The World Turned Upside Down: The Second Low-Carbohydrate Revolution by Richard David Feinman Page B
Authors: Richard David Feinman
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only is there
nothing
at all to the diet heart hypothesis, that is, not only is dietary fat
not
involved, but there is the possibility that, outside of well-defined
genetic
conditions like familial hypercholesterolemia, diet is just not a major
player
in cardiovascular disease. Very surprising given our current view of
things and
likely to change as we learn more but you have to go with the data.
Summary
The first low-carbohydrate
revolution,
around 2002, was
precipitated by Gary Taubes's deconstruction of the diet-heart
paradigm,
probably more accurately described as calling attention to the
self-deconstruction by continued failure of experimental tests. In
combination
with the multi-center study headed by Gary Foster, the door was open
for
examination of just what scientific support there was for low-fat ideas
and
whether the iconoclastic diets based on carbohydrate restriction might
not be
better. The nutritional establishment, however, refused to accept the
results
and more or less continues to stone-wall carbohydrate restriction. It
will
require a second revolution. To understand what the issues really are
requires
some familiarity with nutritional biochemistry. The macronutrients are
the main
focus. That's next.
Chapter 5
Basic
Nutrition:
Macronutrients
Carbohydrate, fats and protein. These
are
the macronutrients because of the quantities in which they are consumed. Micronutrients include
vitamins and minerals, obviously to be taken in small amounts. It has
become
common to refer to foods as "nutrient-rich" or "nutrient-dense," or
not,
according to whether somebody thinks that they have high amounts of micro nutrients.
This
annoying imprecision is taken by some people – I'm certainly one of
them – as
an indication of how unscientific, that is, how lacking in attention to
detail,
the field of nutrition is.
During the period from 1970 to 2000,
roughly the time in which
observers began to notice an "obesity epidemic," there was an excess of
consumption of calories, almost all of which was due to carbohydrates.
Protein
is usually the most stable part of the diet. In the absence of
financial
considerations, the generally higher satiety of protein probably makes
intake
self-limiting although there may be unique metabolic regulation of
nitrogen
sources. During this period, the total amount of protein in the
American diet
did not change. Figure 2-2 shows, that fat, if anything, went down.
Basics of carbohydrate
chemistry
Chemically, the class of compounds
called
carbohydrates includes
the simple sugars ( monosaccharides )
like glucose and fructose, and combinations of the simple sugars,
disaccharides
like sucrose (one glucose, one fructose) and polymers (polysaccharides)
like
starch and glycogen, as well as derivatives of the sugars, for example,
the
so-called "sugar alcohols."
"Alcohol," that is, ethanol, is not a
carbohydrate despite what
you may hear on YouTube. Whatever the extent to which sugar can make
you as
loopy as alcohol, chemically, ethanol is not a carbohydrate. A horse is
not a
dog. One of the reasons that we make pre-meds study organic chemistry
is that
the precision in naming organic compounds is presumed to carry over
into
pharmacology. It is likely that manufacturers started spelling klonopin
(antidepressant) with a 'k' because they didn't want physicians to
accidentally
prescribe clonidine (antihypertensive).
Figure 5-1 Structure of
simple sugars.
The formal chemical description of
sugars
is that they are
polyhydroxy aldehydes and ketones: Figure 5-1 shows the chemical structures
of glucose and fructose. To simplify where they fit in in biochemistry,
the
common sugars, and related polymers, can be represented cartoon-style
as in Figure 5-2 .
The most common sugar is glucose and
it
almost always cyclizes
(folds up) in the form of a hexagon, at least in aqueous (water-based)
solutions. Fructose can also form a six-membered ring but is more
likely to
cyclize in a pentagonal
nothing
at all to the diet heart hypothesis, that is, not only is dietary fat
not
involved, but there is the possibility that, outside of well-defined
genetic
conditions like familial hypercholesterolemia, diet is just not a major
player
in cardiovascular disease. Very surprising given our current view of
things and
likely to change as we learn more but you have to go with the data.
Summary
The first low-carbohydrate
revolution,
around 2002, was
precipitated by Gary Taubes's deconstruction of the diet-heart
paradigm,
probably more accurately described as calling attention to the
self-deconstruction by continued failure of experimental tests. In
combination
with the multi-center study headed by Gary Foster, the door was open
for
examination of just what scientific support there was for low-fat ideas
and
whether the iconoclastic diets based on carbohydrate restriction might
not be
better. The nutritional establishment, however, refused to accept the
results
and more or less continues to stone-wall carbohydrate restriction. It
will
require a second revolution. To understand what the issues really are
requires
some familiarity with nutritional biochemistry. The macronutrients are
the main
focus. That's next.
Chapter 5
Basic
Nutrition:
Macronutrients
Carbohydrate, fats and protein. These
are
the macronutrients because of the quantities in which they are consumed. Micronutrients include
vitamins and minerals, obviously to be taken in small amounts. It has
become
common to refer to foods as "nutrient-rich" or "nutrient-dense," or
not,
according to whether somebody thinks that they have high amounts of micro nutrients.
This
annoying imprecision is taken by some people – I'm certainly one of
them – as
an indication of how unscientific, that is, how lacking in attention to
detail,
the field of nutrition is.
During the period from 1970 to 2000,
roughly the time in which
observers began to notice an "obesity epidemic," there was an excess of
consumption of calories, almost all of which was due to carbohydrates.
Protein
is usually the most stable part of the diet. In the absence of
financial
considerations, the generally higher satiety of protein probably makes
intake
self-limiting although there may be unique metabolic regulation of
nitrogen
sources. During this period, the total amount of protein in the
American diet
did not change. Figure 2-2 shows, that fat, if anything, went down.
Basics of carbohydrate
chemistry
Chemically, the class of compounds
called
carbohydrates includes
the simple sugars ( monosaccharides )
like glucose and fructose, and combinations of the simple sugars,
disaccharides
like sucrose (one glucose, one fructose) and polymers (polysaccharides)
like
starch and glycogen, as well as derivatives of the sugars, for example,
the
so-called "sugar alcohols."
"Alcohol," that is, ethanol, is not a
carbohydrate despite what
you may hear on YouTube. Whatever the extent to which sugar can make
you as
loopy as alcohol, chemically, ethanol is not a carbohydrate. A horse is
not a
dog. One of the reasons that we make pre-meds study organic chemistry
is that
the precision in naming organic compounds is presumed to carry over
into
pharmacology. It is likely that manufacturers started spelling klonopin
(antidepressant) with a 'k' because they didn't want physicians to
accidentally
prescribe clonidine (antihypertensive).
Figure 5-1 Structure of
simple sugars.
The formal chemical description of
sugars
is that they are
polyhydroxy aldehydes and ketones: Figure 5-1 shows the chemical structures
of glucose and fructose. To simplify where they fit in in biochemistry,
the
common sugars, and related polymers, can be represented cartoon-style
as in Figure 5-2 .
The most common sugar is glucose and
it
almost always cyclizes
(folds up) in the form of a hexagon, at least in aqueous (water-based)
solutions. Fructose can also form a six-membered ring but is more
likely to
cyclize in a pentagonal
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