Dr Campbell's 'The Low Carb Fraud' - Book Review

Following on from the success of his best-selling book The China Study, Dr Campbell turns his hand at debunking the science behind a low carbohydrate diet. Here is our take on his new book, The Low-Carb Fraud.

Before we delve into Dr Campbell’s book describing why the science behind a low carbohydrate lifestyle is flawed, here is a little background on Dr Campbell’s research.


The data collected by Dr Campbell and his team is based on the data published in Diet, Life-Style, and Mortality in China: A Study of the Characteristics of 65 Chinese Counties. This study was a massive undertaking involving thousands of man hours collecting and analysing data. A feat to be reckoned with and a study which has yet to be rivalled within nutrition academic circles for sheer scope and size. The data presented in this study is the foundation upon which the bestselling ‘The China Study’ book is based on. The book claims that this study is the definitive proof that a plant based diet is key to prevent disease. He argues that the reason behind our current health issues is because we consume too much animal based products i.e. dairy and animal protein. There are a lot of critiques on the web as to why the conclusions reached by Dr Campbell in his book do not reflect the data that was presented in the study. Our aim here is not to criticise the China Study, but rather a response to the claims made in Dr Campbell’s book the Low Carb Fraud.


Throughout the book, Dr Campbell singles out Gary Taubes’s arguments as the ones that need correction (Gary Taubes is a science journalist, writer of Good Calories, Bad Calories and Why We Get Fat. He is one of the mainstream advocates for the promotion of a low carb lifestyle to help prevent and manage the current obesity epidemic). Dr Campbell states that the science behind a low carbohydrate lifestyle is flawed.


However, upon reading his book, it seems to me that Dr Campbell is unaware of what a low carbohydrate diet is actually all about. Advocates of this lifestyle do not promote a zero carbohydrate lifestyle but rather a differentiation between simple, complex and dietary fibre carbohydrates due to their effect on blood sugar.


He goes on to say that carbohydrates are required to “facilitate the digestion and absorption of other nutrients in the gut” - carbohydrates, according to biochemical textbooks, are required as a bulking agent (dietary fibre) however starches and simple carbohydrates have little to no impact on mineral and vitamins. Rather, dietary fat is required to facilitate fat-soluble vitamin absorption, not to mention that the greatest nutritional profiles come from fruits and vegetables that contain a higher degree of dietary fibre rather than anything else.


Dr Campbell goes on to add that a diet low in carbohydrate is by definition a diet high in fat. This is not necessarily true. A dietary approach such as Natural Ketosis, allows the body to enter a state of nutritional ketosis through a low sugar, low starch, high protein, moderate fat approach. He goes on to explain that a low-fat diet, with this fat coming from plant based food items is good for health. By this I’m assuming he means the omega-3 & 6 found naturally in nuts and seeds - which funnily enough are also a main staple on a low carb diet.


Our bodies are also made up of cholesterol. In fact, if dietary cholesterol is not sufficient to meet the body’s demand, then the liver will have to produce cholesterol. A diet deficient in cholesterol leads to conditions such as Non-Alcoholic Fatty Liver Disease (NAFLD). One way of explaining why excess carbohydrate intake (from simple and starchy food items) is to understand how foie gras is made: ducks are fed a high carbohydrate, low fat diet to help fatten their livers up to produce this French delicacy. In humans, the same process is happening through the continuous health message to eat 50% of your total energy from grains and less fat. Studies have shown that when a low carbohydrate diet is followed, liver function is helped.


However, what was most unsettling about reading this book is that Dr Campbell describes and understands the dangers that too much or too little sugar in the blood can have on overall health. Yet a diet rich in fruits and plant based foods such as legumes (legumes are not starchy carbs but related to pulses which are still starchy), whilst they do have a level of other important micronutrients, will be digested into simple sugars which will reach the bloodstream. This latter outcomes far outweighs any nutritional benefits from consuming these items as a staple in one’s diet.


Eating starch whether in legumes or grains or root vegetables will raise insulin levels significantly in some people which leads to weight gain and other metabolic disorders.


Weight loss and health are not simply the results of calculating energy intake, but about maintaining your hormones balanced, especially insulin, and your inflammation markers low. For optimal benefits, it is important to ensure that real food is the core of your nutrition regimen. Here at Natural Ketosis we believe that real food is key to keeping healthy and slimmer forever.


Further Reading:


Browning JD, et al. (2011). Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction.  Am J Clin Nutr, 93(5): 1048-1052


Steven E. Shoelson, Jongsoon Lee, Allison B. Goldfine. (2006). Inflammation and insulin resistance. J Clin Invest. 116 (7): 1793-1801.


Linda Wasserbach York, Swathy Puthalapattu, and George Y. Wu. (2009). Nonalcoholic Fatty Liver Disease and Low-Carbohydrate Diets. Annual Review of Nutrition. 29: 365 -379


David Tendler, Sauyu Lin, William S. Yancy Jr., John Mavropoulos, Pam Sylvestre, Don C. Rockey,Eric C. Westman. (2007). The Effect of a Low-Carbohydrate, Ketogenic Diet on Nonalcoholic Fatty Liver Disease: A Pilot Study. Digestive Diseases and Sciences, 52 (2) :589-593


Goodarz Danaei, Carlene MM Lawes, Stephen Vander Hoorn, Christopher JL Murray, Majid Ezzati. (2006). Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment. The Lancet, 368 (9548) : 1651-1659,


Rossi M, Turati F, Lagiou P, Trichopoulos D, Augustin LS, La Vecchia C, Trichopoulou A: Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC). Diabetologia 2013.


Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC: Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA 2007, 297(9):969-977.


Halton T.L, Willett W.C, Liu S., Manson J.E, Albert C.M, Rexrode K, Hu F.B.  Low-Carbohydrate-Diet Score and the Risk of Coronary Heart Disease in Women. NEJM, 2006, 355:1991-2002  


Hession M, Rolland C, Kulkarni U, Wise A & Broom J. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obesity Reviews, 2008, 10 (1): 36-50.


Daly M.E, Paisey R, Millward B.A et al. Short-term effects of severe dietary carbohydrate-restriction advice in type 2 diabetes-a randomized controlled trial. Diabetic Medicine, 2006, 23: 15-20.


Dyson P.A., Beatty S., & Matthews D.R. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. Diabetic Medicine, 2007, 24: 1430-1435.


Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Annals of Internal Medicine, 2005, 142: 403–411


Yancy WS, Jr., Olsen MK, Guyton JR, Bakst RP, Westman EC: A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med 2004, 140(10):769-777


Foster GD, et al. A randomized trial of a low-carbohydrate diet for obesity. NEJM, 2003, 348:2082-2090


Samaha FF, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. NEJM, 2003, 348:2074-2081    


Brehm BJ, et al. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab, 2003, 88:1617–1623


Shai I. et al. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. NEJM, 2008, 359:229-41.


Forsythe CE, Phinney SD, Fernandez ML, Quann EE, Wood RJ, Bibus DM, Kraemer WJ, Feinman RD, Volek JS: Comparison of low fat and low carbohydrate diets on circulating Fatty Acid composition and markers of inflammation. Lipids 2008, 43(1):65-77.


Volek JS, Fernandez ML, Feinman RD, Phinney SD: Dietary carbohydrate restriction induces a unique metabolic state positively affecting atherogenic dyslipidemia, fatty acid partitioning, and metabolic syndrome. Prog Lipid Res 2008, 47(5):307-318.


Volek JS, Phinney SD, Forsythe CE, Quann EE, Wood RJ, Puglisi MJ, Kraemer WJ, Bibus DM, Fernandez ML, Feinman RD: Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet. Lipids 2009, 44(4):297-309.


Nickols-Richardson SM, et al. Perceived hunger is lower and weight loss is greater in overweight premenopausal women consuming a low-carbohydrate/high-protein vs high-carbohydrate/low-fat diet. J Am Diet Assoc. 2005, 105:1433-1437.


McClernon FJ, Yancy WS Jr, Eberstein JA, Atkins RC, Westman EC. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity 2007, 15(1):182-7.


Aude YW, et al. The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat. Arch Intern Med. 2004, 164:2141-2146


Meckling KA, et al. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab, 2004, 89: 2717–2723


Keogh JB, et al. Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. Am J Clin Nutr, 2008, 87 (3):567-576


Tay J, et al. Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects.J Am Coll Cardiol 2008, 51:59–67


Guldbrand, et al. In type 2 diabetes, randomization to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Diabetologia, 2012, 55:2118–2127


Nancy F. Krebs, Dexiang Gao, Jane Gralla, Juliet S. Collins, and Susan L. Johnson. Efficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese Adolescents. J Pediatr, 2010, 157(2): 252–258.


Paoli A, Rubini A, Volek J.S, Grimaldi K.A.  REVIEW: Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. EJCN, 2013, 67: 789–796.


Samaha F.F, Foster G.D, Makris A.P. Low-carbohydrate Diets, Obesity, and Metabolic Risk Factors for Cardiovascular Disease. Current Atherosclerosis Reports, 2007, 9:441–447


Liu X, Zheng G, Xingwang Y, Li H, Chen X, Tang L, Feng Y, Shai I, Stampfer M.J, Hu F.B., Lin X. Effects of a low-carbohydrate diet on weight loss and cardiometabolic profile in Chinese women: a randomised controlled feeding trial. BJN, 2013, 110, 1444–1453  


Bueno N.B, Vieira de Melo I.S, Lima de Oliveira L, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. BJN, 2013, 110, 1178–1187  


HM Dashti, TC Mathew, T Hussein, et al. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol, 2004, 9(3):200-205.


Andrew P, McPherson C & McEneny J. The biochemistry of ketogenesis and its role in weight management, neurological disease and oxidative stress. J Physiol Biochem, 2012, 68:141–151


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Pérez-Guisado J, Muñoz-Serrano A & Alonso-Moraga A. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. Nutrition Journal 2008, 7:30  




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