From August 25 – 28, I had the opportunity to attend the Low Carb Conference in beautiful San Diego, CA. I was particularly keen to learn more about the scientific advances of how a low carbohydrate lifestyle contributes to metabolic health, and I was not disappointed. At this conference we covered low-carb diets, the ketogenic lifestyle, carnivore, and in the spirit of diversity & inclusion, welcomed a view on plant-based diets and their application to a low-carb lifestyle.

What I particularly liked about the topics and speakers was the emphasis on evidence. Listening to a few people spouting off on social media about “diet x” without any science, proof, medical application or the like is simply a waste of time, and if you’re taking your nutrition advice from a TikTok “socialista“, I would suggest you rethink your strategy. Conversely, listening to some of the leading medical thought leaders in the field of metabolic health highlight the thousands of people they have helped reverse metabolic disease through sound scientific and grounded evidence is inspiring and shows what is possible with focus and discipline.

In all candor, while it was rewarding & motivating to listen to top experts in this field showcase the power & proof of a healthy dietary approach, it was equally rewarding to listen to the stories of conference attendees who have found a new lease on life through dietary changes, and how they are trying to offer hope and guidance to local communities & networks. Here are my top five takeaways from this year’s conference.

1. The Science is Real
2. More Than Just a Fad
3. Uncovering the LDL Hyper-Responder
4. Politics & Industry vs. Truth & Evidence
5. Sustainability: A Better Way

The Science is Real

Two of the guest speakers at the conference were Dr. Eric Westman, MD, Associate Professor of Medicine at Duke University, and Dr. Steven Phinney, an industry expert in low-carb science for 40 years, a Professor of Medicine Emeritus at the University of California Davis, and co-founder of Virta Health. Both of these medical thought leaders have been able to demonstrate resounding success in applying a low-carbohydrate or ketogenic diet to helping their patients completely turn around their metabolic health. Remember, we’re talking about more than just weight loss. The application of a ketogenic diet has not only helped patients lose weight but improved their cholesterol, lowered their blood pressure, reduced their risk of heart disease, reduced their inflammation, and significantly reduced if not eliminated their need to inject insulin to cope with Type 2 Diabetes (T2D).

Dr. Westman is a great example of a doctor who was following the U.S. Dietary Guidelines for years, and found his patients continuing to decline in metabolic health. He actually converted to a low-carb recommendation after seeing a few of his patients make remarkable progress, and when he asked them what they were doing, they talked about how they “cut out the carbs.” Dr. Westman did his own research, began applying it with patients, and has now written books on the power of following this lifestyle. For over 20+ years he has treated thousands of patients with great success, and takes a balanced approach to low-carb depending on the situation of each patient.

Dr. Phinney is an incredibly accomplished leader in this field, and offered insights behind the life-changing results Virta Health is showing to help patients reverse their metabolic disease. Through the combined power of a ketogenic dietary lifestyle application, tracking/monitoring and counseling, not only do patients significantly improve metabolic health, but in many cases, reverse their T2D!

More Than Just a Fad

The ketogenic diet was the most searched dietary lifestyle, based on google search, in 2020, and in 2021, had the highest menu growth of any dietary plan. What you may not be aware of are the following historical uses:

• In 1860, William Banting famously documented his weight loss journey of -52 lbs, where he followed a dietary protocol very similar to a modern low carbohydrate diet. 
• In the late 19^th century, dietitians & physicians were prescribing a low starch diet for both weight management & epilepsy treatment, especially for children.  
• The ketogenic diet has been used to treat epilepsy, especially in children, for over 100 years.  

More and more “keto” food products are being introduced, trying to capture sales related to the growing trend, but unfortunately, are offering a poor nutritional ingredient list that is hardly “keto” or “keto-friendly.” The reality is there is not a nutritional or macro-nutrient (macro) standard a food company must follow to classify a product as “keto.” So, when you look at the nutritional ingredient panel and see a product loaded with ingredients like maltitol, soluble corn fiber, tapioca starch, agave nectar, sucralose, palm oil, and a host of other poor ingredients, stay away. Unfortunately, these processed foods that do not support a ketogenic lifestyle run the risk of ruining the credibility of the dietary lifestyle, as consumers will eat them and then deem the diet as not working when they “mysteriously” do not see any metabolic improvement! As I’ve discussed on numerous occasions, a successful application of the ketogenic lifestyle is applying Q M F: Quality foods, Macronutrient mix, & Frequency of feeding modulation. If something carries the name “keto” and comes in a box or bag, and has an extensive ingredient panel, it’s probably a good idea to keep walking and look for something much more nutritionally dense and non-processed.

Uncovering the LDL Hyper-Responder

We have been told hundreds of times that LDL cholesterol is “bad” (the bad cholesterol), and if your LDL is high, you have a higher risk of heart disease. Interestingly, when one successfully applies the ketogenic diet, all of the metabolic markers improve: A1c, Blood Pressure, HDL, Triglycerides, Liver Health (NAFLD), Obesity/BMI, and usually, LDL. However, there are examples of people who see an increase in their LDL cholesterol numbers. What would cause an increase in LDL, which could signify an increased risk of heart disease? One of the presenters, Dave Feldman, has been leading a body of research to find out, and the work is astounding. First, Mr. Feldman is not a doctor, but a software engineer, so he’s looking at the data through a different lens. He has a hypothesis, which has been captured in a recent medical journal article, that a portion of the population are what he calls “Lean Mass Hyper-responders” (LMH), which see an increase in LDL when on a carbohydrate restricted diet (CHD), including a ketogenic diet. The thinking is, as someone who is on a CHD, who is both lean and athletic, needs fuel, the LDL molecules act as transporters to move fat through the blood stream to be used as energy. What I really appreciate about Mr. Feldman’s approach is he knows he needs to validate this hypothesis with quantifiable results, and he is approaching the validation through rigor and transparency. If you think you might be a LMH, and you would like to see if you could be included in the ongoing study to measure this effect, visit https://citizensciencefoundation.org/study/.

Politics & Industry vs. Truth & Evidence

The famous quote from Henry Kissinger resonates even louder today:

If you’re wondering why Bill Gates has bought 270,000 acres of U.S. farmland, making him the single largest private owner of farmland in the country, just look back to Mr. Kissinger’s quote. Controlling the food supply yields control over people, and to do it requires both industry & government to collaborate. From the 1960’s when industry began aggressively growing the use of seed oils (soy, corn, etc); to the 1970’s when the U.S. Dietary Guidelines were established; to the 1980’s where the demonization of fat accelerated while the use & consumption of sugar and carbohydrates exploded; to industrialization of farming focused on soy and corn to supply an animal feedstock industry in the 1990’s; to the consolidation of major food suppliers, fertilizer companies and the animal feed industry that favors quantity/volume over quality; to today’s metabolic health emergency we see across the globe, we have been on a relentless march toward illness for the last 60+ years.

Author Nina Teicholz, who wrote the excellent book The Big Fat Surprise has been on a crusade to reveal the political biases and inconsistencies about how our government has used sketchy evidence (at best) to push a high carbohydrate/low-fat/low meat consumption diet, ignoring reams of data that shows the opposite way of eating (ie, low-carb) has a wealth of proven health benefits. At the conference, she spoke at length about the lack of transparency and the “double-standard” being applied by government officials when considering a low-carb diet, citing some intriguing facts:

• Just looking at pubmed.gov shows over 800 clinical studies on the effectiveness of low-carb diets, and yet the U.S. Dietary Guidelines still does not recommend this dietary approach. How does this number of studies compare with, for example, a vegetarian diet? There are 2X the number of studies on low-carb vs. vegetarian, yet vegetarian has been recommended by the U.S. Dietary Guidelines since 2015.
• As more health practitioners put a low-carb diet into practice, both for themselves AND for their patients, with resounding success, the call to include a low-carb diet with the U.S. Dietary Guidelines is getting louder. In fact, almost 80% of the comments submitted to the USDA-HHS asked for consideration of a low-carb diet.
• Why would the U.S. Dietary Guidelines Advisory Committee ignore the hundreds of studies and outpouring of support from medical professionals and citizens who have transformed their lives through this dietary lifestyle? Conflict of Interest. A recent publication from Cambridge University Press demonstrated how deep the alignment is between industry who is against the low-carb lifestyle and members of the committee. What percentage of the committee had a conflict of interest? 95%.
• We know we need to reduce our consumption of processed food. Ask yourself why we read articles on the dangers of processed food, and processed meats, almost daily, yet our government and industry are working overtime to promote the use of plant-based meat substitutes, which are highly processed with a host of poor ingredients?
• Finally, do you recall the early 2022 U.S. News ranking of the top diets and where the low-carb options fell on the list. You guessed it…near the bottom. It’s almost like some people in government and industry do not want us find out there is a better way to metabolic health because that would be an inconvenient truth.

Sustainability: A Better Way

One of the most eye-opening aspects of a debate where both sides can be allowed to express an evidence-based point-of-view is how often there is more commonality than difference. Case in point: sustainability. I’ve heard vegetarian & vegan proponents vilify the ketogenic and carnivore lifestyle due to the impact on the planet through greenhouse gas emissions, water pollution and poor land usage. The irony is those who really understand a low-carb lifestyle and the importance of quality foods completely agree with the vegans and vegetarians on these issues! Where we differ is the pathway to the solution.

Our animal feed processes need a wholesale change. From using cheap soy feed that is grown on land secured by cutting down rainforest; to keeping animals in unhealthy conditions that require heavy antibiotic use to keep infections at bay; to using hormones to add size and weight unhealthily to the animals; to the polluted run off from poor farming practices that renders fresh water tables undrinkable; to the heavy use of nitrogen fertilizer and run-off that causes stream, river and open-water dead zones by accelerating the growth of algae that ultimately absorb the oxygen required by fish to survive; the current animal farming process is broken and unsustainable. However, that does not mean the solution is to eliminate all meat and fish consumption. All of these issues can be addressed, and largely reversed, through sustainable, regenerative animal agricultural practices. If you’re not familiar with regenerative agriculture, here is a quick guide.

Consumers are still eating meat, but all meat is not created equal, nor are all protein sources. The problems mentioned above from our current animal-protein ecosystem can all be fixed/reversed, which is being proven at small farms and communities across the world. By utilizing best practices, animals can lead a healthier, more enjoyable life free to roam; the land can be managed to encourage healthy soil through rotation and using animal fertilizer as opposed to nitrogen-based chemicals; the use of hormones and antibiotics can be reduced if not eliminated; animals can convert grass (which humans cannot digest) into quality protein (that humans are built to digest); and finally, through this combined effort, the quality of the protein is substantially better for human nutrition. Is regenerative farming more costly? Currently, yes. Is it effective? Absolutely!

The U.S. spends over $3.5 trillion per year in healthcare costs, with 90% related to chronic disease. Diabetes and obesity are two of the biggest drivers of this enormous financial cost to our citizens and economy. So, what if we spent more in food quality and less in healthcare treating chronic disease? What if those who choose to eat meat can get access to quality protein without environmental harm? What if people who choose a vegetarian or vegan lifestyle can peacefully co-exist with those who choose to eat animal protein behind a shared desire to support their nutritional lifestyle in a sustainable manner? What if…