Eades Confuses Liver Issues Relies on Very Weak Studies

[Blood Sugar 101]

I finally got a hold of the new Eades book. Because I have heard a lot of discussions about how his diet is supposed to reduce liver fat, and because liver fat is a very important issue, about which I have been reading research, I read it with great attention.

Unfortunately, what I found was very disappointing.

1. Eades cites a grand total of two studies to prove support his point that a low carb diet can lower liver fat. He doesn't cite the names of the authors, but I was able to find the studies. One is the study on which he bases his claim that three days of a low carb diet can reduce liver fat. Since this flies in the face of everything else I've read, I read the study closely.

It turns out that what it really is, is a study arguing for the use of a certain MRI technique to measure liver fat instead of the only accurate technique known now, liver biopsy. This is NOT a standard way of measuring liver fat at all, and the study was uncontrolled and did not compare the liver fat estimate from the MRI with a biopsy results, there is no way of validating that the fat amounts the imaging software calculated were accurate.

Given the 3 day time period in which liver fat supposedly dropped, and that it dropped in relationship to the person's size, it is almost certain that what the imaging was really measuring was the drop in liver glycogen stores due to going into ketosis.

So this study is almost worthless for evaluating whether or not a low carb diet reduces liver fat.

The other study I found was a very small study done by the Low Carb study group at Duke university that involved 5 obese individuals who spent 6 months eating a diet of less than 20 grams of carbs a day along with a special, unspecified nutritional supplement. This study reports that it found some decrease in liver fat on biopsy (The only accurate test for liver fat.)

However, the abstract does NOT quantify the amount of the decrease in liver fat, an omission that suggests it was small. In addition, the P value which is a statistical measure of how likely it was that the result was not due to chance was not impressive. This increases the likelihood the change was very small. One of the five subjects saw no decrease in liver fat after 6 months on the <20 g diet.

This suggests strongly that if you think you are going to make a significant difference in your liver fat in 3 days, you are dreaming.

2. The "Detox" Eades prescribes--the first 2 weeks, has nothing to do with liver fat. He is simply cutting out a few substances that use liver cytochromes to remove chemical substances from the body, i.e. CYP450. These are used by ibuprofen, caffeine and the other drugs he mentions. But they have NOTHING to do with fat.

3. Another piece of poor sciences is the repeated statement Eades makes that high insulin levels make people insulin resistant. This simply is not true. High BLOOD sugar levels make people insulin resistant. Defective livers clogged with fat may also increase insulin resistance completely independent of insulin levels and he is right that fructose will clog up the liver with fat.

But insulin resistance has nothing to do with how much insulin you have circulating. People with Type 2 diabetes often have low insulin levels and sky high insulin resistance. Genetic flaws make people prone to insulin resistance even when their blood sugar and insulin levels are normal and they are normal weight.

The actual diet is a crash diet most people will find extremely difficult to follow because instead of going into the details of how to choose your foods, he just presents a list of recipes (things you would find very hard to find out in the real world on a daily basis) and no explanation of why you would want to eat those foods.

After explaining that there are some studies suggesting high fat intake will lower liver fat, Eades presents us with a very high PROTEIN diet, which there is NO evidence for. In fact there is some evidence high protein diets are worse for liver fat than high carb diets (without fructose).

He also seems to think that protein won't turn into carbohydrate in the body and that protein's ability to stimulate glucagon production is good. This is wierd, as glucagon is the hormone that RAISES blood sugar, so stimulating it will raise blood sugar and in a healthy person require more insulin.

I really liked Protein Power 11 years ago. It was the book that got me started low carbing. But I think Dr. E has let his celebrity lifestyle and all those fancy restaurant meals he photographs on his blog go to his head.

It also annoyed me that he writes the book as if he was still practicing as a doctor seeing patients for weight loss which he hasn't done for a while.

Bottom line: You aren't going to cure anything in 6 weeks, particularly not liver fat. The decent research has found that on careful examination very little makes much of a change in liver fat. The tests your doctor uses to tell you that you have fatty liver do not tell you if you have cured it. Lots of things will normalize the tests without making any difference in your liver fat on biopsy, including metformin, which physiologically is a lot like low carbing.

My guess is that avoiding HFCS, keeping blood sugar normal, losing weight slowly over a couple years and maintaining that loss over a couple years, and perhaps exercise over a long period of time may slowly reverse fatty liver. Very slowly if the Duke study is anything to go by.

ONE LAST THING: Intracellular Liver Fat turns out not to be the same as visceral fat. And recent research is suggesting that it is NOT VAT (visceral fat) but intracellular liver fat that causes insulin resistance and the associated metabolic problems.

[rottinluv]

Very interesting! Thank you for your valuable research!!

[Mariasol]

Very interesting. Thank you for taking the time to share it with us.

I read the book but didn't pick up on those errors. What annoyed me was that he says that for a menopausal woman (Mary) the 6 week plan was not enough and that hormone regulation was also required without going into any details about it.

[Blood Sugar 101]

Originally Posted by Mariasol

Very interesting. Thank you for taking the time to share it with us.

I read the book but didn't pick up on those errors. What annoyed me was that he says that for a menopausal woman (Mary) the 6 week plan was not enough and that hormone regulation was also required without going into any details about it.

Well what really annoyed me was that his wife, Dr. Mary Dan Eades, who was the one explaining how it was only when she was menopausal that she discovered it was impossible to lose weight in menopause with exercise--after being a weight loss doctor for many years.

That statement pretty much floored me. It also makes me wonder just how many patients they really had in their clinic.

Plus the plug for bioidentical hormones from compounding pharmacies annoyed me. They aren't a weight loss panacea by any means and while some hormones really help, some of the compounded estrogens can have disasterous effects on blood sugar. They sure did for me.

I've been reading through the popular diet books out of curiosity, and it seemed to me like they had pretty much sliced and diced whatever was popular, made it into a collage, and then given nothing more than the exact details of the diet that had worked for only the two of them, when they were crash dieting for their show.

I expect a lot more from bestselling authors charging $25 for a book.

[jlieb62]

Losing my first 30 pounds is what got rid of my fatty liver. There was no magic to it, in fact I was even vegetarian for a large part of that time and eating plenty of fruit and whole grains. Just had another mri recently and my liver is still fat-free. There are no doubt many variables at work with fatty liver, but for me personally weightloss was the key and not carb-control.

[Blood Sugar 101]

Jim,

That's excellent news. It's harder to know what people need to do who aren't significantly overweight but still have the fatty liver. Years of eating the HFCS had done that to a lot of people, as does drinking.

[jezzie]

I really liked Protein Power 11 years ago. It was the book that got me started low carbing.
But I think Dr. E has let his celebrity lifestyle and all those fancy restaurant meals he photographs on his blog go to his head.

It also annoyed me that he writes the book as if he was still practicing as a doctor seeing patients for weight loss which he hasn't done for a while.

Excellent thread.

I thought the original Protein Power book explained low carb the best.
It, and the Schwarzbein Principle, were my go to books way back when.

Thanks.

[Blood Sugar 101]

Originally Posted by jezzie

Excellent thread.

I thought the original Protein Power book explained low carb the best.
It, and the Schwarzbein Principle, were my go to books way back when.

Thanks.

I agree, but over the years, now that I've researched blood sugar extensively and written my own book on it (now an Amazon Diabetes bestseller), I've come to realize all the low carb diet doctors get the mechanics of insulin resistance wrong.

Continuing to cite "Syndrome X" for example, is a sign of not having kept up. The genetic studies have really illuminated what is going on "under the hood" with insulin resistance, and it is turning out to be much more complex, and diverse, a condition that was believed before. There is a huge genetic component that kicks in regardless of what you eat or how much you exercise. No one has found a way to undo it.

Most importantly, the measure used in research to measure "Insulin resistance" turn out to be highly inaccurate (this isn't my judgment, it's other research) because it doesn't factor in the impact of insulin deficiency on blood sugar.

So many treatments that supposedly reduce insulin resistance turn out to do nothing of the kind. What they do is lower blood sugar and thus the HOMA measurement used to evaluate insulin resistance. The actual insulin resistance, as measured by how effective a unit of insulin is in lowering blood sugar, does not change. When someone is insulin resistant and cuts carbs, their blood sugar and HOMA assessment drop. but their cells (and liver) remain as resistant to insulin as they were before.

And Eades is (and has always been) just plain wrong about excess protein. It does raise blood sugar, sometimes a lot. 58% of the protein not used to repair muscle will turn into glucose.

People capable of secreting insulin won't be able to detect this, because they'll secrete insulin to take care of it. But if they do they'll be fighting against fat loss because of the higher insulin level provoked will store fat.

I read Eades' blog and it is one of the less informative blogs on the subject of physiology. He mostly just looks for studies to bolster his opinions or opportunities to make fun of bad science (to the loud cheers of his supporters), rather than looking carefully at the new research evaluating it for what light it might cast on a complex topic. Given the huge profits there are in writing the kinds of books he writes, and his high flying lifestyle, this is understandable. But he is profiting at the expense of his readership.

The fact is all the studies show that most LC dieters do stall out after 6 months and that many drop out in frustration. We see it on this board all the time. There is more to be understood about effective dieting than anyone knows, yet, and there is NO quick (or even slow) "weight loss secret" that will work for everyone--give them weight loss they can maintain without having to become unnaturally obsessive about diet--especially the very obese people who tend to be the audience for these kinds of products and whose metabolic problems are always complex.

[Kisha]

Great post! I guess that explains why some diabetics are showing an increase in blood sugar levels (due to more protein).
The things that I don't like about his book is:

1. It's 166 pages and the rest of the book is ALL recipes! I like having some new recipes on my shelf but... I didn't buy the book for recipes. I got to the last bit of readable pages, and felt a tad bit disappointed!!!

2. No acceptable food lists to customize your diet to your needs.

3. No troubleshooting for diabetics, or side effects.

4. No symptoms or signs that show you are in fact on the right track... other than abdominal fat to measure? Oh and lab tests...

I am trying to work on detoxing my body. I think that it IS GOOD to reduce some of the toxic things we consume on a daily basis. It made me re-evaluate a lot but I believe in order to maintain long term health it shouldn't just be a temporary change.

I have reduced my caffeine intake, I am using the shakes as substitute meals, and I am working on trying to fully do the diet correctly.

But I dont think this is a diet a person should go on immediately who's never done low carbed before. Low carbing is a journey and you can't just drop all your habits in one night. But I do think that this is a good diet if your feeling that your low carbing has slowed or even stalled or has gotten sloppy. You might give it a whirl. There are tips in there that could help you get past the hump. However, I believe that it's target audience is more for those skinny people who got middle aged pooch's, rather than the general public at whole!

I liked his tips on sleep. But I swear it said in that chapter that he'd get into more detail about sleep. Then never did. /shrug...

PS I first got into low carbing by reading about the "Schwarzbein Principle" although, she's not much on low carbing, just real foods, more over. Technically anyway. Compared to Atkins or PP. I think Schwarzbein is definatly a good start towards a more healthy lifestyle. And further weight loss can be added later as you adopt at least some of the fundamentals of healthy eating.

LASTLY, I think it is TRUE you can find significant changes to your health in SIX WEEKS. Blood sugars can normalize, energy can increase, better sleep, and overall health/weight. That in itself is good for you and your liver regardless if it's not a complete cure.

[Kisha]

I agree, but over the years, now that I've researched blood sugar extensively and written my own book on it (now an Amazon Diabetes bestseller), I've come to realize all the low carb diet doctors get the mechanics of insulin resistance wrong.

And this is a conflict of interest completely!

[Blood Sugar 101]

Originally Posted by Kisha

And this is a conflict of interest completely!

Hardly. My book is a small press book only available online. All the information in the book is available FOR FREE on my web site, a fact that is disclosed in the book. Every statement in it is backed up by peer reviewed research, cites provided. It's about how blood sugar works and how to keep blood sugar from destroying your organs, not weight loss.

So I'm not competing with Eades.

[Kisha]

Oh okay well cool.