The Case for Keto: Rethinking Weight Control and the Science and Practice of Low-Carb/High-Fat Eating

by Gary Taubes

the British nutritionist John Yudkin pointed out that when we restrict carbohydrate-rich foods—specifically, grains, starches, and sugars—we are restricting the foods that bring the least to the diet in terms of vitamins and minerals. In the case of sugar, it brings nothing at all but energy (hence the term “empty calories”) and a metabolic burden to the liver that may very likely be the cause of insulin resistance.

Berry’s conversion experience is typical of many of the physicians I interviewed. He started putting on excess fat in his mid-thirties and believed (based on what he described as the “four hours of nutrition education we got in medical school”) that “if you want to lose weight you create a calorie deficit.” He assumed that if he religiously followed this “state-of-the-art” wisdom, it would fix him. It didn’t. “So now I looked like a fat lazy doctor, with stiff joints and reflux and allergies,” he told me. “I felt like shit all the time, and I’m supposed to go into a patient’s room with my gut hanging over my pants and tell him what to do. How does that work?”

This, again, is one reason many of the physicians I interviewed who have clinics dedicated to weight loss and maintenance and treating diabetes with LCHF/ketogenic eating often talk in terms of breaking an addiction to carbohydrate-rich foods. There’s a good reason, as Miller said to me, why alcoholics don’t celebrate the successful completion of a twenty-eight-day rehab program with a champagne toast.

One of the smoking cessation doctors gave me a metaphor I can now use with my patients: Every day I drive to work, I try to hit as many green lights in a row as I can. But if I hit a red light, or even five in a row, I don’t turn around and go back home. I just try again from there. I still try to see how many green lights I can hit.

never get hungry in surgery anymore,” she told me. “I’m cranking away in ketosis, my head is clearer than it’s ever been. I’m hungry when I get home in the evening, but I’m not ravenous.”

Cauliflower rice is also a staple. For the first time in her life, she told me, she has to work to keep weight on. “That’s shocking because I am a perimenopausal woman who was morbidly obese at one point. So this is working really, really well at the moment for me. If that changes, I’ll adjust. It’s not a religion.”

Establishment experts often ridiculed Atkins for saying that “ketosis is better than sex,” but there’s a lot to be said for the energy that people experience when they are freely mobilizing fat and burning it for fuel.

The most common side effect is what used to be known as the “Atkins flu,” now typically known as the “keto flu.” As I said earlier, when you lower insulin, your kidneys will excrete sodium (salt) in urine rather than retain it. This goes along with several pounds of water that’s no longer bound up with glucose

in its storage form, glycogen.

For those who are averse to drinking either, pickle juice is another sodium-and-electrolyte-rich solution.

Carrie Diulus told me, she won’t get on a plane without a bag of macadamia nuts for her snack.

The solution is to add more fat: butter or olive oil on the vegetables; chicken thighs with the skin on instead of chicken breasts without; fatty cuts of meat and fatty fish instead of lean.