Okay. Thank you. So Andreas Eenfeldt is my name. I am a medical doctor from Sweden. So that explains the accent if you (inaudible). And I am going to talk about the Food Revolution happening in Sweden right now, people eating real food and improving their health and how perhaps the same thing might be happening in America soon.
But let’s start with David here, the famous statue by Michelangelo. It’s a masterpiece from the Renaissance, 16th century, Italy. But this is when David was living in Italy. Then he moved to the United States and he started watching the Dr. Oz show on TV. And this is what happened. It’s not pretty and of course, David is not alone because obesity has quite recently become a huge problem in the entire Western world, including so many of my patients. And the question is why and what can we do about it? I am trying to do what I can. So I started a blog in Swedish three years ago, it’s called Diet Doctor in English and it’s going to be interesting journey because when this blog was just getting started there were like 500 visits every day. So obviously there is a big interest in the subject of food and health.
Now a year later there were about 5000 visits every day and this year it’s up to 19,000 per day which is quite a lot for a small country. So something big is happening in Sweden. And to understand what, we have to go back in time few million years. So this is a basic view of human evolution and there is only one point I want to make. This took millions of years. So it takes a long time to change our genes. But other than obesity epidemic, they didn’t take millions of years, as you know, may have started slowly long time ago but the main part of it, most of it has taken place in the last 27 years.
And how is this basically even possible? Something must have changed in the environment. And what happened 27 years ago in 1984? Well, for example, a big campaign was launched to teach the American people to fear fats and cholesterol. And the idea was that food like eggs and bacon raised the cholesterol in your blood and thus it could give you a disease. Now this was largely an unproven theory back in the ‘80s. So this campaign I might say was an experiment. And there were scientists back then who issued warning saying that there may be unforeseen consequences for this. Things we haven’t thought of. And perhaps one such consequence we should have anticipated and that is, if you eat just one kind of food, you’re going to have to eat more of something else and thus you want to be hungry all the time. And if you eat less carbohydrate, if you eat just fat, you are going to have to eat more carbohydrates such as bread and pasta and sugar.
Now all carbohydrates are digested into simple sugars in the gut and when they are absorbed in the blood raising the blood sugar, the body produces the hormone insulin as you know, which is also the body’s main fast growing hormone. So ironically this could happen, eating less fats could give us more problems with obesity. Of course, some people are thinking, hold on, it’s not quite this simple because what about [Ricky Gervais], that professor in Dubai was speaking about, eat a lot of fruits, vegetables which is carbohydrates and they weren’t fat. In fact, they were fit and healthy. And what about all the Asian people eating all the rice? There were no obesity epidemic traditionally in those countries.
So obviously if you get away with this you can eat a large proportion of carbohydrates and not get fat. But when these populations were eating unrefined starch, not white flour and they weren’t eating any purified sugar or fructose mostly either. In the Western world, we didn’t replace the fat only with fruit, vegetables or brown rice. We replaced it with sugar frosted donuts, French fries, ice cream, white bread, soda and juice for example. So this is rapidly digested carbs that quickly raise the blood sugar, insulin goes up and if you are sensitive, you can make it gain weight. Now this is of course still only theoretical. But now we know what happened when we tested this low fat advice. In an uncontrolled experiment, perhaps unethical experiment, this is official statistics over the obesity rates in the US like in 1985. How many have seen these statistics? Perhaps, half the group. It’s pretty spectacular, right?
And this is the year after the campaign to fear fat was launched and if you take a look at the states, the blue states have around 10% obesity and in the white states, there is not even good data because obesity wasn’t a massive problem like that. But let’s take a look by moving ahead two years at a time. In 1987, ’89, ’91, ’93, and ’95 you see something is happening rapidly in the dark blue states that weren’t on the map at all, just 10 years before. Now it covers half the country and what was that? That’s 15% obesity, that’s a massive increase already. ’97, ’99, 2001, ’03, ’05, ’07, and last year, so this is crazy, right? The data states that’s over 20% obesity, that’s doubled just a few short time ago. And the orange states, that’s over 25% obesity and the rest states over 30%. So the obesity epidemic is spreading like a cancer across the country and obese Americans have become common in just a few decades, just the one generation and kids are affected too as well.
So obviously this isn’t the genetic problem. This is something in the environment and it started when we began to eat refined carbohydrates and sugars instead of fat. And [they get in a voice] because obesity is not just a cosmetic problem, this is strongly associated with all kinds of Western diseases such as diabetes, heart disease and even cancer and the traditional view is that obesity leads to these other conditions but that’s not necessarily true. It could just as well be true that the same thing that makes us fat makes us sick.
Anyway, there is not even any sign of this obesity epidemic slowing down, it’s just advancing every year in America. And you might wonder [where is it from now on] and according to some researchers, if nothing happens, if the trends continue every American would be obese or overweight by the year 2048. Nobody would be normal anymore. And obviously this is crazy, it’s not okay. We have to do something about it, and perhaps we can learn something from where I come from which is Sweden, a small country in Northern Europe and there is about 9 million Swedes and they are known for at least three different things: the [corporate dada], the Nobel prize and finally, fad diets. This is the journal the Lancet, it’s a very prestigious journal and recently they published a paper called fad diets in Sweden, of all places because they were horrified by the popularity of the diets called LCHF standing for low-carb high fat. And it’s basically low carb diet where you remove all sugar and starch such as bread and the goal is just to lose weight and improve your health and the focus is on real food diet, meat, fish, and eggs and vegetables and the difference between this and traditional paleo diets is allows for high-fat dairy products as well such as butter, cheese and some heavy cream but are no [sugar] in it because that’s too much carbs.
And perhaps the big protein is a bad thing to eat in big amounts but the question is first of all, there is no restriction at all on saturated fat which faced some people quite nervous and we will get to that but you might also wonder is this a fat or not? We will get to that too after some perspective because this is the sales of butter in Sweden from 925 up to few years ago and you can see it’s come down to less than half because probably we have been getting the same advice in Sweden to avoid fat, avoid saturated fat, mostly perhaps to avoid cardiovascular disease. But also the thinking has been that if you remove this calorie dense food you’re going to lose weight. That’s one problem we need to work like that in America and in Sweden, if you add the statistics for overweight and obesity, you can see that it didn’t quite work in Sweden either because in the same time period, we’ve been getting more problems with obesity.
Now if you look at on the right hand of the butter sales, you can see it’s actually increasing again now. And this has been going on even more in the last year. So interestingly obesity epidemic seems to have at least slowed down and I believe it will be possible to reverse it. So what happened in the last few years here? Well, lot of things but there is one event that kind of made the media really interested in low carb diets. And it started with this woman, a doctor called Annika Dahlqvist, general practitioner and she had problems with her weight herself, tried unsuccessfully to lose weight in different kinds of ways until she found the low-carb diet and she lost her excess weight. And she improved her health. So she started giving the same kind of advice to her patients. And they lost weight and felt good. So she started a blog and got (inaudible) ended up in the papers and on TV. And then of course, everybody was happy about this. So through dieticians actually notified the highest medical authorities in Sweden, the National Board of Health and Welfare because they felt that recommending obese patients and diabetics to eat fat was unacceptable. Of course, they thought that they were going to die.
Now the National Board of Health and Welfare, they quickly discovered that this was not quite easy to answer. Should they reprimand this doctor? Should they take away her medical license or not? They had to do an investigation, and it took two years and back in 2008 in January, they came with their conclusion and they said that this is okay. The doctor can give advice to her patients to eat low-carb diet with a lot of fat because like they said in their conclusions, low-carb diets can today be seen as compatible with scientific evidence and best practice for losing weight, as the number of studies have shown an effect in the short term and no evidence of harm has emerged. And as you could imagine, this really affected the debate because this ended up in all the papers and all the Television channels and that low-carb had been called the dangerous fat diet. But now the highest medical authority in Sweden said the opposite that has proven to work and there is no dangers. So this was a revolution in the debate and it’s been gaining popularity this kind of eating ever since and now according to new survey, 23% of Swedes are trying to lower their carb in diet which is quite a lot I would say.
So the question is, is it a fat or I would like to ask, is rich in fat the diets (inaudible) multi-million dollar design my plate, which is all based on this old idea that fat raises the cholesterol in the blood and gets you heart disease. Now that’s it. After half a century of research, we now have an answer from reviews of all the evidence. The answer is no, it doesn’t work. Avoiding saturated fat doesn’t make you live any longer or say from dying of a heart attack. In fact, if you look at all the observational data, there is not even an association giving that people who defy the advice, I mean eating a lot of saturated fat, they don’t get sicker than people who followed the advice and avoided. So it doesn’t work.
And if you want to take a look at these reviews, you can find these studies which links to them at my English site DietDoctor.com/science. Some might be wondering what about the cholesterol because it’s true that avoiding fat and avoiding butter is going to lower your cholesterol but the thing is it turned out to be not quite so easy because it’s the HDL that’s mostly good cholesterol and that’s a bad thing. Also, (inaudible) the LDL particles which is also a bad thing. So it’s not really good for your cholesterol and in Sweden, lot of authorities are starting to acknowledge this in public in the papers such as a professor called [John Burgler] said this in Sweden’s biggest paper, “Two generations of Swedes have been given bad dietary advice and they have avoided fat for no reason. It’s time to rewrite the dietary guidelines and base them on modern science”. That’s also give to everyone a guideline, professor Burgler says it’s because he has been doing this kind of research.
Another example, another professor is saying this, “People have been recommending low-fat diets but through the years, then it turns out to be completely wrong. There is no proof in correlation between saturated fats and cardiovascular disease,” and the third example, another professor, especially cardiovascular researcher said this, “It’s time to face the facts. There is no connection between saturated fats and cardiovascular disease”. So question is who cares about this? Is it just academic discussions or does it have any practical, no meaning? Well, the fear of cholesterol and saturated fats, that’s the foundation over the last decades of dietary advice and that when the foundation falls, the entire low-fat advice falls. So this is a fact, I would say, and it’s time to stop giving this advice.
There might be a paradigm shift going on. Like in science, in the 17th century people believed that the earth was the center of the universe and then came to know that wasn’t quite like that, was the opposite, we circled around the sun. It took it quite a long time for the scientists to acknowledge this, so it takes some time. And that’s the paradigm shift that I think is starting now. And this is what’s going to happen I think. We used to think that saturated fat is bad and now we are going to see that it’s safe to eat. We used to think that carbohydrates are good. We might see that it can become a problem that too much of it can they get fat and sick. And looking at the science of low-carb, it’s interesting. I am going to talk about two different things for weight loss and for diabetes.
Starting with weight loss, it usually – now people are saying it doesn’t really matter what you eat, it’s all about the calories. But it turns out when you actually test fats, it’s not that simple because in studies time after time, low-carb turns out to give you more weight also on average. This is after one year and this is up to two years, statistically significant void, the low-fat advice but on the difference tricks of it, but when you have bad compliance at the end so and if you look at shorter trials where the compliances are still good, then low-carb is destroying the competition with weight, more weight loss in study after study.
In fact, if you look at the all randomized controlled trials where they found statistically significant difference, this is good. The result is 14 of them what do you think it’s going to be, how many for low carb, how many for low fat? It’s actually 14 to zero, low fat hasn’t got a single one and if you want to see the studies they are online whole page as well and – but I find this very disturbing because today obese patients are given the ineffective advice to avoid fat and calories and what happens when the patients fail to lose weight using this bad advice? Do they get a more effective advice? Do you think? No, is that we conclude that they are lazy, hopeless gluttons and we kept away their stomach to stop them from eating.
So gastric bypass surgery is becoming one of the most common operations in the world and I think we need the reality check very soon because these are helping organizations that they are removing, and that, it’s like trying to surgically adapt our bodies to the industrial food. How about first giving people some help to follow a more effective advice that might help them to lose weight, avoiding sugar and starch? This is a Norwegian friend of mine called Ronnie Mathisen in Paris a few years ago. Since then he’s lost quite a lot of weight eating low-carb high fat diet. And he made a movie using before and after pictures that he has allowed us to see. So this is before and you can see something is happening. Now Ronnie is eating all the food he wants, only avoiding sugar and starch. You can see the fat melting away. Quite interesting, you can see from the side, the fat melting away with no voluntary calorie restriction, eating all the real food he wants.
Now we can do this in a reverse. And it becomes a nice metaphor I think for western population eating more sugar and starch and they are adapted to handle regularly. This is what happened to America. Problem, too sugar and starch and the solution is to get rid of the sugars and starch and this is what happens. So I’ve shown you a picture of Ronnie in Paris a few years ago. This is Ronnie in Paris last week, looking good and feeling great. Now today Ronnie is not in Paris any more, he is in America in Los Angeles and he is sitting right over here. So if you want to have some tips on how to lose weight with no hunger, you can ask Ronnie. Or you can take a look at my page DietDoctor.com/LCHF, a totally free guide.
Now weight loss is not the whole story. Because if you look at these weight loss trials, these randomized controlled trials, an interesting pattern emerges. You look at all the trials here and you look at different factors like weight loss, you see the dark blue first statistically significant advantage for low carb, also for weight loss, even for no sugar, for HDL cholesterol, for triglycerides, for blood pressure and not a single study has shown an advantage for low fat, they are all pointing to the advantage for low-carb and these are of course as you know, this is the metabolic syndrome, this is obesity and diabetes.
So how about diabetes? You know what diabetes is, it’s too much sugar in your blood. Now where does the sugar in the blood come from? Mainly from our diet, from the carbohydrates that are broken down, it’s the sugars that we get. So interesting, because this is a huge problem now and 30 million diabetes in the ‘80s is on the way to half a billion in a few decades. It’s an explosion. And even worse, the people who get that disease are not expected to get well. They are expected to get a little bit more sick every year.
And what kind of advice do we give them? Good advice perhaps, because the bottom of the food pyramid, that’s starch in food and that is the food that raised the blood sugar because it’s digested to glucose and it gets into the blood stream and that is blood glucose, right? Ironically about 100 years ago, people knew that diabetics were supposed to avoid the carbs. This is a group from 1917 and you can Google for the title if you like you can read it and this is page 12 and 13 that kind of sums it up. This is the foods that diabetics should avoid on the right side. Now number one, sugar, number two, starches and various examples, flour, bread, biscuits, rice, macaroni, pasta. In fact, the title of the page is foods strictly forbidden, which is now the base of the food pyramid where we have an epidemic of diabetes where the diabetics are getting sicker every year.
Coincidence? I think not. Just take a look at the left side, the good foods that’s fat, butter and olive oil, all kinds of meat, all kinds of fish, all kinds of eggs, that was supposed to be good food for diabetics about 100 years ago. Well guess what, it went beautifully for my patients, today in Sweden, they all improved their blood sugar from eating like this and usually lots of other things as well.
I would like to talk about all the studies that have tested this and actually in showing some good results but I don’t have a timeframe, you can find it on my webpage. Instead I am going to tell you how to improve this for yourself without reading the single study. This is food I ate last year and it’s a big piece of meat, bread and butter, it’s vegetables, bread and butter and it’s paleo sauce, you know what that is? That’s butter and eggy oats. So it’s a dietitian’s nightmare. It’s actually home-made. So I know what’s in that. And this is huge amount of saturated fats and a lot of protein but almost no carbohydrate, just a few grams.
So what happens to my blood sugar when I eat this? I decided to test it. And a normal fasting glucose is perhaps between 72 and 108 and that you can get up after eating food. And on the other side is time after eating after six hours. So this is what happened. Wasn’t the day an exciting evening? Nothing happened. So if you don’t eat any carbohydrates, you don’t get any glucose going into your blood stream and nothing happens to your blood sugar, it’s not really rocket science and interestingly for a comparison, I went to the International Congress of Obesity which is a huge conference for bariatric physicians and obesity researchers. Once a year about 10,000 of them go to the same place and they discuss the latest science when it comes to treating obesity. And that’s – last year it was in Stockholm, Sweden. So I went there and that’s where I ate the worst lunch I have had in years. Here is some of it and if you don’t believe me, you can see International Congress of Obesity 2010 Stockholm today’s lunch, and this is the way it looked like. There were no [orthodontists], this is what you got, if you were going to eat. So it’s sugar and there is a lot of sugar in the yogurt, it’s 14 grams per 100 gram which is a lot added sugar and then we have sugar in the natural package from the food and we had fewer starch.
Now some of you may think that this sandwich contained something really fat and nice proteins stuff but that’s not the case. This is supposed to be a tuna sandwich but I can tell you it’s here somewhere and it’s like a homeopathic dose. It doesn’t really count. I would say this is all sugar and starch and then just for comparison, this is the old me and this is the new me. You see, I was a bit shocked actually to see such a big difference. I think they are not quite used to eating lot of carbs like this but it went all the way up to 179 in an hour and then it dropped quickly. So after three hours it’s below fasting levels which is also interesting because I was feeling hungry at that time wanting to eat something and I didn’t but that’s also interesting because eating this kind of food can often I think make you hunger after a while and you eat more.
Anyway this curve, this result is still healthy according to the guidelines. If I was diabetic, it would have looked even worse. It might shock off the slide. So which kind of diet do you think you can recommend to diabetics? Because this one is not allowed according to dietitians but I think this is what diabetics should eat. And that my patients eating food like that do great in my experience. But that’s not the kind of advice that they get from doctors and from dietitians today. This is a free brochure in Swedish, it says food for diabetics and you can see there is a lot of food here and I mean paleo friends might think differently but I think that’s not the best kind of food for diabetics at least. And I think many of you would agree and it’s just kind of worse when you look in the brochure because it says that foods that raise the blood sugar slowly is good. For example, food, rice, pasta, potatoes and bread which as you remember is exactly the kind of food that was strictly forbidden a 100 years ago, exactly the kind of food that ends up in the blood stream as glucose and raises your blood sugar.
So you just saw that it raises the blood sugar, so who gives out these free brochures, do you think? In this case, it’s a drug company which is kind of interesting because what do the drug companies sell? Medicines for lowering your blood sugar and then when they give out free brochures that raise with advice that raised the blood sugar, the patients are going to get sicker and they will need more medication and the drug companies are going to make more money.
So I think this is a big problem and I think we have a lot of problems in the society today and the question I guess is this, how do we change this? It seems like it’s a hard thing to do because there is a lot of interest – lot of economic interest in this, it’s not just the pharmaceutical companies, it’s not the companies making the low-fat products, the food, and even the USDA, but US Department of Agriculture are giving out set of guidelines for every American and I don’t think that the Department of Agriculture is going to stop recommending range any time soon. So I don’t think we are going to get change from these players. I think change will have to come from the bottom, from people like us.
So how? Well, I am a believer in a viral kind of spreading of these ideas, meaning that if we have an idea, a method that works well enough and we get people to try it and they feel better and lose weight, they are going to tell their friends and their friends are going to ask them how they did it and it’s going to spread like a viral infection, but a good one. So that’s the main thing I think. And the most of course we can the media and why not new media like blogs, conferences like these, books and why not papers and the TV because (inaudible) they love story is about losing weight to getting health by diet change. So I think they are going to pick up on these and I am sure they are already doing that.
And maybe we could think something about the message. I am a big believer in the fact that – I think that the paleo community and the low-carb community can learn a lot from each other and benefits from each other. So just try to sense about this, I think it’s a good thing to focus on the health aspect, it’s not just the weight loss, this is for health. And we have lots of studies to show this. Also like a lot of people are saying now it’s a good thing to focus on real food and here I think the low-carb community has a lot to learn from paleo, because there is a lot – there is a big problem with low-carb especially in America in my experience. Dreamfields pasta, and it is of course not the only problem but it’s a very good example of the problem because this is marketed as a low-carb pasta, only it’s made from wheat like any pasta.
How is this possible? Well, they have a patent-pending process they say for making the pasta, the wheat un-digestible, so most of these carbs are going to be protected and they are going to pass through your system and only small amount of carbs are going to be absorbed. And this sounds too good to be true. In fact, I know it’s too good to be true because I tested this pasta myself and it didn’t work although you don’t have to take my word for it, because this is such a good example because this has been tested by real scientists. In a very nice journal called Diabetic Care, actually some low-carb researchers were surprised by this idea that you can eat pasta as the low carb diet. So they wanted to get the data from the company to take a look but they wouldn’t give it out.
So they had to test it themselves and they used [Campbell] and there’s who ate the Dreamfields pasta and regular pasta at different times. And they checked the blood sugar, you know what they found, they didn’t find any difference whatsoever which is amazing to me. [Carl Factor] says I think it’s not carb fact, I think it’s a carb fiction, I think it’s fairytale for people who want to eat pasta on their low-carb diets. Of course, they want to believe it. And there is lots of these low-carb fairy tales out there. Really quickly, for examples, this is bread made from wheat flour and it’s called low-carb bread, I’d say it’s a high carb bread.
Here we have an ice cream and actually really some sugar and lots of sugar, I’d say that’s a high carb product and even the Atkins company are disgracing themselves by selling Atkins cookies. You know what the biggest ingredients in these cookies are? Can you guess? It’s is wheat flour and another big ingredient is sugar alcohols. So it’s basically all carbs and this is a low-carb company selling high-carb cookies. Not good. I think we really have to focus on real foods like meat, fish, vegetables, and perhaps if you dare, butter. So I think this kind of dieting really helps a lot of people to regain their health and eat good food compared to the old advice that I think today mostly benefits corporations that make a lot of money from the status quo.
Finally, I think it’s good to focus on the fact that this is based on new science, science showing that works as opposed to the old science that said the low-fat diets would protect us from heart disease, and it didn’t work. And here I think the paleo community can benefit somewhat from the studies on low-carb because like someone lecturer said before, there is some NICE trials on paleo diets but they are pretty few, they’re quite few and pretty small. So there is a lot more science when it comes to carb restrictions for weight loss and for diabetes. And I think we are not used to that. And I think it’s a good thing like I would have said that yesterday to not to get revenges about, not to get dramatic but try to continuously update our knowledge and improving and learning from each other and by making our idea as close to perfect as possible. If we do that, I don’t think we need to fear this resistance to change. I don’t think we need to fear the cause like (inaudible).
All the forces in the world are not so powerful as an idea this time has come. And we have said, I want to leave you with the story of Ken Jacobson. Now Ken had got type 2 diabetes early in life in this forties and he gained a lot of weight, weighed 250 pounds and he got heart disease. He got heart attack after heart attack and he had seven of them. He needed a coronary bypass surgery to get new vessels to get oxygen to his heart and he needed 12 drugs every day just to control his risk factors, it was a chronic pain, he was feeling tired all the time and life was becoming pretty miserable.
Until one day little more than a year ago, when he went to the store to get food, and for some reason he started talking to a guy he didn’t know, by their counter, and they started to talk about doctor. Now this man told Kenneth that he and his wife had been eating LCHF, low-carb, high fat for life and lost a lot of weight, they felt great, and even more interesting, his wife had got rid of her diabetes. So Kenneth was intrigued by this, he got an address through the internet and he went home to read the same night. And the next day, he started to eat real food except no sugar and no starch.
Now a little more than a year later, Kenneth, he doesn’t weigh 250 pounds anymore, he weighs 185, he doesn’t need 12 drugs a day, he’s down to one. And then when he went to the doctor early this summer to get a check-up, he had normal blood pressure, he had a good cholesterol profile and even normal blood sugar with no medication. So his values were perfect. And now he enjoys his biggest interest in life, he rides his motorcycle again.
Now as a doctor in my practice, I see similar cases all the time and this is important because across the world, millions of people, if not hundreds of millions of people like Kenneth could start eating real food and improving their health. The good news is I think that soon they would do that. I believe it because the evidence is here now. The paradigm shift is coming and people like us can make it happen. So we can change the world. Thank you.