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Have to admit.  I have a mancrush on Gary Taubes.  Nearly 20 years ago, he walked right up to dieting conventional wisdom and punched it right in the mouth with his New York Times article What It’s All Been a Big Fat Lie?  In that article, he questioned whether the established conventional dieting wisdom of the last 50 years had been a “lie,” that fat made you fat, that carbs were good, that eggs bad, that sugar good since no fat and we all just need to exercise more and eat less to lose weight.  Taubes was writing about the Dr. Atkins Diet, the heretical belief that eating fat and removing carbs would make you healthy. 

At the time that he wrote that article, the conventional establishment went apoplectic claiming that following the diet would lead to a rash of strokes, heart attack and premature death.  That took a lot of chutzpah for a non-medical doctor to take on the establishment that way.  Taubes didn’t really say the high fat/low carbs diet was right, but he did raise significant questions about whether conventional wisdom was wrong.

What’s the verdict since then?

Taubes tries to answer that in his most recent book The Case for Keto.  

The jury’s still out.  Conventional wisdom still really hasn’t budged, but the next generation Atkins, Keto Diet, has been gaining legions of followers among the medical community and that gives Taubes more credibility and power. 

In 2002, he was just an outsider pounding his 95 diet theses on the castle walls of conventional wisdom.  He was more of a rabble rouser, albeit a very smart and Harvard educated one. 

Now he lectures at medical schools, and 20 years out, the book contains multiple interviews with Keto friendly MD’s, and cites multiple peer reviewed studies stating that Keto and its cousin Atkins are very effective at reversing obesity and the adverse health markers associated with obesity. 

And it’s just plain fun to read.  You clearly have to be a gifted writer if you can make an entire career about writing about the virtues of “fat.”  This is the fourth book following Good Calories Bad Calories, Why We Get Fat, and the Case Against Sugar

What’s my verdict as a lay jury person of the diet wars?  I have no medical credentials, but I am lawyer by trade, and have 20 years of experience evaluating evidence, and cross-examining scientific conventional wisdom.

Here’s my view.  I think we should still presume conventional diet wisdom is right … as a starting point unless and until it has proven wrong over and over and over and over and over beyond a reasonable doubt. I think it has as it relates to the cause of obesity and getting out of it. 

As Taubes so eloquently points out in the book, you just can’t ignore so many learned anecdotes from doctors in the field reversing their patients obesity and all of the complications.  The conventional wisdom is that you just need less calories and exercise more, but every real doctor “knows” that patients won’t do either so they just treat the symptoms to stave off the evitable decline associated with obesity.

If everything else has failed and Keto reversed diabetes and achieved positive reversals on blood sugar and blood pressure, what are docs supposed to do? Tell patients to keep eating carbs again?

Keto and fat solve the twin drivers of obesity: insulin and hunger.  Especially processed carbs and sugar do the exact opposite, making it very difficult to just eat less.  Yes, as Taubes concedes, It can drive up “bad cholesterol,” but there is now more nuance on bad LDL cholesterol and people in the field just can’t wait until the science gets the final peer reviewed longitudinal studies come in.  Studies are expensive, slow and subject to conflict.  The studies that have come in so far have been very favorable to Keto and Atkins.  Docs simply cannot “unsee” what they seen and they know that a 60 year old obese patient can’t just wait for 20 years for 20 year study results to come in.  Decisions have to be made in the field since time clock could run out before the results come in.  

So that’s my verdict.  If you’re obese and everything else has failed, talk to a keto doc or keto dietitian and start getting fit, especially so you don’t start making classic keto mistakes like eating eggs and bacon all of the time.  

On the other hand, if someone is slim, fit and metabolically healthy, then just stay the course.  Keep doing what you’re doing.  

I do think Keto/Atkins now have gotten more nuance on carbs too as well as sugars, especially once people get to a healthy weight too.  So that’s my view as lay jury of one.

To get the complete nuance, read the book.  Tomorrow, I am going to talk about the various diet camps.  They’re a lot of more nuance than you think.