I recently read Carbohydrates Can Kill, by Robert K. Su, M.D., written in 2009. Per Amazon.com’s rating system, I give it four stars ( I like it).
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Many developed Western societies have a love affair with carbohydrates, particularly concentrated sugars and highly processed grains and starches. The U.S. is a good example. Our skyrocketing rates of overweight and obesity (68% of adults) are testament to that. Obesity is strongly linked to cancer, high blood pressure, heart attacks, diabetes, strokes, and premature death. It’s not too much of a stretch to blame carbohydrates for at least a portion of these diseases and others. Dr. Robert Su thoroughly reviews these connections in Carbohydrates Can Kill.
Blissfully unaware of his prediabetes
Blocked heart arteries are the No.1 cause of death in developed countries. A growing trend among the experts is to abandon the theory that total and saturated fats cause heart disease, pointing instead to excessive consumption of sugars and processed grains and other starches. Dr. Su makes a fairly convincing case for the carbohydrate theory of heart disease. He’s also convinced that carbs cause high blood pressure, dementia, many cancers, diabetes, overweight, perhaps even most diseases.
This book addresses overweight, adverse health effects of obesity, nutrition and digestion in detail, and numerous scientific studies supporting his ideas.
One of the most interesting things to me was Dr. Su’s personal medical story. At age 62, he found himself 40 pounds (18 kg) overweight, blood pressure 205/63, and having apparent reversible heart pains (angina) when stressed or exercising. The combination of salt restriction and exercise didn’t help. Reducing carbs to 60-70 g/day and continued exercise (walking and stair-climbing) did the trick, helping him lose 30 pounds and controlling angina and high blood pressure. I expected him at any time to reveal he had a heart attack, stroke, or heart bypass surgery, but he dodged those bullets. His problems at 62 were a wake-up call. He didn’t want to end up prematurely dead or disabled, a burden to his family and unable to spend quality time with them. So he undertook major lifestyle changes. Very inspirational.
In addition to a medical degree, Dr. Su has a degree in pharmacy. He knew he’d be put on multiple drugs if he went to a doctor for treatment of his symptoms. Like me, he’s wary of drug side effects and wanted to avoid them, opting for diet and exercise instead. He gambled and won. I’m sure at least a few others would not be so lucky.
Dr. Su cites evidence that high blood sugars cause inflammation, which can predispose to cancer. Diabetics do indeed have a higher risk of certain cancers, yet he didn’t mention that diabetics have a lower risk of prostate cancer.
Dr. Su is anti-alcohol. The studies are mixed on the overall health effects of alcohol, but the bulk of the studies link low-to-moderate consumption of alcohol with less cardiovascular disease and longer lifespan. Clearly, heavy drinking can be lethal.
Like all books, CCK isn’t perfect. First, it could have used better editing to eliminate grammatical errors and wordiness. Next, I suspect Dr. Su is getting a little ahead of the science when he states that “….most diseases, if not all, are directly or indirectly caused by too much blood sugar.” If carbohydrates are so deadly (mediated via high blood sugar), why do the Kitavan’s of Melanesia have such low rates of heart attack, stroke, overweight, and diabetes, despite a diet deriving 69% of total calories from carbohydrates? (Calories from carbohydrates in the U.S. are about 50% of the total.) Granted, Kitavan’s carbs are mostly unrefined. Could the Kitavans be genetically protected from carb toxicity?
So, what do we do if carboydrates are so dangerous? Dr. Su recommends limiting carb consumption to a maximum of 100 grams a day. (By way of reference, average U.S. carb consumption is 250 grams a day.) Simple sugars and highly processed grains and starches should be avoided. Additionally, he recommends a yearly glucose tolerance test to determine fasting blood sugar, then blood sugar readings every 15-20 minutes after an unspecified meal for two or three hours. I wonder if a single hemoglobin A1c blood test would suffice. I agree with Dr. Su that fasting blood sugars should be under 110 mg/dl (6.1 mmol/l)—if not lower—and all blood sugars after meals under 150 mg/dl (8.3 mmol/l).
Dr. Su is a tireless advocate for carbohydrate-restricted eating. Visit his website: carbohydratescankill.com. If his diet and exercise ideas were widely adopted in the U.S., we’d be a healthier country. This book is a worthy read for anyone with overweight, obesity, diabetes, prediabetes, or otherwise enamored of concentrated sugars and highly processed grains and other starches. Note that one of every three U.S. adults has prediabetes, including half of all those over 65, and most of them are unaware.
Steve Parker, M.D.