Yellowish Nodules on a Man Consuming a Carnivore Diet
jamanetwork.com
jamanetwork.com
RE: "6 to 9 lb of cheese, sticks of butter, and additional fat incorporated into his daily hamburgers"
This implies a daily intake of hamburgers (presumably ground meat only if it's a strict carnivore diet) with 6-9 pounds of butter and cheese extra per day? Is that time frame correct? Is there an approximate daily kcal for that? A pound of butter is 3200 calories, while a pound of mozzarella is 1200.
(1) https://www.sciencedirect.com/science/article/abs/pii/004896...
I was going to make a joke sbout how I'd bet this gentleman lived in Florida...
... but it seems like 2/3 authors are in Tampa, with the other in Houston.
Florida Man is a thing. (So glad I don't live there anymore)
I've likely had orders of magnitude more cheese and butter than this guy, and I've yet to have yellow nodules or the 10 heart attacks I apparently should have had by now. Both of us are N=1 case studies, so basically meaningless outside of identifying a particular clinical condition.
I assumed the excess protein would be undigested, but can't back that up with a citation.
I don't think someone here is lying. There may be some level of exaggeration, as in my experience a lot of cheese (particularly hard cheeses) can lead to extremely painful stools, but calories really aren't as meaningful as one might assume, especially when switching from a diet that directly supplies carbohydrate and one that doesn't.
The human body needs a certain amount of glucose in the blood, but it can't get that from fats (at least as far as I am aware). It can obtain it from protein through a process called gluconeogenesis, but that's a relatively expensive process that requires more ATP than what ultimately results from it. The human body also treats that process in a more demand-driven manner than one where exogenous carbohydrates are consumed. This isn't an absolute, but it's generally less supply-driven. If protein can't be used for glucose or building tissue, it's more likely to become waste eventually.
See "rabbit starvation":
https://hekint.org/2022/01/26/rabbit-starvation-protein-pois...
If it were a given that eating lots of fat leads to extremely high levels of cholesterol, my irises would look at bit strange by now at the very least.
Now excuse me while I go eat about a pound of eggs and cheddar cheese for breakfast. (not a joke)
You slice it in small pieces. And add some wine. And a friend to call 911. /s
Heterozygous FH will typically put someone at a total cholesterol roughly around 500mg/dl, and homozygous will get them closer to the 1000mg/dl mark. Dietary factors for most people will affect their lipids up to +/- 40mg/dl, and medication is generally required for anything beyond that.
For the gentleman with cholesterol nodules, that’s a not-unheard of symptom of homozygous FH and the associated cholesterol levels. I’m sure his diet is exacerbating it, however I would be genuinely surprised if that were the primary cause of his count being > 1000mg/dl. (With homo-FH and an extremely restricted diet, he’d still be unlikely to get below 900mg/dl)
It's quite possible that it's a combination of diet and genetics, but people can quite easily get to incredibly harmful LDL levels with diet alone.
Edit: here's a case study of someone getting to TC of 488.7mg/dL. I think you'll struggle to get higher quality data than case studies because these kinds of diets are (thankfully) fairly uncommon and no ethics board is going to sign off on an intervention study that's likely to raise blood lipids by this kind of level.
https://academic.oup.com/jes/article/5/Supplement_1/A37/6240...
> …significantly higher than his baseline of [sic] level of 210 to 300
so they measured before and 8 months after the diet change to find a 4x increase in cholesterol
In normal situations (enough food to be found) that means they eat some bugs on a daily basis. In bad situations (not fruit to be found), they are known to hunt for small vertebrates.
Besides fruit they eat a lot of green leaves, but due to the low caloric content of leaves this is often left out.
We humans probably have a similar species diet to them. But we also have tradition, and moved to colder climates by using a technologies know as "grain" (domesticated grasses with artificially large seeds) and "cooking".
Every species can find their food in nature. It will look tasty to them and they can eat it without cooking.
This man's symptoms are not so weird. We're not meat+dairy eaters (no animal takes dairy after the weaning stage, that only mammals have).
Meanwhile a lot of humans have no trouble subsisting of just a carnivore diet without any negative symptoms.
It's pretty accurate to call humans omnivores.
As said: all primates are omnivores. And what you eat is up to you. But biologically we are very close GI-wise to the "frugavorian omnivore" primates mentioned.
> Humans aren't specialized for eating plants and especially not green leaves. That requires a wholly different type of metabolism.
Where's your research? I mean we are not grass eaters, like cows. But we do really well on tender green leaves. If you dont eat tender green leaves 2x per day you are advised to take a magnesium supplement.
> Meanwhile a lot of humans have no trouble subsisting of just a carnivore diet without any negative symptoms.
Where's the long term research? Many claim this, but the populations that have many centenarians are not carnivores. Populations with really high meat intake (Inuit), do not get very old. Many biologists agree our intestine is too long (ans several other reasons I forgot). You seem to have no case here.
Are you sure you are not falling for the diet fad wrt carnivoreism?
You have any large studies to support this or just "Trust me bro" science based around the idea that consuming other animals makes ya stronk?
There are plenty of dietary studies and science which show that a high meat diet is pretty unhealthy over the long term. GI and colon cancers rates go up, heart disease goes up, along with other cardiovascular diseases, diabetes, etc. Lots of very preventable diseases are VERY prevalent in high meat diets.
You can always find individuals who buck this trend but over a large number of people the data is very clear that a high meat diet tends to be pretty unhealthy for most people.
I grew up near logging towns and the whole "carnivore diet" cult thing reminds me of when rural men will drink motor oil to prove how it doesn't hurt them. They're a stronk guy who will survive anything.
Everyone will have a little bit of plaque, even if you try to eat well. Teenagers will already have traces of it before they reach adulthood. All you can do is try to slow down the buildup. And, well, this ain't it.
This review paper is a really good overview of the model, and it's actually pretty approachable: https://academic.oup.com/eurheartj/article/41/24/2313/573522...
https://www.health.harvard.edu/heart-health/ask_the_doctor_i...
My understanding is that we don't have contemporary evidence of people successfully reverting arterial plaque, but I admit the studies probably didn't faithfully reproduce these starvation conditions!
https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.120.0...
... not 1000 mg/dL.
/s
Another reason is that for about 300 years people in Europe who did things that made their neighbors tremble in horror† had to flee for their lives, and a lot of them fled to parts of America including Argentina and the US. Consequently the US is rather full of people who are inclined, culturally or possibly genetically, to put whatever crazy ideas they happen to believe into actual practice rather than following tradition or majority opinion. Diet fads in the US go back at least 200 years.
Myself, I dropped 17 kg on a carnivore diet starting a couple of years ago, and I've kept it off on a much more mixed diet since then.
______
† Quakers, Puritans, Anabaptists, Old Believers, Jews, etc.
If the thesis is that obesity came from removing saturated fat from the diet, why is it that there wasn't problems with obesity during WWII when saturated was strictly rationed out of the general populations diet?
I mean, FFS, magazines sold magic powders to woman to help them become fatter. (Being too skinny was seen as unattractive).
That thesis is clearly wrong, though there are still people who believe it. If you want to spend ten minutes getting better informed, you can read a chapter-length thorough rebuttal at https://slatestarcodex.com/2020/03/10/for-then-against-high-.... Reading the sources it cites will take you longer than that. But the very simple explanation is that it is well known that traditional diets that do not produce high levels of obesity include many different levels of both fat intake and saturated-fat intake. Whatever is unique about the modern industrial obesogenic diet of ultra-processed foods, it isn't that it contains uniquely low levels of saturated fats.
The research behind ultra processing has legs from what I've read. My none expert take is that it has more to do with the fact that portion sizes are larger and caloric density is higher.
It doesn't take long to find videos of people from all over the world visiting the US and commenting on how much food is served.
That also jives with why drugs like semaglutide work so well at reducing weight.
Large portion sizes are real, but they are downstream of whatever is unnaturally increasing US appetites. Restaurants, housewives, and househusbands in the US don't serve 1500-kcal meals because they're in some kind of conspiracy to fatten your kids up for slaughter. They serve them because people complain if they don't.
The "ultra-processed" meme is clearly pointing at something critical, but it can't itself be the answer, because it's ontologically incoherent. As the post I linked above says:
> I’ve previously found [this meme] frustrating – it reeks of a sort of unreflective technophobia. What part of processing makes food bad? How does mere contact with a machine turn food from healthy to unhealthy? What food counts as “processed” or “not processed”? Is ground beef processed, since you grind it? Are scrambled eggs processed, since you scramble them? Is bread processed, since wheat doesn’t grow in loaves? Is water processed, since it goes through water processing facilities? Is the Eucharist processed, even though the processing only changes its metaphysical essence and not its physical properties? Everybody I ask acts like the answers to these questions are obvious, but everyone has different answers, and nobody can tell me their decision procedure.
So, is it corn? Missing micronutrients? Industrial polysaccharide thickeners? Fungicides like propionate? Nanoparticles of titanium dioxide? Antinutrients like phytate and citrate reducing bioavailability of polyvalent-cation micronutrients? Some combination? Lots of people have promising hypotheses but nobody knows. Anybody who claims to know is either lying or insane, often both.
I think we have some experimental evidence to suggest that at least some of the UPF associations are due to texture - those foods that you can basically inhale without chewing seem to drive higher caloric intake. We also have an incredibly strong signal of mass gain from sugar sweetened beverages which are also easy to consume with minimal effort.
I think it’s likely that cultural and economic factors play into this too. Japan has the same proliferation of UPFs, yet does not suffer the same obesity effects as the West does. There are probably a number of things that play into this: Japan has an incredible children’s food education policy, and they presumably have a different culture around food (many western cultures emphasise a “finish your plate or you’re ungrateful” approach).
I also have an intuition that the rise of two income households raising children is a factor in this. It’s a lot to ask of a couple that they both hold down full time jobs while cooking the kind of meals that used to be the domain of a stay-at-home parent.
Really interesting area to think about in terms of research and policies, but as you say we just don’t have strong evidence at the moment.
In the meantime it’s great that GLP-1 agonists are available to reduce the damage done, but it’s a shame we have to resort to such things in the first place.
The changes in behaviour are also really interesting. Even after cessation of the drug, it seems like many patients keep healthier eating patterns and while they do put on weight, they tend to settle on a lower weight than baseline before intervention.
So we should absolutely keep an eye on outcomes as time goes on, but so far the results are overwhelmingly positive. These drugs are saving lives and the new ones in the pipeline look significantly more effective. It’s an exciting time to be alive!
Pushing a new diet drives a ton of revenue. Advertising, TikTok, talk content, experts, books, etc.
There's a financial reason Dr. Oz was always on about some batshit crazy new one.
You can see it in TV advertisements too. Once meat consumption took off in the US there was a proliferation of antidiarrheals, antacids, and other medications to deal with the symptoms of a high meat diet. You can see it on TV advertisements. Kind of interesting.
Even today, a high meat diet is a status symbol in the US.
"Avoid saturated fat" "nuh uh our ancestors were alpha males that ate nothing but raw meat and black coffee, we must have evolved for that diet!"
People fall for it because people like eating meat and there's enough bad studies to cherry pick to support that position.
It's not unlike a family member of mine who falls for every woo scam because whatever is being peddled from drum circles to breathwork makes them feel good so of course they spend $3k to become a "professional sound bath instructor".
American culture is increasingly distrusting experts and worshipping flim flam artists because they make a compelling podcast or YouTube video.