Revisiting my low-carb gurus today led me to discover this new book by Gary Taubes. Controversial? Probably will be. But Taubes does his homework. If you have a concern about diabetes, this could be a helpful resource.

RETHINKING DIABETES
What Science Reveals About
Diet, Insulin, and
Successful Treatments

I have a library copy, it’s another 500 page history of dietary guidelines, so much repeated from earlier books. If you have read the previous four books, which covered some aspects of diabetes, he hasn’t added much.

It is only a Re-Think of Diabetes if you have been following USDA and ADA guidelines. He is still using the Carbohydrate-Insulin Model, but not giving any consideration to the Personal Fat Threshold model, https://optimisingnutrition.com/personal-fat-threshold/ or why High Carb Diabetes protocols like Mastering Diabetes or Starch Solution also work. His book is good if you view it only from a low carb lens.

If you have a CIM theory that works …. but also a flock of Black Swans, that also work, then it is an incomplete hypothesis.

Someone already wrote what my review would be … This book doesn't stray far from others written by Gary. He came up with a conclusion and then wrote a narrative to support that conclusion, as opposed to looking at the evidence as a whole and drawing a conclusion from it. It ignores most research from at least the last 15 years delving into the physiological mechanisms of type 2 diabetes, showing that it is indeed reversible and not chronic, and demonstrating reversal through fat loss regardless of carbohydrates and insulin (e.g., the work of Roy Taylor, Michael Lean, etc.).

Thanks, Janet, for additional input (from someone who's read the book!)

I've been reading the book, as I've read all his others. But I've found it fascinating and new, so perhaps it's a nerd thing.

For instance, early on, he covers how well the "animal diet" worked for diabetics before insulin. Today we call it carnivore. It worked BETTER than poor diet and insulin does now. Not the first I've heard of it, but the first time I've read about it any depth at all. One would think it would be part of diabetes treatment. We even use leeches now, for delicate surgery. Bring back the animal diet!

And I cannot repeat enough: not every region has enlightened doctors and dieticians. They keep telling my friend's father he's not eating enough carbs when he's got the best glucose control in the entire practice, simply from Atkins. For YEARS now. No, the information is out there but for some, this book will be NEW and AMAZING enough to shake something lose.

Do other histories of diabetes treatment cover the animal diet? No. It's all, "Before insulin, diabetics died, end of story."

That's the kind of "detailed description of the science derailment" I got from Good Calories, Bad Calories about the influence of Ancel Keys. That is what he's good at.

I also can't sit down and read it like I do a thriller, so I bought it because I knew I'd have to take my time, with breaks. Heck, I re-read Good Calories, Bad Calories because he's a fascinating science writer. Explaining where scientists went wrong is one of his specialities.

Wear Bear is right, I forget that I re-considered low carb diets in 2010 after reading Good Calories, Bad Calories and within a few months was a patient of Dr Westman's, a half hour away at Duke, with support from my GP and oncologist. VLC works well, best place to start, great for T1s, but when that doesn’t reverse diabetes for some, we are left looking at new theories.

Taubes wrote that this book, like GCBC, is targeted to physicians and dietitians. If he wanted to help diabetics, it should have at least been shorter than the Why We Get Fat length, with a simple diet.

More on Dr Roy Taylor's book, Your Simple Guide to Reversing T2 Diabetes.. It is still 99 cents, maybe permanent?, and worth every penny.
He only spends 37 pages of a 78 page pocket guide to explain what diabetes is, and how the Personal Fat Threshold explains the success why both obese and normal weight people can develop it, regardless of carbs and insulin.
Clear writing and Each short chapter ends with a "quick read."


It is Energy Toxicity: The Culprit Behind Your High Insulin
https://optimisingnutrition.com/energy-toxicity/

Fully agree with your review, WB. It’s an excellent book that contains current thinking and research on the causes and pervasive issues responsible for poor metabolic health. Taubes is thorough and well-versed in this topic. I appreciate his updated perspectives on this important topic.

While I'm not arguing with Dr Roy Taylor, I don't see the fine distinction in his argument. Is he using, (like a doctor) a distinction between obesity and overweight?

If it's triggered by excess body fat, and varies by person, I would still think of it as a disease sensitive to overweight. But of course, I'm not a trained doctor. But then, the good ones supercede their training.

And some stay caught up. All this new research NOT changing medical advice? Much more wrong there.

Also, we can't help but see The Answer as "the one that worked for us." With increasing understanding of how varied we can be in our individual responses, "One Diet to Rule Them All" will never work.

Which makes it better, but more complicated. I don't see any reason NOT to focus on hyperinsulemia, but expand it. Hormone derangement is part of gaining excess weight.

Leptin is another major player. That's what these new drugs target, and ruins the appetite. But no one is thinking of the downstream effects.

Also, I'm sure Taubes and the publisher will offer a simplified guide, as they did about calories and fat.

Dr Taylor doesn’t make a distinction between obesity and overweight, except to show how irrelevant to a diabetes diagnosis it is. His first study in 2011 established that diabetes could be reversed even in a person with a "normal" BMI of 24, who loses the fat stored in his liver and pancreas, and BMI maybe drops to 21, still normal, but reversed diabetes. Another had a BMI of 29, then lost fat to BMI of 26, reversed diabetes but was still "overweight"…because his weight was under his "personal fat threshold", low enough so fat in the pancreas was removed, allows it to recover, (which, btw, takes two years for a permanent change, so maintaining weight loss is important)

These studies are not theoretical to the NHS, the northern UK cities have South Asian and Far Eastern populations where the "healthy BMI ranges" are set lower, "normal” is below 23 BMI. He has cases of diabetes in patients with a BMI of 19. After more studies since 2011 showing the same diabetes reversal, the NHS is rolling out his program to GPs.

Carbohydrate restriction works if you become fat adapted and can maintain a weight below your fat threshold and have no evidence of diabetes, e.g. David Unwin's program. Most on this forum have already tried "low fat" and will choose low carb to improve blood glucose. But you can also become carbohydrate adapted, through dextrose training, fruitarians like the Mastering Diabetes guys, or Starch Solution…that also works. A person will develop type 2 diabetes when they’ve become "too heavy for their own body". It doesn’t matter if their BMI is within the ‘normal’ range, or what they choose to eat, fat or carbs. They’ve crossed their personal fat threshold and become unhealthy.”
Dr Naiman talks about it, minute 44 to 60: https://podcasts.apple.com/us/podca...i=1000624625885

In addition to one's Personal Fat Threshold, I found the area under the BG curve to be one of Marty Kendall's most persuasive reasons to not eat excessive amounts of fat. Yes it keeps you feeling fuller longer, but it keeps BG (& presumably insulin) levels higher for longer and not just on a graph, but in ME on only 25g of net carbs per day & <10g carbs per meal!:

https://optimisingnutrition.com/gly...hydrates-vs-fat

I still eat plenty of fat (~70g/day instead of ~90g, or 1.75 Tablespoons less added fat a day), but more protein & nutrients, to keep me feeling as satiated I did on LCHF. My personal carb threshold/maximum (what Atkins called the Critical Carb Level for Maintenance) to avoid cravings, binging & inflammation is still 35g, the same as it was when I first tried DANDR 50 yrs ago!

Other Optimisers on DDF found they could finally drop their fasting glucose down to the "normal" range after years of high readings, some on Metformin.

Just avoiding seed oils has done wonders for my inflammation. How much seed oil "fat" is causing the problem with dietary fat? Since it is almost impossible to completely avoid while eating out, and fast food is loaded with it.

This seepage of adulterated foodstuffs into our food supply has only really started getting studied. And the big food companies aren't granting money for it.

Just finished reading this book since you can’t quibble with the price of $.99 on Amazon. Very well written guide explaining the cause of T2D and the concept of the personal fat threshold (PFT). Getting below one’s PFT is essential to avoid/ correct T2D. The fact that one’s PFT is variable by the individual makes this a very useful guide. Dr. Taylor covers several methods for getting below the PFT, which enables people to choose the approach that works best for them. I have a couple concerns, the first are the recommendations for the daily shakes one uses to start the day with for 8 weeks of calorie restriction. Reviewing the ingredients raised red flags for me. The second is the recommended daily protein intake of 50g for an adult. That certainly isn’t enough for me if I want to avoid rapid sarcopenia. Other than those issues, I would recommend the book, as the strategy is well defined. It’s very similar to using a low carb approach combined with some intermittent fasting to achieve the first 8-week stage of calorie restriction. Thanks for the recommendation, Janet.

Here’s an excellent interview by Metabolic Link of Dr. Ben Bikman. While it’s long and detailed, it supports Dr. Taylor’s clinical findings by focusing on insulin resistance starting with adipose resistance:

https://m.youtube.com/watch?v=bn1U2Spl0-k

He doesn’t use the PFT term, but discusses its principles and metabolic dynamics.

Thanks Rob, I will definitely listen to the Ben Bikman interview.
Completely agree about Dr Taylor's diet plan lacking enough protein. It's not for me, I think a slower weight loss using nutrient dense foods works better maintain healthy blood glucose for the longer term.

Diedra has seen improved BG by watching the area under the curve. My Waking BG and A1c finally improved by progressively dialing back the energy in my diet from fat and carbs. My carbs were already low, so I was slowly raising fiber and reducing fat.

If we all have an individual fat threshold, then maybe we all have an individual response to the major macros, too.

Every time I delve into the Rice Diet, I am fascinated. There's three macro nutrients, and three ways for people to respond to this extremely high carb, low fat diet. We all know what happens with high carb, high fat, of course Diabetes.

One third of people on high carb, low fat improved their diabetes. It proved difficult for people to stick with -- as I recall, the doctor in charge said "he had to whip them" which I hope was illustrative language -- but it did work.

If we were serious about medical diets, we would at least study it more. But there's no money for actual science that isn't tainted, as we know from grants given because they fit the lipid hypothesis, so competing theories were starved out of contention. Corporations had a lot of money invested in the one they preferred.

Much of what we do know about nutrition came from successful medical diets. Low carb, ike Banting, still works. And it keeps coming back. Not that it works for everybody. But I think it forms a path to

Because, macro-wise, low carb of any kind is easier to stick to than the Rice Diet. So trying that is going to help more people. The 80/90s were a sea of low fat products, and that made the diabetics of today, didn't it?