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The Asian Paradox: End of the Line for Low Carb Diets?

The fact that the populations of many parts of Eastern and Southeast Asia have traditionally been slim while consuming a high carbohydrate diet, typically rich in white rice is often considered as a ‘Asian Paradox’ by advocates and followers of carbohydrate restricted Low-Carb, Paleo and Primal type diets who hypothesize that such a dietary pattern promotes weight gain. Mark Sisson, a prominent Paleo diet advocate recently explained that the so-called ‘Asian Paradox’ is not a paradox because he believes that Asians have traditionally conformed to a lifestyle and diet that is comparable with his recommendations.1

Sisson attributes the leanness and health of the traditional living Asians to regular exercise and a diet rich in unprocessed foods including fresh meat, offal, bone broth as well as vegetables, with rice playing a neutral role. In addition, Sisson attributes much of the observed increases in rates of obesity, diabetes and coronary heart disease in Asia in more recent years to an increased intake of sugar, and the replacement of rice with wheat and saturated animal fats with omega-6 rich fats. However, Sisson provided scant evidence to support his claims regarding the composition of traditional and modern diets in Asia. Considering that obesity, diabetes and cardiovascular disease are major causes of disability and death throughout the world, this warrants an examination of these claims.2

Concerns of Low-Carb and Paleo Diets
Sisson advocates a diet that is rich in animal protein and fat and poor in carbohydrate. Sisson has an 80/20 rule which allows 20% of dietary intake from non-Paleolithic foods from his list of approved foods, including items such as full-fat dairy, chocolate, coffee and wine, as well as the supplements that he sells. Sisson would have his targeted audience believe that humans have conveniently adapted to many foods that were not typically available during the Paleolithic period which are popular among followers of low-carb diets, but not the foods that they typically shun. As such a dietary composition is probably not coincidentally all that different from other popular carbohydrate restricted diets, this makes the diet that Sisson promotes essentially in one variant or another a rebranded Atkins diet. Aside from the lack of originality, there is an ever-increasing amount of evidence demonstrating harm of such a diet.

More: http://www.drmcdougall.com/misc/2013nl/aug/travis.htm

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Every dog needs to do what works for them

Don't read about it in a book, try it out and see what works for you.


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Cyril's picture

I tend to agree.

I tend to agree. Worked for me. (YMMV)

"Cyril" pronounced "see real". I code stuff.


"To study and not think is a waste. To think and not study is dangerous." -- Confucius

Cyril's picture

For what it's worth

For what it's worth, I may have an unusual metabolism but I still eat a lot - of all of meat, fat, sugar, carbs, and vegs (and some fruits) - and remain just as thin as I have always been, no more no less (okay, I may have gained 3 pounds, tops) after four years spent living in the USA.

The main thing, I think, is I have also not quit this habit I have had since the mid 90s :

I walk at least 2 to 3 miles a day (closer to 3) - 5 days a week - if only to get to and back from work, get the groceries, or whatnot.

Physically, I feel pretty good without effort. Check ups (still uneventful, happily) are the main reason why I ever have to see my doc.

"Cyril" pronounced "see real". I code stuff.


"To study and not think is a waste. To think and not study is dangerous." -- Confucius


I lived in China for a good portion of 2012. I ate a typical Chinese diet. Large quantities of fruits and vegetables. More food than I have ever eaten in the US... before or since. Because I read Sisson's book prior to my trip, I went light on the rice. But the Chinese people consume huge quantities of white rice at most every meal.

Good poultry or meat is hard to come by there. Too expensive. I lived in a southern city, small by Chinese standards-- 6 million people. It was an hour bus ride, one way, to buy good chicken breasts.

I came back much thinner than when I left. You must keep in mind that many people there, particularly small business owners work seven days a week and think nothing of it. AND, it is not unusual to walk 15 minutes to dinner and 15 minutes home.


Asians can eat more rice/carbs because they are continually performing physical labor, not sit on their arse and watch MSM. They also eat a lot of vegetables.

A recent issue of Scientific

A recent issue of Scientific American was all about food.
Was interesting to read and makes sense. One of the things mentioned is the fact that the amount of energy you actually gain from food is highly variable not only based on the way its prepared, but even person to person; even differences between protein and carbohydrates, etc between people.(the one thing I didnt like was the fact that they mostly focused on energy gained from food and practically left nutrients/vitamins off entirely in terms of major health effects(aside from mentioning it stops things like scurvy and blindness); I think they can get away with doing that given the topic mostly on energy gained, but its still kinda a let down)
Anyway, raw food requires more energy for you to digest compared with that of cooked food, which the heat has caused the cells to weaken and/or break open for easier digestion.
Then there is the fact that gut bacteria will play a large role as well where one person might have a kind of bacteria that would break down specific food and give them more energy from it than another person who does not. The easiest example here is people who can digest milk versus those who cant.
Anyway, the lesson here is that no diet is going to effect two people exactly the same way and you should judge for yourself what works for you, not what other people tell you is gospel.

To climb the mountain, you must believe you can.

COPD is beri-beri a B1 deficiency.

Ninety nutrients are required for full heath.

Based on 297 scientific papers. Create a deficiency then remedy the disease by supplementation. Over 900 diseased can be remedied with science based nutrition.

The food we can eat is variable, person to person the nutrients one needs every day like oxygen and water are known

Free includes debt-free!

Just curious...

Has anyone tried the diet suggested in the Wheat Belly book? I haven't read it myself but I've heard that Judge Napolitano lost about 60 pounds using it.

Also, I was wondering if anyone has experience using the ancient Einkorn wheat mentioned in the book? I've heard it's easier to digest than the modern genetically modified varieties.

The China Study Myth ...

... here is a critique of the so-called "China Study:"


Also, check out the 20-year Harvard Study that shows no association between low carb and coronary heart disease risk:


And then, there is this thing we call "common sense."

- When anthropologists find human bones and teeth that were from people living before the age of agriculture, they find bones and teeth in good condition; when they are from people post-agriculture, they find decayed teeth and bones.

- Humans have one stomach, like lions, not 4 stomachs to process plant cellulose, like cows.

- Humans have teeth that bite and rip, like lions; they don't grind, like cows.

- Humans are animals. Therefore, all human fat stored is saturated fat. All cells require cholesterol. It stands to reason that maybe, just maybe, saturated fat and cholesterol are NOT dangerous to animals that need such things.

- It is now well-understood how macro-nutrients break down and are utilized in the human body:

--- Dietary protein -> breaks down into amino acids -> amino acids flow through the blood and are utilized as building blocks to form human protein and cells of all kinds in the body

--- Dietary fats -> breaks down into fatty acids -> fatty acids (not glucose) is the preferred energy source burned by the human body

--- Dietary carbohydrate -> breaks down into glucose (blood sugar) -> elevated blood sugar causes the pancreas to make insulin -> the insulin is released and opens the fat receptors of the fat cells -> meanwhile, excess glucose is converted to fatty acids -> excess fatty acids are stored in the fat cells, making the person "fat"

--- Without carbs in the diet (in this case, NO carbs, not just LOW carbs), the human body CANNOT accumulate excess fat

- When it comes to micro-nutrients (vitamins and minerals), the KEY is bio-availability. It is irrelevant how much of a nutrient shows up in a food chart (that number is determined by a testing process that has nothing to do with how it is utilized in the human body). What is important is how much is absorbed by the human body ("bio-availability"). And for this, animal foods are FAR superior to plant foods.

--- Zinc from animal sources is superior to zinc from plant sources:

--- Iron from animal sources is superior to iron from plant sources:

This is true across the board.

You lost me at

humans are animals.


The law cannot make a wicked person virtuous…God’s grace alone can accomplish such a thing.
Ron Paul - The Revolution

Setting a good example is a far better way to spread ideals than through force of arms. Ron Paul

Not Animals?

humans are animals.


Humans aren't constrained by the same Laws of Nature as other animals?

1988vote *has* never been overweight--

for years we were semi-vegetarian, but we ate whole grains, including gluten grains and not much meat--

for 'sugar' we used honey, molasses and raw sugar--

one of us got sick--

went to an alternative physician (specializing in Chinese medicine)--

was put on a paleo diet--

borderline gluten intolerant; went off the wheat and other gluten grains--

the other half of 1988vote decided at that point never to eat 'sugar' again--

and to limit honey, maple syrup--

not even raw sugar and never any kind of corn sweetener; that is the worst no-no--

one of us was put on a diet where meat was eaten daily, but only grass fed/pastured meat (and not much red); wild fish and poultry mostly--

was on that diet for a few months and got SICK of meat; envied the other half who didn't have to eat meat daily--

it's been almost 2 1/2 years--

if half of us has had any sugar it's been unknowingly--
the other half has had none and restricts honey and maple syrup (and sometimes agave, but not much) to 1 T./day--

both of us are now eating meat (2-4 oz.) only 3 times/week; never pork, but always pastured/organic--

same with eggs

we each lost between 15 and 20 pounds; it's hard to say, because we hadn't weighed ourselves much, but our clothes began to hang--

and now we can't keep our weight up unless we eat more carbs than one of us is supposed to eat--

I know this is a very unusual problem, but we are the thin twins; we look really strange next to most of our peers, who have 'stomachs'--

this isn't bragging; this is a huge issue. Literally, if we don't really pile on the carbs (whole grains/legumes, sweet potatoes/squash)--

we are underweight--

it's a strange problem to have, I know--

the physician approved a slight grain increase, but not as much as is now being consumed.

Without eating these grains--

weight drops drastically, and we both have to eat all day long--

it gets ridiculous; there is more to life than preparing meals, and we are 'from scratch' cooks and eaters--

but you have to have time for other things: work, etc.--

so, this is our experience; we are in our 60s--

and we have to work to keep weight on--

we do both exercise; one of us does yoga; the other does tai chi, and we both walk; one of us runs--

it's not fun to be nothing but skin and bones--

and the fact is that grains and legumes are much cheaper than meat--

we are much happier eating 2-4 oz. meat (mostly poultry and fish, sometimes beef or lamb)--

three times a week--

than every day; THAT was a sentence; we are VERY underimpressed with paleo diets--

one of us is still gluten free, though, and much happier--

it's hard to be awake; it's easier to dream--

The older you are

the fewer carbs and calories you can take in. If I want to lose five pounds I have to restrict my diet to no more than 1000 calories and 20 grams of carbs. That's it. I can normally take in up to 1200 calories, but if I consistently take in more, I gain weight.

My opinion is that the diabetes and obesity problem in this country is caused by high fructose corn syrup. Stay away from it and it is in almost everything in a regular grocery store. I shop health food store, but if I buy anything in a regular grocery store I read the ingredients carefully.

The Atkins diet works. The candida diet is the Atkins diet on steroids. Both work, but I can't stay on them for more than 3 months at a time because it is torturous...can't eat much. But if you want to lose weight, go for it.


McDougall is the same vegan activist who still hypes the discredited China Study as evidence animal protein causes heart disease.

Aside from the lack of originality, there is an ever-increasing amount of evidence demonstrating harm of such a diet.

Ha! What evidence? Can McDougal come up with any clinical trials that directly compare low-carb/paleo eating with his own recommendations?

The linked article cites a great many studies, but not a single one of them is a clinical trial directly testing low-carb diets. Some studied risk factors and claim a low-carb diet raises them, others noted spikes in cardiovascular events and other diseases just when low-carb diets were becoming popular or when the population as a whole ate less wheat.

Then to top it all off, he links to that obnoxious low-carb vs plant-based video which compares images of proponents of both sides, claiming the "paleo-pushers" are fat, while the vegan gurus are all lean (actually, more like victims of malnutrition). As if this proves anything. The video mistakenly does not use Mary Enig's photo when mentioning her book (she's actually thin) and conveniently ignores many of the major players in Paleo like Sisson and Robb Wolf. But McDougall himself appears in this video more than once as a shining example, so it's no surprise he's just overjoyed to show it to you, despite his immense confirmation bias rumbling in the background.

Why can't McDougall just perform a study that directly compares a low-carb diet with a high-carb vegan diet with coronary disease risk factors? The answer is that these studies HAVE been done, and every single one of them shows greater improvement in risk factors on a low-carb diet.

No clinical study has shown that a high-carb diet improves coronary risk factors more than low-carb. I challenge McDougall to find one. Because of this fact, McDougall is left to chip around the edges with arguments about weak statistical correlations, observational studies, experiments on lab animals, and clinical studies performing tests which are so far removed from reality their conclusions are irrelevant.

McDougall talks a good talk, but he'll never tackle the issue head on and call for a direct clinical study, because he knows he will be discredited.

Low Carb Denialism


I doubt that you even read this article very carefully. It was not even written by Dr. McDougall, but by myself. In the article there are many references to both clinical trials and epidemiologic studies which tested low-carb diets against diets primarily based on low-fiber refined carbohydrates (ie. reference 6 and 86, which are meta-analyses that are not in agreement with your claims). Considering the evidence I provided showing the benefits of replacing nutrient poor low-fiber carbohydrate rich foods with high-fiber carbohydrate rich foods, the findings would have evidently been even less in favor of low-carb diets had these studies focused primarily on fiber rich diets.

You stated:
“Why can't McDougall just perform a study that directly compares a low-carb diet with a high-carb vegan diet with coronary disease risk factors? The answer is that these studies HAVE been done, and every single one of them shows greater improvement in risk factors on a low-carb diet.”
How many such studies can you cite which had good compliance? Reference number 9 in my article is perhaps one of the very few studies that even came slightly close to such a comparison, and this study does not support your claims.

This “obnoxious” video shows that many of the most popular low-carb advocates have experienced difficulties controlling their own weight while apparently adhering to the diets that they recommend for weight loss. It is not to say that all or even most low-carb advocates are fat, but it does cast doubt on the diet being as effective as claimed. Even if Mary Enig is considered slim, the co-author of the book is clearly overweight which casts doubt on the author’s claims. As I mentioned in the article, Sisson practices caloric restriction and therefore cannot be cited as an example that ad libitum low-carb diets are effective for weight loss.

Many of the cited experiments on animals cannot simply be considered irrelevant. If a compound can cause atherosclerosis in so many different animal species, including over one dozen different species of non-human primates, there would be rational to suggest that the substance could also adversely affect the health of humans. Also presented in the article are the findings of the health of several non-industrialized populations that subsisted almost exclusively on naturally raised animal foods. These populations are clearly not a good role model of health.

Although I have cited the China Study a couple times in my posts, the focus was on how the data has been misused by the low-carb crowd, and was not the primary source of evidence that I based my conclusions on.

GreyWyvern – I challenge you to actually read the studies I cite instead of making up nonsense that you were probably hoping that no one would correct.

it's all about calories

If you want to lose weight, cut calories. Nothing else works. I used to be into low-carb, but I just didn't feel well on such a diet, which caused me to question this approach. I was into the paleo idea for a long time, but I don't buy it anymore. Studies of hunter-gatherer communities have shown that most of their calories come from gathering, not hunting. So even hunter-gatherers are not low carb.

“With laws shall our land be built up, but with lawlessness laid waste.”
-Njal Thorgeirsson

Understanding nature is hard...

If you want to lose weight, cut calories. Nothing else works.

Understanding nature (science) is hard. I see you have given up already. How does your body decide whether to burn or store "calories"?


Studies of hunter-gatherer communities have shown that most of their calories come from gathering, not hunting. So even hunter-gatherers are not low carb.

Yeah, gathering the fat and organs after a kill.


The blue pill is easier to swallow...

this is an interesting article


Looks like I was wrong. Some hunter-gatherers eat a lot of meat, and some don't. Go figure, different groups of people eat different diets.

“With laws shall our land be built up, but with lawlessness laid waste.”
-Njal Thorgeirsson

Some hunter-gatherers eat a

Some hunter-gatherers eat a lot of meat, and some don't. Go figure, different groups of people eat different diets.

It's no the meat they're after. It's the fat and the organs.

Man The Fat Hunter: Animal Fat Shortage as a Driver of Human Evolution

fanaticism is limiting

And I see a lot of it in the paleo-diet movement. I am just suggesting some moderation. I am not opposed to meat. I love meat and eat it daily. I hunt and fish. But I also love vegetables and healthy starches. You can argue whatever you want, but humans struggled in small groups until agriculture.

How does your body decide whether to burn calories? Physical exercise and timing. I like intermittent fasting and exercising till I am covered with sweat. Check out this site, it has some good info on intermittent fasting:

The point I was trying to make is that if you are trying to lose weight, you have to cut calories or burn more calories. If you change your diet, but are still gorging on caloric-heavy foods, and you do not seriously up your calorie burning, you are looking for the easy way out. There are no easy ways out, unless you want to get your stomach stapled.

“With laws shall our land be built up, but with lawlessness laid waste.”
-Njal Thorgeirsson

Nothing succeeds like excess.

And I see a lot of it in the paleo-diet movement.

Who said anything about paleo-diet? Sounds like a strawman...


I am just suggesting some moderation.


but humans struggled in small groups until agriculture.

That's a pretty ignorant statement on multple levels... http://youtu.be/kb_t-sVVzF0?t=20m37s

How does your body decide whether to burn calories? Physical exercise and timing.

How does the body decide to burn fat calories or sugar calories? Hint... technically the body doesn't "burn calories," it "burns" ATP.

The point I was trying to make is that if you are trying to lose weight, you have to cut calories or burn more calories.

Your obsession with "calories" indicate you're confused about cause and effect.

If you change your diet, but are still gorging on caloric-heavy foods, and you do not seriously up your calorie burning

Maybe it's just as likely that in order to "burn more" you have to eat more of those "caloric-heavy foods."

What Is Hunger, and Why Are We Hungry?

Diabetes Disaster in China

This is staggering, esp.

Clarification of "The Asian Paradox" & Low Car Diets

"There is an ever-increasing amount of evidence demonstrating harm of such a diet."

I have checked in at the DP regularly on the recommendation of a friend, and I am generally satisfied after reading comments to shed light on posts that might mislead some readers. I don't think that some errors in this post, especially the above comment, or Sisson's explanation of the Asian Paradox (which is incomplete and unconvincing) are likely to be corrected soon or as specifically as is needed. Though his approach is largely correct, such details like the use of coffee, wine are, in my experience and from some more advanced information I've learned, quite legitimate concerns.

The scientific research has been piling up so far as evidence for Paleo and Primal diets (just Google it) to the point that you can hardly question the superiority of it anymore.

From lipid levels (as cited in studies that I heard discussed on a recent Kat James' radio show), for example, point out that the small particle LDL can actually be caused by low-fat diets, but the approach cannot be just "dabbled in" for the best body-wide, anti-inflammatory effects.

Moreover, how it is executed (i.e., Atkins, primal raw, Low carb), etc varies widely.

I found this out from Kat James' book and then again from participating in her Total Transformation programs(which, by the way,she has been conducting all over the world and long before Mr. Sisson appeared on the scene).

I also learned from following her radio show that she's had a lot of "health heroes" on like Robert Scott Bell, Jonathan Emord, who worked with Ron Paul, Andrew Wakefield, etc.)

The reason Asians can get away with the carbs is because they didn't have their metabolisms ruined by American dietary choices or traditional foods that cause deficiencies in their genes.

It's actually what Americans are exposed to in terms of severity and frequency of blood sugar spikes as children—along with the metabolic health of their parents—that predicts each person's "biochemical thresholds" (the threshold at which something that does not "spike" one person's blood sugar (like a bowl of blueberries on an empty stomach) will actually spike another's (and negate a huge part of the benefit) according to Kat James' premice.

Kat had never read (or even heard of) Atkins when she saved her own life from a failing liver and eating disorder twenty years ago, which she achieved by simply experimenting with food, and noting that she became "more free" of her "horrible food obsessions" the more she cut out even the "health food" carbs.

James differs in opinion with Mr. Sisson about the inclusion of wine, coffee, etc., saying they are "deal-breakers" that remove the most critical part of the benefits and she teaches that fasting and juicing and mere "Paleo" will also keep challenged and obsessed people biochemically "stuck" with some foods.

Who NEEDS to eat this way?

Kat James says "Tarzan types" don't need it, but that anyone with adrenal, autoimmune, food, weight, inflammatory, neurochemical (especially addictions) or thyroid issues, epilepsy, ADHD, and much more, NEED to eat in her "Total Transformation" style.

One of our heroes (on Daily Paul)quietly attended her program and was so transformed that he shared his photos (which she took) on his website, but the site could not credit Kat with his transformation, due to a "conflict of interest" with a sponsor of his awesome website.

Another piece of wisdom from Kat James is that excess protein turns (drum roll)into Sugar!

Kat has identified many deal-breakers which hamper making her program work at its best. Kat's "Total Transformation" program immediately reversed my younger brother's diabetes, which had plagued him for a decade or more. My brother then went on to lose 110 pounds, and was featured in her award-winning book, "The Truth About Beauty." Listen here, fellas, Kat's book is for everyone, men and women alike, who want to be healthy or who desire to restore themselves to health.

Once again—and this goes for "The French Paradox" too —what a person eats and drinks as a child and their genetic make-up predicts (according to Kat James)an individual's DEGREE of sensitivity or insensitivity to certain hormones and that will determine how far they need to go to achieve a NORMAL metabolism, and a healthy relationship with food.

You can learn how to do this by FEEL and not by numbers through Kat James Total Transformation Programs.

Let Food be thy Medicine

Nearly 3/4 of the food I eat is composed primarily of carbohydrates. Sound like too much "high carb" food?
Consider that humans are made of carbon and our bodies derive energy from sugar.
I'm within normal weight range for my BMI, I am rather slender with a muscular build and I have plenty of energy to get everything done I need to in a day with plenty more for fun and adventuring.
Maybe just my genetics?
Well, why is it that everyone else in my family has weight problems and health problems like diabetes except those with similar diet as me.

The main difference is QUALITY of carbohydrates (as well as proteins & fats and everything else).
Good exercise will do wonders, as well as getting plenty of sleep and living a "good" life (less bad stress or however you want to say it).

In my opinion, carbs are not the problem, so don't hate yourself over eating them. But if you want to improve your health EDUCATE yourself on the matter with the same Libertarian thinking that got you to this site. You'll see that fear is governing the sick.

Coincidentally, your brain functions with sugar. Makes me wonder why the "authorities" are telling us not to eat it and giving us the worst quality of it ;^)

there is no magic diet that works for everyone

People are individuals, with different genetics, lifestyles, and histories. Find out what works for you and stick with that. There is no universal human diet. Just about the only universal is to eat wholesome fresh food and to avoid processed crap.

“With laws shall our land be built up, but with lawlessness laid waste.”
-Njal Thorgeirsson

The Fat Diet:

Misrepresentation of facts (just like MSM)


I am from southern India where white rice is the staple food. So I know a thing or two about health status in India.

India has the most number of diabetics in the world (a direct consequence of unrestricted carb consumption). The diabetics to population ratio maybe small but increasing as the traditional cultural lifestyle is being supplanted by modern lazy (no-exercise) lifestyle.

Through anecdotal information (from my grand-parents and many other senior people back in India), I see that the Indian diet HAD more variety of vegetables and ghee in their diets. Moreover there were other healthy gluten-free grains other than rice such as raagi, jowar (millets) in the diet back even 50-100 years. Nowadays after a so-called 'green revolution', industrial farming has decreased the soil fertility significantly and has now made a majority of the population depend on easy white rice and gmo tomato and onions.

Read this first -

"Almost one Chinese adult in ten has diabetes. A 2010 study estimated that more than 92 million Chinese adults have the disease, with another 150 million showing early symptoms.[4] The incidence of the disease is increasing rapidly; a 2009 study found a 30% increase in 7 years.[5]"

"India has more diabetics than any other country in the world, according to the International Diabetes Foundation,[6] although more recent data suggest that China has even more.[4] The disease affects more than 50 million Indians - 7.1% of the nation's adults - and kills about 1 million Indians a year.[6] The average age on onset is 42.5 years.[6] The high incidence is attributed to a combination of genetic susceptibility plus adoption of a high-calorie, low-activity lifestyle by India's growing middle class.[7]"

There is no asian paradox. Your entire article is flawed.

Technically eating whole foods (including white rice/potatoes) is far better than maybe processed high-fat junk. But that paleolithic diet is about emulating the diet people had before the invention of agriculture and herding of sheeps. The health of these paleolithic people was significantly better than current or past neolithic cultures.

Specifically Mark Sisson's primal blueprint puts a great emphasis on veggies and fruit and how to include them in large proportions. It still recommends the same 150g max carbs per day as found in other great research works such as 'The Perfect Health Diet' by the Jaminets. Ofcourse you can up your carbs if you are physically active enough - computer job and living in the couch doesn't cut it though.

Please take your pre-convictions somewhere else and don't feed the tptb's agenda of poisoning everyone with their SAD diet.

The "slim" argument is both a

The "slim" argument is both a strawman and a red herring. Do Asians not suffer from other phenotypic expressions of poor glucose control besides obesity? That is, weight by itself isn't a good indication of health.