In late October 2016, the journalist Catherine Price joined me for breakfast at a National Association of Science Writers conference in San Antonio, Texas. Catherine has type 1 diabetes, which has given her more than a passing interest, both personal and professional, in how the macronutrients she consumes influence her blood sugar and hence the work of managing her diabetes. She politely insisted at our breakfast that I had to write a book that communicated the messages from my research and my previous work, which informed people both how and what to eat if they are among those on the spectrum from merely fattening easily to fully diabetic and hypertensive. As is invariably the case with Catherine, her arguments were persuasive. This book is a direct result of that breakfast meeting. As I wrote and researched it, it evolved to be something different than we had initially envisioned (for better or worse), but it would not have happened had Catherine not started the process. I am very grateful.
This book is also the end result (so far) of twenty years of research, writing, collaboration, and revolution. As such, any acknowledgments section of reasonable length is bound to be inadequate. The most important individuals contributing to this work, without which none of it would have happened, are the physicians and other medical practitioners who took it upon themselves to try to solve the problem of obesity when the research establishment and the authorities had so conspicuously failed. These individuals have all the attributes that you would want for both doctors and scientists. They are compassionate and curious; they are open-minded and have the courage of their convictions. They did not, as Winston Churchill might have said, stumble over the truth and then pick themselves up and hurry on. Rather, they observed without bias; they generated hypotheses and tested them as best they could. They were less concerned with how they might appear to their colleagues and their peers than with establishing reliable knowledge that might help their patients.
There are now (by my estimate) a few tens of thousands of these physicians worldwide, and their numbers are swelling every day. I am grateful to them all, but I owe a particular debt of gratitude to the earliest adapters, those who assisted my research in its early days when they were only a handful and when speaking to a journalist was likely to do far more harm to their reputation than good. They included Robert Atkins (with all the controversy his name entails), Mary Vernon, David Ludwig, Mary Dan and Michael Eades, Eric Westman, Steve Phinney, and Jeff Volek (a PhD and an RD, not an MD).
For this book, over 140 physicians, dietitians, health coaches, and parents of children with obesity from around the world gave graciously of their time to speak to me about the challenges they and their patients or clients or children face in embracing (or failing to embrace) LCHF/ketogenic eating. I list them here in alphabetical order:
Pedro Aceves-Casillas, Riyad Alghamdi, Richard Amerling, Ahmad Ammous, Martin Andreae, Matt Armstrong, Lisa Bailey, Janethy Balakrishnan, Enrica Basilico, Susan Baumgaertel, Hannah Berry, Ken Berry, Ashvy Bhardwaj, Kathleen Blizzard, Shari Boone, Evelyne Bourdua-Roy, Sean Bourke, Coen Brink, Barbara Buttin, Patrick Carone, Charles Cavo, Aamir Cheema, Kelly Clark, Jonathan Clarke, Zsofia Clemens, Brian Connelly, Kym Connoly, Mark Cucuzzella, William Curtis, Bob Cywes, Joseph Dirr, Carrie Diulus, Susan Dopart, Georgia Ede, Barry Erdman, Vicki Espiritu, Jenny Favret, Sarah Flower, Peter Foley, Gary Foresman, Kyra Fowler, Carolynn Francavilla, Jason Fung, Jeff Gerber, Becky Gomez, Deborah Gordon, Mike Green, James Greenfield, Paul Grewal, Glen Hagemann, Sarah Hallberg, David Harper, Jennifer Hendrix, Jim Hershey, Birgit Houston, Mark Hyman, Aglaée Jacobs, Rimas Janusonis, Peter Jensen, Bec Johnson, Marques Johnson, Lois Jovanovic, Mirian Kalamian, Katherine Kasha, Fern Katzman, Christy Kesslering, Hafsa Khan, Garry Kim, Kelsey Kozoriz, Janine Kyrillos, Ryan Lee, Dawn Lemanne, Brian Lenzkes, Kjartan Hrafn Loftsson, Andrea Lombardi, Tracey Long, David Ludwig, Unjali Malhotra, Mark McColl, Joanne McCormack, Sean Mckelvey, Nick Miller, Victor Miranda, Jasmine Moghissi, Campbell Murdoch, Daniel Murtagh, Toni Muzzonigro, Ted Naiman, Mark Nelson, Lily Nichols, Brett Nowlan, Robert Oh, Stephanie Oltmann, Sean O’Mara, Randy Pardue, Claire Parkes, Rocky Patel, Charles Pruchno, Lara Pullen, Christina Quinlan, Allen Rader, John Raiss, Sundeep Ram, Deborah Rappaport, Michelle Rappaport, Deb Ravasia, Laura Reardon, Caroline Richardson, Patrick Rohal, Jonathan Rudiger, Amy Rush, Jennifer Rustad, Brian Sabowitz, Andrew Samis, Laura Saslow, Robert Schulman, Cate Shanahan, Ferro Silvio, Michael Snyder, Eric Sodicoff, Sarah Sollars, José Carlos Souto, Alexandra Sowa, Franziska Spritzler, Monica Spurek, Jeff Stanley, Erin Sullivan, Bridget Surtees, Mihaela Telecan, Wendy Thomas, Maria Tulpan, David Unwin, Priyanka Wali, Robert Weatherax, Donna Webb, David Weed, John Wegryn, Eric Westman, Eliana Witchell, Sue Wolver, Miki Wong, Rick Zabradoski, and Carin Zinn.
I’m exceedingly grateful to those friends, researchers, and physicians who read this manuscript in draft: Mike Eades, Andreas Eenfeldt, Mark Friedman, Sarah Hallberg, Bob Kaplan, David Ludwig, Naomi Norwood, Steve Phinney, Catherine Price, Laura Saslow, Carol Tavris, and Sue Wolver. All provided valuable comments and criticisms, while preventing me in multiple cases from erring badly. The manuscript was made immeasurably better because of their contributions and criticisms. Any remaining errors and failings, of course, are my responsibility alone. With David Ludwig and Mark Friedman, in particular, I have been fortunate to have an ongoing discussion of these issues that never ceases to inform my understanding and challenge my preconceptions.
I would like to thank my extraordinary agent, Kris Dahl at ICM, who has been with me for all my books. I am deeply indebted and forever grateful to Jon Segal at Knopf, who has shepherded all four of my nutrition books into print and given me the confidence that I could say what had to be said (no more, no less). He has become a good friend along the way. I’m also grateful at Knopf to Erin Sellers, Victoria Pearson, Maggie Hinders, Lisa Montebello, and Josefine Kals.
Three institutions have made this work possible over the years: the Robert Wood Johnson Foundation (for The Case Against Sugar), the Laura and John Arnold Foundation (for funding the Nutrition Science Initiative), and CrossFit Health, in particular Greg Glassman, Jeff Cain, and Karen Thompson. I am deeply grateful to all three organizations. I also have to thank my colleagues, present and past, at the Nutrition Science Initiative and especially my fellow board members, Victoria Bjorklund and John Schilling, for their unwavering support, assistance, and friendship.
To my family, Sloane, Nick, and Harry, thank you for everything, with love. Nothing more need be said.