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Updated links to all of references in Fiber Menace

Anticipating in advance how controversial Fiber Menace may become, I've included footnotes and references at the end of each chapter, including, when available, the links to the original sources on the Internet.

That decision has served me well! Since the publishing of Fiber Menace in 2005, not a single medical authority came out to refute any of its findings because that would have also meant picking up a fight with all of the academic sources cited in the book.

Since then, many of the URLs referenced in the book have been moved, renamed, abandoned, or removed by their respective publishers. To help anyone wanting to review these links, my colleagues and I have brought them up-to-date in the spring of 2016. Here is a complete chapter-by-chapter list:

Introduction: Thou Shalt Not Eat Any Abominable Thing

1Bible, King James Version; Deuteronomy.14:3.

2Nabisco Graham Crackers; 21 g of carbohydrates and 1 g of fiber per one 28 g serving; NDB No: 18617; USDA National Nutrient Database for Standard Reference; [link]

3John Harvey Kellogg, MD; Treatment for Self-Abuse and its Effects: Plain Fact for Old and Young; F. Segner & Co.; 1888.

4For impacted stools to happen, a person must experience rectal impaction, which is an abnormal accumulation of hard stools inside the rectum. This is a condition usually associated with toddlers, paraplegics, the bedridden, infirm, and very old—not exactly a group of characters with sex on their minds.

5Strict vegetarians (i.e. vegans) don’t consume dairy, eggs, fish, seafood, fowl, or meat of any kind. Their diet consists of nothing but carefully combined vegetables, fruits, grains, and legumes. Protein malnutrition among vegans is common, and widely described in medical literature. Many Westerners consider themselves “vegetarians” even though the only food they exclude from their diet is red meat and pork. Nonetheless, the lore of “healthy vegetarians” is quite popular. I’ve yet to meet a person who didn’t know one, even though only 1% of adults in America (under two million) are practicing vegans, and most of them take prodigious amounts of supplements—vitamins, minerals, essential fatty acids, and free-form amino acids needed to maintain half-decent health.

6Kellogg Company of today was the result of an acrimonious split between John Kellogg and his brother and business partner Will, who insisted on adding sugar to the cereals. Sugar won. True to his principles, Dr. Kellogg never spoke to brother Will again.

7Kellogg Company Annual Report 2004; Page 30; [link]

8 Although fiber wasn’t explicitly mentioned in the scriptures, even God couldn’t have foreseen that some people would be crazy enough to consume indigestible substances and wash them down with lighting oil. Besides, Graham’s and Kellogg’s anti-sex crusade is a willful desecration of the sanctity of marriage.

9Philip S. Schoenfeld, MD, MSEd, MSc; Guidelines for the Treatment of Chronic Constipation: What Is the Evidence?; Medscape Gastroenterology. 2005;7(2) ©2005 Medscape; [link]. This quote refers to the following studies:

(7) Badiali D, Corazziari E, Habib FI, et al. Effect of wheat bran in treatment of chronic nonorganic constipation. A double-blind controlled trial. Dig Dis Sci. 1995;40:349–356.

(8) Anderson AS, Whichelow MJ. Constipation during pregnancy: dietary fibre intake and the effect of fibre supplementation. Hum Nutr Appl Nutr. 1985;39:202–207.

(9) Graham DY, Moser SE, Estes MK. The effect of bran on bowel function in constipation. Am J Gastroenterol. 1982;77:599–603.

Part I. Fiber Madness or Madness From Fiber?

1Protein-Energy Malnutrition; The Merck Manual of Diagnosis and Therapy; 17th ed,; Section 1, ch. 2; [link]

Chapter 1. Fiber Carnage

1Functional Constipation; Ch. 7: Rome II: The Functional Gastrointestinal Disorders by Douglas A. Drossman (editor);

2 Dietary, Functional and Total Fiber, Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients) (2002), Food and Nutrition Board (FNB), Institute of Medicine (IOM); [link]

3 The American Dietetic Association recommends fiber for children only after two years of age, and no more than 5 grams + the child’s age. That amounts to 7 to 13 grams of fiber for the two to eight-year-old age group. Health implications of dietary fiber, J Am Diet Assoc 2002;102:993–1000; [link]

4 Mayo Clinic; Fiber–A Good Carb; Consumer Health Tips and Products; June 11, 2004; [link]

5 KELLOGG’S ALL-BRAN WITH EXTRA FIBER; NDB No: 08253; USDA National Nutrient Database for Standard Reference; [link]

6 Metamucil Psyllium Fiber for Regularity, Smooth Texture, Orange; Package Detail; [link]

7Metamucil Powder; RiteAid Patient Counseling; © First Databank; The Hearst Corporation;  [link]

8 Weston A. Price, D.D.S. Nutrition and Physical Degeneration; 6th Edition. (Examples of tooth decay related to fiber consumption are provided through out the book.)

9There is still considerable controversy as to whether the pyloric valve is completely closed during gastric digestion or not, hence “locked” is written in parenthesis. Still, whatever the mechanisms, the stomach has a remarkable ability to retain its content until it is almost completely liquefied. For more information, see The Pyloric Sphincteric Cylinder in Health and Disease by A.D. Kleet; Internet edition: [link]

10 Hiatus Hernia; The Merck Manual of Diagnosis and Therapy; 3:20; [link]

11 Pancreatitis: Inflammation of the pancreas; The Merck Manual of Diagnosis and Therapy; 3:26; [link]

12 Crohn's Disease; The Merck Manual of Diagnosis and Therapy; 3:31; [link]

13 Functional Constipation; C3: p. 389;  Rome II: The Functional Gastrointestinal Disorders by Douglas A. Drossman (editor);

14 Dietary, Functional and Total Fiber—Summary; Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients); Food and Nutrition Board; Institute of Medicine;  2002; 7:265; [link]

15 What are polyps; Colon Polyps & Colon Cancer; D. E. Mansell, MD; [link]

16 Pelvic Organ Prolapse in the Women’s Health Initiative: Gravity and Gravidity; Hendrix SL., Clark A., Nygaard I., Aragaki A., Barnabei V., McTiernan A.; Am J Obstet Gynecol 2002;186:1160–1166.

17 Vaginitis Due to Vaginal Infections; National Institute of Allergy and Infectious Diseases (division of National Institutes of Health); [link]

18 Linda Van Horn, PhD, RD; Fiber, Lipids, and Coronary Heart Disease; A Statement for Healthcare Professionals From the Nutrition Committee; American Heart Association; [link]

19 Ibid (same as above).

Chapter 2. Water Damage

1 Health implications of dietary fiber, J Am Diet Assoc 2002;102:993–1000; [link]

2 Health implications of dietary fiber—Position of ADA; J Am Diet Assoc. 1997;97:1157–1159; [link]

3 Water. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, The National Academies Press. 4–56:2003; [link]

4 Health implications of dietary fiber; J Am Diet Assoc 2002;102:993–1000; [link]

5 Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004), Food and Nutrition Board, Institute of Medicine; pp 4–2:5.

6 Water and Sodium Metabolism, 2:12; The Merck Manual of Diagnosis and Therapy;[link]

7 Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004), Food and Nutrition Board, Institute of Medicine; p 4–1; [link]

8 National Health and Nutrition Examination Survey Home; [link]

9 Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004); Food and Nutrition Board, Institute of Medicine; [link]

10 The stomach doesn’t secrete properly diluted digestive juices directly, as is commonly and incorrectly thought. Specialized glands secret hydrochloric acid and digestive enzymes into the stomach’s cavity until their concentration in the already existing volume of liquid is brought up to the proper level. The liquids come from saliva, water, drinks, and solid food. When liquids aren’t available, the stomach will secrete necessary water.

11 Definition of osteoporosis: “A generalized, progressive diminution of bone density (bone mass per unit volume), causing skeletal weakness, although the ratio of mineral to organic elements is unchanged.”— 5:57; The Merck Manual of Diagnosis and Therapy; [link]

12 Cardiac Arrest; 16:206; The Merck Manual of Diagnosis and Therapy; [link]

13 Dr. Atkins was overweight, had heart problems: report; U.S. National-AFP News; Feb 10, 2004.

14 Mineral Deficiency And Toxicity; 1:4; The Merck Manual of Diagnosis and Therapy; [link]

15 Blood chemistry, especially mineral balances, is maintained within a fairly narrow range at the expense of all other organs. If a blood test indicates certain mineral deficiencies, the situation may be quite dire. Not all deficiencies related to mineral stores—certain endocrine (hormonal) disorders, for instance—may be perceptible through a blood test.

16 Water and Electrolytes. Recommended Dietary Allowances. National Aca­demy Press. 10th Edition, p. 250.

17 R.F. Schmidt, G. Thews; Water and Electrolyte Balance; Human Physiology, 2nd edition; p. 764.

Chapter 3. Atkins Goes to South Beach

1. Glucose Homeostasis and Fuel Metabolism; Medical Biochemistry, Baynes J, Dominiczak M; p. 243

2. Lipids. Recommended Dietary Allowances: 10th Edition (Dietary Reference Intakes). National Academy Press. 10th Edition, p. 49

3. Ibid., p. 59

4. Beef, short loin, porterhouse steak, separable lean only, trimmed to ¼ fat, USDA select, cooked, broiled; NDB No: 13469; USDA National Nutrient Database for Standard Reference; [link]

5. Magic in a Box; Ripley's Believe It Or Not; 2004 edition, p. 23

Part II. The Fiber Menace Gets Real

1 Ulcerative Colitis; NIH Publication No. 03–1597 April 2003; [link]

Chapter 4. Dysbacteriosis

1R.F. Schmidt, G. Thews. Colonic Motility. Human Physiology, 2nd edition. 29.7:733.

2Search on keywords “dysbacteriosis” and “dysbiosis”: [link],[link], on 6/19/2004.

3The Nobel Prize in Physiology or Medicine 1908. Nobel e-Museum. [link]

4Antibiotic-Associated Colitis; 3:29; The Merck Manual Of Diagnosis and Therapy; [link]

5American Dental Association. “ADA continues to believe that amalgam is a valuable, viable and safe choice for dental patients and concurs with the findings of the U.S. Public Health Service that amalgam has ‘continuing value in maintaining oral health.’» ADA Statement on Dental Amalgam, Revised January 8, 2002; [link]

6Mercury Compounds. U.S. Environmental Protection Agency. [link]

7Thomas M. Ball, M.D., M.P.H, et al. Siblings, Day-Care Attendance, and the Risk of Asthma and Wheezing during Childhood, New England Journal of Medicine, 2000 Aug;343:538–543.

8 Borody TJ, Warren EF, Leis S, Surace R, Ashman O.; Treatment of ulcerative colitis using fecal bacteriotherapy; Journal of Clinical Gastroenterology. 2003 Jul;37(1):42–7. PMID: 12811208.

Chapter 5. Constipation

1Epidemiology of constipation in the United States. Sonnenberg A. Koch TR., Dis Colon Rectum. 1989 Jan;32(1):1–8.

2Definitions, epidemiology, and impact of chronic constipation; Rev Gastro-enterol Disord. 2004;4 Suppl 2:S3-S10. PMID: 15184814.

3Constipation; American Gastroenterological Association; on-line brochure;

4Definitions, epidemiology, and impact of chronic constipation; Rev Gastro­enterol Disord. 2004;4 Suppl 2:S3-S10. PMID: 15184814.

5Prevalence of Major Digestive Disorders and Bowel Symptoms, 1989; National Center for Health Statistics, #212, March 24, 1992.

6Digestive Disorders, Fast Stats A-to-Z; National Center for Health Statistics; [link]

7Hemorrhoids; NIH Publication No. 02–3021; February 2002; [link]

8What are hemorrhoids?, a web site of Hemorrhoid Care Medical Clinic; [link]

9Diverticulosis and Diverticulitis; NIH Publication No. 04–1163; April 2004; [link]

10Constipation; The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2000 by Houghton Mifflin Company;
on-line edition: [link]

11About Kids GI Health; Constipation; International Foundation for Functional Gastrointestinal [link]

12R.F. Schmidt, G. Thews. Colonic Motility. Human Physiology, 2nd edition. 29.7:730.

13Ibid. 29.7:731.

14Tucker DM, et al; Dietary fiber and personality factors as determinants of stool output; Gastroenterology. 1981 Nov;81(5):879–83.

15A commode is a piece of furniture with a compartment for a chamber pot. Depending on the owner’s social status, upscale commodes—the progenies of contemporary bathrooms—had a seat concealed by the flip-up cover. The less fortunate had to rely on the outhouse or ditch. Most of the underdeve­loped world still does, and, actually, this is to their advantage, as the squatting position over a ditch is far more natural and superior to the higher-up toilet bowl, and less likely to cause constipation and hemorrhoids.

16Concise Medical Encyclopedia in six volumes, Volume 2, page 364, article “Feces.” (Russian language, 1991, Publishing House Soviet Encyclopedia.)

17Gatekeeper is the term used in the managed medical care industry (HMO). It describes the role of primary care physicians to limit patients’ access to expensive specialists. The gatekeepers, on average, allot less than 10 minutes to each patient.

18Constipation; American Gastroenterological Association; on-line brochure; [link]


20Site search on keyword “Fiber.” July 2, 2004.

21Functional Constipation; Rome II: The Functional Gastrointestinal Disorders by Douglas A. Drossman (editor); 3:386.


23Health implications of dietary fiber; J Am Diet Assoc 2002;102:993–1000; [link]

24Information about the Bristol Stool Form Scale is available on the Family Doctor Books’ web site (, which “are published by Family Doctor Publications in association with the British Medical Association.” Information is excerpted from the book entitled “Understanding your Bowels” by Dr. Ken Heaton. The actual preview chapter contains a number of egregious errors, particularly in the Passage times through the gut chart. While the rest of the information is mostly accurate and useful, some of the information will differ from this book in similar ways as most medical and popular literature related to this subject. The suggestion that Type 3 stool is “ideal” is incorrect, because this form is typical of latent constipation. [link]


26Functional Constipation; Rome II: The Functional Gastrointestinal Disorders by Douglas A. Drossman (editor); 3:384;

27USDA Nutrient Database for Standard Reference; [link]

Chapter 6. Hemorrhoidal Disease

1Hemorrhoids; NIH Publication No. 02–3021; February 2002; [link]

2What are hemorrhoids?, a web site of Hemorrhoid Care Medical Clinic; [link]


4The conjugated biliary salts form in the gallbladder from bile, and are the precursors of gallbladder stones. Fat-free or low-fat diets and obstruction of the duct that connects the gallbladder to the duodenum contribute to for-mation of gallstones. The obstruction itself may be caused by salts, stones, inflammation, or a combination of all three. The actual release of salts may be sudden, without any apparent reason, or preceded by a specific event, such as an airplane flight, certain foods, or medication. Apparently, the changes in atmospheric pressure or some other factors may cause the re-lease of biliary salts during or after the flight. When the released salts reach the large intestine, they cause profuse stools or diarrhea because of their strong laxative effect. People may often confuse this condition with “travelers” diarrhea, since it isn’t described in medial literature.

5Clinical Resources (Patient Brochures). The American Gastroenterological Association. [link]

6Hemorrhoids; NIH Publication No. 02–3021; February 2002; [link]


8What are hemorrhoids?, a web site of Hemorrhoid Care Medical Clinic; [link]

Chapter 7. Diverticular Disease

1Diverticulosis and Diverticulitis; NIH Publication No. 04–1163; April 2004; [link]


3Diagnostic radiography with specialized gamma camera that detects the distribution of a radioactive compound inside a specific organ or tissue.

4Prevention. Diverticular Disease. Health Guide A-Z. Jul 2004. [link]

5Diverticulosis; 3:33; The Merck Manual of Diagnosis and Therapy; [link]


7Prescription Information for DONNATAL EXTENTABS® Rev. 06/04; [link]

Chapter 8. Irritable Bowel Syndrome

1Irritable Bowel Syndrome; NIH Publication No. 03–693; April 2003; [link]

2Irritable Bowel Syndrome; 3:32; The Merck Manual of Diagnosis and The­rapy; [link]

3Irritable Bowel Syndrome; 7:C1:357; Rome II: The Functional Gastrointestinal Disorders by Douglas A. Drossman (editor);[link]

4Irritable Bowel Syndrome; The Burden of Illness;; [link]

5What I need to know about Irritable Bowel Syndrome. NIH Publication No. 03–4686, April 2003; [link]



Chapter 9. Ulcerative Colitis and Crohn’s Disease

1Ulcerative Colitis; NIH Publication No. 03–1597 April 2003; [link]

2Inflammatory Bowel Diseases; 31:3;The Merck Manual of Diagnosis and Therapy; [link]

3Crohn’s Disease; 31:3; The Merck Manual of Diagnosis and Therapy; [link]

4 Ulcerative Colitis; NIH Publication No. 03–1597 April 2003; [link]

5 Crohn’s Disease; 31:3; The Merck Manual of Diagnosis and Therapy; [link]

6 Diet and Stress; Ulcerative Colitis; Mayo Clinic; [link]

7 Ulcerative Colitis; NIH Publication No. 03–1597 April 2003; [link]

8Crohn’s disease; 31:3; The Merck Manual of Diagnosis and Therapy; [link]

9Ulcerative Colitis; NIH Publication No. 03–1597 April 2003; [link]


Chapter 10. Colon Cancer

1Arthur Schatzkin, M.D et al.; Lack of Effect of a Low-Fat, High-Fiber Diet on the Recurrence of Colorectal Adenomas; The New England Journal of Medicine; April 20, 2000; 342:1149-1155.

2Joene Hendry; ‘Digestible’ Carbohydrate May Boost Colorectal Cancer Risk; Reuters Health; June 27, 2002.

3National Center for Chronic Disease Prevention and Health; Colorectal Cancer Information; [link]

4Fiber: Start Rounding It. Harvard School of Public Health. [link]

5Psyllium; Alternative Field Crops Manual; [link]

6Isabelle Romieu, et al.; Carbohydrates and the Risk of Breast Cancer among Mexican Women; Cancer, Epidemiology, Biomarkers & Prevention 2004 13: 1283–1289.

7Federal Citizen Information Center, The Food Guide Pyramid; [link]

8WHO Cancer Mortality Databank; [link]. The most recent (2014) epidemiological data for digestive cancers is available here: [link]

9Joene Hendry; ‘Digestible’ Carbohydrate May Boost Colorectal Cancer Risk; Reuters Health; June 27, 2002.

10Isabelle Romieu, et al.; Carbohydrates and the Risk of Breast Cancer among Mexican Women; Cancer, Epidemiology, Biomarkers & Prevention 2004 13: 1283–1289.

Part III. Live to Eat, or Eat to Live? Both!

Chapter 11. Avoiding the Perils of Transition

1T. Fukawa, N. Izumida; Japanese Healthcare Expenditures in a Comparative Context. The Japanese Journal of Social Security Policy; Vol 3, No. 2 (Dec 2004).

2Rice, white, medium-grain, cooked; NDB No: 20051; USDA National Nutrient Database for Standard Reference.

3 Kellogg’s Raisin Bran; NDB No: 08060; USDA National Nutrient Database for Standard Reference.

4 Obesity, percentage of adult population with a BMI>30 kg/m2 (2003); Organization for Economic Co-operation and Development;


6 There is a commonly held misconception that native Africans consume a high-fiber diet. That may very well be true for very poor Africans living on some form of public assistance, but in traditional African tribal societies all of the food came from ranching, herding, hunting, and fishing, and not from land cultivation, which was taught to Africans by European missionaries and colonizers quite recently. Land overdevelopment for agricultural use has led to continent-wide environmental disaster, which brought along starvation, epidemics, and genocidal wars.

7 Morbid obesity is defined as being 100 lbs over ideal body weight or having a BMI (body mass index) above 40. According to his first book, a 6’ tall Dr. Atkins weighed 135 lbs when he graduated high school—a weight that was close to his ideal. At the time of his death Dr. Atkins weighted 258 lbs, a significant enough difference to qualify him for gastric bypass surgery, which is only approved for morbidly obese individuals.

8 Philip S. Schoenfeld, MD, MSEd, MSc; Guidelines for the Treatment of Chronic Constipation: What Is the Evidence?; Medscape Gastroenterology. 2005;7(2) ©2005 Medscape; [link].

9 Ibid.

10 Ibid.

11 To learn more about food additives consult “A Consumer’s Dictionary of Food Additives” by Ruth Winter, M.S. Its 6th edition lists 12,000 additives that are routinely added to food. The 5th edition contained only 8,000 entries. At best, I am familiar with just 2 to 3% of them. There are so many additives because concocting and selling ersatz foods from factory-made ingredients is immensely more profitable than dealing with perishable, natural foods.

12 There are six types of laxatives: bulk-forming (fiber, psyllium), lubricant (mi­neral oil), emollient stool softeners (Colace), hyperosmolar (lactose, sorbitol), stimulant (sena, castor oil, aloe juice), and saline. All of them have side effects, and none are suitable for people affected by IBS, Crohn’s disease, or ulcerative colitis. This represents a particular challenge for people with severe organic constipation. In that case, the brief use of saline laxatives to normalize stools is the lesser evil.

13 U.S. Food and Drug Administration; Questions and Answers on Zelnorm (tegaserod maleate); [link]

14 Most sliced cheeses that are sold in supermarkets are factory-made (pro­cessed) from various dairy and non-dairy components. Natural cheeses are made from fermented whole milk and are gradually ripened to the desired consistency. Most of them still retain live bacteria. Softer cheeses, such as brie, contain more live bacteria.

15 R.F. Schmidt, G. Thews. Colonic Motility. Human Physiology, 2nd edition. 29.7:731.

16 Resisting good food and fine spirits while dining out is a challenge. The price for indiscretion is paid the morning after: fatigue from poor sleep, dry mouth from alcohol-related dehydration, headache from sulfites added to wines, bloating from overeating, etc. These after-effects, even the minor ones, ruin my ability to research and write, sometimes for days. For these reasons, I avoid parties and conventional restaurants like the plague. We do eat out often, though, but mostly in sushi bars or simple restaurants, which serve the most basic food. It’s hard to overindulge in sashimi, lobster tail, or a piece of rotisserie chicken. As Spartan as it may seem, ours isn’t an austere existence, but a preferred lifestyle dictated by professional and personal necessities. In other words, I do it for the same reasons other responsible professionals (models, actors, athletes, anchors, surgeons, pilots, etc.) watch their diets, take supplements, and go to bed early: to walk the walk, talk the talk, look the part, and move ahead.

17 Similar symptoms may accompany severe hangovers, because excess alcohol blocks gastric digestion. If you feel nausea after too much food and too many drinks, it’s best to throw up immediately to prevent further putrefaction and ensuing poisoning.

18 To make digestive juices, the body draws water mainly from the blood. A dry mouth an hour or so after a meal means that your body is partially dehydrated, because it needed to use a lot of intrinsic fluids to make up the digestive juices. Drinking while the meal is digesting isn’t going to relieve dehydration, because the water you just drank can’t get down into the duodenum and get assimilated back into the bloodstream. This water can, however, dilute digestive juices, extend digestion, and cause indigestion. So it’s best to swish a sip of mineral water and spit it out. Also, chewing something sweet stimulates saliva secretion, and relieves a dry mouth condition. It’s a good idea not to drink liquids at least 4–6 hours after a protein-based meal, longer for older adults.

19 Smith J.L.; The Role of Gastric Acid in Preventing Foodborne Disease and How Bacteria Overcome Acid Conditions; Journal of Food Protection, Volume 66:7, 1 July 2003, pp. 1292–1303(12).

20  It’s a challenge to have just one protein-based meal a day because we are conditioned to variety from childhood. In reality, variety is the enemy of good digestion, because your digestion can never adapt well to an ever-changing array of food. It works fine in the young and healthy, but as we get older, variety causes all kinds of digestive problems. To avoid this trap, I adapted to a Japanese style of eating. In Japan, a communal bowl of warm cooked rice is available all day long for breakfast, lunch, and snacking. Proteins are consumed mostly with dinner. I boil myself 2.5 oz (70 g) of regular white rice each morning, add 50–60 g of butter (82% fat), and eat the first batch around 12 pm, the second around 4 pm. That’s about 50 g of carbs and almost zero fiber. We have dinner between 7 and 8 pm, which usually consists of a small piece of herring (a source of salt) with a slice of butter, and a simple dish without sides, such as lamb or beef stew, grilled chicken, lamb chops, or filet mignon. We don’t cook fish at home, because once you get used to sashimi, home-cooked fish isn’t very tasty. I may have a glass of wine with our meal, but prefer not to, because it stimulates too much appetite and tires me out for the rest of the evening. For desert, I may have two-three small butter Danish cookies, a scoop of natural ice cream, or a small shot of port. Bite-size sweets, especially when chewed very slowly, raise the blood sugar back up, and suppress appetite. It took me about five years to gradually adapt to this little food, and to enjoy it. I’m rarely hungry, nor do I experience any kind of distress before or after a meal. My weight stays stable at 155 lbs (5’7”) plus or minus 2–3 lbs. My exercise routine is limited to daily walks, and brief morning stretches, yet my body is quite fit and muscular for a relatively sedentary writer who is over 50. I work 12 to 15 hours every day in front of the computer, mostly writing, reading, or researching the Internet. My wife, who is much more active physically and emotionally, has a slightly more varied diet (banana, morning coffee, occasional bagel, and one or two European beers daily). Tatyana is also 5’7,” weighs 125 lbs, and has never been to the gym or dieted. We both take professional-quality supplements, because our diet is certainly deficient in many essential vitamins and minerals. We drink primarily European bottled water with a high mineral content, about three to four glasses daily—one in the morning, one with supplements, and one before dinner. Obviously, we drink more when outside in the heat, mowing the lawn, etc.

21 Rare organ meats (liver, kidney), soft eggs yolks, raw fish, and caviar are the most abundant dietary sources of vitamin B6. It is easily ruined by cooking. Quality supplements are the optimal source, because the consumption of rare organ meats, soft yolks, and rare fish is generally discouraged for sanitary purposes. Raw carrots and brewer’s yeast contain a great deal of B-complex vitamins. However, their widespread consumption is a nutritional novelty.

22 The healthier you are, the higher the probability of a foul mood, because even a slightly elevated insulin level in healthy people lowers glucose faster than in people already affected by metabolic disorders, such as diabetes or insulin resistance. That’s also why younger, healthier people are impacted by severe depression more often than middle-aged adults, who are either not as healthy, or have already begun counting carbs for health and weight reasons.

23 In people such as myself and my wife, who are accustomed to a low-carb diet, fatigue and the occasional bad mood are associated with cravings not for sugar, but for sashimi, rare steak, raw oysters, foie gras, or eggs Benedict—all abundant sources of tryptophan and vitamin B6 (except oysters).

24 “Sugar uptake” is a clinical term which describes the relative rate of change (dynamics) of measurable blood sugar. Slower uptake indicates the presence of a metabolic disorder, such as diabetes. On the other hand, a very fast uptake in healthy people may cause hypoglycemia.

25 The liver, muscles and cells store excess glucose as glycogen, a complex carbohydrate represented by a very long chain of linked molecules of glucose. When the blood’s glucose gets too low, and none is coming from food, the pancreas releases the hormone glucagon, which in turn stimulates the breakdown of glycogen into glucose. The glucagon also stimulates the release of triglycerides from adipose tissue (body fat). Cells, other than the brain’s, can metabolize triglycerides into energy via the process known as lipolysis, which Dr. Atkins made famous by incorrectly naming it “ketosis” in his first book (1972). He somewhat correctly called it “ketosis/lipolysis” in his second (1992), and, correctly used the term “lipolysis” in his final (2002) book. This error cost him dearly, because ketosis is a shorthand for diabetic ketoacidosis (DKA)—a deadly condition specific to hyperglycemia (extremely high blood sugar), dehydration, and acidosis (elevated blood pH). Naturally, doctors were up in arms, because “safe ketosis” for them is akin to “safe coma.”

26 Natural yogurt is almost lactose-free, because most of the lactose is consumed by bacteria during fermentation. Supermarket-variety yogurts are lite­rally cooked from skim milk, milk solids, and soluble fiber additives to create body rather than fermented naturally. They still retain most of the lactose, and aren’t suitable for low-fiber diets or people with allergies and lactose intolerance to dairy.

27 Alcoholic beverages contribute to obesity not just from their energy content, estimated at seven calories per gram of pure alcohol, but from lowering the blood sugar, which causes intense sugar cravings and stimulates the appetite. Because of its potent sugar lowering effect, alcohol also stimulates insulin release. That’s why some mildly drunk people are so aggressive and rage-prone. Alcohol’s influence on the blood sugar/insulin dynamic is behind the dumb-ass recommendation that people affected by diabetes drink wine. Considering alcohol’s impact on the liver, kidneys, hypertension, and triglyce­rides, wine for diabetics is as poisonous as sugar syrup.

28 This isn’t what you’re going to read in books dedicated to this subject, because the glycemic index concept was originally developed for people with insulin-dependent diabetes, but was later transferred to healthy people without adequate thought and analysis. In automotive terms, the engine that runs on low RPMs (revolutions per minute) will outlast the same engine that runs at high RPMs, assuming that both run the same amount of time. However, if you run your low RPM engine for five hours at a time, and your high RPM for only 10 minutes, guess which engine will last longer?

29 Technically, digested carbohydrates enter the body as either glucose, fructose, or galactose—the three basic molecules that make up all carbohydrates. For example, table sugar (sucrose) is made from one molecule of glucose and one of fructose. Milk sugar (lactose) is made from glucose and galactose, also one of each. Glucose was originally called grape sugar, because grapes contain pure glucose. Both the fructose and galactose get converted into glucose by the liver; however, their exact metabolic path is murky even today. Many processed foods add fructose instead of sugar as the main sweetener. Because table sugar must be listed on the label separately from total carbohydrates, this little trick allows manufacturers to label a pro­duct as “low sugar” or “no sugar added,” which is true in a formal, legal sense, but a blunt deception in terms of human physiology and metabolic impact. The hypoglycemic effect of fructose is similar to glucose. Fructose is made from cornstarch.

30 Another reason for after-the-meal drowsiness is, of course, hypoglycemia. If you can’t afford a snooze after lunch don’t eat mixed (i.e. protein and carb) meals. The meal must be either pure carbs to speed up digestion and utilize insulin (just like water, carbs don’t get assimilated until they reach the small intestine) or carb-free to prevent the release of stored insulin, which shoots blood sugar down as soon as you begin eating. This approach requires some time to adapt your endocrine system to a new eating pattern.

31 The following conditions are associated with albuminuria: bladder tumor, congestive heart failure, diabetic nephropathy, glomerulonephritis, nephrotic syndrome, polycystic kidney disease, interstitial nephritis, membranous nephro­pathy, necrotizing vasculitis, glomerulonephritis. reflux nephropathy, renal vein thrombosis, malignant hypertension, heavy metal poisoning, and others.

32 Paul Whittaker, et al.; Iron and Folate in Fortified Cereals; Journal of the American College of Nutrition, Vol. 20, No. 3, 247–254 (2001); [link]

33 Newer Knowledge of Dairy Foods; National Dairy Council; [link]

34 Catherine S. Berkey, et al.; Milk, Dairy Fat, Dietary Calcium, and Weight Gain: A Longitudinal Study of Adolescents; Arch Pediatr Adolesc Med 159: 543–550.

35 The Use and Misuse of Fruit Juice in Pediatrics; American Academy of Pediatrics; Committee on Nutrition; Pediatrics 2001;107:1210–1213.

36 Agricultural Research Center; USDA National Nutrient Database for Standard Reference; [link]

37 Dietary Guidelines for Americans 2005. The U.S. Department of Health and Human Services; [link]

38 United States Department of Agriculture; [link]

Chapter 12. The Low-Fiber Advantage

1 The level of LDL (“bad”) cholesterol is determined primarily by age and genetics. Normally, it goes up as people get older, and has no direct bearing on your diet, because LDL cholesterol (as measured) is produced exclusively by the liver regardless of your diet’s fat and cholesterol content. Actually, a falling level of cholesterol, including LDL, indicates liver disease, and is in fact one of the first symptoms of impending liver failure and death. According to The Merck Manual of Diagnosis and Therapy (2:15. Hyperlipidemia), the ave­rage (that means 95th percentile) level of cholesterol (LDL+HDL) for healthy people “ranges from 210 mg/dL (5.44 mmol/L) in Americans < 20 yr old to > 280 mg/dL (> 7.25 mmol/L) in those > 60 yr old.” [link]

2Paradoxically, if your goal is to add bulk to your diet, you are better off taking a supplemental fiber, than consuming a high-fiber natural diet, because supplements don’t add any digestible carbohydrates to an already bad mix.

3“Prediabetes” is a recently concocted term that describes people who have most or all of the symptoms of type II diabetes, except that their blood test is still below the threshold for diabetes. Please note that diabetes itself is a “syndrome,” which means a group of symptoms that make up a disorder. Because most physicians still rely on highly unreliable “fasting plasma glucose” blood tests, a great deal of people with diabetes aren’t diagnosed at all, are diagnosed with the incorrect type (i.e. type I or II), or are wrongly diagnosed (don’t have any diabetes).

4I am acquainted with someone who experienced a remission of hepatitis C infection (determined by the absence of antibodies) after following a near zero-carb diet for about five years. He adopted that diet after reading my Russian-language books, because he was affected by type II diabetes, which is now also in complete remission. By current yardsticks, a recovery from hepatitis C is considered a miracle. I’m not surprised, however: just as antibodies from most vaccines eventually wear off, apparently hepatitis C antibodies can also vanish. You just have to create a proper environment for healing. Apparently, a zero-carb diet did it for this man. Keep in mind that just one case like this, even well documented, is still considered anecdotal and unrepresentative, and is in no way indicative of what may transpire in any other case.

5 U.S. Center for Disease Control, Special Focus: Diabetes; [link]; page 11.