las

Welcome all seeking refuge from low carb dogma!

“To kill an error is as good a service as, and sometimes even better than, the establishing of a new truth or fact”
~ Charles Darwin (it's evolutionary baybeee!)

Friday, January 17, 2014

Insulin Caused Cerebral Stress

I'll be bumping and/or posting up a bunch of short blog posts these next few days.  This one was inspired by Fred Hahn, who I guess has been in an experimental mood of late and tried ... da dA DAAAH!  The potato diet!  It's hard to believe sometimes that it's been almost 3 years since I posted the original here on that diet!  A LOT has changed.  But to recap, this post was initially written to highlight the degree of mental gymnastics that TWICHOOBs (Taubes Wrong Insulin Carbohydrate Hypothesis Of Obesity Believers) must go through to explain the simplest of observations.  

You see, for two months, a man named Chris Voight ate only insidious glucose spiking and insulin provoking potatoes, lost around 20 lbs and saw improvements in his lipid and glucose metabolic markers.  This is not difficult to explain at all, because Voight reported having difficulty consuming to his maintenance calories.   When CO exceeds CI, the deficit must be made up for from body stores, hence fat loss.  As to the improved glucose metabolism?  Well, thanks to several studies in the interim, it's pretty safe to say that with 20 lbs lost came some losses in ectopic fat so that whatever hepatic IR he had (FBG was 104) was ameliorated some (FBG fell to 94), and no doubt his glucose stimulated insulin secretion (GSIS) improved as well.  



This post was inspired by Peter/Hyperlipid's attempt to spin some tale of transient hepatic IR mediated insulin degradatory control over insulin levels and such.  Fred latched onto that and here is his initial post on Facebook (you should be able to read it as a member of general public).   Pertinent excerpt:
I WAS eating less total calories than when I was eating plaeo. No question. I was trying to keep cals the same, but it was hard. VERY hard. My best day was about 1500 cals. So you could say my fat loss was due to just eating less food than before. BUT it was all carbs! So if carbs make you fat, why didn't I get fatter if carbs (potatoes!!) make you fat?

Now bear with me here...
Given the mechanism by which fat is mobilized eating an all potato/no fat diet (which is basically body fat mobilization to produce insulin to lower blood glucose levels), the more potatoes you eat, the more fat should be mobilized. MORE fat used/burned by eating MORE total carbs sans the fat.
 Fred seems very twisted up inside over losing weight eating such a high carb diet.  No amount of reminding him of the caloric deficit would suffice -- as he said to me in comments, that's not a mechanism!  OK.  I'll let you read his musings if you like, they aren't worth discussing here.   But here's an interesting anecdotal admission:


That's interesting because joint pain is so often blamed on starch in the low carb community, but also interesting in light of continued paleo/low carb controversy.  People who have been schooled by Taubes and Eades, or worse Hahn and Sisson, truly believe that carbohydrates cause insulin resistance and that all of this can be traced back to the evil glucose and insulin spikes.  Unfortunately, we don't hear much about problems possibly being caused by carbohydrate restriction.  But Fred is around my age and he's already had a partial knee replacement due to his arthritis.  There are other big names who seem to have been ravaged by arthritis despite their clean low carb eating.  How is that possible that something improved?  I submit that if Fred did any sort of real workout he'd have noticed the performance difference as well.  

I have to give Fred some props for doing this and reporting accurately.  Now if only he could let go of his mired-in-bad-science dogma and realize that calories count, insulin does more than inhibit lipolysis and facilitate fatty acid uptake into adipocytes, etc.  So without further ado, the flashback:




Original Publish Date:  3/16/2011
What?

No, I haven't uncovered some damning study on this.  I was, however, directed to this post by Petro/Hyperlipid in a discussion on another blog:   Potatoes and weight loss (1)

Peter's post begins with:  "I tried and failed to produce a comprehensive post about weight loss on an all potato diet. It runs to too many pages. This is a brief simplification."  This indicates to me a fair amount of mental energy expended on this topic, hence my post title.


You see, the carbohydrate/insulin hypothesis simply doesn't stand up to scrutiny of all the high-carb cultures with remarkably low incidence of obesity and diabetes.  Nor does it square with the results of Chris Voight who ate potatoes for 60 days straight.   You see, all in all, Voight lost 21 pounds, saw triglycerides and LDL plummet, and had a 10 point reduction in his fasting blood glucose.  How can that be eating one of the notoriously highest glycemic foods out there?  

Now I applaud Peter for not pulling facts out of his nether regions like Taubes does to explain away the Japanese, but the mental gymnastics he's obviously had to engage in here were a futile waste of time.

Contrary to Taubes' assertions, as I'm sure Peter knows, the scientific method works by formulating a hypothesis consistent with existing observations and then testing that hypothesis in a controlled manner.  We don't just propose an alternate hypothesis and require everyone else to amass overwhelming evidence to refute it.  To wit, given the observation that, when people eat less and/or move more, they lose weight, or when people eat more and/or move less, they gain weight, a reasonable hypothesis is that energy surplus causes weight gain and energy deficit causes weight loss.  There are countless studies whose results time and again yield results that are consistent with the calorie hypothesis.  The more controlled and verifiable the intake/activity, the more consistent the result.  I don't have to explain away anything.

Voight provides the details of his diet that includes the nutritional info on potatoes.  Of note, a 110 cal potato contains 3g protein = 12 cal = 11% protein.  Not overly high, but not as low as one might envision an all potato diet containing and likely enough to maintain LBM as much as many other plans (he would have had 60g protein a day).  Keep in mind potato protein is a complete protein (rare in the veggie world, that's just a quick reference, I've confirmed this previously on more reputable sites).  I haven't listened to interviews, but I'm sure he added a little fat to the mix as I've read in discussions.  Oh how hungry he must have been though?  Well, it turns out potatoes are quite satiating.  

Peter, OTOH, has started out with a flawed hypothesis and has to expend a lot of time and energy to make the results of Voight's experiment fit his hypothesis, rather than looking at the results and formulating a hypothesis to explain it.  

This man lost weight because he ate fewer calories than he expended.   The easiest explanation is that he had a bit of a crusade motivating him to stay on a monotonous diet.  Monotonous diets are notorious for resulting in lowered intake.  Lower intake = fewer calories = lost body (fat & fat-free) mass.  Potatoes are also awfully filling.


74 comments:

Sanjeev said...

All scientists need to do some of this, obviously - one argues for one's favourite thesis, especially if the career has been built on it

But what about the scientist without a horse in the race, looking to ferret out something to tell physicians and the public?

at the end of the day's bottom line, when the rubber hits the road[0] One of Jamie Hale's rules for being a good scientist is still definitive:

account for all the data, NOT ONLY the data that agrees with you

(and DEFINITELY NOT as Gary Taubes does, only consider all the data you can fold, spin, spindle, mutilate, twist & torture to support you)

[0] GOD I hate that MBA speak. Have to wash my mouth out now.

John said...

I liked Peter's post. It nicely showed how a high carb diet can increase insulin sensitivity and lower fasting insulin.

Based my limited knowledge at this moment, my potato speculation would be:
* Eating a lot of potatoes raises insulin postprandially.
* From James Krieger's insulin series: the insulin spike suppresses apetite. So in the short term calorie intake is reduced.
* From Peter's post: several of those insulin spikes will lead to higher insulin sensitivity and lower fasting insulin levels in the somewhat longer term. So, given that insulin inhibits lipolysis, a lower fasting insulin level seems to allow for more fat loss.
* From Robert Lustig's interview with Jimmy Moore: high insulin interferes with leptin signalling. So lowering fasting insulin means that the brain sees more of the body's energy reserves. So it will upregulate the thyroid, increasing energy expenditure and making fat loss even easier. Better leptin signalling also suppresses apetite, lowering calorie intake even more.
* In the end, fewer calories are eaten than are expended.

If this has any basis in reality, then insulin seems to play a key part, and it is a nice explanation why the man ate fewer calories, why he expended more, and why he lost fat.

So perhaps Peter's whole insulinocentric view of metabolism and bodyweight is not that far fetched. In my opinion it is compatible with the "calories in - calories out" idea. It just provides a deeper insight. The problem is that deeper insights are not always the easiest explanation.


John

Sanjeev said...

I saw the headline again and thought

"somebody saw Scanners and thought 'must be Insulin !!!'"

Christian said...

Your inability to look through this whole calorie issue remains your greatest weakness. You fail to see that what you call "a reasonable hypothesis" is just a tautological observation about how closed physical systems get bigger or smaller.

"This man lost weight because he ate fewer calories than he expended."

No he didn't. You fail to see that his caloric deficit is not a cause of his condition. However you give a real cause a sentence later, which could be "a monotonous diet". THAT then is the cause (or better: a possible cause), not the caloric deficit. THE PRESENCE OF A CALORIC DEFICIT IS TRIVIALLY IMPLIED BY THE SHEER FACT THAT THE MAN LOST WEIGHT. "Explaining" this weight loss (= caloric deficit) with a caloric deficit is nonsensical.

It is not Peters hypothesis that is flawed but ultimately your way of thinking about energy terms. I am still not sure if you understand the fundamental difference between energy terms and energy rates.

Apply the scientific method to your little "hypothesis" and you will you see that it doesn't bear any explaination for the observation. But this is precisely what we want: an explaination and not a tautological repetition of the obvious.

CarbSane said...

It is not Peters hypothesis that is flawed but ultimately your way of thinking about energy terms. I am still not sure if you understand the fundamental difference between energy terms and energy rates.

What are you talking about?

"Explaining" this weight loss (= caloric deficit) with a caloric deficit is nonsensical.

No, your comment seems to be.

Christian said...

"What are you talking about?"

Maybe you should read the studies that you quote more carfefully. An energy surplus is the result of integrated energy intake rates exceeding integrated energy expenditure rates for a given amount of time. Then by definition, if this value exceeds zero, the system has increased in mass. The question we try to answer is, why - in obese people - this happened or happens for prolonged periods of time. Your answer or "hypothesis" that it is because of the energy surplus is tautological.

"No, your comment seems to be."

If you feel offended by what I am writing, feel free to ignore my comments. :)

CarbSane said...

Christian, please cite one study where they are integrating measured energy rates to determine TDEE or energy intake. You're going off on some wild tangent there.

As to offending me, nonsensical statements such as your comments have devolved the never does.

My hypothesis is simple and supported by thousands of studies. Eat more energy than you expend, gain. Eat less, lose.

Frank said...

@Christian, reading your comments here and there I get the impression that you ackknowledge that energy balance matter, but you are looking for a reason else than lazyness/glutonny and willpower to why the obese are so. A bit like "It's not your fault if you're fat, you're metabolism is acting agasint you" Is that so?

You probably know that there are multiple factor influencing obesity, such as viral infection, hormonal imbalance, microbiota, obesogens, but also an easy acces to not satiating caloric dense foods and people moving a lot less than they use to.

Are you really looking for a single factor and a single solution to this problem? And do you really think that it is mainly hormonal, such as leptin resitance or any other hormonal impairement?


Is it really impossible to think that people are fat because they have been sitting on their ass and eating whatever they want whenever they want for the past 20-25y? Is it always the result of a metabolic problem, ie ppl don't move and eat because their body tell them to do so?

Why do I eat healthy and go to the gym few times a week althought I really don't always feel like doing this... it looks more like willpower to me than anything else.

What kind of answer are you looking for?

Christian said...

"please cite one study where they are integrating measured energy rates to determine TDEE or energy intake."

I could cite you a physics textbook if that helps? Every study implicitly does the integration when assessing TDEE because the "basal metobalic rates" are already given in a user friendly manner and approximated as fixed energy portions for a given time interval. Eating is also an energy RATE or a flux. Look at "the dynamics of human body weight change". They want to model body mass change. You cannot do that with energy terms. And we want to explain it. You also cannot do that with energy terms.

"My hypothesis is simple and supported by thousands of studies. "

Your hypothesis isn't a hypthesis. Your hypothesis restates a simple fact about how closed physical systems get bigger or smaller (and even confuses association with cause). It bears no explaination for this observation. The only thing the studies support is the fact that, the more precise you can actually assess intake and expenditure rates, the better it predicts fat loss. A trivial fact. However this doesn't provide us with an explaination for why some people are fatter than others. It also provides no explaination for the fact why this potato guy was able to sustain the energy deficit without getting hungry. Actually it doesn't provide an explaination for anything.

Christian said...

@ Frank:

I "ackknowledge" energy balance for what it is: a state equation: Give me the calories you ate last year and the calories you expended, and I tell you much you gained or lost. Besides this "ability" the energy balance equation can do nothing for us. In particular not explain obesity.

Obesity is a multifactorial problem and I am not searching for an "ultimate answer". I just try to understand more about it. A calorie deficit or surplus is just not a cause. And making it a cause obfuscates the discussion. Actually it prevents a reasonable discussion.

Because I do in fact believe that a lot of people get fat by sitting on their asses and eating french fries all day. I just doubt its all of them.

CarbSane said...

Christian, I cannot understand anything you're saying at this point.

Here's my plain and simple explanation. People gain weight when intake > expenditure and vice versa. You're right, it's not a hypothesis, it's a fact.

As to the rest, I'm getting that you see integral signs and now think everybody is integrating all the time. No. Energy, not rate, is determined rather simply for intake (Atwater factors) and for expenditure by measuring heat evolved and CO2 exhaled and such.

What is your technical background?

Kurt G. Harris MD said...

Hello CS

You said:

"Here's my plain and simple explanation. People gain weight when intake > expenditure and vice versa. You're right, it's not a hypothesis, it's a fact. "

Christian is pointing out, and I agree, that that this is neither an explanation nor a hypothesis. It is a tautology that tells us nothing. Like saying morphine has opiate properties. Or that adding heat is accompanied by a higher temperature. In each case there is no explanation at all, as the one is simply contained in the definition of the other.

I've read Peter's post and can find nothing wrong with his explanation, nor can I find him endorsing the cartoon "carbohydrate/insulin hypothesis" that you keep using as your straw man, as if anyone believes insulin operates in a total vacuum to create fat without any constraints- regardless of whether your mouth is sewn shut or if you are force fed.

He quite explicitly says that liver insulin resistance determines your tolerance for carbohydrate. This would apply to the Kitavans or any other non NAD damaged cultures, as well as to me personally. I never was fat. I could eat anything I want if I only cared about weight. My own clinical experience with patients also supports this, as well as the experience of many other clinicians. The formerly obese and diabetics I know all do best on real food relatively low carb diets. If they are still fat on LC, they are either really broken or have emotional eating issues - basal ganglia overriding the hypothalamus I suppose. Probably very common, actually.

I am sure it would suck to be so broken you might have to go LC and ALSO count and measure for the rest of your life, but maybe that's you? If it is you, that's unfortunate but does that mean the rest of us that don't weigh and measure and can eat anything we want must be lying? Or that carbs and their metabolic effects have NOTHING to do with weight loss for the more mildly broken who want to lose weight? You are promoting a false dichotomy here: CICO vs Insulin explains everything. Both are nonsense.

CS, you really could do some useful thinking here if you were to lose your "I hate Gary Taubes" filter. It seems to be distorting your view of just about everything you read... That and your NEFA phobia.

arus said...

cause ==> effect

(1) intake > ependiture (calorie surplus) ==> weight gain.

(2) intake < expeniture (calorie deficit) ==> weight loss.

(3) intake = expenditure ==> no change in weight.

===========================

sedentary + eating much ==> calorie surplus (if (1) is given)

eat less + move more ==> calorie deficit (if (2) is given)

being an emotional eater ==> calorie surplus (if (1) is given)

bad food choices ==> calorie surplus (if (1) is given)

be a person that blunts hunger signaling after binges (whatever the reason) ==> no change in weight.(if (3) is given)

the list will go on endlessly. there are many reasons for calroie surplus or deficits. but not so many for weight gain or weight loss.

are you with me christian?

Harry said...

Hi Christian,

I'm not sure your position and CarbSane's are effectively at odds. It's really only a philosophical debate at this stage; you're just arguing about your preferred definitions of 'cause'; an old chestnut that goes way back to Aristotle (and of course, further).

In terms of the factual precedents for weight gain, you both agree that positive energy balance is implied.

In terms of the factors that promote positive energy balance in humans, you both agree that they are many and varied (including the palatability and availability of foods to disordered metabolisms etc.).

Where's the locus of the big disagreement?

Cheers
Harry

King said...

Christian - maintaining a calorie deficit is the key factor in losing weight and vice versa. There's really no more to understand beyond that point. Case in point: me. This week I've been doing a PSMF diet from sunday to thursday (900 kcals a day, max 20g fat and 20g cho, the rest protein). I lost 4 pounds during the week. I did a bit of exercise, but less so than I normally do. On friday I took a break, ate over 3500 kcals worth of food, of which was more than 600 grams of carbohydrate (rice, honey, white bread etc - low fiber stuff mainly), and exercised for a little over two hours, burning a total of 1560 kcals (pulse watch). This morning my weight was 199.7 pounds (down .1 since the day before, and down 4 since sunday's 204 pounds). Calorie balance is key. There's no argument.

CarbSane said...

I'll have some more specific responses later, but for now, let me say that I'm not trying to explain what causes obesity. Tautology schmautology, I'm so sick of this nonsense "it tells us nothing". It tells us that to reverse obesity we must take in less than we expend.

IMO, most obese have long since - for whatever reason - kissed "natural" homeostasis goodbye.

Christian said...

CarbSane, I tried to come up with a study that illustrates the integration. I came up with something better and you do not have to get a physics book - just look at Keith Frayns book page 4, Figure 1.2! The y-axis are labeled appropriately. I quote:

"The rate of energy intake is zero except when eating or drinking, when it may be very high. The rate of energy output is at its lowest during sleep. [...] the areas under the curves will balance - except for any difference in the amounts of energy stored".

I hope you remember how you can calculate an area under a curve ...

That is precisely what I tried to explain to you. It is so fundamental that it is in a textbook about metabolic regulation on page 4! I phrased it this way:

"An energy surplus is the result of integrated energy intake rates exceeding integrated energy expenditure rates for a given amount of time. Then by definition, if this value exceeds zero, the system has increased in mass. The question we try to answer is, why - in obese people - this happened or happens for prolonged periods of time. "

Your "plain and simple explaination" states that this happens because of an energy surplus. What is my technical background? I would say it is sufficient to realize that your "explaination" isn't an explaination but rather an imprecise repetition of the question we try to answer.

@ arus, no i am not with you. You start out with a wrong assumption. It should be this way:

calorie surplus == weight gain
calorie deficit == weight loss
otherwise no change

These fundamental truths follow from a dull state equation that IS APPLIED FOR A GIVEN AMOUNT OF TIME (say a day, week or month). Your error is the same as CarbSanes error. Confusing energy terms (surpluses and deficits) with energy rates (eating, moving, resting), associating cause and effect with them and applying arrows, where no arrows belong.

The only thing I agree though, is that a sedentary lifestyle, being an emotional eater, making bad food choices, etc. are possible contributors to a mismatch between intake and expenditure rates. But this statement actually poses more questions than it answers ...

@ Harry: Actually my objection has a reason. My main point is that it obfuscates the discussion and it makes identification of real causes difficult. It even prevents a reasonable discussion! Because whenever someone proposes a real reason or explaination (like Peter does) then Carbsane will object and say its nonsense, a calorie surplus is the cause. Which is the real nonsense of course.

@ King: I did the PSMF myself. Worked splendidly.

Christian said...

"It tells us that to reverse obesity we must take in less than we expend. "

Good look reversing obesity with that insight.

Kurt G. Harris MD said...

"IMO, most obese have long since - for whatever reason - kissed "natural" homeostasis goodbye."

But that is precisely the point. If that is so, why? Because they failed to weigh and measure? Why are the obese different and what does the tautology of CI=CO tell us about this difference? Is tells us zero about it.

Sanjeev said...

Millions have taken weight off and keep it off through conscious application of conservation laws.

I'm sure all of them would have been better off listening to you and waiting for your magnum opus that explains all before doing something about their obesity.

___________
Christian said...
Your inability to look through this whole calorie
... weakness ... failure ... failure
__________________

quite the stream of consciousness there

Your dual inabilities to look past your nose and your proclivity to repetitively blow the same verbal diarrhea out your anus is yours.

Please, copy and paste and repeat your post (the same post you've copied & pasted many times already) a thousand more times, the 10 thousandth time it will not be any more true, and the millionth time, it will not erase those millions of people who've used your useless tautology that has no information.
___________
Christian said...
Your inability to look through this whole calorie
... weakness ... failure ... failure
__________________
A simple "we disagree on xxx " might have done the job.

You're on ignore.

Sanjeev said...

> It tells us that to reverse obesity

thought experiment: you fund obesity studies.

10 proposed studies land on your desk, 5 proposing permanent increased caloric surplus for obesity control, 5 proposing caloric deficits.

Which ones to pick and why?

Like the physicist that complained about the blocked toilet and how conservation of mass says nothing useful;

allll-righty-then, as Ace Ventura would say ... let's see you try ALL possible solutions, including all that require creation of new mass/energy from nothing.

See you when you're done in a hundred years.

SAYING it tells you nothing useful and then actually behaving that way ... I have yet to see it.

Todd Hargrove said...

I think Kurt and Christian have a point.

If I heard some people speculating about why the home baseball team lost, I would expect discussion of whether the pitching was to blame, or the hitting, or maybe a strategic decision by the manager. I wouldn't expect anyone to say that the loss happened because the home team didn't score as many runs as the other.

Harry said...

Oh, and if "eating less and moving more causes weight loss" constitutes a tautology, the following exchange would be meaningless:

Patient: "Doctor, I'm currently stable in weight, and you say I need to lose weight; but how should I do that?"

Doctor: "By establishing a negative energy balance"

Patient: "Oh, ok. But how do I do THAT?"

Doctor: "By eating less and moving more than you currently do"

Now, if ELMM and CICO were just tautological for weight loss, then the doctor would have added no new information with her last response (which clearly she did). She might have well have answered with "By losing weight" (which clearly would have been a LESS informative answer).

Whilst ELMM may no be the advice that works for many people (that's a whole 'nother story!), it nonetheless does provide a factual account of what causes weight loss at the physical level.

Cheers
Harry

Kurt G. Harris MD said...

@Harry

Losing weight IS a negative energy balance. I would find a new doctor if I was the patient in your scenario. Especially if I were doing hours of cardio a week and was hungry all the time like all the fat people I see working out at my gym on stairmasters.

Customer: Did you find out why my tire is flat?

Useless Mechanic: It is leaking air.

Helpful mechanic: It has a nail in the carcass causing a leak.

@Sanjeev

You said:

"let's see you try ALL possible solutions, including all that require creation of new mass/energy from nothing. "

Sanjeev, there is no one on this board, certainly not me, who believes that mass or energy is created from nothing. I stipulate CS's and your tautology, that there must be an energy deficit. The question is how to achieve it.

I.Normal weight people eating a healthy whole foods diet don't need to do anything - their weight is spontaneously regulated with zero conscious thought the same way their breathing and thier thirst are regulated, They don't accidentaly die of cerebral edema from polydypsia, nor do they die of dehydration because they forget to drink enough. If the brain and gut and liver are as unbroken as the kidneys, no conscious thought need be given to the weight or energy content of food, ever.

II. Some metabolically damaged people can heal their damage with time and abstinence from what caused the damage. Then they can be like the people in I, and need never weigh, or measure their food or their exercise output, ever. These people exist. I am one of them.

III. Some metabolically damaged people may be so metabolically deranged that they must always eat a particular diet, say low carbohydrate diet, in order to maintain weight. Otherwise, they gain.

IV. Some people may be further damaged, and have to eat LC and consciously eat to less than satiety - probably because of persistent leptin resistance. Such people, in their frustration, may then speculate that categories I-III don't exist. It is not fair, but these people may be stuck with being food conscious forever, like alcoholics who can't avoid the drink without daily AA meetings. It's not their fault. But the existence of such people doesn't prove that CICO is the only thing we can say about fat loss, anymore than the existence of people with diabetes insipidus would imply that all people have to worry about how much water they drink al the time.

V. The regulation of fat stores involves the whole organism. It follows there may be at least as many ways that a person can gain or lose fat as there are parts to the regulatory whole. Like insanity, brain damage, inflammation, conscious over-riding of the satiety signals, etc. - think Bobby Sands or Dick Gregory.

It is totally obvious to me that all these categories exist, and they are all interesting. They are not at all mutually exclusive.

Why perseverate on CICO? It is true but it tells us nothing. It is not interesting.

blogblog said...

You see, the carbohydrate/insulin hypothesis simply doesn't stand up to scrutiny of all the high-carb cultures with remarkably low incidence of obesity and diabetes.

Societies like the Kitivans are actually the very rare exceptions. Obesity is actually extremely common in traditional high carb societies - particularly in Africa, Polynesia and the Mediterranean. Ancel Keys noted that all older Italian women who ate a traditional pasta diet were fat.

If you actually study bother to study traditional high carbohydrate societies where people are healthy you discover that:

a) the diets have only one staple food (rice, potatoes, sweet potatoes, cassava etc) and exceptionally monotonous and unpalatable.

b) that it is necessary to force feed yourself huge amounts of food to obtain your daily caloric intake. eg 4kg of boiled potatoes per day.

c) these diets are almost totally devoid of refined carbohydrate.

d) there is typically little excess food available.

e) these societies have reasonably high levels of physical activity

William said...

I think one of the problems with trying to calculate calorie balance (i.e., CICO in practice) is that energy expenditure changes. So even if food intake is less [than it was before], body weight could stay the same or even increase.

Frank said...

@Christian (and Kurt)

I Understand your point and your question is more adequate from a scientific standpoint.

but...

what do you propose to do, in real life, with an obese client, if you don't have access to any medecine?

For nutritionist and sports nutritionist and coach or other people who help other people losing weight it takes concret action.

It usually mean reducing portion size, weightin food if that fail, making better dietary choices, and start exercising.

Now I think the hardest challenge that people are facing is behavioral and more of a question of willpower and motivation then metabolic regulation.

The greater tool to have in a weight loss intervention are psychological and behavioral tools. Any coach who has helped enough client will tell you so.

So it comes to a point where what you are trying to answer is not very important in term of getting result in real life, say you can't have access to a pills which would fix something physiologicaly broken.

It is much more important that the individual follow the diet than the diet itself, as long as the diet is just a bit sound. The hardest part is, again, to have him follow the diet.

But I think we all agree that a lot of factors, including behavioral and environmental, plays a role in obesity. I personnally think that the latter play the bigger role and are the more effective at getting results.

arus said...

"
If I heard some people speculating about why the home baseball team lost, I would expect discussion of whether the pitching was to blame, or the hitting, or maybe a strategic decision by the manager. I wouldn't expect anyone to say that the loss happened because the home team didn't score as many runs as the other. "

awesome but this is the very point!
the home team lost because they didnt't score as many runs as the others. this is the reason for losing. the reason for not scoring may have multiple reasons.

i doubt it is reasonable to jump over some cause and effect connection.

i'll tell you what happens often in soccer games. the home team plays superior...more possesion of the ball, more shots on goal, more corner kicks....
all of them are good variables that often predict the outcome of a game.

but every once in a while the team that plays awful scores in the last minute and wins the game. a totally undeserved win.
but the ultimate law is valid: the team that has more goals wins. why the team has more goals than the other team is less important.

Christian said...

@ Frank: Your objection is valid but it is my honest opinion that in order to give good advise to obese people the first thing to do is to have a thorough understanding about whats causing the problem. And you can't do that if you are continuously obfuscating the discussion by objecting "that's nonsense, they have to eat less than they expend". It's like a discussion about how to attract people for an art exhibition and talking all day about artists, flyers, decorations and that sort sort of stuff but someone is always objecting "that's nonsene, we just have to make more people come than leave". Yeah we kinda do, but can you just shut the f*ck up? :)

"this is the reason for losing."

That IS losing. You can't be a good coach with the insight that "the team that has more goals wins.". And you can't reverse obesity with the insight that "you have to eat less than you expend". You just repeated the problem. I mean you can do that of course to motivate yourself. But the important thing is if you are a player and someone is presenting a real strategy, you just should not object that thats nonsense because the only strategy to winning is to score more than the other team. I don't think you would be in that team for long.

Christian said...

To wit, given the observation that, when one team scores more than the other team, they win, or when one team scores less than the other team, they lose, a reasonable hypothesis is that a positive difference of scored goals causes the win and a negative one causes the loss. There are countless matches whose results time and again are consistent with the scoring hypothesis. The clearer I can have a look at the actual scores the more consistent the result.

CarbSane said...

To all the why-ners (sorry, but this whole thing gets very old to me) I've never said that CICO explains the obesity epidemic. But, it is a fact that the obese have taken in more than they expended for a considerable time. There is no support for the carb/insulin hypothesis that insulin causes partitioning to fat cells and starving our other cells making us hungry to then eat more and move less. Show me that study. I've seen where keto diets lead to more fat partitioning ...

IMO, obesity in our society is a no brainer. As the great Malcolm Kendrick has said, for starters we almost never eat out of hunger. What's with the 3 meals a day? And look at the food we eat.

Kurt, Peter, Gary - all lean men who have never been fat trying to explain to the rest of us why we get fat? Male, female, if you're obese, or have been, YOU know why. Please. It requires no mention of insulin in all but a few pathological cases (Lustig's hypothalamic obesity comes to mind). Underlying metabolic defects that cause obesity are relatively rare in humans - which is why absent an obesogenic environment, human obesity rates are in single digit percents.

This may sound blunt, but it's just how I feel: I don't care what you can eat and why you don't get fat. That is irrelevant to why those of us who do, do. The obese eat more than the lean on average. Fact. Deal with the reality folks and you have to find a way to do something about it you can live with in the long run.

No obese person got that way the same way another did. I needed to understand why I got obese to do something about it and it had nothing to do with my fat cells going wild in response to insulin. I'm sure of that.

I would also like to address this notion of starvation diets. The Minnesota study has folks referring to 1500 cal diets as starvation diets because that was the approx caloric intake during the starvation phase in that study. For starters, these weren't obese men to begin with, and they cut their intake in half to approximately this level and gave them mostly carbs - very little protein or fat. Of course they were hungry. Balance that out with adequate protein and fat and cut the carbs down and that is hardly a starvation diet. That's maintenance levels for a lot of women my age/life stage for instance, and well within normal CRD recs (over even).

CarbSane said...

@Kurt: Here's the basis of Peter's argument in this post: "The ultimate determinant of weight loss is fasting insulin. " I've seen him state multiple times that he has an insulin-centric bias. He's expressed liking or disliking a paper/study based on whether or not it requires him to challenge his bias. Maybe I'm reading a different blog, but he seems firmly entrenched in Taubes' insulin theories. My strawman? I think not.

CarbSane said...

@Christian: You do realize that AUC = total energy right? In a controlled diet study, does someone sit there and watch the participant and directly measure the cal/min they take in and integrate this? Nonsense. They measure the total energy eaten. TDEE is a bit more difficult but we don't measure thermal flux and rate of CO2 expired and integrate, but rather measure temp changes or amounts of CO2 expired. Extrapolating also is not the same as integrating.

I don't understand the purpose of these comments at this point.

Voight lost weight eating fewer calories in potatoes than he expended. We don't need to understand how Conchetta Farrel got obese to figure out why Voight lost weight.

CarbSane said...

@John, in re-reading your response and re-reading Peter's post, one thing becomes apparent. He's just inadvertently obliterated a sacred cow of carb/insulin theory. Massive carb consumption leads to insulin sensitivity, not IR. I agree :)

CarbSane said...

@blogblog: The traditional Pima ate almost 80% carb very low fat diet. Most of these cultures get fat when exposed to fat in the diet in conjunction with refined carbs. The blandness or boredom of diets composed largely of one or two foods is irrelevant if one is trying to conjur up an insulin-centric explanation. Which was my point, and I think we're in agreement to a point in that anyone eating 20 potatoes/day for two months is bound to eat less.

Frank said...

@Christian

But you still don't offer any concret action to be taken. Do you know guy like Martin Berkhan or John Berardi? They have helped a lot of individual losing weight and making insane body recomposition. Most of them are not working with very obese person that might be very metbolically damaged, and I also believe that these people might be a case apart, but I don't think John or Martin have to understand why someone gets obese to get the results they get. They understand that the person must eat less and move more, and how they can help them achieve that.

I think what Kurt said is true, ie, there are multiple categories of individual, but I think that, except for the very obese, CICO works pretty well and the real challenge is in applying it, and I don't think it takes a complete understanding of obesity to do so.

That being said, there still people who are helping obeses very well using CICO.

http://www.thepermanentejournal.org/issues/2010/spr/or/132-obesity-problem-solution-or-both.html

Here, they have used a supplemented fasting protocole with great result on many obese person.

Anyway, I think CS and most people on that board agree on many things, we just don't look at it with the same perspective. Which is fine and I appreciated Kurt and Christian being here and presenting their perspective.

Frank said...

I just want to add that i'm much more sensible to a view such that the one presentend in the link I post above, ie people who are really helping other in real life losing weight, than people who are trying to understand who it works behind a computer. And they will all tell you that there is a strong emotionnal/behavioral component to weight gain/lost.

And I can understand why CS and myself and other are stuck on CICO, and the reason is that it is what WORKS in real life if you want to get results. CS had to get results and she knows that this is what she had to do on a daily basis to see those results. There is, so far, no other solution that have been proposed, and i'd be curious to know, if you ever discover the underlying causes of obesity, Christian, what solution you will propose, else than taking a pill.

I think you should read the link I posted above to get the perspective from someone who has helped a lot of individual losing weight.

Todd Hargrove said...

Carbsane,

People who ask why there is an obesity epidemic are "why-ners?" You seem to suggest that asking this question is a bad idea because the answer is already a "no brainer" - we live in an "obesogenic environment!" Another tautology! That is like saying the problem with a losing baseball team is that they have too many losogenic players, or that MCain lost the election because it was a demogenic environment. What is it about the environment that makes it obesogenic? Kurt and Peter propose some possible answers, what are yours?

You also said that you don't care how someone can manage to stay thin while eating ad libitum because it is irrelevant to the concerns of an overweight person. If I was failing at anything, I would certainly want to know why other people are succeeding with ease, indeed without even trying. In the context of weight control, answering this question would help us understand why people fall into Kurt's different categories. By the way, your understanding that you need to eat in a completely different way than Kurt to say thin shows your implicit acceptance of the validity of his different categories.

You also say that people are rarely metabolically broken. What? Isn't that what metabolic syndrome is? Fatty liver, insulin resistance, leptin resistance, diabetes? Why does metabolic syndrome happen and how can it be fixed? Why are you are Kurt different? These are interesting questions. People who try to answer them should not be accused of failing to understand that people just need to eat less and move more.

John said...

"He's just inadvertently obliterated a sacred cow of carb/insulin theory. Massive carb consumption leads to insulin sensitivity, not IR."

Oh, so it seems that Peter is not that "entrenched in Taubes' insulin theories" after all.

What bothers me is that you put up a post in which you call his hypothesis "flawed" without providing any support for why it would be flawed. And then you re-read his post and you notice that he's saying something you actually agree with.

Inadvertently you appear to be admitting that you didn't read Peter's post very well. No problem, but in that case it might not be so wise to write a post about it in the first place.

I'm still waiting for your explanation on the flaw in Peter's hypothesis that lipolysis will be inhibited due to high fasting insulin. Isn't that just textbook insulin action?
So if the potato guy started with a high fasting insulin level, and he managed to lower it via potato consumption, wouldn't it be expected that a calorie deficit then would result in more fat loss? With no reduction in the fasting insulin level, the same deficit might have caused a loss of muscle. Still a loss, so the CICO argument holds true, but my understanding is that overweight people usually want to lose fat.


John

Christian said...

@CarbSane, if you don't understand what I am saying with my comments, then at least don't create a straw man. Why should studies assess energy intake via integration? Absolutely ridiculous. I am also not claiming that the values for TDEE are assessed via thermal flux integration.

"Underlying metabolic defects that cause obesity are relatively rare in humans"

Ah - and I am sure you applied the scientific method to arrive at this statement - like you did with your calorie surplus causing something statement. And how can that be by the way? I thought the calorie surplus is causing the weight gain and nothing else. Fact. Period. No?

And why on earth should the fact, that some people can eat what they want and don't get fat, have nothing to do with an eventual cause for obesity??? There are research projects built around this very idea, i.e. studying the lean and their effortless weight management in order to understand more about weight regulation and the development of obesity.

@Frank, sorry. I am not a medical doctor nor do I have any background in treating obese people to make a qualified statement about a definite cure. The IF fasting approach seems reasonable if it can positvely effect hormonal regulation and thereby help sustain a deficit without feeling hunger. But it doesn't seem to work for everyone. And what do you mean by "CICO works pretty well"? Can you define CICO as a concrete action? And don't forget that my objection wasn't about any treatment options working or not working well. My objection was that a calorie surplus (or deficit) isn't the cause of something and making it so obfuscates discussion about real causes (or treatment options).

Sanjeev said...

Kurt, I've had no problems with you since our iTulip discussions. Disagreements, but nothing more. I've seen in the past you can be open minded & reasonable[0].

I was simply tired of the same post repeated ad nauseum, with zero support (plain assertion is not argument), and with un-earned, undeserved attitude.

[0] sometimes ; )

Sanjeev said...

> Why perseverate on CICO? It is true but it tells
> us nothing. It is not interesting.

who is "us" exactly - the obese person[0] who controlled their obesity strictly through conscious control, weighing their food and controlling their movement?

Take the case of a person who lost a lot of weight years ago and starts gaining weight. What's he to do? Search out an "interesting" hypothesis, or wait 100 more years for scientists to produce something "interesting" ?

OR apply conservation laws, maybe as he did when he first lost the weight, to figure out what's going on and how to get back on track?

Should he just sit back & let the weight come back, or start weighing the food again, and get a fitbit or bodybugg?

I suppose it depends on your definition of "interesting".

How about "useful and necessary for a lot of people"

or "a broad commonality (maybe the only one?) between those who've been successful, long term, on Pritikin or Atkins"

[0] this would be me on my current "weigh-the-food-move-more" diet, the first time I deliberately applied conservation laws to my diet, and now the longest time that I've not been obese.

arus said...

"
And why on earth should the fact, that some people can eat what they want and don't get fat, have nothing to do with an eventual cause for obesity???"
@christian: put these people in a close system and watch their intakes.magically they manage to stay in caloric balance despite being in a "bad food" environment.

no one here isn't interested in the cause for that.

but until we have found the magic bullet we try to work with what we have. do you have a better explanation than CICO that holds true for every person (however metabolically deranged they might be or not) ??

that is said one can work out good advises for the average joe. eat low carb (if that helps hunger control), take a walk every day, get some friends, eat less :) , eat less enrgy dense foods, seperate carbs and fat, eat 10 potatoes a day, ...whatever helps.

where is the conflict?

blogblog said...

"@blogblog: The traditional Pima ate almost 80% carb very low fat diet. Most of these cultures get fat when exposed to fat in the diet in conjunction with refined carbs."

Another utterly absurd claim.

There are two distinct groups of Pima:

- The traditional Pima farmers of Mexico have normal body weight and good health. They eat a highly varied diet containing moderately high levels of fat and protein.

- the Pima of Arizona live on a high carbohydrate diet consisting primarily of maize flour. They have extremely high levels of obesity and diabetes. They were lean and healthy when they were lived on a traditional diet.

ie. The Pima got fat when they ate less fat.

CarbSane said...

@blogblog:

http://care.diabetesjournals.org/content/16/1/369.abstract

Who is making utterly absurd claims?

The Pima are yet another example of Taubes ignoring inconvenient facts.

Frank said...

@Christian

You are absolutly right that CICO is not the cause, the real cause are the factor affecting CICO, but when I say that it is CICO that work, I mean that ultimatly any intervention that will produce results is aimed at influencing CICO.

I think it's utopic to think that you can lose weight without feeling hunger at all. I don't think there is a quick fix to obesity and somewhere people will have to deal with obstacles and difficulties. Hence, again, I think willpower/motivation has a lot to do with successful intervention.

But i'm gonna echo arus here in wondering where is the conflict. Indeed CICO is not the underlying cause but it is what must be ultimatly adress if you want to lose the weight, be it with specific diet, social support, pills, medical intervention, psychological or environmental intervention, whatever the mean you use, you must affect CICO. I think we all agree about that, the difference is that we see it maybe more from a practical standpoint whereas you guys look at it from a theorical standpoint. Both are important.

Arus had made some valid point in that, are we going to wait for the ultimate factor (and we know a single factor does not exist) to be found or aren't we going to do what we know we can do so far... reducing portion size seems to work pretty well for the vast majority of individual.

Christian said...

@Arus, Frank: that was the only objection or conflict that I had: look at CarbSanes "hypothesis" again and my response. Beyond that - i.e. regard concrete intervention methods, I would say that I agree with a lot of what you (and CarbSane) are saying. Except for some subtleties maybe. For example I am convinced now that "taking a walk every day" without any significant diet change will do little to nothing for weight loss. But I don't really want to discuss that here because my main point wasn't about any intervention method.

I also think that I am not looking at this from a purely theoretical standpoint. The thing is, CICO isn't an intervention method. The intervention method that is usually associated with it is the "calorie-counting-expenditure-estimating-and-aiming-for-deficit" approach. That works for a lot of people, no question. But also many of them experience hunger while doing it and fail. The ultimate question is, why do they experience hunger and how can they avoid it? Or even better: how can they tweak their diet and moving patterns (and other influences) that no counting or estimating is required so that they naturally match intake rates to expenditure rates again (at a healthy fat level). We already have a lot of very good answers to those question, i.e. I would consider the information available at wholehealthsource, panu, etc. excellent in this regard. And in order to give better answers in 10 or 20 years we have to find out more about the possible (real) reasons you mentioned. It just won't happen if we are stuck in the "just eat less and exercise more" or "calories in minus calories out" tautologies.

Harry said...

If I can just put on my philosopher's hat for a minute and regurgitate some "Informal Logic 101":

It's all about the definition of 'cause'. The dispute here is not about matters of fact (we all agree that weight loss and negative energy balance are physically coterminous); rather, the dispute is about what kind of explanation counts as a causal explanation, and not just a re-statement of facts.

Maybe this will help:

Causes can be categorised in terms of conditions;
some conditions are necessary conditions (i.e. those conditions must be met if the event is to be caused, but do not of themselves bring about the event. For example, in order to contract a head cold, it is a necessary condition that you come into contact with the acting virus; even though this doesn't ensure that you WILL catch the cold);
some conditions are sufficient conditions (i.e. the meeting of these conditions will always result in the event, even though this condition is not the only way to bring about the event; so it's not a necessary condition. For example, standing uncovered in the rain is a sufficient condition for getting wet, but it's not necessary, as you can also get wet in the shower);
finally, there are conditions that are neither necessary or sufficient, but still contribute to the effect; these are call 'contributory causes'. For example, cold weather contributes to catching a cold, but is neither necessary or sufficient.

Alrighty then!

Where does this leave us with CICO as a cause for weight? And, where does it leave, say, the low-carbohydrate way of eating?

I'll open it up for discussion, but my take is that positive energy balance is a necessary condition for weight gain, and is also a sufficient condition for weight gain.

By contrast, eating a low carbohydrate diet is neither necessary or sufficient to cause weight loss. It is therefore at best a contributory cause (in the same category as other dieting techniques that may or may not work).

Cheers
Harry

CarbSane said...

Interesting take Harry!

I truly believe every obese person knows their contributing causes.

I'm not really sure where anyone gets that I think CICO "causes" anything.

Christian has hijacked yet another post with this nonsense. The point of this post was simply to point out how we overcomplicate the simple at times.

Why did Voight lose weight eating potatoes? He ate less. Why did Haub lose weight eating Twinkies and such? He controlled calories. Why do people lose weight eating low carb? They eat less.

CarbSane said...

The thing is, CICO isn't an intervention method. The intervention method that is usually associated with it is the "calorie-counting-expenditure-estimating-and-aiming-for-deficit" approach. That works for a lot of people, no question. But also many of them experience hunger while doing it and fail. The ultimate question is, why do they experience hunger and how can they avoid it? Or even better: how can they tweak their diet and moving patterns (and other influences) that no counting or estimating is required so that they naturally match intake rates to expenditure rates again (at a healthy fat level). We already have a lot of very good answers to those question, i.e. I would consider the information available at wholehealthsource, panu, etc.

So what are you doing here since you think Kurt and Stephan have the answers?

Applying CICO IS an intervention Christian. People get hungry? News flash! People get hungry on low carb too. People fail on low carb all the time.

There's no easy answer to reversing obesity.

That wasn't the point of this post, however. It was to illustrate the mental gymnastics required to make the insulin theory match observation.

Ironically, Peter argues (correctly) that using one's insulin increases sensitivity. But my point was that insulin need not even be considered here. Voight ate fewer calories than he expended. Voight lost weight.

Christian said...

Harry, positive caloric balance = weight gain

=> PCB is necessary for weight gain, PCB sufficient for weight gain and vice versa.

No real need to consult logical reasoning here. But we can if you like to ;)

@ CarbSane: You wrote that an energy surplus causes weight gain is a reasonable hypothesis. I said this is an error and you don't understand why. So be it. And could you stop it with the straw mens??? People get hungry on low carb, yeah. People fail on low carb, yeah. There is no easy answer to obesity, yeah. Where have I claimed otherwise?

And you wrote: "I'm not really sure where anyone gets that I think CICO "causes" anything."

Was that supposed to be ironic? Because I am just reading your hypothesis again ("a reasonable hypothesis is that energy surplus causes weight gain and energy deficit causes weight loss.") and I am wondering.

Nigel Kinbrum said...

The cognitive bias is strong in the Taubes "nut-swingers". See Gourmand Rats?

I'm your defender, apparently. Bless! :-D

CarbSane said...

Christian, I should have been more careful in my wording. Should have stated that thermodynamics doesn't "cause" anything, but imbalances in CICO most certainly are the cause of gains or losses. I'll leave it to all the geniuses in the room to argue over some elusive one true cause of CICO imbalances that leads to obesity. You won't find one because it doesn't exist.

To repeat: The purpose of this post was to highlight how one must go through hoops to make the insulin hypothesis fit observations that seem counter to it. No such convolutions are needed when one accepts the simple fact that if Voight lost weight he took in less than he expended.

CarbSane said...

@John: I don't believe the insulin-centric theories offer us any deeper insight. More they are a bit of a distraction. Peter's description of how carbs promote insulin sensitivity is spot on, but I doubt he noticed he just flattened one of Taubes' houses of cards on that one. Carbs (massive fructose excepted) are not the dietary inducer of insulin resistance.

CarbSane said...

Hi Nige! Thanks for your efforts. The bunny ears seem to really bother a lot of people.

If folks can read this and still consider Taubes credible, there's not much more one can do.

Taubes is now spawning an air of despair in low carb circles - that of irreparably damaged metabolisms for which the only cure is a greater dose of carb restricting intervention. And if no carbs doesn't do it, that's the best you can do. I'll not shut up so long as he's peddling this sort of crap!

Harry said...

@ Christian

Consider the propositions (1) "Positive energy balance implies weight gain" and (2) "Positive energy balance is the same thing as weight gain".

Do you see a difference?

If you don't, you're effectively arguing that every sufficient condition is the same thing as the event it causes (e.g. prolonged rain fall is the same thing as water-logged sub-soils).

You really have to be careful when making the charge of tautology (when one term is explaining another). It's not enough to argue that the explanation is redundant in practice; you actually have to show that the explaining term is redundant insofar as it contains no extra information to the other term.

IOW, even if it were true that the energy balance equation doesn't effectively help people to volitionally alter their weight (because the one term implies the other), to make the tautology charge stick, you'd need to show that positive energy balance means exactly the same thing as mass gain.

Tautology is not a matter of logical implication (many things imply other things without meaning the same thing); it's a matter of information redundancy.

Cheers
Harry

Christian said...

Actually you are correct. The proposition "positive caloric balance = weight gain" is sloppy, I agree. More precise:

If the "event" positive caloric balance (defined as the difference between integrated energy intake rates minus integrated energy expenditure rates > 0 for a given amount of time, see Keith Frayns book Metabolic Regulation) happens, then mass gain (defined as an increase in energy stores, i.e. muscle, fat, bones, ...) is trivially implied because of thermodynamic principles. That is clear.

Also mass gain happens only by this principle, i.e. there is no other meaningful mechanism (that I know of) contributing to mass gain other than via the energy rates (mainly eating, resting, exercising). Only in the case of mass loss I would count "surgery" as an exception.

So if we exclude surgery then positive (negative) caloric balance implies mass gain (loss) and vice versa. They are not identical events but with the premises I would call them information redundant.

What I am still not absolutely sure about is whether the statement "positive caloric balance causes mass gain" is false (because of the word "cause") or whether it is just tautological in a rhetorical sense.

Harry said...

"positive (negative) caloric balance implies mass gain (loss) and vice versa. They are not identical events but with the premises I would call them information redundant"

I think you're still going a step too far here. We need to make another distinction (yes, I know talking with philosophers can be tiresome) between practical utility on the one hand, and information redundancy on the other hand.

While you can feasibly (although not without contest) claim that the proposition "negative energy balance causes weight loss" has no practical utility (i.e. it doesn't help people lose weight), the charge of information redundancy is over ambitious.

Clearly, if someone asks "How should I go about ensuring that I lose weight?", and you reply "By losing weight", this is information redundant.

If, on the other hand, you reply with "By ensuring that you consistently consume less energy than your resting metabolic rate plus activity", you have added some new information. Now, you are free to argue that the information is useless for many people, but to claim that the reply contains zero information is patently false.

I would add as a sidebar that the simple awareness of energy balance (and the attendant application of ELMM) has enabled many people to volitionally manipulate their weight (e.g. body builders, athletes trying to meet a weight class, jockeys wasting etc.). Whether or not this mere knowledge is sufficient for long-term weight management in the gen pop is of course a whole 'nother ball game!

If I may, let me suggest that your best bet is not to claim that the energy balance explanation for weight state is tautological, but to claim that it has weak explanatory efficacy for the purposes to which it is usually applied (i.e. for helping people manage their weight). Just like a kinesiology professor who tries to teach a kid how to ride a bike by explaining it in terms of quadriceps flexion and moment arms, you could argue that the energy balance equation may be an explanation that, while technically correct, is entirely useless for certain audiences.

Cheers
Harry

CarbSane said...

Gluttony & sloth cause weight gain. Howzzat?

Christian said...

@ Harry: I understand what you are trying to say but I disagree in so far that I see a fundamental difference beetween:

"By ensuring that you consistently consume less energy than your resting metabolic rate plus activity"

and

"Negative energy balance causes weight loss."

The latter statement is either false or information redundant in my opinion - depending on how you define the word "cause". Not only is it misplaced in a scientific conversation about this topic, it is misplaced in general.

The former statement is not necessarily information redundant as you say and can be used as a weight loss tool (not a very good one though). Following this advise has practical, psychological and physiological limits. I think we also agree on that. However it seems to work for some obese people and it certainly has to be applied if one aims for 1-digit body fat percentages, where conscious undereating is a necessitiy.

@CarbSane: "Gluttony & sloth cause weight gain. Howzzat?"

In my opinion it is false for the majority of obese people but at least it is better than "positive caloric balance causes weight gain". ;)

CarbSane said...

Whatever Christian. I realize you're trying to be cute. But even the cutest child gets annoying after a while. Food for thought.

I'm not going to respond to these sorts of comments of yours anymore. They make no nevermind to me because I know why I got fat and I know why most got fat. So arguing what is a tautology or the direction of causality that's just stupid regarding TFLOT and obesity is just a royal waste of time. Sorry I got caught up in that in the first place.

Christian said...

Another straw man. I am not trying to be cute. I am pointing out that you are mistaken about this subject of CICO, cause and effect. If you think it is a royal waste of time discussing it, ok. I think it is key.

CarbSane said...

Straw man? You keep pointing out the same thing over and over and over. Getting awful Razwellesque.

Sanjeev Sharma said...

I wonder if Christian's out there still thinking he understands that material

Fred also makes a point I think many miss about diets that reduce (reward-system activation here:

> I was trying to keep cals the same, but it was hard. VERY hard. My best day was about 1500 cals.

in the modern context these diets can take a HUGE amount of executive function.

>Fred, you do realize that this little experiment of yours counters all the carbs = insulin = fat stuff your friends espouse. Right????

it puts the lie to a lot of low carb slogans I've seen over the years on so many "support forums"[1]

"take away the fat and your body will think it's starving and hold onto the fat it has"

"fat's the most satiating macro"

"if your body sees fat coming in it won't feel the need to hold onto the fat it has"

[1]https://www.google.ca/search?q=%22cone+of+silence%22+smart&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a&gfe_rd=cr&ei=08LaUtniD8WC8Qfi_YGACg

http://www.wouldyoubelieve.com/cone.html

keeps outsiders & their skepticism out, keeps echoes in

Sanjeev Sharma said...

OMG - Fred's so late to Evelyn's game

Fredrick Hahn http://www.jci.org/articles/view/107382
JCI - Stimulation of Insulin Secretion by Long-Chain Free Fatty Acids. A DIRECT PANCREATIC EFFECT www.jci.org
Section on Metabolism, Molecular Disease Branch, National Heart and Lung Institu...

t s said...

Saponin

Sanjeev Sharma said...

I'm surprised there hasn't been more comment ...

I'd love to know what color the sky is on the planet where Fred & Peter smoke crack, dream in technicolor & call an incestual mutual bias reinforcing circle jerk "being scientific".

Those two just take the cake.

HOLEY MOLEY.

carbsane said...

My soup from the other night. Note I left the peels on!

carbsane said...

Yeah I told him that on FB and he was like "what are you talking about" ... LOL. But he spun a different tale entirely that doesn't even make enough sense for you to think Fred would believe it!

Sanjeev Sharma said...

I have seen (ANECDOTE ALERT!!) a lot of reports of long-term low carbers (including me) having trouble re-introducing carbs. This has included cramps, bloating, "carb coma" (excessive sleep time), daytime sleepiness are the ones that stick out in my own experience & from those reports.

does this seeming quick and easy transition for Fred make anyone suspicious of Fred's "low carbing"? I was really reminded of the Eades' reports from a while ago.

LWC said...

I wonder if this could define the period for repeating topics in paleo. Wasn't there an "epic" comment thread at MDA about the potato diet around the time of your first post? And now potatoes as food are "discovered" again.

t s said...

leave out the meat and jack up the sauce to Masala, Korma or Vindaloo level, you will have the Ma-Pi Resurrection Diet!

Will Kriski said...

It's humorous to watch paleo types explain how the largest long living populations ate a starch based diet. After watching a variety of Plant Positive videos, it seems unlikely that the low carb authors actually believe what they are writing, and are more likely catering to the people who like to hear good things about their bad habits in order to make money (easy to get from the animal industries). Saturated fat -> cholesterol -> heart disease is widely accepted by the scientific community. Potatoes are incredibly satiating and have been the key to my fat loss and muscle gains.

carbsane said...

It truly is amusing to observe.

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