Book Review: The Art and Science of Low Carbohydrate Living

I just finished reading The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable, by Stephen Phinney, M.D., Ph.D., and Jeff Volek, Ph.D. published this year.  I give it four stars per’s rating system ( I like it).

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The authors medicalize overweight and obesity by naming the cause of most cases to be “carbohydrate intolerance,” along the lines of lactose intolerance and gluten intolerance.  Given the myriad illnesses and shortened lifespan associated with obesity, medicalizing it isreasonable.  Ask Gary Taubes why we get fat, and he’ll say it’s excessive consumption of carbohydrates, especially sugars and refined flours.  Ask Phinney and Volek, and they’ll say “carbohdyrate intolerance.”  For them, the “treatment” is avoidance of carbs.

If a patient asks me why he’s fat, I guess I’d prefer to say “you have carbohydrate intolerance,” rather than “you eat too many carbs.”  It’s less confrontational and doesn’t blame the patient.

So how many of us in the U.S. have carbohydrate intolerance?  The authors estimate a hundred million or more – about a third of the total poplulation, or more, who could directly benefit from carbohydrate restriction.  I agree.

Before reading this book, I was convinced that carbohydrates are indeed major contributors to overweight and obesity, especially concentrated sugars and refined grains.  The authors cite much of the pertinent scientific/medical literature. 

Gary Taubes made the same case in his brilliant book, Good Calories, Bad Calories.  Dr. Robert Atkins argued the same in Dr. Atkins New Diet Revolution.  The problem is that many healthcare providers such as physicians and dietitians are biased against those sources.  Physicians resist a non-physician such as Taubes giving them advice about the practice of medicine.  And most physicians over 45 still labor under the misconception that dietary cholesterol and total and saturated fat are major-league killers, so they’ve already dismissed Dr. Atkins and don’t have time to get caught up to date on the recent research.

Phinney and Volek have wisely targeted this work towards healthcare providers such as physicians, so it’s somewhat technical and clinical.  Both have Ph.D.s and Phinney is also an M.D.  The authors are respected researchers who thoroughly review the science behind low-carb eating.  They explain how high blood pressure, metabolic syndrome, type 2 diabetes, and other conditions are related to carb consumption.

I rate the book four stars instead of five only because it’s a little pricey at $29 (US).

Smart nutrition- and fitness-minded folks will also benefit from a reading.  For a more consumer-oriented book, I recommend the authors’ The New Atkins for a New You or Taubes’ Why We Get Fat.

Steve Parker, M.D.


Filed under Book Reviews, Carbohydrate

8 responses to “Book Review: The Art and Science of Low Carbohydrate Living

  1. Steve… know I respect you! You don’t tell your patients that? You tell them it’s the cals, right?

    • Richard Merrill

      Steve, how often have you a heard a conversation something like this:

      Me: I can’t understand why I’m gaining wait! It must be this, it must be that. I just don’t understand why this is happening!
      You (Steve): It’s really quite simple. You’re taking in more calories than you’re burning. It’s really just that simple. Eat less, burn more.

      Let’s look at this same conversation slightly differently. Let’s say you (Steve) are the owner of a restaurant and you notice that the restaurant is a lot more packed today than normal. You ask me:

      Steve: Why is the restaurant so packed today? Is it this, could it be that, I really don’t get it!
      Me: Well it’s really quite simple Steve. There are more customers coming in than there are going out. It’s really just that simple.

      And that’s why the whole calories thing doesn’t do it for low-carbers. We acknowledge that there’s more calories coming in than going out. The question is why. Why do some people stop eating before they gain weight and why do others keep eating?

  2. …meaning, you don’t let them off the hook and think it’s the carbs, right? We are not, after all this time…on separate paths surely!!
    what’s been working for me:

  3. Hey, Steve.
    So good to hear from you! I’m still a believer in calories in/calories out, for sure. On the other hand, fat tissue is regulated in a major way by insulin. Without insulin, type 1 diabetics waste away, losing fat and muscle mass, and eventually die if they don’t get insulin. People who make adequate amounts of insulin don’t have to worry about that.

    • Tuan Nguyen

      Insulin promotes the creation of fat from glucose, and the storage of fat in adipose tissue, especially around the viscera.
      Prolonged exposure to high level of dietary carbohydrates results in decreased insulin sensitivity, a higher level of insulin in the blood serum, obesity, and accelerated senescence and degeneration of cells (ref Cynthia Kenyon, the DAF2 and the FOXO genes).

  4. I’m appreciating more and more that nutrition (including weight loss), has to be at least somewhat of an individual thing…..
    Good to catch up on your blog Steve – always appreciate your work!

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