CHEWING THE FAT:
THE LOW-CARB DIET PHENOMENON
STEPHEN BYRNES, PhD, RNCP

Richard Allen knew something was very wrong. In the late 1980s, the graphic designer and father of two suffered a heart attack at the age of 35. Thankful that he survived, Richard followed his doctor's instructions to the letter to avoid another heart attack and to avoid making a widow of his wife.
"I did everything they told me. I took my medications religiously. I exercised more. And I followed a low-fat, low-cholesterol diet. I stopped eating eggs (too much cholesterol). I cut back on meat and trimmed all the fat off what little meat I did allow myself. I started eating more fruits, vegetables, and whole grains and avoided butter. It was not exactly the tastiest diet, but I figured I was helping to preserve my health, so it was worth it."
In 1995, however, something unexpected happened:
"I went in for a routine check-up and some blood was drawn for some tests. I was stunned to find out that my blood sugar levels were extremely high and I was subsequently diagnosed with adult-onset diabetes. I was dumbfounded. I had done everything they told me. I thought I was living and eating healthy and here I was a diabetic who now needed to take a new set of medications for a new disease."
Several years later, his blood sugar elevated and recalcitrant, Richard was taken off the oral diabetes meds and put on injection insulin--all the while following the dietary advice he'd been told would make and keep him healthy. Frustrated, confused, and overweight, Richard ran into an old friend who had recently changed her diet to include more animal fats and meat and exclude most grains, starchy vegetables, sugar and junk food. The friend had seen marked improvements in her and her family''s health and invited Richard to a picnic near Sydney, Australia, put on by people following the "Optimal Diet," a high-fat, low carbohydrate diet developed by a Polish medical doctor.
Intrigued, Richard attended and met several of the diet's devotees, as well as a visiting naturopath who successfully utilised low-carb diets in his practice, and Dr. Bogdan Sikorski, a pharmacologist/ toxicologist. Collectively, they answered Richard's questions and testified enthusiastically as to the diet's effectiveness for a number of conditions, including heart disease and diabetes. After meeting with a Polish medical doctor who was on the Optimal Diet himself, Richard decided to abandon his low-fat/high carb diet ("What good had it done me anyway?" Richard exclaimed) and adopt a completely different way of eating.
NOT JUST FOR WEIGHT LOSS
Richard's story is not unusual. In recent years, there has been an explosion of lay and professional interest in low-carb diets. The public, disillusioned with the supposed effectiveness of low-fat diets and facing ever-climbing rates of obesity and diabetes, have been embracing starch-free diets in droves. Though the diet has been mostly associated with weight loss, practitioners and scientists alike are discovering the benefits of low-carb diets for a number of diseases--from multiple sclerosis to diabetes.
Low-carb diets are nothing new. Throughout history writers such as Anthelme Savarin (1), William Banting (2), Vilhjamur Stefansson (3), and Weston Price (4), in one way or another, all advocated lower carb diets. In more recent times, Drs. Richard Mackarness (5) and John Yudkin (6) both authored books espousing a lower carbohydrate intake. It is only in recent years, however, that the low-carb diet has achieved such wide and sustained popularity.
Myths about low-carb diets abound and this article will deal with several of them. It is important for readers to know that the low-carb craze is a true phenomenon, encompassing many writers and many approaches. Though each differs from the other in slight ways, the bottom line is this: To be healthy, humans need to reduce their intake of carbohydrates in any form and increase their intake of protein and fats, especially animal fats. The following is a summary survey of the various approaches to low-carb nutrition. Despite their critics, low-carb proponents stand by their nutritional recommendations as healthy and vibrant.

DR. ROBERT ATKINS
The most famous populariser of low-carb diets has been American medical doctor, Robert Atkins. His book, Dr. Atkins' Diet Revolution, was first published in 1970 and has sold millions of copies. The latest revision was released in 2002 under the title Dr. Atkins'' New Diet Revolution (Avon Books; 2002). Unlike earlier versions of the book, the latest revision is heavily referenced, thus ending frequent criticisms that his diet theories have no scientific basis.
Atkins' approach to weight loss is simple: Reducing your carbohydrate intake to less than 40 gms a day will induce ketosis/lipolysis in the body, a condition where the body breaks down fat instead of glucose for energy, resulting in weight loss. The allowable foods are unlimited amounts of meats, fats, cheeses, non-starchy vegetables, and limited amounts of nuts and low-carb fruits such as strawberries and blueberries. Off-limits are honey, sugar in any form, breads, grains, and all starchy vegetables like potatoes.
In Atkins', and other low-carbers view, excessive amounts of carbohydrates stimulate excessive insulin release by the pancreas. Insulin is the hormone that carries sugars into our cells for use. It is also the fat-storing hormone and excessive levels lead to obesity and a host of other hormonal imbalances which in turn lead to a plethora of degenerative diseases. If insulin levels remain high, due to excessive amounts of carbs in the diet, ketosis/lipolysis cannot occur.
Ketosis/lipolysis, then, is the key to weight loss on the Atkins' diet. Atkins explains: "The Atkins Nutritional Approach stimulates the process of lipolysis [which is] burning your fat for energy. A secondary process of lipolysis is ketosis. Ketosis occurs when you are taking in a low level of carbohydrates from the food you eat . . . .Lipolysis results in the creation of ketones (ketosis), a perfectly normal and natural function of the body." (7) Ketones can be used as energy by the body, including the brain.
Atkins has always been criticized about ketosis--dieticians claim that it is a dangerous state for the body to be in. It is well-known that during starvation, the body will enter ketosis and break down fat for energy. Diabetics can also enter ketosis, leading to bodily acidosis, a life-threatening state. The two conditions, however, are not alike as will be explained later in this article.
Dr. Atkins has propounded his philosophy of low-carb living in other books, not related to weight loss, most notably Dr. Atkins'' Age-Defying Diet (St. Martin''s Paperbacks; 2001). In this title, he applies lower-carb diets to improving longevity. In his non-weight loss approach, Atkins allows more carbs per day (40+ gms), but still recommends that daily intake should not exceed about 100 gms or 400 calories.
Atkins has been criticised by establishment nutritionists and some medical doctors for promoting a diet that, because it is high in animal fat and protein, will lead to heart disease and other diseases (dealt with later in this article). Curiously, critics also accuse the diet as not including vegetables--something which is clearly false if you read the recipes included in the books.
Atkins has also been criticised by other low-carbers for not emphasising food quality on the diet and for using various artificial sweeteners in several of his food products. Atkins also has added a line of processed soy products to his diet. It is the carbohydrate-free soy protein powder that allows him to create starch-free breads and energy bars. Critics point out that processed soy products could be harmful to the immune, digestive, and endocrine systems (8).
Criticisms aside, a recent study revealed the effectiveness of the Atkins Diet (and by extension, all low-carb nutritional approaches) for weight loss, especially in comparison to its polar opposite: the low-fat, high-carb diet. The multicenter study showed that the Atkins Dieters had more weight loss, more adherence to the diet, and better blood lipid profiles than the low-fat, high-carb dieters (9).

BARRY GROVES & THE CALORIE FALLACY
In the United Kingdom, another low-carb approach has been espoused by engineer and author Barry Groves, PhD. Speaking from his English home, Dr. Groves recounted his experiences over the years with low-carb diets:
"My interest in nutrition and its effects on health really began in 1962 when I was working in Singapore with the Royal Air Force. We had a problem, my wife and I -- we were overweight. Since our marriage in 1957, each of us had gained nearly 13 kilos (28 lbs). We had tried all the usual ways to lose weight: cutting calories, eating inert fillers, taking appetite suppressants, wearing sweaty clothes, indeed we tried just about every weight-loss idea going -- with results that were decidedly short-term".
"The first moment of revelation came, sudden and unexpected, when I was walking through the bustling Changi Market. I saw a second-hand bookstall and, as I am an inveterate browser, stopped to see what was on offer. One small paperback stood out. It was called Eat Fat and Grow Slim by Dr Richard Mackarness. That book changed our lives -- and our figures -- for good".
"The book advocated what we thought was impossible: an unrestricted-calorie diet for weight loss. It said in so many words: eat as many calories as you like, and the pounds will fall away. Because this proposition seemed so out of keeping with all we had read up to that time, we decided to see what it could do for us. To our astonishment, it worked -- and it has gone on working now for forty years".
"Then the questions began: If an unrestricted-calorie diet can achieve such results, why are all the books and magazine articles in favour of calorie-controlled diets? I began my research and the answers came. All the evidence I found persuaded me that low-calorie dieting is a snare for the overweight and a delusion for all concerned. As I read on and on, it dawned on me that a vast 'health' industry made a very good living out of the business of offering expensive solutions for the problems, so they said, of keeping ourselves slim and fit. All those advertisements on television -- eat this special food, try that diet -- could they have anything to do with the profit motive"?
"Later we began to hear that the diet we had been following, which was relatively high in animal fat, might be dangerous in terms of increased risk of heart disease. And so, when I retired from the Royal Air Force in 1982, I devoted myself full-time to a literature search into the healthiness of 'healthy eating'. I started with the biggie -- fats, cholesterol and heart disease. I read everything I could find: the studies and learned papers; the follow-up letters and studies that they referred to, and so on. All too soon I found that, contrary to the dogma trotted out in newspapers and magazines, radio and TV, there is little evidence to show that 'healthy eating' is good for any aspect of health".
"I had started to give talks in 1971 about my experience with slimming on a high-fat diet to any group that would listen. In the 1980s I extended these talks to include other diseases and, at the same time, began to write articles and my first book: Diet and Be Damned. The publishers, Hodder-Headline, were interested but told me that this book was too important for publication by an unknown author. They suggested I write a slimming diet book first. The Calorie Fallacy was published in 1994. Another publisher, Vermilion (an imprint of Random House), asked me to write a similar book for them and published my Eat Fat, Get Thin! in 2000. Both these books were aimed at a lay readership".
"Now in my mid sixties, after forty years of eating a low-carbohydrate, high-fat diet, I weigh 3kg (7 lbs) less than I did when I married and my wife is 7 kg (15 lbs) lighter. I also seem remarkably fit for my age. I took up archery in 1982 at the age of forty-six as a social outlet. In all I have taken twenty British Records in Target, Clout, and Flight archery, plus eleven international Gold Medals and four World Records. This, despite the fact that I take very little exercise as, for the last thirteen years I have spent most of my day sitting in front of a computer. I attribute this to my diet too as it is well documented that Eskimoes, on a high-fat diet, do not lose muscle tone when they retire to their igloos during the protracted Arctic winters."
Over the years, Groves has seen the low-carb diet help with a wide range of conditions besides weight loss including gastrointestinal disorders, migraines, eczema, psoriasis, arthritis, autoimmune diseases like lupus, heart disease, even multiple sclerosis.

LIFE WITHOUT BREAD
Life Without Bread (Keats Publishing; 2000) is mostly based on the clinical experience of Dr. Wolfgang Lutz, an Austrian medical doctor who successfully used low-carb diets for decades on thousands of patients. The results of Lutz' clinical successes have been published in several European medical journals (mostly in German) and he even authored a German version of LWB as far back as 1967 to good response (the book is now in its 6th edition). His work, however, was ignored in the English-speaking countries. After many years, with the help of American biochemist Dr. Christian Allan, Lutz succeeded in securing an American publisher and the results of his experience and research are now available to all English-speaking people.
In Lutz and Allan's definition, the low-carb diet should include no more than 72 gms of carbohydrates a day. The rest of the diet should be made up of protein and fat from a range of plant and animal sources. In sharp contrast to other low-carb books, Allan and Lutz discuss the effectiveness of low-carb nutrition in treating and preventing several diseases such as cancer, heart disease, diabetes, colitis, and Crohn's disease. Obesity is also dealt with, but is not the main focus of the book.
Lutz and Allan assert, "We've presented powerful evidence that the low-fat theory of nutrition has not fulfilled its promise, and that low-carbohydrate nutrition is a valuable tool in the fight against disease. This alternative to the fat theory is based not only on clinical information from over ten thousand patients in Dr. Lutz' practice, but also on basic biochemical facts and large amounts of published research data from many scientists and medical researchers throughout the world." (10)
In their meticulously referenced book, Allan and Lutz explain exactly how excessive carbohydrate intake negatively impacts the body's hormonally-controlled metabolic processes. Metabolism is a delicate equilibrium between anabolism (processes that build up and repair) and catabolism (processes that break down). "Too much carbohydrate in the diet disrupts the balancing act between anabolic and catabolic forces because it sends too much insulin into the blood. Since the body will always move to balance anabolic and catabolic reactions, increases in insulin must be dealt with in some way." (11)
That "way" is for the body to reduce its output of other anabolic hormones such as human growth hormone (needed to stimulate tissue repair and growth), and increase its output of catabolic hormones such as various corticosteroids (which can weaken the immune system). The consequences should be obvious: Chronically elevated insulin levels disrupt the entire endocrine system, leading to decreased tissue repair (from lack of growth hormone), reduced sexual function (from lack of sexual hormones), poor immune function, and insulin resistance.
The term "insulin resistance" is mentioned frequently in low-carb literature. It refers to our cells' inability to respond to insulin. Insulin is the hormone that shuttles glucose into our cells. It can do this by attaching to certain receptors on the cell wall. But when the receptors are full, the insulin/glucose cannot get in, leading to higher blood sugar and insulin levels. Over time, the elevations lead to hormonal imbalances which lead to the long-term damages mentioned above. The cell receptors get full by being clogged up with fat--the result of excess carbohydrates (not fat!) in the diet being converted into triglycerides (fat) by the liver. Sometimes, "insulin resistance" and its cluster of associated conditions, is referred to as "Syndrome X."
Allan and Lutz spend a considerable portion of their book debunking many of the myths surrounding low-carb nutrition. A theme running through the book is that saturated fats, found primarily in fats of animal origin, are not the villains modern nutrition makes them out to be.
The final chapter of LWB is also unique to the low-carb nutrition books available. It shows how to implement the low-carb eating plan in various people. Lutz and Allan wisely point out that older patients need to be eased into the program over a period of time, as opposed to jumping into it cold-turkey. They point out the possible health hazards of such an approach. This chapter is invaluable for clinicians.

THE OPTIMAL DIET
Polish medical doctor Jan Kwasniewski is credited with developing the so-called "Optimal Diet" a high animal fat, moderate protein, low-carb diet. "JK," as he is referred to by his followers, has authored numerous books in Polish on his research; a cookbook is also available. Two English translations of his books are currently available, the most recent being Homo Optimus, which contains recipes and the clinical effects of the Optimal Diet on a variety of diseases. (12)
The Optimal Diet differs from other low-carb approaches in that it maintains fairly strict ratios of the macronutrients in its meals. Dr. Bogdan Sikorski, a pharmacologist and toxicologist and translator of Homo Optimus, explains the salient features of JK's approach:
"The so-called ‘Kwasniewski Diet' also known as the ‘Optimal Nutrition' (ON) was developed over 30 years ago in Poland by Jan Kwasniewski, MD, and over the years it has been implemented by well over a million (some say two million) people in that country, in treatment and prevention of a range of diseases."
"In contrast to other low-carbate dietary regimens, this nutritional model dictates the exact proportion between the three main food components, protein, fat and carbate (1:2.5-3(min):0.8, respectively), which has to be achieved on a daily basis in order to obtain claimed health benefits. Therefore, unlike all other ad-hoc dietary low-carbate models, ON strictly controls daily intake of not only the "offending" sugars but also the intake of protein, the excess of which is also known to be detrimental to health. Most importantly, both fats and proteins should be biochemically as close as possible to those found in the human body, i.e., they have to be obtained from animal products. They should also contain a full complement of micronutrients, with products such as eggs, fatty bone broths, organ meats and pork fat being the most prominent examples." (13)
JK has operated a health clinic called Arkadia for many years in Poland, with visitors from across Europe with a host of degenerative diseases. "I saw miracles happening there," said an Australian medical doctor who emigrated from Poland. "It was simply unbelievable!" Optimal Diet support groups exist in Poland, the USA, and Australia--details can be found on the groups'' website listed at the end of this article.
Despite the diet's clinical success (numerous testimonials can be found on the groups' website), the Optimal Diet and JK have been officially condemned by the Polish medical authorities. In his response to the pronouncement, JK pointed out the unwillingness of the Polish medical board to even consider his careful clinical records, something he has been pushing for over the years.

OTHER VOICES
California-based endocrinologist Dr. Diana Schwarzbein, MD, and author of the best-selling The Schwarzbein Principle (14), is another proponent of low-carb diets. Schwarzbein's work with type two diabetics convinced her that the high-carb, low-fat diet pushed by most medical and nutritional authorities was a recipe for disease, including diabetes. As with Allan and Lutz, Schwarzbein exonerates naturally saturated fats of the evils attributed to them by the establishment. Her easy-to-read and well-referenced book contains numerous case histories and includes a substantial recipe section. Watch for the revision of The Schwarzbein Principle due out in September 2002.
American nutritional psychologist Julia Ross, MA, has written her own low-carb friendly book The Diet Cure (15). Though not specifically a low-carb book, Ross' work definitely leans towards a lower carb diet in helping to balance brain chemistry and maintain health.
Ray Audette, another American, has authored Neanderthin (16) which espouses a lower-carb diet that excludes all grains, dairy, and processed sugars. Audette, once stricken with rheumatoid arthritis, cured himself with the diet.
Medical doctors Michael and Mary Eades have authored two books espousing the low-carb approach, not just for weight loss but for a host of degenerative diseases and a way of living, too. Protein Power (17) and The Protein Power Lifeplan (18) encompass the Eades' philosophy and approach. As with Schwarzbein, the Eades'' work grew out of their clinical experience with patients: What they learned in medical school about diet and disease did not match up with their results with patients.
Nutritionists Ann Louise Gittleman (19) and Robert Crayhon (20) have also made their literary contributions to the low-carb movement.DANGERS?
Despite the clinical and biochemical evidence supporting the use of low-carb diets, most medical doctors and dieticians feel that such diets are dangerous. The specific fears center around misunderstandings about ketosis and mistaken ideas about the supposed dangers of animal fats and protein.
When used as a weight loss program, low-carb diets (when carb intake is less than 40 gms a day) result in ketosis, a process wherein the body breaks down fat for energy. It is claimed that this state is harmful and can lead to metabolic acidosis and death. While it is true that ketosis occurs in people who are starving to death as the body struggles to find fuel sources, it should be obvious that starving people and low-carb people are not in the same situation as the latter have abundant access to food, while the former do not. Diabetics can also enter a state called ketoacidosis, but this condition results from out of control blood sugar levels brought on by excessive carbohydrate intake. Again, this situation is not analogous to those following a low-carb diet (21).
Critics also accuse low-carb diets of promoting heart disease and cancer. The reason for this is that low-carb diets are invariably high in animal fat and meat and it is believed that these contribute to these illnesses. But several researchers have shown that naturally saturated fats do not contribute to heart disease (22). For example, an Indian study of over one million male railway workers found that the meat-eating ones had a heart disease rate eight times less than the vegetarian ones who ate much less saturated fat (23). Swedish medical doctor and chemist Uffe Ravnskov, MD, PhD, has authored The Cholesterol Myths (24) which exhaustively debunks the belief that naturally saturated fats or cholesterol cause heart disease.
The idea that animal fats or protein foods like red meat cause cancer is also an idea that is not true. Lipid biochemist Mary Enig, PhD, and her colleagues have shown that cancer rates correlate more closely with refined vegetable oil and trans-fatty acid intake from foods like margarine and vegetable shortening, not with animal fats (25). An exhaustive review paper by Australian researchers showed conclusively that red meat does not cause cancer (26). In contrast, some published research fingers refined sugars and excessive carbohydrates as the prime factors in cancer (27).
Critics also claim that eating a lot of animal protein will cause osteoporosis over time, but controlled studies have not borne this belief out. (28) Another criticism is that the increased protein intake on low-carb diets will hurt the kidneys or contribute to kidney stone formation but, again, studies have not shown these notions to be true. (29)
Many believe that carbohydrates are necessary to maintain our energy levels, but the body can utilize fatty acids for energy, as well as convert protein into glucose on an as-needed basis. "The mitochondria in our cells, the organelles that generate energy for us, are specifically designed to use fat for energy," said Dr. Allan. "Furthermore, many organs prefer fat as an energy source--not glucose," he concluded. Indeed, the heart prefers naturally saturated fatty acids for its energy needs, not glucose (30).
Another myth is that one needs to eat lots of fruits and vegetables to get enough vitamins and minerals each day. But Dr. Allan counters that, "While we do get some vitamins and minerals from plant foods, we can get more of them from animal foods. Even more importantly, there are many vitamins and cofactors that we only get from animal foods." Dr. Allan also commented that the public are misled into thinking that animal foods do not provide many nutrients because food-nutrient tables typically exclude animal foods from their lists, listing only plant foods instead. The reality is, however, that animal foods contain higher levels of almost every nutrient. Vitamins like A and D are only found in animal foods and nutritional factors like carnitine and CoQ10 are predominantly found in animal foods as well.
A final criticism is that low-carb diets do not have long-term published research testifying to their effectiveness, but this is not really true. Nutritional anthropological research of such population groups as the Inuit and Masai have shown that these heavy meat and fat eating peoples enjoy excellent health on their native diets (31). Furthermore, Stefansson and his travel companion Karsten Andersen ate nothing but a mixture of raw and cooked meat and fat for over one year in a monitored experiment at New York's Bellevue Hospital--with no ill-effects noted. Andersen''s health actually improved! (32)
The Fat of the Land
Despite the pronouncements to the contrary, low-carb diets have much to offer beyond weight loss. Before dismissing them as dangerous food fads, you should take a close and unbiased look at the clinical and biochemical research that supports them to see what benefit they could have for you.

Stephen Byrnes is a nutritionist who utilises low-carb diets in his practice. Visit his website and subscribe to his free newsletter at http://www.Power-Health.net

RESOURCES
The Weston A Price Foundation, www.WestonAPrice.org. An organization devoted to disseminating Weston Price''s research and providing accurate nutrition information. Local chapters are located in the USA, Canada, Australia, and the United Kingdom.
The Optimal Diet, http://www.members.optushome.com.au/bartim/. English translations of Dr. Kwasniewski''s books can be gotten from the website.
Barry Groves, PhD, http://www.second-opinions.co.uk
Uffe Ravnskov, MD, PhD, http://www.ravnskov.nu/cholesterol.htm
All of the books mentioned in this article are available from your local book seller, or from www.amazon.com.
NOTES
1. AB Savarin. Physiologie du Gout. Dtsch. Ausgabe: Bruckmann Querschnitte, Verlg.-Nr. 1152, F. Bruckmann KG, Munchen, 1962.
2. W. Banting. Letters on Corpulence. London, Harrison, 1864.
3. V. Stefansson. The Fat of the Land, New York, MacMillan Publishing, 1956.
4. WA Price. Nutrition and Physical Degeneration, New Canaan, CT; Keats Publishing, 1997.
5. R. Mackarness. Eat Fat and Grow Slim. Garden City, NY; Doubleday & Co., 1959.
6. J Yudkin. Sweet and Dangerous. New York; Van Rees Press, 1972.
7. RC Atkins. Dr. Atkins' New Diet Revolution. New York; Avon Books, 2002, 57.
8. S Fallon & MG Enig. "Tragedy and Hype: The Third International Soy Symposium." Townsend Letter for Doctors & Patients, July, August 2001. Posted at http://www.westonaprice.org.
9. (a) GD Foster, HR Wyatt, JO Hill, et al. Evaluation of the Atkins Diet: A randomized controlled trial. Obes Res. 2001;9(suppl 3):O132; (b) WS Yancy, JR Guyton, RP Bakst, et al. A randomized controlled trial of a very-low-carbohydrate diet with nutritional supplements versus a low-fat/low-calorie diet. Obes Res. 2001;9(suppl 3):PG17. Summary article is posted at http://www.medscape.com/viewarticle/418266
10. C Allan and W Lutz. Life Without Bread. New Canaan, CT.; Keats Publishing, 2000, 147.
11. Ibid., 27.
12. J Kwasniewski and M Chylinski. Homo Optimus. Poland; WGP Publishing House, 2002.
13. Dr. Bogdan Sikorski, PhD, personal interview, June 12, 2002.
14. D. Schwarzbein and N Deville. The Schwarzbein Pricnciple. Florida; HCI Communications, 1999.
15. J Ross. The Diet Cure. New York; Penguin Books, 2000.
16. R Audette and T Gilchrist. Neanderthin. New York; Jeremy Tarcher, Inc., 1999.
17. M & M Eades. Protein Power. New York; Bantam Books, 1997
18. M & M Eades. The Protein Power Lifeplan. New York; Bantam Books, 2000.
19. AL Gittleman. Eat Fat, Lose Weight. Illinois; Keats Publishing, Inc., 1999.
20. R Crayhon. The Carnitine Miracle. New York; M Evans Publishing, 1999.
21. RC Atkins. Dr. Atkins'' New Diet Revolution. New York; Avon Books, 2002, 57-58.
22. U Ravnskov. The Cholesterol Myths. New Trends Publishing; Washington, D.C., 2000; MG Enig. Know Your Fats: The Complete Primer on Fats and Cholesterol Bethesda Press; Maryland, 2000, 76-81; R Smith and E Pinckney. Diet, Blood Cholesterol, and Coronary Heart Disease: A Critical Review of the Literature. Vector Enterprises; California, 1991; The Cholesterol Conspiracy. Warren Greene, Inc.; USA, 1991; S Byrnes. Diet and Heart Disease: Its NOT What You Think. Whitman Books; 2001, 25-52; GV Mann, ed. Coronary Heart Disease: The Dietary Sense and Nonsense. Veritas Society; London, 1993.
23. SL Malhotra. Epidemiology of ischemic heart disease in India with special reference to causation. Brit Hrt J, 29, 895-905, 1967.
24. U Ravnskov. The Cholesterol Myths. New Trends Publishing; Washington, D.C., 2000.
25. MG Enig et al. Dietary fat and cancer trends--a critique. Fed Proc, 1978, 37:2215.
26. JS Baghurst et al. Does red meat cause cancer? Aust J Nutr Diet, 1997, 54(4):S1-S44.27.
27. (a) J. Witte et al. Diet and premenopausal bilateral breast cancer: a case control study. Breast Canc Res & Treat, 1997, 42:243-251; (b) S. Francheschi et al. Intake of macronutrients and risk for breast cancer. Lancet, 1996, 347:1351-6; c) S. Francheschi et al. Food groups and risk of colo-rectal cancer in Italy. Inter J Canc, 1997, 72:56-61; (d) S. Seely et al. Diet Related Diseases--The Modern Epidemic (AVI Publishing; CT), 1985, 190-200; (e) WJ Lutz. The Colonisation of Europe and our Western diseases. Med Hypoth 1995, 45:115-120.
28. H. Spencer and L. Kramer. Factors contributing to osteoporosis. J Nutr, 1986, 116:316-319; Further studies of the effect of a high protein diet as meat on calcium metabolism. Amer J Clin Nutr., 1983, 37:6: 924-9.
29. J. Dwyer et al. Diet, indicators of kidney disease, and late mortality among older persons in the NHANES I Epidemiologic Follow-up Study. Amer J of Pub Health, 1994, 84:(8): 1299-1303.
30. ML Garg. Lipids, 24 (1989):334-339.
31. (a) WA Price, op cit., 59-73, 129-163; (b) HL Abrams. Vegetarianism: an anthropological/nutritional evaluation. J Appl Nutr, 1980, 32:2:53-87.
32. V Stefansson. "Adventures in Diet." Harper's Magazine, November, December, 1935, January 1936; CW Lieb. The effects on human beings of a twelve months exclusive meat diet. JAMA, July 6, 1929, 20-22.