by Mark Hyman
It all started when—based on the seemingly sound advice of our government, our health care agencies, and the food industry—we cut out fat, which turns out to be the essential ingredient for health and weight loss. Then we replaced fat with sugar and carbs. In 1992, the government published its Food Guide Pyramid. At the base of the pyramid were carbs, and we were told to eat six to eleven servings of bread, rice, cereal, and pasta a day. At the tippy top of the pyramid were fats and oils, which we were told to use only sparingly. The food industry jumped on board with the low-fat craze and created everything from low-fat salad dressing to fat-free yogurt to low-fat desserts (remember SnackWell’s cookies?). And since they were low in fat (which we equated with “healthy”), you could eat the whole box—which many of us did!
Like good citizens, we listened to what our government advised, and now the average American consumes 152 pounds of sugar and 146 pounds of flour per year. Almost 20 percent of our daily calories come from sugar-sweetened beverages like soda, sports drinks, sweetened coffees and teas, and juice.1 These liquid sugar calories are far worse than solid sugar or other carb calories because they go straight into fat production and storage. They are biologically addictive, increasing your craving for more sugar.2 And since your body doesn’t recognize these calories as food, you end up consuming more total calories than you would from solid food.3 Sugar-sweetened drinks also wreak havoc on our health. In a dramatic study in the journal Circulation, researchers attributed 184,000 deaths each year to the effects of drinking these sugary concoctions. These drinks have been proven to cause obesity, heart disease, type 2 diabetes, and cancer.4
We now know from the research that sugars and refined carbs are the true causes of obesity and heart disease—not fats, as we’ve been told. Carbs turn on the metabolic switch, causing a spike in the hormone insulin, and this leads to fat storage (especially dangerous belly fat). Sugar and carbs, not fat, as you’ll see in the pages to come, are also the main causes of abnormal cholesterol. Sugar and refined carbs are the culprits behind type 2 diabetes, many cancers, and even dementia.5 As I have written about extensively in my books The Blood Sugar Solution and The Blood Sugar Solution 10-Day Detox Diet, the steep rise worldwide in type 2 diabetes and pre-diabetes directly resulted from the glut of refined carbs and sugar in our diet.
RETHINKING OUR FEAR OF FAT
When it comes to fat, we have a semantics problem. In other languages, the word for the fat we eat is different from the word for the unwanted stuff clinging to our midsections. And even within the world of fat we eat, there are many different kinds, some good and some bad. We don’t have that confusion with sugar. Sugar is sugar is sugar. All forms of sugar (with small and relatively insignificant differences) have the same negative effects on your body. It doesn’t matter if it is table sugar, high-fructose corn syrup, agave nectar, honey, or any of the other 257 names for sugar. It’s all sugar.
But fat is not fat is not fat. There are saturated, monounsaturated, polyunsaturated, and trans fats, and even within each, there are different types. Saturated fats come in many flavors, as do polyunsaturated fats (I will explain in more detail soon). Bottom line: Not all fats are to be vilified, and eating liberal amounts of the right ones will not make you fat. In fact, the right ones are key to health and weight loss!
Our views on fat, thankfully, are shifting. Over the last five years, the scientific evidence has been mounting that high-fat diets outperform low-fat diets for weight loss and for reversing every single indicator of heart disease risk, including abnormal cholesterol, diabetes, hypertension, inflammation, and more.6 In fact, the evidence has found no link between dietary fat, saturated fat, or cholesterol and heart disease.7
Joslin Diabetes Center at Harvard, one of the top diabetes centers in the world, was named after Dr. Elliott P. Joslin. In the 1920s he recommended a diet of 75 percent fat, 20 percent protein, and 5 percent carbohydrates to treat diabetes. After fat became demonized in the 1950s and 1960s, a low-fat, high-carb diet (55 percent to 60 percent carbs) was recommended by the scientists and doctors of the day. For decades, the American Diabetes Association (ADA) promoted this diet as the diabetes epidemic worsened year after year. Now researchers at Joslin Diabetes Center are once again recommending diets of up to 70 percent fat for the treatment of type 2 diabetes.8
As one example of how effective a high-fat diet can be, the head of the ADA in the Los Angeles region, Allison Hickey, had type 2 diabetes for 11 years. She followed the ADA advice, exercised, and was on injections and pills. Yet her diabetes was poorly controlled. After going on the diet I recommended of over 50 percent fat and slashing her carbohydrate intake, she got off her injections and most medications, and her blood sugar returned to normal. Her digestive problems and brain fog also disappeared.
Unfortunately, not everyone is getting the message about the importance of fat, and we still have a ways to go. The ADA is still pushing old and dangerous advice. It now recommends avoiding refined carbs but still pushes the low-fat message, even though studies have found that those who eat fatty nuts have a lower risk of developing type 2 diabetes,9 and those who add a liter of olive oil a week and consume nuts on a daily basis have a significantly lower risk of heart attacks and death.10
For years, scientists pulled out their hair trying to understand the so-called French paradox. Why could the French eat so much butter and fat and be so thin and have lower rates of heart disease? They should have been paying attention to what I call the American paradox: how could Americans eat less and less fat and yet get fatter and fatter? How did they not wonder why Americans were eating less fat and yet getting more and more heart disease? Our paradigm was so entrenched we couldn’t see it. The psychiatrist R. D. Laing said, “Scientists can see the way they see with their way of seeing.”11
I am at the intersection of scientific research and clinical practice. My life’s work has been dedicated to finding answers to my patients’ problems and keeping them healthy for life. I wrote this book to clear up the confusion and give you the skinny on fat in our diet and fat in our bodies, and to outline a plan to help you figure out exactly what to eat to lose weight, reverse disease, and get vibrantly healthy.
In Eat Fat, Get Thin, I will take you on a guided tour of fat—both the fat we eat and the biology of it in our bodies—and show you how the fat you eat actually does not make you fat. Eating more of the right fats helps you lose weight and prevent dementia, heart disease, diabetes, and cancer, all while giving you the added side benefits of improved mood, skin, hair, and nails. Sounds crazy, for sure. For decades, I believed fat was to be avoided at all costs, too, until I dug into the evolving research. Based on what I discovered, I changed how I practiced medicine and saw with my own eyes the dramatic results in my patients’ lab tests, bodies, and health. One patient, for example, increased the fat in his diet to about 50 percent of his overall food intake, and his cholesterol dropped 100 points. His triglycerides dropped 300 points in just 10 days, and his chronic asthma and reflux went away, while his energy soared.
I have uncovered some surprising facts in researching this book and testing and treating more than 20,000 patients over 30 years. I have documented my findings with many references throughout this book, so you can confirm them yourself if you find them hard to believe:
Dietary fat speeds up your metabolism, reduces your hunger, and stimulates fat burning.12
Dietary fat helps you reduce your overall calorie intake, not increase it.13
Dietary fat, and saturated fat specifically, does not cause heart disease.14
Dietary saturated fat raises the good kind of LDL (light, fluffy LDL) and raises HDL (the “good” cholesterol).15
Diets higher in fat promote more weight loss than diets high in carbs, and they are easier to stick to.16
Dietary fat reduces inflammation,17 risk for clotting, and all heart disease risk factors.18
Dietary fat improves blood vessel health.19
Dietary fat improves brain fun
ction and mood and helps prevent dementia.20
Diets very high in fat and low in carbs can reverse type 2 diabetes.21
“Good” vegetable oils (such as soy, corn, sunflower, safflower) are harmful; they create inflammation and oxidize or make your cholesterol rancid, making it more likely to cause heart disease.22
Dietary saturated fat (from butter or coconut oil) does not raise saturated fats in your blood.23
Carbohydrates—not dietary fats—turn into saturated fats in your blood, the fats that cause heart disease.24
Excess carbs stimulate your appetite and belly fat storage and slow your metabolism.25
Carbohydrates turn on the fat production factory in your liver (called lipogenesis), causing high cholesterol and high triglycerides while lowering the good cholesterol (HDL) and creating small, dense, dangerous heart-disease-causing LDL particles.26
Sugar and refined carbs—not fat—are responsible for the epidemic of obesity, type 2 diabetes, and heart disease27 and the increased risk of dementia and premature deaths.28
MY OWN TRANSITION FROM FAT TO FIT
I went to medical school in the early eighties, in the heyday of the low-fat craze. I avoided fat and recommended my patients do the same in order to lose weight and prevent heart disease. I became a vegetarian, and for ten years I avoided any animal products except low-fat yogurt and egg whites. I kept oils to a minimum and ate lots of bread and pasta (then promoted as a health food). I knew too much sugar wasn’t that good for you, but I ate plenty of whole-wheat low-fat cookies and low-fat frozen yogurt because I craved sugar and carbs. I was young and a runner, so I burned a lot of it off, but as I got older I noticed my body change. I developed love handles, my belly got a little bigger, my pant size increased two inches, and my body seemed flabby and less muscular. By the time I was thirty-five, I’d gained fifteen pounds. I studied nutrition and followed a healthy balanced diet—the same one I recommended to my patients—so I thought it was just normal aging. I didn’t eat junk food; I never had soda or processed food. I ate a whole-foods diet rich in grains, beans, fruits, and veggies and didn’t go overboard on sugar. I ate little fat. But my body just kept getting flabbier.
As the research started emerging on the dangers of sugar and refined carbs (even whole wheat bread), I cut down on sugar and carbs. But still, I feared fat, especially saturated fat, which I “knew,” as a doctor, was the cause of heart disease. If I exercised a lot (like riding my bike thirty-five miles a day), I thought I could keep some of the excess weight off, but it wasn’t sustainable.
Then, over the last ten years, as the tide turned, I began to change my own eating habits and my recommendations to my patients. I saw people lose one hundred or more pounds and reverse type 2 diabetes. I saw my patients get off insulin and optimize all their cholesterol levels not by eating less fat, but by eating more fat.
The changes in my own body were remarkable. Not only did I have more mental focus and clarity, but I lost the fifteen pounds, the love handles, and two inches off my waist, and at fifty-five years old I am more muscular and fit than I’ve ever been, while working out less; I feel younger and more energetic than ever.
Now I eat fat for breakfast without fear or guilt, with a big smile on my face and a deeply satisfied tummy. Sometimes I have whole eggs cooked in grass-fed butter or extra virgin coconut oil (high in saturated fat but super healthy), or a “fat” shake with a bunch of nuts, seeds, and coconut butter. For lunch I have a big salad with fatty sardines or wild salmon, doused in olive oil and sprinkled with fatty pumpkins seeds or pine nuts; and for dinner I might have grass-fed lamb without the fat cut off, and three or four veggie dishes cooked in olive oil, lemon, and spices and salt.
When I traveled to Tibet in my twenties, I was invited into the yurts of nomads and fed salty yak butter tea (actually it is dri butter—from the female yak), which was deeply satisfying and kept me going for a long time at high altitudes. And sometimes now I have the American version created by my friend David Asprey, Bulletproof Coffee—coffee blended with butter and MCT oil from coconut (a super fat that is a super fuel for your brain and your body). One close friend in medical school was an Arctic explorer who cross-country skied to the North Pole while living on sticks of butter for fuel. He was remarkably healthy and way ahead of his time.
Eating a high-fat diet—especially a diet high in “dangerous” saturated fat—sounds crazy, and up until ten years ago, I would have told you it was a health hazard. But my own body, my own blood work, and thousands of my patients and tens of thousands of others who have followed this approach in my online community all tell the true story. They all report the same benefits from welcoming fat back into our diets. And the emerging research on fat and health, which we will nerd out on in this book (sorry, I love the science… I can’t help myself!), supports these benefits.
LET’S TALK ABOUT YOU
There are lots of fascinating findings and facts throughout this book that will surprise you, and I’m looking forward to sharing every one of them. But before we get to that, let’s talk about the real reason you’re here: You want to know how to lose weight and feel great. The program in this book will get you there, but before you embark on your journey—as with any journey—it’s helpful to get a sense of where you are starting from when it comes to carbohydrates, fats, and your health.
As many of you know, I have written extensively about diabesity, which is the comprehensive term I use for the range of problems and diseases caused by blood sugar and insulin imbalances. Diabesity runs the gamut from having a pooch of extra belly fat to obesity, from moderately high blood sugar to pre-diabetes to full-blown type 2 diabetes. All the problems on this spectrum can have deadly consequences.
Diabesity is a disease of carbohydrate intolerance. Just as some people are gluten intolerant, many are carbohydrate intolerant. For those people, carbs drive a hormonal and brain chemical chain reaction that makes it almost impossible to lose weight or get healthy.
Diabesity affects 1 out of every 2 people in this country, 1 in 2 Medicare patients, and 1 in 4 teenagers. It affects skinny people, too! Twenty-three percent of adults look skinny but are what doctors call metabolically obese normal weight, or TOFI (thin on the outside, fat on the inside). Ninety percent of people with diabesity are not diagnosed… so there’s a good chance that you have it and don’t even know it. And it’s the very thing standing in your way of losing weight and living a long, healthy life.
Are You Carbohydrate Intolerant?
If you answer yes to any of the following questions, you may be carbohydrate intolerant and already have diabesity or be heading in that direction. But the higher the score, the worse your carbohydrate intolerance, and the more you’ll benefit from the Eat Fat, Get Thin program:
For questions 1 to 9, score 1 point for a “yes” response.
For questions 10 to 13, score 2 points for a “yes” response.
1. Do you have a family history of diabetes, heart disease, or obesity?
2. Are you of nonwhite ancestry (African, Asian, Native American, Pacific Islander, Hispanic, Indian, Middle Eastern)?
3. Do you have trouble losing weight on a low-fat diet?
4. Do you crave sugar and refined carbohydrates?
5. Are you inactive (less than thirty minutes of exercise four times a week)?
6. Are you overweight (body mass index, or BMI, over 25)? (Go to www.eatfatgetthin.com to calculate your BMI based on weight and height.)
7. Do you have heart disease?
8. Do you have high blood pressure?
9. Do you suffer from infertility, low sex drive, or sexual dysfunction?
10. Do you have extra belly fat? Is your waist circumference greater than 35 inches for women or greater than 40 inches for men?
11. Has your doctor told you that your blood sugar is a little high (greater than 100 mg/dl) or have you actually been diagnosed with insulin resistance, pre-diabetes, or type 2 diabetes?
12. Do you have high le
vels of triglycerides (over 100 mg/dl) or low HDL (good cholesterol) (less than 50 mg/dl)?
13. For women: Have you had gestational diabetes or polycystic ovarian syndrome?
If you score more than 5, you have advanced carbohydrate intolerance or diabesity and would do better on the Eat Fat, Get Thin Plan until your score improves to less than 5 (based on your labs, waist size, blood sugar, blood pressure, etc.). If you answer yes to any question but score less than 5, you may still have carbohydrate intolerance and benefit from the Eat Fat, Get Thin Plan. In fact, it is worth it for anyone to try because of all the plan’s other benefits in addition to weight loss and reversing diabesity.
Even if you score 0, the plan is worth trying for all the plan’s other benefits.
Do You Have FLC Syndrome?
In addition to carbohydrate intolerance, millions of Americans (and people around the world) have FLC syndrome—that’s when you feel like crap! What most of us don’t know is that this is directly related to the food we eat. Food can harm us or it can heal us. Whole, real, low-glycemic (low in sugar and refined carbs), high-fat (good fat), phytonutrient-rich food heals, while high-carb, low-fat, processed foods harm. And it is not just that you feel bad. The underlying inflammation and hormonal imbalance driven by eating the wrong foods drive not just symptoms but diseases and accelerated aging.
Take the following quiz to find out where you rate on the FLC scale. For the “before” part of the questionnaire, rate each of the symptoms based upon your health profile for the past thirty days. You’ll take this quiz again after the twenty-one-day Eat Fat, Get Thin program. But without a baseline score, twenty-one days from now you may have a hard time believing just how different your “after” results are.