eat more lean protein and less bread. And I know modern science and medicine backs that up.

Lilian

Interesting post and even more interesting comment by Jody, our historian-on-call :)

You know, it's quite hard for me to read posts from my dieting friends. A Brazilian blogging friend recently wrote about my comment to her diet post that "it's because of people like you that there can't be happy chubby girls."
Yeah, the truth is: I don't like being skinny either... :( I've been working up the nerve for a long time now to write a post about this because I'm afraid that if I complain about not being able to gain any weight people will just hate me because I represent all that they cannot have. So I just don't talk about it.

Sorry about the little rant, it's just that the issues I face are similar, just the opposite. It seems that no matter what I eat can make me gain any weight and that does bother me. Oh, and I have PCOS too, some weird kind, I guess (I have to say that I'm not very informed about it since I was able to get pregnant after 1 year and I don't mind not having regular cycles -- my only symptom basically, but this is off topic, so I'll stop here).

Jade

Lilian, that does seems like a powder-keg of comment, a lot of women who struggle with their weight have trouble seeing a world where someone doesn't like being skinny. I for one have been chubby most of my life, and while I know early it was a self-medication for depression, what I really did to myself was train my body to be the best fat storing machine it could possibly be.

So now I am stuck because my husband and I want to have children, but my body just won't cooperate without medication, and diet modification. I would simply like to be healthy. Yea, skinny would be cool, but healthy is what I need. Healthy is what we all need...

Jo

Lilian, I think we're talking two different issues, though. I think most of the people participating in this discussion aren't looking to be thin to be happy -- we're just looking to be healthy, which for a lot of us means losing some weight (but not necessarily becoming what our culture considers "skinny"). I do agree that you're unlikely to find sympathy in the world at large, just because our cultures are so effed up about weight and beauty -- but at the same time most fat people don't get a lot of sympathy either, because the answer is so simple -- "just eat better and get a little exercise!" When it often isn't that simple.

In sum: I sympathize. It sucks to have a problem most people won't "get."

katie

"Another cruel irony is that unless I eat a very low-carb diet, I'm not capable of doing much exercise -- my blood sugar plummets immediately and I'm left with the shakes and a cold sweat, barely able to get back home"

gee, you just described my afternoon.

and yes, it sucks to have a problem most people won't get. especially when one of those people is the person you married.

Jo

Jody! I think you have a valid criticism -- that it's so easy to look to some imagined history to justify...oh, anything, and that's not always the most accurate way to go about things.

However!

In this case, I think you're buying a common fallacy, which is assuming that people advocating one aspect of history wish to invoke everything else about the period. It reminds me of the homebirth argument -- how someone will say, yes, sure, wouldn't it be nice to labor unmolested, but WOMEN DIED ALL THE TIME BACK IN OLDEN DAYS! DO YOU WANT TO DIE? Of course not; of course the idea is to take the good parts of what came before, and modify them with certain advances. Therefore, while I wish to avoid a wheat-heavy diet, I do not wish to forego things like written language and eyeglasses. I think the lifespan argument is a red herring, because it wasn't that paleolithic people died for lack of Tastykakes (or so I assume). There were injuries and sepsis and plain old starvation and yes, childbirth.

I agree with you 100% that grains allowed populations to grow that had previously been constrained by food supply. Absolutely. However, it does not logically follow that we should therefore eat grains as the majority of our diet (as is the standard American recommendation). From what I've read, these sudden bulges in food supply allowed societies to balloon beyond what they might otherwise support, and then when the next drought hit (or the fields got flooded), all that extra population had nothing to eat. One might argue that the Green Revolution was an amazing thing that fed legions of the starving; one might also argue that it sent the Earth into population overshoot, with collapse an inevitable (if far-off) consequence.

In short, what I mean is: Yes, grain and sugar got things done, in a Eurocentric kind of way, but I think it's a mistake to therefore assign positive value to grain and sugar. (Not that I am judging and lamenting the progression of history, no -- just that I am saying we should keep our opinion neutral there.)

Finally, I think the importance of looking at ancestral diets is this: social evolution does not equal biological evolution. I think it is most informative if we examine the likely diets of preagricultural people, because that will tell us what we, as animals, evolved eating, and therefore what we are most likely suited to eat. Being omnivores, we have an amazing amount of latitude on that count -- much like black bears, who are more than happy to live on garbage and "people food." The bears get happy, the bears are well-fed and reproduce -- but does that therefore make garbage the best diet for bears? Does that exempt bears' bodies from requiring what they required for millions of years?

Shannon

I was diagnosed with PCOS and after reading everything I could and seeing a nutrionist who put me on a 'low carb' diet, the pounds I had stored my entire life just started falling off. I'm now 6 months pregnant with a healthy baby girl and I couldn't agree more that for some people, monitoring and precisely controlling their diet is the only way to be healthy, feel good and get what they want.

Jody

Jo, I was only waiting for your comment to return and clarify my point, because after I left my computer, I realized the whole evolution issue -- which of course IS the point -- slid right away from me.

So, if I understand correctly, you're arguing that the species evolved in conditions where the human diet consisted of fruits, berries, roots, nuts, possibly insects, and then later fish and game. The introduction of agriculture 10,000 years ago marks the beginning of a more carb-heavy diet, but carbs are not well-suited to the human gut as it evolved up to that point. We should avoid them in part for that reason, and strive for a pre-agricultural diet.

(I will say, in passing, that our closets primate relatives -- chimps -- subsist almost entirely on fruit. I think that suggests that we, as a species, probably depended on fruit sugars for some large percentage of our own calories at SOME point in the evolutionary process.)

Let me break for a minute to say that I was never arguing for a carb-loaded diet or a big serving of tea with sugar for everyone, everyday. Yes, I raised the historical fact of regular and reliable population expansion when more carbs are introduced to challenge the argument that the human gut and endocrine system isn't suited, by biological evolution, to a carb-heavy diet. But that doesn't mean that we should go overboard, or behave as our food-poor ancestors did. After all, I'm insulin resistant myself.

Okay, so if I understand correctly, the argument is that carbs are the human equivalent of garbage in Yellowstone, and we're in a protracted dietary crisis similar to that suffered by the bears.

This doesn't make sense to me for a couple of reasons:

1. Agriculture didn't "just" lead to population growth. It led to population growth because people became healthier; they lived longer, and could reproduce more. The population explosion I reference occurred in the 1600s and 1700s, not just in Europe but in Africa and Asia, too. Corn, manioc, and potatoes dramatically expanded people's caloric intake. Suddenly the species, worldwide, had access to something that various Asian peoples had enjoyed ever since they began cultivating rice: new, reliable, easily stored sources of energy. The effects were almost immediate: everywhere, the species began to live longer, more reproductively successful lives.

In general, if I understand evolution correctly, reproductive success is a mark of successful species adaptation, is it not?

All the mortality factors you cited were still fully at issue, and yet the population still grew, probably because young women were stronger and better fed and could live long enough to bear more than one child. And the children were strong enough to live to adulthood themselves. Nothing else had changed: only diet. We didn't begin to tackle infection, illness, or childbirth for another 250 years.

Bears who eat the wrong diet become more susceptible to disease and have reduced fertility. There's nothing in the long span of human history (as an evolving species) to suggest that carbs have had the same effect. On the contrary, whenever carbs have been consumed in sufficient (as opposed to over-abundant) quantities, they've tended to
result in healthier populations.

The healthiest native American populations, for example, tended to be those that fished, planted corn and beans, and hunted, each in their season. The great empires of central and south America had grain crops at their base (both for good -- more and healthier populations capable of creating culture -- and for bad -- more slavery to grow the food). Corn was life.

Maybe that was a species anomaly, maybe it was just prepping us for the fall, but it persisted for thousands of years.

Again -- I'm not arguing that we should get 60% of our calories from carbs. I'm simply arguing that the history of the species doesn't suggest that we're ill-adapted to carbs. It suggests we're well adapted to them.

2. I believe (although maybe my dates are wrong) that species change has been especially rapid and adaptive with regards to the digestive tract. I have the issue of lactose intolerance in mind -- northern Europeans seem to have adapted/evolved relatively quickly NOT to have lactose intolerance, unlike much of the rest of the species. Certainly that evolution dates only from the birth of agriculture.

This suggests to me that it's possibly not such a good idea to go back before the last ice age to determine the ideal diet for the modern human digestive system. The modern human digestive system has not been unaffected by the last 10,000 years of environmental change, it has not been quarantined from the adaptive pressures of the biological world around it.

Ultimately, I just do not see the point in referring to the paleolithic period to describe how best to feed the 21st century body. First, because I don't think the reaction of the species to carbs over the last ten thousand years supports an argument that we're ill-adapted to them. Second, because I believe the human gut shows signs of being one of the most rapidly evolving systems in the body. And third, because there are more than enough modern arguments about the ill effects of carbs to convince us to change our eating habits.

In any case, I apologize for the lack of clarity in my original post. I did not mean to argue that you wished to live a paleolithic lifestyle. I meant to argue that nothing about the species as it was then suggests that theirs was the perfect diet for our species, time unchanging, amen; and I meant to argue that our history as a species suggests that carbs have been a positive force in species growth. I hope that I'm more clear now?

Jody

Re-reading your comment (to make sure I said what I mean to say, this time at least!), I see that I forgot to emphasize:

Lifespan is not a red herring, not least because lifespan and species growth are linked. If a particular dietary change leads to people living longer, more reproductively successful lives, for extended generations of time, then I believe that evolutionary biology sees that dietary change as a successful behavioral adaptation. The bears living on junk food didn't experience that success -- if they weren't shot for mauling people, they had fewer babies and got sicker faster and the population fell.

Is there something about the evolutionary argument I'm missing?

And the main species population growth point I meant to reference (my parochial obsession with the Columbian Exchange notwithstanding) isn't anywhere in modern history: it's with the birth of agriculture itself. As a species, we're limited before then; we're empire-builders afterward. Maybe not because of anything special about the calories in grains themselves -- but almost certainly because grains can be stored, even for seven years at a time, so when the droughts come, you still have food for the people.

Agriculture does allow populations to grow and be vulnerable to crop failures. But agriculture is far more reliable than any other food source up to that time. People were vulnerable to drought when they ate fruit and nuts and foraged foods, too -- there were no fish in the rivers, no animals at the dry watering holes. It's the amazing capacity of grains to be stored -- as TastyKakes or sheaves of wheat -- that makes them species-changers in our history.

We've been evolving and adapting within an agricultural environment for the last 10000 years. I just don't think we can go back to our paleolithic ancestors for guidance on the single best set of foods to eat, anymore.

Jody

Oh Good Lord, did I go on and on, or what? How embarrassing....

ozma

"But when you spend a year eating brown rice and lentils and vegetables, a little lean meat, and plenty of yogurt, dairy, and whole grain, and then you gain forty pounds and feel horrible all the time, it sounds both laughably wrong and a little bit dismissive."

Um, YEAH. SAY IT SISTER. I'd say tofu and broccoli and brown rice. Now South Beachey type thing works OK for me. Atkins makes me feel yucky. Also, I cannot eat soy anymore because of thyroid and I don't like meat too much so beans are my staple food and I cannot give these up. I want to warn you about soy but it sounds you don't overdo soy. It's OK, but people should be careful because too much is not good.

It means a lot to me, you posting this! I wish more people would write their stories because it is truly incredible that there is absolutely no one out there talking about this. And hence, no one will believe that 1600-1700 calories a day of foods that nutritionists universally agree are healthy can make you OBESE. Obese! (It's not like I never ate ice cream but I have no binging tendencies and do not eat garbage at all in excess. I monitored my caloric intake very carefully for a very long time and it was totally normal).

Also, I exercised a fair amount--jogging and vigorous yoga.

For me the death knell happened quickly. 50 lbs. in 3 mos. Medication was a trigger and that was the end of skinny me.

I'm ranting but honestly if I read one more story about (a) how everyone can lose weight if they just deal with their emotional issues or (b) weight loss due to someone who quits eating at McDonald's and starts "snacking on fruit." I hate McDonald's! You couldn't pay me to eat there. Truly, their food disgusts me. I'm sick of these stories. There's so much more to fat than this.

Are all the fat people afraid to talk? Do they blame themselves? Surely I can't be the only one whose body has gone haywire in a freaky way.

Another issue: Health and weight. Weight is a risk factor for some illnesses. Why? They don't even know for the most part! And is it always? Again, more needs to be known about why weight affects systems in the way it does.

There are a lot of fat people at my gym jogging away beside me.

To end my rant, let me say a couple of more things: (1) Weight, I strongly believe, is vastly more complicated than is currently acknowledged. The calories in/calories out theory is such crap and everyone should realize this if only because of the way medication can so dramatically affect weight. Yet, because of the persistent belief in the simplicity of weight gain little research has been done to understand fat.

I think obesity may result from a variety of disorders, many caused by modern diets and lifestyles. Therefore, they are recent.

Honestly, getting people to believe the Atkins diet actually worked was quite difficult. Even when thousands of people lost weight on it, many nutritionists and doctors denied that it worked like Dr. Atkins said it did but was actually a low calorie diet.

(2) Eating is also not just a willpower thing. There are hormonal controls that affect what we eat, how hungry we are and hence our behavior. Is it rational to expect a person to go around all the time when all the chemical alarm bells tell them they are starving to death? Luckily, I do not have this problem but some people's systems are so out of balance this is what is happening to the. The critical thing is to balance the body but we don't have doctors explaining how to do this.

Can we just STOP blaming people for weight? It is a HEALTH ISSUE. It's biological. I even doubt the common belief that there is some emotional component for most fat people but of course I have no evidence! Like most of the things I'm spouting here. I know we want to hate fat people because it taps into some deep fear but honestly--there is something physically wrong when people get fat. And socially wrong because all the food out there is garbage. Go to a convenience market. There is literally nothing to eat. If you are lucky, you may find a bag of unsalted peanuts. In aisles and aisles of food, literally nothing will be actually healthy to eat.

Kim

You go girl!
I am most definitely an Atkins-ite.

May I also add, to all the other great benefits you are having from it, it makes my rheumatoid arthritis a ton better, letting me use less liver polluting drugs.

Jo

Jody! This is awesome! But I have child-tantrum-induced brain fog, so I will have to respond later to your (very interesting) points. Possibly there will be some concessions in there...

Oh, but I wanted to ask: have you read the book _1491_? Specifically the parts about the Amazon being one gigantic orchard? There's a situation that lies outside of both our arguments...

And ozma, I don't eat unfermented soy. Very rarely I'll eat a couple of edamame, or tofu in the miso soup at a restaurant, but other than that I keep it to a little bit of wheat-free tamari. My milk substitutes right now are coconut milk and unsweetened almond milk (very low carb).

ALG

Jo and Jody, you both rock. I just wanted to point that out. I love the back-and-forth, the history stuff, the science stuff, the history of science stuff. It almost makes me want to go back to school.

Lilian

I know my comment had nothing to do with the post, really... (I should have posted it to my friend's blog since her comment ticked me off, and I apologize for that) and thanks for sympathizing with me on this...

Now I have to find the time to read the probably fascinating discussion that issued in Jody's response and yours... etc.

Jody

I have not read that book, not even heard of it, but I'll add it to the list.

If I keep writing comments like this, and avoiding the old diss., I should get around to it by, oh, 2010.

You know, I did some quick research, and it is rather intriguing that broccoli is a member of the cabbage plant, and cabbage is one of those foodstuffs that's been around pretty much forever, ditto blueberries. I wouldn't be surprised if there were some ancient origins-of-species reasons why the best foods for us, are the foods they are.

Although we're very lucky to have predictable access to them on a regular basis, of course. That's definitely new.

Jo

Ah, Jody, I think you'll really enjoy it! It's by far my favorite of the past few years. Good read, fascinating.

This: "And third, because there are more than enough modern arguments about the ill effects of carbs to convince us to change our eating habits." -- I agree with 100%. In general I divorce the theory of paleo eating from that of the modern-day uses of low carb -- just funny that I threw them together here.

You know, though, I think we have to consider that what would make something adaptive in one situation would be maladaptive in another. For example, easily stored grains would equal life in certain situations -- drought, famine, etc. In a time of plenty, the body's ability to hoover up the carbs and turn them into fat is maladaptive. Which is where this -- "Bears who eat the wrong diet become more susceptible to disease and have reduced fertility. There's nothing in the long span of human history (as an evolving species) to suggest that carbs have had the same effect" -- comes into play. In a time where we have unlimited access to grain carbs, when we don't generally do 5000 calories' worth of work in a day, grain carbs ARE leading to disease and infertility! Like, for example, many of us! :) So again, what was a lifesaver in one situation is proving deleterious in another.

Jo

Oh, the thing about broccoli and blueberries reminded me of something else that will remain unsubstantiated for the moment. I was looking at a list of the most allergenic foods, and for the most part they're comparatively new additions to our diet -- wheat, corn, soy, dairy (aside from lactose intolerance, just casein allergy), citrus. This brings up two questions. One, is the increased incidence of allergy to these "new" foods a sign of our incomplete adjustment (evolutionarily) to them? And two, is it possible that any ill effects in the population over time are compensated for by the general population increase brought on by calorie availability? In other words: were there just so many more people around after these foods entered the food supply that the mild negative effects disappeared, from a statistical point of view?

Jo

Oh, and I forgot to add: of all the grains, rice seems to be the least allergenic/problematic.

Jody

Yes, all good issues, here.

It reminds me that I tend to think, by far, that the greatest environmental change facing the human organism in the last century has been the sudden drop in physical exertion. For the entire history of the species, the body has existed in a daily state of exhaustion-inducing physical labor. I would assume that a whole host of systems in the body are adapted, by now, to operate best within such a system. But of course, almost no one does live such a life.

I think about this whenever I read about those folks living non extremely limited calories. Their bodies burn just about every calorie they consume on a daily basis (just as, I assume, babies and toddlers and children on the healthiest of diets do). It's almost impossible for anyone eating even the most typical American diet to achieve that. So then we have to figure out, what, for our particular bodies, is the next-best alternative?

Other dramatic changes in the life of the organism that are less than 150 years old and that seem to be causing a lot of evolutionary stress: speed, noise, and light. I think about this whenever I read Laura Ingalls: she thought a train going 20mph was speeding through the landscape. My children, as babies, drove home under conditions of greater physical stress on the body. But for most of human history, the fastest anyone would have gone would have been, what? A racing horse? A very fast sled trip down a steep mountain? What pressures is that putting on the brain?

And the noise and light issues on the human brain as it evolved for millenia: they're almost too huge to grasp.

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