Why Update Conventional Advice?

1. 2.
Standard nutrition Low-carbohydrate/ healthy
recommendations fat diet is supported by the
are not based on the latest science
latest science
Is safe for everyone
And they can be
And is especially helpful
dangerous if you have
for people with insulin
insulin resistance
resistance
 Should MyPlate Be YourPlate?

• High-carbohydrate foundation? • Carbohydrates unnecessary and

• Increase fruits and vegetables can be dangerous
to 50%? • More fruits and vegetables not
• Low-fat (~2 T oil per day)? the answer

• Choose plant protein? • Natural fats essential and

healthy
• Animal proteins best choice

MyPlate: USDA Dietary Guidelines

 EXPERIMENTAL
Laboratory studies
Animal studies
Human clinical studies
Randomized controlled trials
(RCTs)
OBSERVATIONAL
Naturalistic studies
Epidemiological studies (EPI)
 Food Frequency Questionnaires

Neelakantan N et al. Development of a semi-quantitative food frequency questionnaire to assess the dietary intake of a multi-ethnic urban Asian population. Nutrients. 2016
Sep; 8(9): 528.
Nutrition Epidemiology = Mythology

When tested in
clinical trials,
wrong at least
80% of the time
Young SS, Karr A. Deming, data and observational studies: a process out of control and needing fixing. Significance. 2011;8;116–120.
Expert Critiques of Epidemiology

Ioannidis JPA. The challenge of reforming nutritional epidemiologic research. JAMA. 2018;320(10):969-970.
Archer E et al. The failure to measure dietary intake engendered a fictional discourse on diet-disease relations. Front Nutr. 13 November 2018.
https://doi.org/10.3389/fnut.2018.00105.
What Information Can We Trust?

Just about ANY other kind!

Human History
Biochemistry & Physiology
Plant and Animal Sciences
Human Nutrition Experiments (especially RCTs)
Common Sense
YOUR OWN EXPERIENCE!
Carbohydrates Are Unnecessary… and
Can Even Be Dangerous
“ The lower limit of
dietary carbohydrate
compatible with life
apparently is

ZERO. ”

—US Institute of Medicine and the

Food and Nutrition Board
(2005 Dietary Reference Intake)
Gluco-Neo-Genesis

Fat &
Protein
Glucose
All Carbohydrates Become Glucose
Whole

(concentration
and rate vary)
Refined
 Sugary Diet

Daly ME et al. Acute effects on insulin sensitivity and diurnal metabolic profiles of a high-sucrose compared with a high-starch diet. Am J Clin Nutr.
1998;67(6):1186-96.
Insulin Resistance & Type 2 Diabetes

Healthy Mild IR Moderate IR Severe IR High Blood

Sugar

Time
 Playing with Fire
High blood sugar and insulin levels promote:
Inflammation & Oxidation
Advanced Glycation End Products (AGEs)
Hormonal Imbalances
Insulin Resistance

Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001;414(6865): 813-820.
Ghasemi R et al. Brain insulin dysregulation: implication for neurological and neuropsychiatric disorders. Mol Neurobiol. 2013,47(3):1045-1065.
Kiecolt-Glaser JK. Stress, food, and inflammation: psychoneuroimmunology and nutrition at the cutting edge. Psychosom Med. 2010;72:365-369.
Aragno M and Mastrocola R. Dietary sugars and endogenous formation of advanced glycation endproducts. Nutrients. 2017 Apr 14;9(4).
Lee Y et al. Hyperglycemia- and hyperinsulinemia-induced insulin resistance causes alterations in cellular bioenergetics and activation of inflammatory signaling in lymphatic
muscle. FASEB J. 2017 Jul;31(7):2744-2759.
Daly ME et al. Acute effects on insulin sensitivity and diurnal metabolic profiles of a high-sucrose compared with a high-starch diet. Am J Clin Nutr. 1998;67:1186-96.
Bodily Conditions
Type 2
Diabetes

Heart
Cancer
Disease

Insulin
Fatty
Resistance
Liver PCOS
Disease

Erectile
Obesity
Dysfunction
Brain Conditions
Bipolar
Disorder

Schizo-
ADHD
phrenia

Insulin
Resistance

Alzheimer's
Depression
Disease
Insulin Impact
Sugars & Refined Grains
Fruits/Roots/
Grains/Legumes
Insulin
Level
Protein

Fat
LCHF Is Perfect for Insulin
Resistance
Low-carbohydrate (20-50 g per day max) best

Avoid fruits, starchy vegetables, grains and legumes

But aren’t starches important staple foods?

 Starch Is Sugar in Disguise

1. Grace MR. Cassava Processing. FAO Plant Production and Protection Series No. 3. Rome, Italy: Food and Agriculture Organization of the UN; 1977.
2. Che Jusoh MR et al. Sago supplementation for recovery from cycling in a warm-humid. Temperature (Austin). 2016;3(3):444-454.
3. United States Department of Agriculture. National Nutrient Database for Standard Reference Legacy Release. April 2018. https://ndb.nal.usda.gov.
Starchy Staples Aren’t Nutritious

*USDA Recommended Daily Allowance (RDA) for women over 19 years of age
United States Department of Agriculture, Agricultural Research Service. National Nutrient Database for Standard Reference Legacy Release. April 2018.
https://ndb.nal.usda.gov/ndb/foods
Plant Toxins and Anti-Nutrients

Oxalates

Glycoalkaloids

Protease Inhibitors

Goitrogens

Lectins

Phytate
 Brown Rice vs. White Rice
• Vitamins, minerals, fiber • Low vitamins, minerals, fiber
• Lectins, phytate, arsenic • No lectins, phytate; low arsenic
• Boiling removes lectins, reduces • High insulin impact
arsenic/minerals, but not phytate
• White rice = refined carbohydrate
• Boiling increases insulin impact

Mwale T et al. Risk and benefit of different cooking methods on essential elements and arsenic in rice. Int J Environ Res Public Health. 2018 Jun;15(6):1056.
Uphadyay MK et al. A review of arsenic in crops, vegetables, animals and food products. Food Chem. 2019 Mar 15;276:608-618.
Nakata H et al. Isolation of rice bran lectins and characterization of their unique behavior in caco-2 cells. Int J Mol Sci. 2017 May; 18(5):1052.
Perera I et al. Manipulating the phytic acid content of rice grain toward improving micronutrient bioavailability. Rice (NY) 2018;11:4.
Life without Rice

White rice can be a reasonable option if you don’t have insulin

resistance, but once you do, unfortunately you should avoid it.

This is a loss—culturally, socially, economically.

Teach future generations to eat wisely.

Image credit: Sasin Tipcha / 123RF

 What about Fruits and
Vegetables?
If you have insulin resistance,
fruits and starchy vegetables are best avoided,
BUT...
guidelines say people must eat more fruits and
vegetables to be healthy.
Is this true?

Image credits: Romanov / Pixabay; Payless Images/123RF

Fruits & Starchy Vegetables
Not Required
Vitamin C (cruciferous veg,
Everything that’s in fruit and peppers, spinach, etc.)
starchy vegetables can be found in
Potassium (bok choy, mushrooms,
non-starchy vegetables
spinach, broccoli, etc.)

Only difference is fruits and

starchy vegetables contain a lot
more carbohydrate
Insulin Sensitive Insulin Resistant
Fat Is the Ideal Human Energy Source

Image credits: Rawpixel; lilkar/123RF

Fat Is Sophisticated and Important

Vitamin absorption
Insulation of body and nervous system
Cell membrane structure & function
Healthy skin and hair
Immune function
Cell signaling
Brain development
 Animal Fats Are Essential

EPA
DHA
Arachidonic Acid

Difficult to replace with

plant fats
 Fat is Fine!
A 2016 meta-analysis of 10 RCTs
totaling 62,447 subjects found no
evidence to support a connection
between dietary saturated fat and
heart disease.

Harcombe Z et al. Evidence from randomised controlled trials does not support current dietary fat guidelines: a systematic review and meta-analysis. Open
Heart. 2016;3(2):e000409.
 Low-Carb Better for Weight Loss
Randomized Controlled Trials (RCTs) of Low-Carb & Low-Fat Diets

Public Health Collaboration UK. www.phcuk.org/rcts

Natural Fats Are Healthy

Unprocessed animal fats (chicken fat, beef fat, etc.)

Unrefined red palm fruit oil
Virgin coconut oil
Avocado fat
Olive oil
Cold-pressed, unprocessed nut oils
Plant Proteins? Animal Proteins?
 Nutrient Animals Plants
Folate (B9) ✓ ✓
Vitamin C ✓ ✓
Vitamin E ✓ ✓
Vitamin K1 ✓ ✓
✓
Iron
Iron ≥3x more ✓
bioavailable ✓
non-heme

✓
Vitamin AA
Vitamin 12-24x more✓bioavailable ✓
carotenoids

✓
Vitamin DD
Vitamin D3—easier✓to use/store ✓
D2
Fullcomplement
Full complementof of only quinoa, soy,
✓ ✓
amino acids
amino acids buckwheat
B12
B12 ✓ ✗
Vitamin K2K2
Vitamin (MK-4)
(MK-4) ✓ ✗
EPA &&DHA
EPA DHA ✓ ✗
Redefining Staple Foods

Widely available
Affordable
Primary source of calories

How about safe and nutritious?

Protein: Consider the Source

Image credit: Suzi Smith

A Healthy Diet Looks Like This

✗
✗
✗
 Science-Based Common-Sense
Nutrition Planning for 21 Century
st

Clinicians: offer low-carbohydrate diets as an option to patients with IR

Policymakers: include low-carbohydrate diets in public health guidelines

as an option

It makes no sense to base the dietary guidelines on the

one macronutrient we don’t need and that diabetics
[and pre-diabetics] can’t handle.
—Zoe Harcombe PhD
Connect with Me!
www.diagnosisdiet.com
psychologytoday.com/blog/diagnosis-diet

@GeorgiaEdeMD

/GeorgiaEdeMD

Special thanks to Suzi Smith for presentation design and graphics