A talk by Tim Noakes. Original slides available here: http://www.health.uct.ac.za/centenary/past_events/centenary_debate/

1. @ProfTimNoakes
Slides available on www.health.uct.ac.za
Professor TD Noakes OMS, MBChB, MD, DSc, PhD (hc), FACSM, (hon) FFSEM (UK)
Discovery Health Professor of Exercise and Sports Science
MRC/UCT Research Unit for Exercise Science and Sports Medicine,
University of Cape Town and
Sports Science Institute of South Africa

3. Economic Within 5 years of The presence of A high fat diet
considerations the widespread the genetic reverses
drove the adoption adoption of these predisposing allknown
of the current guidelines rates of condition, coronary risk
dietary guidelines diabetes and carbohydrate- factors in persons
without proper obesity increased resistance, with carbohydrate-
scientific explosively. explains why large resistance
evaluation or numbers of whereas a high
proof. persons in carbohydrate diet
predisposed worsens those
populations factors.
become obese and
diabetic when
exposed to a high
carbohydrate diet.

4. TODAY 2.5 - 3.5 MILLION
YEARS AGO
Omnivore Vegetarian
Homo sapiens Australopithecus Africanus

5. This change For 3.5 million years
occurred as humans we have done very
became the best well without being
mid-day persistence told what we should
hunters in the eat
animal kingdom

6. TRIBE / COUNTRY HEIGHT (cm)
Cheyenne 176.7
Arapaho 174.3
Crow 173.6
Sioux 172.8
Blackfeet 172.0
Australia 172.0
Canada 171.0
United States 171.0
Norway 169.0
United Kingdom 166.0
Russia 165.0
Italy 161.0
PLAINS INDIANS HUNTING BUFFALO BEFORE
THE ARRIVAL OF THE WHITE MAN
Steckel RH, Prince JM. Tallest in the world: Native Americans of the
Great Plains in the nineteenth century. Am Econ Rev 2001; 91: 287-294.

7. MODERN PLAINS INDIANS HUNTING
THE WHITE MAN’S DIET

8. THE COUNTRIES WITH THE HIGHEST PERCENTAGE
OF OBESE ADULTS
Rank Country Adult obesity (%)
1 Nauru 78.7
2 Samoa 74.8
3 Tokelau 63.2
4 Kiribati 50.3
5 Marshall Islands 46.0
6 Federated States of Micronesia 44.0
7 French Polynesia 40.4
8 Saudi Arabia 36.1
9 Panama 33.9
10 United States 33.7
11 United Arab Emirates 32.8
12 Iraq 32.2
13 Mexico 29.4
14 Kuwait 29.0
15 Egypt 28.9
16 Bahrain 28.5
17 New Zealand 25.4
18 Macedonia 25.3
19 Seychelles 25.1
20 Australia 24.8
21 United Kingdom 24.0

9. ANCEL KEYS (1904-2004)
8
7 US
Canada
6
CHD (deaths per 1000)
Australia
5
4 England & Wales
3
2
Italy
1
Japan
0
0 10 20 30 40 50
Percent calories from fat

10. CHANGES IN CIGARETTE CONSUMPTION MATCHES
THE CHANGING INCIDENCE OF HEART DISEASE
40 All heart disease 5000
Cigarette consumption
35
4000
Cigarettes per capita per year
Annual deaths per 100,000
30
25 3000
20
15 2000
10
1000
5
0 0
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010
Year

11. COUNTRIES WHERE DATA WERE AVAILABLE
WHEN KEYS PUBLISHED
8
US
“….the evidence from 22 countries for which data are available
7 Finland Canada
US
Canada
indicates that the association between the percentage of fat
6
Australia
CHD (deaths per 1000)
Australia
calories available for consumption in the national diets and
5 NZ
Ireland
mortality from arteriosclerotic and degenerativeGreat Britain
4
Israel heart disease is
England & Wales
not valid; the association is specific neither for dietary fat nor
Switzerland
W. Germany
Sweden
3 Chile
for heart disease mortality. Clearly this tenuous association
Italy Italy Norway
2 Portugal Holland
cannot Japan as much support
serve Italy for the hypothesis which
1
etiologic factor France
implicates fat as anCeylon Denmark in arteriosclerotic and
Japan Mexico
degenerative heart disease.”
0
0 10 20 30 40 50
Percent calories from fat
Yerushalmy J, Hilleboe HE. Fat in the diet and mortality from heart disease; a methodologic note.
N Y State J Med 1957; 57: 2343-2354.

12. “….the evidence from 22 countries for which data are available
indicates that the association between the percentage of fat
calories available for consumption in the national diets and
mortality from arteriosclerotic and degenerative heart disease is
not valid; the association is specific neither for dietary fat nor
for heart disease mortality. Clearly this tenuous association
cannot serve as much support for the hypothesis which
implicates fat as an etiologic factor in arteriosclerotic and
degenerative heart disease.”

13. RICHARD NIXON
APPOINTS EARL “Food Bill” insures that US
BUTZ AS farmers receive $5 billion per
SECRETARY OF year to grow corn and soy.
AGRICULTURE An additional $5 billion for
other farmers.

14. “Food Bill” insures that US
farmers receive $5 billion per
year to grow corn and soy.
An additional $5 billion for
other farmers.

15. • Reduce consumption of fat
• Switch from saturated fat to vegetable fats
• Reduce cholesterol to 1 egg per day
• Eat more carbohydrate, especially grains
The McGovern Report was written by a junior staffer, a
vegan, who had no training in the nutritional sciences.

16. UNITED STATES SENATE SELECT COMMITTEE ON
NUTRITION AND HUMAN NEEDS (1968-1977)
“What right has the federal
government to propose that the
American people conduct a vast
nutritional experiment, with
themselves as subjects, on the
strength of so very little evidence?”
Philip Handler, National Academy of Science

17. UNITED STATES SENATE SELECT COMMITTEE ON
NUTRITION AND HUMAN NEEDS (1968-1977)
“Resolution of this dilemma turns on
a value judgment. The dilemma so
posed is not a scientific question; it is
a question of ethics, morals, politics.
Those who argue either position
strongly are expressing their values;
they are not making scientific
judgments”.
Philip Handler, National Academy of Science

18. UNITED STATES SENATE SELECT COMMITTEE ON
NUTRITION AND HUMAN NEEDS (1968-1977)
“…a trial of the low fat diet recommended by the McGovern
Committee and the American Heart Association has never
been carried out. It seems that the proponents of this dietary
change are willing to advocate an untested diet to the nation
on the basis of suggestive evidence obtained in tests of a
different diet. This illogic is presumably justified by the belief
than benefits will be obtained, vis-à-vis CHD
prevention, by any diet that causes a
reduction in plasma lipid levels”.
Ahrens EH. Dietary fats and coronary heart
disease: unfinished business. Lancet 1979; 2: 1345-1348.

19. 2010:
…no significant
evidence for During 5-23 y of follow-up of
concluding that dietary 347,747 subjects, 11,006
developed CVD or stroke.
saturated fat is Intake of saturated fat was not
associated with an associated with an increased
increased risk of risk of CHD, stroke or CVD.
Consideration of age, sex and
coronary heart disease study quality did not change
or cardiovascular the results.
disease.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the
association of saturated fat with cardiovascular disease. Am J ClinNutr 2010; 91: 535-546.

20. 2011:
There were no clear
effects of dietary fat
changes on total mortality
or cardiovascular mortality.

21. CONSUMPTION OF ANIMAL FAT IN USA FALLS AS
INCIDENCE OF HEART DISEASE RISES
40 All heart disease 15
Animal fat
35
Pounds animal fat per year per person
Annual deaths per 100,000
30
10
25
20
15
5
10
5
0 0
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010
Year

22. Economic Within 5 years of The presence of A high fat diet
considerations the widespread the genetic reverses
drove the adoption adoption of these predisposing allknown
of the current guidelines rates of condition, carbohy coronary risk
CONCLUSION:
dietary guidelines diabetes and drate- factors in persons
without proper obesity increased resistance, explain with carbohydrate-
scientific explosively. s why large resistance
evaluation or numbers of whereas a high
proof. Keys was wrong.
persons in
predisposed
carbohydrate diet
worsens those
Fat in the diet does not cause
populations factors.
become obese and
diabetic when
heart disease.
exposed to a high
carbohydrate diet.
Diet-heart hypothesis is wrong.

23. Economic Within 5 years of The presence of A high fat diet
considerations the widespread the genetic reverses
drove the adoption adoption of these predisposing allknown
of the current guidelines rates of condition, carbohy coronary risk
dietary guidelines diabetes and drate- factors in persons
without proper obesity increased resistance, explain with carbohydrate-
scientific explosively. s why large resistance
evaluation or numbers of whereas a high
proof. persons in carbohydrate diet
predisposed worsens those
populations factors.
become obese and
diabetic when
exposed to a high
carbohydrate diet.

24. MILLIONS OF YEARS

25. 28
YEARS

26. INFLUENCE OF 1977 DIETARY GUIDELINES ON
% OBESITY IN USA
50
40
Dietary goals for
Percent with BMI> 30kg.m2
Americans
released
30
20
45-64 years
10 30-44 years
65 years & over
18-29 years
0
1971-74 1976-80 1988-94 1999-00 2005-06
2001-02
Year

27. DIABETES AND OBESITY RATES IN THE US HAVE SORED
SINCE THE ADOPTION OF THE 1977 DIETARY GUIDELINES
% of Americans with diabetes % of US children who are obese
1980
2010 1980
2010
% of US adults who are obese
1980
2010

28. CHANGES IN US MACRONUTRIENT INTAKES – 1971 - 2000
NHANES MEN NHANES WOMEN
3000 CHO:FAT:PROT 3000 CHO:FAT:PROT
42:37:17 49:33:16 45:36:17 52:33:15
+6.8%
2500 2500
Carbohydrate-induced Hyperphagia
2000 2000
Energy intake (kcal)
+21.7%
1500 1500
+23.4%
1000 1000 +38.4%
-5%
+11%
500 500
-14%
+3%
0 0
71-74 76-80 88-94 99-2000 71-74 76-80 88-94 99-2000
Intake Carbohydrates Fat Saturated fat
Hite AH, Feinman RD, Guzman GE, et al. In the face of contradictory evidence: report of the

29. Economic Within 5 years of The presence of A high fat diet The Woman’s
CONCLUSION:
considerations the widespread the genetic reverses Health Initiative
drove the adoption adoption of these predisposing allknown Randomized
of the current guidelines rates of condition, carbohy coronary risk Controlled Dietary
dietary guidelines diabetes and drate- factors in persons Modification Trial
without proper
scientific
obesity increased
explosively.
Explosive increase in rates
resistance, explain
s why large
with carbohydrate-
resistance
(WHIRCDMT) of
which my
evaluation or
proof.
of obesity and Type II
numbers of
persons in
whereas a high
carbohydrate diet
opponent was
Project Leader
diabetes in the US has
predisposed
populations
worsens those
factors.
proves that the
prescription of a
been caused by an
become obese and
diabetic when
high carbohydrate
diet to persons
increased carbohydrate
exposed to a high
carbohydrate diet.
with either known
heart disease or
intake resulting from the diabetes
constitutes
1977 Dietary Guidelines
medical
malpractice.

30. Economic Within 5 years of The presence of A high fat diet
considerations the widespread the genetic reverses
drove the adoption adoption of these predisposing allknown
of the current guidelines rates of condition, carbohy coronary risk
dietary guidelines diabetes and drate- factors in persons
without proper obesity increased resistance, explain with carbohydrate-
scientific explosively. s why large resistance
evaluation or numbers of whereas a high
proof. persons in carbohydrate diet
predisposed worsens those
populations factors.
become obese and
diabetic when
exposed to a high
carbohydrate diet.

31. WHY DOES OBESITY OCCUR ONLY IN SOME WHEN ALL EAT
HIGH CARBOHYDRATE DIETS?
Largest man in the American police
world in 1903 officer in 2012

32. Obesity cannot be due simply to doing too little
exercise.
In a homeostatically-regulated system, any
reduction in energy expenditure will be matched
by an exactly equal reduction in energy intake.
Conversely any sustained increase in energy
consumption should be matched by an increase
in energy expenditure.
Hence the problem must be that the homeostat
has been broken by the 1977 Dietary Guidelines.

33. THE CONDITON OF CARBOHYDRATE RESISTANCE
KF Petersen, S Dufour, DB Savage. PNAS. 104; 12587–12594, 2007.
180 Meal Meal 250 Meal Meal
10am 2:30pm Insulin-resistant 10am 2:30pm
Plasma glucose concentrations
Plasma insulin concentrations
160 Insulin-sensitive
200
140
150
(µU/mL)
(mg/dL)
120
100
100
80 50
60 0
10am 12pm 2pm 4pm 6pm 10pm 12am 2am 4am 6am 10am 12pm 2pm 4pm 6pm 10pm 12am 2am 4am 6am
180 28 P = 0.00005
Plasma triglyceride concentrations
160 24
140
De novo lipogenesis
20
120
(mg/dL) 16
(mg/dL)
100
80 12
60
8
40
20 4
0 0
10am 12pm 2pm 4pm 6pm 10pm 12am 2am 4am 6am Insulin sensitive Insulin resistant
Petersen KF, Dufour S, Savage DB, et al. The role of skeletal muscle insulin resistance in the

34. The metabolism of every human is
not the same.
Those with carbohydrate
resistance are unable to
metabolize carbohydrate safely.

35. METABOLIC PROFILE OF PERSONS WITH CR
INGESTING A HIGH CARBOHYDRATE DIET
Elevated blood glucose concentrations
Elevated blood insulin concentrations
Elevated HbA1c concentrations
Elevated blood triglyceride concentrations
Reduced blood HDL-cholesterol concentrations (HDL-C)
Increased small LDL-cholesterol particles (LDL-C P)
Increased blood uric acid concentrations
Increased blood ultrasensitive CRP concentrations
Additional features:
Fatty liver
Obesity
Hypertension

36. BLOOD RISK FACTORS FOR CORONARY HEART DISEASE
Total Cholesterol
Ultrasensitive CRP
Fibrinogen
Glucose
HbA1c
Homocysteine
HDL-cholesterol
LDL-Cholesterol
LDL- Cholesterol particle size or number
Lp (a)
Insulin
Omega 6 to Omega 3 ratios
Triglycerides
Uric Acid

37. THE DIETARY FAT HYPOTHESIS FOR HEART DISEASE
Atherogenic Dyslipidaemia (AD)
Increased LDL
High fat cholesterol Arterial
diet Increased “clogging”
triglycerides
Reduced HDL
cholesterol
OBESITY, DIABETES, HYPERTENSION, GOUT, METABOLIC
SYNDROME ARE SEPARATE/DISTINCT DISEASES

38. RELATIVE IMPORTANCE (BASED ON HAZARD RATIO) OF
DIFFERENT RISK FACTORS FOR CORONARY HEART DISEASE
RISK FACTOR HAZARD RATIO (RANGE)
Diabetes 2.04 (1.76 – 2.35)
Age 1.87 (1.73 – 2.02)
Current smoking 1.79 (1.66 – 1.94)
Systolic blood pressure 1.31 (1.26 – 1.37)
Total [Cholesterol] 1.22 (1.17 – 1.27)
[Triglyceride] 1.19 (1.15 – 1.23)
[HDL-Cholesterol] 0.83 (0.78 – 0.87)
Di AE, Gao P, Pennells L, et al. Lipid-related markers and cardiovascular disease

39. PREDICTIVE VALUE OF HbA1c FOR CORONARY HEART
DISEASE EVENTS AND ALL-CAUSE MORTALITY
8
Coronary heart disease events
7 All-cause mortality
Age-adjusted relative risk (95% CI)
6
5
Carbohydrate resistance
4 “Pre-diabetes”
3
2
1 Total Cholesterol
Hazard Ratio
0
<5.0 5-5.4 5.5-5.9 6.0-6.4 6.5-6.9 >7.0 Known
diabetes
Hemoglobin A1C concentrations (%)
Khaw KT, Wareham N, Bingham S, et al. Association of hemoglobin A1c with cardiovascular disease and mortality in adults:

41. CUMULATIVE INCIDENCE OF IHD FOR DIFFERENT
RANDOM BLOOD GLUCOSE CONCENTRATIONS
Ischemic heart disease Myocardial infarction
100
>11mmol/L (>198 mg/dL)
90 9-10.9 mmol/L (162-197 mg/dL)
7-8.9 mmol/L (126-161 mg/dL)
80 5-6.9 mmol/L (90-125 mg/dL)
<5 mmol/L (<90 mg/dL)
Cumulative incidence (%)
70 Overall log rank p<0.001
60
50
40
30
20
10
0
20 30 40 50 60 70 80 90 100 20 30 40 50 60 70 80 90 100
Age (Years) Age (Years)
Benn M et al. Non-fasting glucose, ischemic heart disease and myocardial infarction. Journal of the American College of Cardiology 59; 2012.

42. BLOOD GLUCOSE (mmol/L) IN THE NORMAL RANGE PREDICTS
CARDIOVASCULAR OUTCOME
2.0
1.5
Hazard Ratio
Total Cholesterol
1.0 Hazard Ratio
0.5
Group 1 Group 2 Group 3 Group 4 Group 5 IFG
2.8-4.4 4.5-4.6 4.7-4.9 5.0-5.2 5.3-5.5 5.6-7.0
Shaye K, Amir T, Shlomo S, Yechezkel S. Fasting glucose levels within the high normal range
.

43. Economic
considerations
Within 5 years of
the widespread
The presence of
the genetic CONCLUSION:
A high fat diet
reverses
allknown
The Woman’s
Health Initiative
drove the adoption adoption of these predisposing Randomized
of the current
dietary guidelines
guidelines rates of
diabetes and
condition,
carbohydrate-
Their abnormal
coronary risk
factors in persons
Controlled Dietary
Modification Trial
without proper obesity increased resistance, carbohydrate
with carbohydrate- (WHIRCDMT) of
scientific
evaluation or
explosively. explains why large
numbers of metabolism explains
resistance
whereas a high
which my
opponent was
proof. persons in
predisposed
why those with
carbohydrate diet
worsens those
Project Leader
proves that the
populations carbohydrate
factors. prescription of a
become obese and
diabetic when resistance develop high carbohydrate
diet to persons
exposed to a high
carbohydrate diet.
obesity, diabetes and
with either known
heart disease or
coronary heart disease
diabetes
when eating a high constitutes
medical
carbohydrate diet. malpractice.

44. Economic Within 5 years of The presence of A high fat diet
considerations the widespread the genetic reverses
drove the adoption adoption of these predisposing allknown
of the current guidelines rates of condition, carbohy coronary risk
dietary guidelines diabetes and drate- factors in persons
without proper obesity increased resistance, explain with carbohydrate-
scientific explosively. s why large resistance
evaluation or numbers of whereas a high
proof. persons in carbohydrate diet
predisposed worsens those
populations factors.
become obese and
diabetic when
exposed to a high
carbohydrate diet.

46. A HIGH FAT DIET REVERSES ALL CORONARY RISK
FACTORS MORE EFFECTIVELY THAN A LOW FAT DIET
ApoB/ApoA-1 High Carbohydrate Low Fat
ApoB Low Carbohydrate High Fat
Total Saturated Fatty Acids 12% CHO 60% Fat KetogenicDIet
Small LDL-C particles
Triglyceride/HDL-C
HDL-C
Triglyceride AUC
Triglyceride
Leptin
HOMA
Insulin
Glucose
Abdominal fat
Body mass
10 0 -10 -20 -30 -40 -50 -60
Percent change
Volek JS, Fernandez ML, Feinman RD, Phinney SD. Dietary carbohydrate restriction induces a unique metabolic state positively

47. “Meta-analysis … on data obtained in 1,141 obese
patients, showed the low carbohydrate diet to be
associated with significant decreases in body weight,
body mass index, abdominal circumference, systolic
blood pressure, diastolic blood pressure, plasma
triglycerides, fasting plasma glucose,
glycatedhaemoglobin, plasma insulin and plasma C-
reactive protein, as well as an increase in high-density
lipoprotein cholesterol. Low-density lipoprotein
cholesterol and creatininedid not change
significantly,whereas limited data exist concerning
plasma uric acid”.
Santos FL et al.

48. THE DIETARY CARBOHYDRATE HYPOTHESIS FOR HEART DISEASE
Hyperglycaemic HyperinsulinaemicAtherogenic Dyslipidaemia (HHAD)
Low
 Glucose Omega
 Insulin 3, high
Omega 6
High  Triglycerides
carbohydrate  HDL-C • Arterial inflammation
*
(fructose) diet  Small LDL-C • Metabolic syndrome
particles • Coronary heart
disease/stroke
 Uric acid*
• Obesity
 CRP • Diabetes
Fatty liver • Hypertension
ONE CAUSE, ONE TREATMENT FOR ALL CONDITIONS

49. Economic Within 5 years of The presence of the A high fat diet
CONCLUSION:
considerations the widespread genetic reverses
drove the adoption adoption of these predisposing allknown
of the current guidelines rates of condition, carbohyd coronary risk
dietary guidelines diabetes and rate- factors in persons
without proper obesity increased resistance, explains with carbohydrate-
scientific explosively. why large numbers resistance
evaluation or of persons in whereas a high
proof. predisposed carbohydrate diet
populations become worsens those
obese and diabetic factors.
when exposed to a
high carbohydrate
diet.

50. The 48 836-person
Economic Within 5 years of The presence of A high fat diet
Woman’s Health
considerations the widespread the genetic reverses
Initiative of which
drove the adoption adoption of these predisposing allknown
my opponent was
of the current guidelines rates of condition, carbohy coronary risk
the Project
dietary guidelines diabetes and drate- factors in persons
Director proves
without proper obesity increased resistance, explain with carbohydrate-
that the 1977 US
scientific explosively. s why large resistance
Dietary Guidelines
evaluation or numbers of whereas a high
accelerate disease
proof. persons in carbohydrate diet
progression in
predisposed worsens those
persons with
populations factors.
either known heart
become obese and
disease or
diabetic when
diabetes. Thus his
exposed to a high
landmark study
carbohydrate diet.
provides the
definitive evidence
disproving Keys’
false diet-heart
hypothesis.

51. WOMEN’S HEALTH DIETARY MODIFICATION TRIAL
48 836 post-menopausal women
40% assigned to low fat 60% to self-selected
eating pattern dietary behaviour
Subjects reduced energy from Control subjects received a copy
fat to 20% and from saturated fat of Dietary Guidelines for
to 7% and increased fruit and Americans “as well as other
vegetable intake to at least five health-related material but had
servings per day and grains to at no contact with nutritional
least six servings per day. interventionists”.
Subjects were followed for 8.1 years.
Howard BV, Van HL, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women's

52. Conclusion: The study “did not
significantly reduce the risk of coronary
heart disease, stroke, or cardiovascular
disease in postmenopausal women and
achieved only modest effects on
cardiovascular risk factors”.
But was that all they found?

54. “...THE HR FOR THE 3.4%
OF WOMEN WITH CVD AT
BASELINE WAS 1.26 (95%
CI 1.03-1.54)....”
This is entirely predictable as a high carbohydrate diet produces
HHAD
(hyperglycaemichyperinsulinaemicatherogenicdyslipidaemia) in
those who are metabolically vulnerable.

56. “The results of this study do not change
established recommendations on disease
prevention. Women should continue to …
work with their doctors to reduce their
risks for heart disease including following
a diet low in saturated fat, trans fat and
cholesterol”.
E Nabel, Director, NHLBI.

58. “This study shows that just reducing total fat
intake does not go far enough to have an
impact on heart disease risk. While the
participants’ overall change in LDL “bad”
cholesterol was small, we saw trends towards
greater reductions in cholesterol and heart
disease risk in women eating less saturated
and trans fat”.
J Rossouw, Project Director, WHIRCDMT

59. THE UPTON SINCLAIR THEOREM
“It is difficult to get
a man to understand
something, when his
salary depends
upon his not
understanding it”.

63. Shikany JM, Margolis KL, Pettinger M, et al. Effects of a low-fat dietary intervention on glucose, insulin, and insulin
resistance

64. “….women with diabetes at baseline did
experience adverse glycemic effects of the low-
fat diet, which indicated that
unless accompanied by additional
recommendations to guide carbohydrate
intake”.
Shikany JM et al.

66. The Look AHEAD Trial was terminated
prematurely in October 2012 after 11.5
years as it was found that even when
combined with exercise, the Prudent diet
had no measureble effect on development
of arterial disease and its complications in
persons with Type 2 Diabetes. Continuing
the trial was considered “pointless”.

67. CONCLUSION:
Economic Within 5 years of The presence of A high fat diet The 48 836-person
considerations the widespread the genetic reverses Woman’s Health
drove the adoption adoption of these predisposing allknown Initiative proves
of the current guidelines rates of condition, carbohy coronary risk that the 1977 US
The WHI provides the definitive
dietary guidelines
without proper
diabetes and
obesity increased
drate-
resistance, explain
factors in persons
with carbohydrate-
Dietary Guidelines
accelerate disease
evidence from a randomized
scientific
evaluation or
explosively. s why large
numbers of
resistance
whereas a high
progression in
persons with
proof.controlled clinical trial that persons in
predisposed
carbohydrate diet
worsens those
either known heart
disease or
disproves the diet-heart hypothesis. populations
become obese and
factors. diabetes. Thus the
research of my
Following the 1977 US “Prudent” Diet diabetic when
exposed to a high
opponent provides
the definitive
Guidelines worsens the outcome of carbohydrate diet. evidence that
disproves Keys’
those who are the most vulnerable false diet-heart
hypothesis.
because they have either heart
disease or diabetes.

68. Economic Within 5 years of The presence of A high fat diet The 48 836-person
considerations the widespread the genetic reverses Woman’s Health
drove the adoption adoption of these predisposing allknown Initiative of which
of the current guidelines rates of condition, carbohy coronary risk my opponent was
CONCLUSION:
dietary guidelines diabetes and drate- factors in persons the Project Leader
without proper obesity increased resistance, explain with carbohydrate- proves that the
scientific explosively. s why large resistance 1977 US Dietary
evaluation or numbers of Guidelines
proof. The Diet Heart Hypothesis of Ancel Keys is WRONG.
persons in
whereas a high
carbohydrate diet accelerate disease
predisposed worsens those progression in
Its widespread promotion in the name of good science
populations factors. persons with
represents the single greatest error in medicine in the
become obese and
diabetic when
either known heart
disease or
past 60 years. exposed to a high
carbohydrate diet.
diabetes. Thus
that landmark
study provides the
definitive evidence
disproving Keys’
false diet-heart
hypothesis.