Low Carb Denver started as Low Carb Vail in 2016. It was then Low Carb Breckenridge in 2017 and 2018 and this year it was Low Carb Denver – just 20 minutes from the airport. The decision to move out of the ski resorts was driven by two things: 1) the altitude – Denver is already the mile high city (1,600m) and Breckenridge is almost double that at 3,000m. Speakers and audience alike were dropping like flies with altitude sickness; and 2) the cost – the ski resorts are terribly expensive and what should be an accessible conference was simply not. Andy and I attended Low Carb Breckenridge in 2017 and commented in the write-up on that conference that 8 slices of bacon cost $12.99 (Ref 1). The move to Denver was clearly the right one, as the number of attendees jumped from around 250-300 to 850.
Low carb Denver 2019 ran from 7-10th March and was held at a recently opened resort called the Gaylord Rockies Convention Centre. The place was like a small village with 1,500 rooms and several restaurants. The resort hosted a bizarre mix of people – individuals there for conferences and many families there for a Disneyland kind of holiday – spending the day in indoor and outdoor water parks (yes – even in sub zero temperatures and snow). The conference rooms were enormous. Our room with 850 attendees still seemed really spacious, even with two huge screens at the front, either side of a large stage. The conference room had no outside windows, which wasn’t great for many of us trying to avoid jet lag. Fortunately the sun shone all week, no matter how cold it was, and so a quick step outside to the atrium and sunlight would flood into one’s eyes helping instantly with the attempts to stay awake.
While the Gaylord Rockies resort solved the altitude problem, it didn’t quite solve the expense problem. The cheapest steak in any restaurant was $38 and America annoyingly adds 20% service to everything and so a couple of single courses soon added up to a really expensive meal. Andy and I borrowed Jeff’s car on the first day there to stock up on cheese, yoghurt, berries and nuts from a supermarket 10 minutes away, so that we could at least have breakfast and lunch in the room.
Following Low Carb Breckenridge in 2017, I did a note based on five take-aways of mine from the conference (Ref 1). This year, I have asked the amazing list of speakers to share their own take-away message from their own presentation and a fabulous number have replied. (I’ll update the blog post if any more arrive). These are in alphabetical order by surname of speaker. Each heading has the name of the speaker, their headline bio (although most will be known to you) and the title of their presentation in quotation marks.
Dr Nadir Ali – Interventional Cardiologist “β-oxidation as the primary driver of LDL on an LCHF diet.”
“In nearly three decades of clinical cardiology practice I have observed extensive vascular disease and calcification in individuals with a lifetime of low levels of low density lipoprotein (LDL) cholesterol. It is also not uncommon to observe octo and nonagenarians with markedly elevated levels of LDL cholesterol in the 200 mg/dl range who have remarkably healthy vascular system with minimal disease. It is therefore difficult to reconcile these observations with the traditionally simplistic view that the most important causal factor in heart disease is LDL cholesterol. One would expect the mainstream medicine to espouse the view that the role LDL cholesterol plays in causality is not settled and explore the biologic role of this molecule in human physiology.
“Both cholesterol and triglycerides are fatty waxy substances that do not dissolve in the aqueous medium of blood. Evolution has therefore devised an ingenious system of water soluble transport vehicles called lipoproteins. The LDL cholesterol mediates important roles in host immune defense, cell repair, antioxidant damage prevention and as a carrier molecule for fat soluble vitamins and coenzyme Q-10, the latter being an integral component of muscle function. These biologically important functions deserve further study. Sadly, mainstream medicine behaves as if the causal role of LDL in atherosclerosis is settled, while a detailed perusal of literature will reveal that we do not understand the pathogenesis of degenerative vascular disease. There is no doubt that there are several components of LDL cholesterol are present in an arterial plaque, but by no means can one assume if it is there to cause disease or mediate vascular repair and healing.”
Dr Ben Bikman, PhD Professor of Pathophysiology, Biomedical Scientist – “The Metabolic Advantage.”
“Ketones elicit disparate mitochondrial effects in muscle and fat tissue. Whereas ketones improve mitochondrial efficiency in muscle cells, enabling greater energy production, the opposite holds true in fat cells, wherein ketones cause fat cells to ‘waste’ energy. Altogether, ketones create a metabolic advantage of selective and seemingly favorable energy wasting.”
Ivor Cummins (a.k.a. The Fat Emperor) – Chemical Engineer and author of "Eat Rich Live Long" – “Avoiding and resolving Modern Chronic Disease.”
"From Centers for Disease Control (CDC) figures, nearly two thirds of US adults over the age of 45 are pre-diabetic or full-blown Type 2 Diabetic. We can argue about how we got here, but not so much about how we tackle this absurd situation. The low carbohydrate approach will be a central part of the strategy across the world. This has recently been exemplified by the work of Virta and others, but in truth they are just building on decades of research – and the reality that a carbohydrate-intolerance disease state is best addressed by restricting carbohydrates in the diet. The revolution is well under way."
Dr Georgia Ede – Physician, Psychiatrist – “The EAT Lancet Diet.”
“My presentation grew out of a critique I wrote for Psychology Today of the EAT-Lancet report, published in January. This influential, well-funded, global campaign seeks to minimize or eliminate animal foods from the human diet, claiming this is the best way to improve public health and protect our environment. Using verbatim quotes from the report, I show the audience how the authors themselves acknowledge that 1) animal foods are nutritionally superior to plant foods; 2) their dietary recommendations are nutritionally inadequate for infants, growing children, teenage girls, pregnant women, aging adults, the malnourished and the impoverished; 3) their high-carbohydrate diet would likely endanger the health of people with insulin resistance (now the majority of us); and 4) everyone else would need to take supplements to meet their nutrient requirements. As for the sustainability argument against meat, EAT-Lancet’s own science director conceded that the extremely low animal food targets were not set with environmental goals in mind, but solely to reduce the burden of chronic disease.”
Dr Andreas Eenfeldt – Founder and CEO, Diet Doctor; Family physician – “Maintaining weight loss and remission of diabetes: How sustainable is it?”
“Low carb and keto are evidence-based diets, that have been shown to result in long-term sustainable weight loss and type 2 diabetes reversal. The main problem is the same as for any lifestyle intervention (smoking, exercise, showering etc.): for low carb to keep working, it’s necessary to keep eating low carb.”
Maria Emmerich – nutritionist who specializes in the ketogenic diet and exercise physiology – “Oxidative Priority – How our bodies process fuels.”
“Our bodies process fuels in a specific order. When fat loss is the goal, we want to leverage this biology to allow our bodies to do what we need, burn fat. This leads to fat loss AND healing. I also show N=many results of clients over the last 15 plus years that resulted in better outcomes for a wide range of ailments. A Ketogenic diet is about more than just weight loss. It can also heal.”
Dave Feldman – senior software engineer, entrepreneur and a citizen scientist – “New Data on Energy, Exercise, and Cholesterol.”
“A series of extensive N=1 experiments helped to provide new evidence regarding a number of phenomena from low carb citizen scientists. This includes evidence such as active weight loss potentially increasing LDL Cholesterol, resistance training potentially decreasing it, and diet demonstrating rapid changes in Lp(a) levels. Moreover, there were further experiments showing coffee sensitivity resulting in higher triglycerides and ultra low carb of under 5g providing a surprising loss of challenging adipose mass for an experimenter with lipedema.”
Dr Jason Fung – Canadian nephrologist, world-leading expert on intermittent fasting and low carb, especially for treating people with type 2 diabetes. Author of three best-selling health books and co-founder of the Intensive Dietary Management program – “Polycystic Ovary Syndrome.”
“PCOS is a reversible disease caused by hyperinsulinemia, which therefore is amenable to dietary treatment with low insulin diets, such as LCHF, ketogenic diets or intermittent fasting.”
Dr Jeff Gerber – Board certified Family Physician, Author and conference organiser – “When Weight Loss Stalls.”
“Literature review reveals that regardless of the approach, initial weight loss is often successful yet weight loss often plateaus and weight can often return to baseline. Energy supply and demand and the hormonal approach to adiposity should not be mutually exclusive and can complement one another. Proper understanding of energy flow (not Calories In Calorie Out), hormones, organ disease and function, Central Nervous System signals, mitochondrial health, dysfunction and ageing, satiety, personal fat threshold, provide insight to establishing an approach that achieves long-term weight loss and health."
Dr Mariela Glandt – Board Certified Endocrinologist – “Reawakening the Pancreas.”
“The take home message from my presentation is that hyperglycemia, fatty acids, and inflammation make beta cells lose their function (de-differentiate). If these conditions are present for a short time and then corrected, then the beta cell can recover fully and we can reverse diabetes, but if the exposure is for a really long time then complete reversal is much less likely. Aim for reversal with LCHF ASAP!”
Dr Zoe Harcombe, PhD – Independent author, researcher and speaker in the field of diet, health and nutrition – “What about fiber?”
“Fiber is not an essential nutrient, which means that we don’t need to consume it; full stop. Something non-essential might still be helpful, but the evidence for fiber being helpful is distinctly lacking. Healthy people might eat fiber but there is no evidence that fiber makes people healthy. A low carb diet can be a superior provider of fiber than a high carb diet (more fiber for fewer carbs) and so people who manage their carb intake don’t need to worry either way.”
Dr Jake Kushner – Medical Director, Pediatric Endocrinology – “Low carb nutrition for type 1 diabetes, a practical guide.”
"Traditional dietary advice for people with type 1 diabetes emphasizes consistent and large quantities of carbohydrates. However, patients who follow this strategy rarely achieve their glycemic targets. In sharp contrast, low carbohydrate nutrition is an exquisitely powerful tool for people with type 1 diabetes, allowing near-normal blood sugars for those who learn to master it. Thus, a low carbohydrate approach may minimize diabetes complications and preserve health for people with type 1 diabetes."
Professor David Ludwig, MD, PhD, Harvard Medical School and Boston Children’s Hospital – “The Carbohydrate-Insulin Model of Obesity: From Metabolism to Management of Type 1 Diabetes.”
“Conventional treatment for obesity, founded on the First Law of Thermodynamics, assumes that all calories are alike, and that to lose weight one must simply “eat less and move more.” However, this prescription rarely succeeds over the long term. According to the Carbohydrate-Insulin Model of obesity, the metabolic state of the fat cells plays a key role in determining body weight. High intakes of processed carbohydrate raise insulin levels and program fat cells to store too many calories, leaving too few for the rest of the body. Consequently, hunger increases and metabolic rate slows in the body’s attempt to conserve energy. From this perspective, conventional calorie-restricted, low fat diets amount to symptomatic treatment, destined to fail for most people. Instead, a dietary strategy aiming to lower insulin secretion promises to increase the effectiveness of long-term weight management and chronic disease prevention.”
Dr Paul Mason – Sport & Exercise Medicine Physician Specialist – “Interpreting blood tests on a low carb or ketogenic diet.”
"LDL particles serve many important functions, and elevated levels are not necessarily a concern. Problems can arise when LDL is modified by either glycation (binding of a sugar molecule like glucose) or oxidation (which may occur with glycation). This can impair the normal recycling of the LDL particles by the liver, and lead to accumulation of LDL within artery walls. LDL therefore only becomes a problem when it is modified, and blood glucose is a key driver of this process.
"Many studies on statin medications utilise dubious research methodologies which leads to an underestimation of side effects. Analysis of data from a recent study however has provided clear evidence that the true side effect rate of mid-range statin therapy is approximately 25%. This study investigated a new class of cholesterol lowering drug and ‘all included patients were required to be on treatment with a statin… unless they had demonstrated intolerance to such treatment.’ A rigorous methodology was applied to the determination of statin intolerance, and by reviewing study data, side effect rates could be calculated.
“Complete statin intolerance was demonstrated to be approximately 10% and partial statin intolerance (intolerant of a dose 1/2 of maximum dose available in a single pill) approximately 20%. Despite this rate of medically diagnosed intolerance, 4-5% of study participants still reported muscle pain, a symptom commonly attributed to statin medications. Thus, the true rate of side effects from mid-range statin use is likely approximately 25%, or 1 in 4."
Professor Dariush Mozaffarian – Jean Mayer Professor of Nutrition and Medicine, and Dean of the Friedman School of Nutrition Science & Policy, Tufts University – “A history of nutrition science: Implications for current research, dietary guidelines and food policy.”
Dariush helpfully shared his take-away message towards the end of his presentation: “Obesity is a minor pathway by which diet affects your health.”
To put this in context – the statement followed this passage: “Diet affects almost every major pathway for health in the body. In the 80s, we were so focused on blood lipids we had our blinders on and we made all of our policy decisions based on blood lipids and blood cholesterol. That led to the low fat, low saturated fat, low dietary cholesterol fetish. Now we’re so infatuated with obesity, we use diet and weight as though they’re interchangeable. We’re just talking about calories and weight; that’s very misleading. Obesity is a minor pathway by which diet affects your health."
Lily Nichols – Registered Dietitian, Nutritionist – “Is Low Carb Safe During Pregnancy?”
“Although conventional guidelines insist on a high carb diet for pregnancy, there are numerous benefits to a lower carbohydrate, real food diet for both mother and baby, particularly in those with insulin resistance/gestational diabetes.”
Dr Bret Scher – Preventative Cardiologist – “2018 Cholesterol Updates: What Do They Mean For Low Carb?”
“The evidence behind contemporary cholesterol guidelines does not include individuals following a healthy LCHF lifestyle. While we don’t know for sure that this provides any protective effects, we do know that the physiology happening in the body is quite different. Therefore we need to interpret the guidelines individually, apply them where appropriate, and question them where appropriate. Working with an expert with knowledge of LCHF will hopefully help guide your evaluation further.”
Gary Taubes – Science and Health Journalist; Co-Founder and President of the Non-Profit Nutrition Science Initiative (NuSI.org) – “How to Think About How to Eat: Lessons from the front line of LCHF clinical practice.”
Gary also presented his take-home message in his presentation: “We are not them – we are people who get fat and sick eating the foods that they eat."
This was in the context of having first said “To break away from the dogma, the dogma has to fail you in some way.” This introduced the fact that virtually everyone in the audience had their own story of how the dietary guidelines had failed them/their family in some way. Gary then went on to say: “My understanding of epidemiology is that we look at what healthy people eat compared to what unhealthy people eat and then assume that if we all eat like the healthy people, we’d be healthy too…” But “we are not them – we are people who get fat and sick eating the foods that they eat."
Nina Teicholz – Science Journalist and Author, Executive Director of the Nutrition Coalition – “US Dietary Guidelines – Why They Matter and How They Might Change.”
"The US Dietary Guidelines are hugely influential in determining our ideas about healthy diets and indeed, our entire food supply. Since they have so clearly failed to stem the relentless rise in nutrition-related diseases, including obesity and diabetes, they ought to be reformed so that they are evidence-based, according to the principle, at least, ‘do no harm.’”
Dr David Unwin – Fellow of the Royal College of General Practitioners (FRCGP), and Senior Partner of the Norwood Surgery & Dr Jen Unwin – Clincial health psychologist – “Behavior change ‘in a nutshell.”
"Our take-away message is for healthcare professionals. If we approach the consultation differently, we can transform the outcome for the patient. We now use a goal orientated model in consultations to establish the difference that weight loss/T2D remission could make to the patient’s life. When people have the gain clearly in mind, we find that it encourages them to take the steps necessary to achieve that goal."
Dr Eric Westman – Director, Duke Lifestyle Medicine Clinic – “Keto Medicine: The Practice of Carbohydrate Restriction.”
“The research studies for using low carbohydrate, ketogenic diets for obesity have surpassed the level of evidence customarily required for US FDA approval for a drug. Because the skills necessary for using a keto diet in medical practice are different than what is now taught doctors, I made the case for creating a new specialty combining internal medicine and obesity medicine called ‘Keto Medicine.’”
Robb Wolf – A former research biochemist is the twice New York Times/WSJ Best Selling author of The Paleo Solution and Wired To Eat – “Will a Low Carb Diet Shorten Your Life?”
“Whether a low carb diet is helpful or harmful with regards to longevity is debatable, but the current ‘research’ claiming a link to shortened lifespan at both very low and very high carb intakes lacks the rigour to make claims of this nature.”
Dr Caryn Zinn, PhD – NZ Registered Dietitian, Senior Lecturer & Researcher, AUT – “Building Healthy Athletes: From beginner to winner!”
“For recreational and elite athletes, Low Carb, Healthy Fat (LCHF) beings together three key elements: high-performance, leanness or optimal body composition for the chosen sport, and health – the neglected element in sport to date. LCHF helps athletes can become metabolically flexible, i.e. able to easily switch between using fat and carbohydrate as fuel for exercise, as needed, and enjoy the widespread range of health benefits that this way of eating provides.”
I sincerely hope that this gives you a flavor of three long and intense days packed solid with academic information and well-presented arguments. All videos will be available on line over the coming weeks and months – thanks to the low carb down under team of Dr Jeff Gerber and Dr Rod Taylor. Huge thanks go to these two men for organizing a quite brilliant event (Ref 2). The final word goes to Dr Jeff Gerber as he shared his take-home message on the whole conference:
"Low Carb Denver 2019 exceeded our expectations yet again. Advancing nutritional science, one healthcare professional and one patient at a time!"
Until the next time…