Wortman: Maintaining 'Status Quo' On Diet And Health Causing Irreversible 'Inertia'

Researcher Dr. Jay Wortman talks tough about low-carb diets

One of the most fascinating researchers of the low-carb lifestyle today comes straight from the Canadian province of Alberta. His name is Dr. Jay Wortman and he has been working with the First Nations from coastal British Columbia--one of the recognized aboriginal groups in Canada--about improving their diet. His interest in livin' la vida low-carb was borne out of a personal health crisis that afflicted him five years ago which he will discuss in my exclusive interview with him today. This man has a lot to say that will have you standing to your feet cheering in affirmation. Now if we can only get government and health leaders to heed this message.

1.  We are pleased to welcome to the "Livin' La Vida Low-Carb" blog today a Metis physician from Canada named Jay Wortman. Dr. Wortman is a behind-the-scenes researcher looking into why low-carb diets work so well not just for weight loss, but also disease management.  Something personally happened in 2002 that caused you to totally change your thinking about diet and nutrition forever.  What was it and how did you initially respond to it?

I have a strong family history of Type 2 diabetes, as do most Aboriginal people. My grandparents, my mother and her siblings and my younger brother all have had Type 2 diabetes and, five years ago, I discovered I had it, too. I was quite familiar with diabetes from my training and clinical experience. You might say I knew too much as I was immediately concerned about the poor prognosis and shortened life expectancy that is common among Aboriginal people who suffer from Type 2.

I am also averse to the use of pharmaceuticals if other measures can be used instead. I wanted to buy some time in order to decide how I was going to manage my problem so I started avoiding any foods that would cause my blood sugar to rise. I immediately started to eat a very low-carb diet without really any knowledge of this kind of approach. Much to my surprise, I experienced immediate positive changes: my symptoms disappeared and my sugars corrected, as did my blood pressure, which had been high, and I started to feel much better. I started losing about 1 pound a day and it was actually my wife who said, “you are on the Atkins diet, dummy!"

I started looking into it and discovered that everything I had believed about diet, diabetes and obesity was likely wrong. My experience in the intervening five years has solidified my belief that obesity, metabolic syndrome, diabetes and probably cardiovascular disease are all part of a disease continuum that is caused by eating carbohydrates in excess of one’s tolerance. And the flip-side is, of course, that all these conditions can be prevented or treated using a low-carb diet approach.

2.  The sudden onset of Type 2 diabetes has become one of the most prevalent health issues of modern society and yet even the most respected organizations in that community, including the American Diabetes Association, still heavily promote a low-fat diet for treating this condition.  As an expert in diabetes as well as someone actually living with this disease, you have an obvious disdain for the tactics employed by the pharmaceutical companies who are convincing many diabetics they need medication to treat their disease.  But we have seen from a series of recent research studies that livin' la vida low-carb can and will help control and, dare say, even CURE the impact of this condition for good!  What dietary methods have you found work best for you to control your blood sugars and manage your diabetes and why isn't this way of eating more heavily promoted to both Type 1 and Type 2 diabetics?

I have followed a very low-carb diet for five years now and have been able to maintain good biomarkers without the use of any medications. It seems perfectly obvious to me that the need for pharmaceuticals to control blood sugar is almost completely determined by the amount of carbohydrate foods consumed. People need the medications in order to eat carbs.

Avoiding carbs basically obviates the need for the medications (unless you are Type 1 or have reached the point where you have burned out your capacity to produce insulin). Of course, if this option were clearly articulated to people, the sales of medications would drop dramatically, so it is convenient that the myth of a minimum daily requirement for carbs is perpetuated. The cynics among us might conclude that the interests of the pharmaceutical industry are driving the dietary approaches and clinical guidelines promoted by the diabetes organizations.

3.  In discovering this natural diet that has kept your diabetes in check, it was your wife who pointed out to you that you were following the Atkins diet.  What did you know about the Atkins diet at the time and did this revelation light the fire within you to begin educating yourself and researching further the amazing health benefits of low-carb living?

After the birth of our son, like many new moms, my wife struggled to get down to her pre-pregnancy weight. She tried different diets and, at one point, brought home an Atkins book. I reacted the way I was taught to by saying something like, “go ahead and try it but these fad diets don’t work over the long haul."

Then when I had my epiphany, she dusted off the Atkins book for me to read. I also started looking into the scientific literature and came across the studies that were just starting to get published back then. I was able to find good evidence that convinced me that this approach that I had stumbled upon, actually had a solid basis both in science and in clinical experience.

4.  Your specific area of interest is the astronomically high rate of Type 2 diabetes among Aboriginal people because they've moved away from their original diet which was actually a very low-carb diet.  With all the health benefits that are being discovered regarding livin' la vida low-carb in recent years, how can government and health officials continue to ignore the evidence that is staring them right in the face while epidemics such as obesity, diabetes, and worse continue spiraling out of control all across North America and around the world?

This is a question I ponder on a daily basis. I feel like I am on a train hurdling down the tracks with the knowledge that, around the corner, the bridge is out and I am frantically trying to stop the train but I am unable to convince those who have the power to apply the brakes of the danger ahead. I think there is a widespread malaise that has been allowed to permeate the institutions of nutritional science, the research community and the areas where nutritional policy is formulated. It is an environment where corporate interests are too close to and influential over what should be an unbiased research agenda.

Governments are run by people who are not content experts and who rely on the “experts” to advise them. As long as the overwhelming majority of the “experts” on nutrition are produced by this system, the status quo will be defended and in the eyes of government their advice will overwhelm anything new and radically different that might emerge, regardless of how correct the new approach might be. In addition, governments have mandates that go beyond nutrition and health to include looking out for the economic interests of the corporate world. This is another area where government is lobbied to maintain the status quo. All this adds up to an inertia that is proving very difficult to overcome.

5.  In addition to the writings of the late Dr. Robert C. Atkins, you were influenced by a man I interviewed at my blog last year named Dr. Eric Westman from Duke University.  It was his first low-carb study that really opened your eyes to what low-carb living can do to help improve health as well as reduce weight.  When you spoke with Dr. Westman for the first time, what was your impression of this man's research and did you know right away that you wanted to join him in conducting even more follow-up research on this somewhat controversial diet plan?

Eric’s 2002 study was the first one that I encountered in the literature. I was able to track him down and proposed that we do a similar study in the Canadian Aboriginal population. I found Eric to be a fine person and very generous with his time and expertise and we have since been able to foster a productive collaboration. He is one of the co-investigators on the project I currently have underway in a Canadian First Nations community.

6.  You have been able to conduct some rather extensive research on low-carb diets since August 2006 alongside Dr. Westman as well as other notable low-carb researchers Dr. Steve Phinney and Dr. Mary Vernon (who I also interviewed last year).  In that specific study, you have been looking at the Aboriginal people and placed them back on the traditional diet that was low in carbohydrates to see if there would be any improvements in their health, including with obesity, metabolic syndrome and Type 2 diabetes.  Can you tell my readers a little more about the preliminary results of the study so far and share about something rather peculiar that has happened among the family members of the study participants?

I have been fortunate to be able to collaborate with Drs. Westman, Phinney and Vernon, all of whom have done significant research in this area. They have helped me design a study where First Nations people eat a diet resembling their traditional diet. In this part of the world, the traditional diet consisted of fish, seafood, game and some edible wild plants, all of which were low in starch and sugar content. They ate a low-carb diet. In modern times they eat huge amounts of refined carbohydrate foods and are paying the price in terms of high rates of obesity, metabolic syndrome and Type 2 diabetes.

Our study guides them back to a diet low in starch and sugar which also offers their traditional foods or modern foods of similar macronutrient content. For instance, if they don’t have moose, they can eat beef or pork or chicken. The main thing is that they are eliminating that high volume of carbs which was not a part of their traditional diet. As you might expect, their preliminary results are good with significant weight loss and improved sugars and lipids.

The unexpected thing for me was the amazing enthusiasm that this community has shown for the study. Spontaneous support groups sprang up, community feasts started featuring low-carb tables, the local store shifted their purchasing to accommodate the dieters, the liquor outlet reported declining alcohol sales and we estimate that a huge number of people have started doing the diet without bothering to join the study.

I have had numerous reports that there is a palpable shift of attitude there, that people suddenly have hope where, in the past there was a sense of resignation. The study is designed to follow weights and biomarkers, of course, so I am now struggling to figure out how to document these other important benefits.

7.  The low-carb diet has been taking a serious beating in the media and among so-called health "experts" over the past couple of years being labeled a "fad," "dangerous," and even "unhealthy."  With all that you have learned about this way of eating and how it has made an impact on your life personally, what can be done to change that perception in the minds of the people who have been convinced diets like Atkins, The Zone, Protein Power and the like are all that and worse?  Also, do you see a day coming soon when low-carb will be accepted as a healthy nutritional approach alongside or even in lieu of low-fat diets?

I think it is incremental. By that, I mean that every little bit of evidence and every little effort helps and that, in the end, the weight of the evidence will eventually tip the scales. This is why I am a prolific writer of letters-to-the-editor and why I think a blog such as this one are important.

As an example, the JAMA article on the A to Z study, which is getting significant media coverage this week is going to turn a few heads. People who observe the research and who may have been unconvinced up to now will start to swing over. It is also important in that it is a well designed and well funded study published in a mainstream journal. This will help others who want to do more in this area to obtain funding and access to the credible journals. It’s all good even though it seems maddeningly slow at times.

8.  You wrote in the Health Promotion Journal Of Australia in August 2006 that the obesity "vaccine" that has been perpetrated on our society has not worked--namely the low-fat diet in combination with exercise.  The definition of insanity is when you continue to do the same thing over and over again expecting a different result.  So how many more years of insanity must we continue to put up with before we as a people demand that enough is enough?  How are the economic interests of the food industry, for example, tied to this insane position we currently find ourselves in?

It is remarkable that when you take the macro view it is so clear that the problems of obesity and related diseases have progressively worsened while we have been subjected to the low-fat/low-cal/increased exercise mantra over the same period of time. It is amazing to me how people can ignore something so obvious. Of course, pointing out this contradiction doesn’t endear me to my mainstream nutritionist colleagues who cling to the currently accepted approach.

I was surprised at first at the willful blindness when it came to discussing evidence and at the emotionality of the attacks I would experience when I did presentations on this topic. This is nothing new to other colleagues who have been at this for much longer but it came as a surprise to me that people who have university educations, where we are supposed to have developed critical thinking skills, can be so dogmatic in their beliefs.

Clearly, the relationship between the agri-food sector and the schools of nutrition and research centres creates an environment where avenues of research that might have negative bottom-line effects can be stifled. It is rare to see nutritional science researchers who have not been the beneficiaries of some kind of funding from the big food products companies or the agricultural marketing boards.

In the area of pharmaceuticals there is some public awareness that this can lead to undesirable outcomes but in the area of food and nutrition policy we seem to remain blissfully in the dark. Perhaps when this begins to change we will see more unbiased nutritional policy developed with low-carb options promoted alongside other choices.

9.  If we continue down this path of destruction with our health without making any changes in the way we eat and live as a society, then what do you foresee happening to modern civilization in the next 50 years?  Some researchers are already predicting 100% obesity by that time which will mean higher mortality rates, greater risk of diseases like diabetes, cancer, and heart disease, and worse.  Is excessive consumption of carbohydrates going to spell the end of the world as we know it?

While the current trend is clearly pointing us in a bad direction, I don’t have an apocalyptical view of the future. Carbs are not going to wipe out the human race. I expect we will eventually come to the realization that a shift in eating patterns is needed. The evidence is continuing to accumulate in the scientific literature and eventually we will reach a tipping point.

One area that intrigues me is the effect of these epidemics on the bottom-line in the wider corporate world. Consider, for instance, that Ford spends about $4 billion annually on health care, of which about $2. 5 billion is for retired employees. This is more than they spend on steel for their cars. Couple that with the cost of lost productivity related to poor health, absenteeism, poor performance, etc. etc. and multiply it across the American industrial sectors and the numbers would be astronomical.

We have enough evidence in the scientific literature now to figure out how much health should improve if this workforce went on a low-carb diet. It should also be possible to calculate what the savings in improved productivity and decreased health costs would be. If we could get corporate America to see the benefits and to promote this among working Americans we might see some change. This is an area I have wanted to pursue but there aren’t enough hours in the day to do everything, unfortunately.

10. THANK YOU, Dr. Wortman, for joining us today for this very important discussion about low-carb diets and their place in the future health of modern society.  Thinking about what may happen if the current philosophy on diet and health remains unchanged can be quite depressing to those of us who have discovered the benefits of the low-carb lifestyle.  Do you have any encouraging thoughts to share with supporters of livin' la vida low-carb that will motivate and inspire us to be proud of our dietary choice?

I get my inspiration from the wonderfully brilliant and inquisitive colleagues I am so fortunate to have found in this area and from the often incredible effects I see when somebody gets on a low-carb diet and starts getting their health back.

You can e-mail Dr. Jay Wortman and show your appreciation to him about his phenomenal research on the low-carb diet at wortman.md@gmail.com.