“You want me to eat WHAT?!  But that’s . . . ,it’s . . . FAT, really?”

” Yes, it is.”

Every day, instruction to my patients is initially seen as Food Pyramid heresy and My Plate iconoclasm. Yes, I want you to flip the Food Pyramid on its head, and push everything off My  Plate and fill it with fat. . . Really. . . Yes, I do.

I was counseled by many school professors over the years that there are two things you should avoid talking about: Religion & Politics. The ketogenic or low carbohydrate dietary conversation involves both.  “Fat Phobia” is a Religion.  We have demonized fat and sainted the treadmill.  You see, fat got a bad wrap when the bomb calorimeter was invented.  We realized that there was twice as much energy found in fat that there was in carbohydrate or protein.  Early nutritionists, understanding that heat is a form of energy, and realizing that energy is conserved, found that food substrates contain a set amount of energy that can be measured in a closed environment.  Naturally,  the Law of Thermodynamics got applied to lend understanding in how people gain or loose weight. We coined the term “you are what you eat” based upon our understanding of the Laws of Thermodynamics. The calorie became “king.”

• 1 gram of carbohydrate = 4 kcal
• 1 gram of protein = 4 kcal
• 1 gram of fat = 9 kcal

For the last sixty years (an entire generation of humans) we have based our diet around the calorimetry of food and have labeled them as good or bad based upon calories. To loose weight, we are taught, you either have to eat food containing fewer calories (fat has the most calories per volume so it must be bad!) or burn it off faster than you take it in (did you go exercise at that new gym next door), right?  Wrong.

First, you and I are not bomb calorimeters.  We are not closed systems. We harbor variable levels of symbiotic bacteria (these also burn fuel at variable rates) and our body temperatures fluctuate to regulate other enzymatic and hormonal processes.

Second, bomb calorimetery functions on the premise that volumes are also held at a constant. Human volume and density change daily.  Simple chemistry tells us that volume = mass / density. The average human mass fluctuates by 5lbs every day and our density changes based upon our hydration status (the amount of water we drink). Because these two variables are not constant in a human being, it is impossible to correctly apply the Laws of Thermodynamics to the human body and accurately predict weight gain or loss.

Third, hormones!  (Anyone married to a pregnant female understands that nothing is as it seems when hormones are involved.) We have a plethora of hormones that change the rate in which fuels are burned or stored in the human body. Our GI flora (symbiotic bacteria in the human gastrointestinal tract) are also affected by hormones and do not have set rates of fuel use or breakdown.  What this means is that you and I process food at different rates and derive different levels of energy and fuel from the same donut.  Genetics plays a leading role in how these hormones are used and turned on and off.  Fat is burned or stored in the body based on a hormonal mechanism I described in a previous post you can read here.

Asking patients to reduce carbohydrate intake to less than 20 grams per day and increasing fat intake to up to 70% of total caloric intake is essentially 20th century nutritional apostasy.

The dietary concepts from the Food Pyramid and My Plate have been embraced by our country for over sixty years.  Changing our views on these as a country will be for many like changing religions.  For those of us “with eyes to see and ears to hear” our work is cut out for us.