NuSi's metabolic ward study.
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Someone posted this in r/keto today.
Dr. Michael Eades has written a biting blog post about Hall and his conclusions. I think it was quite entertaining and interesting. Recommend!
https://proteinpower.com/drmike/2016/05/06/contradictions-and-cognitive-dissonance-the-kevin-hall-effect/
One thing Eades didn't mention is that increased energy expenditure can also be achieved by more body heat. I wonder if they measured that too in the chamber.2 -
Thanks for the link! I'm one that just took Kevin Hall at his word probably because it aligns with my own experience -- I'm looking forward to what the analysis is once the full paper is published.0
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Foamroller wrote: »Someone posted this in r/keto today.
Dr. Michael Eades has written a biting blog post about Hall and his conclusions. I think it was quite entertaining and interesting. Recommend!
https://proteinpower.com/drmike/2016/05/06/contradictions-and-cognitive-dissonance-the-kevin-hall-effect/
One thing Eades didn't mention is that increased energy expenditure can also be achieved by more body heat. I wonder if they measured that too in the chamber.
Interesting take on it. Thanks.
The interview and the abstract do seem to focus on different things. I'm looking forward to reading more!0 -
Foamroller wrote: »Someone posted this in r/keto today.
Dr. Michael Eades has written a biting blog post about Hall and his conclusions. I think it was quite entertaining and interesting. Recommend!
https://proteinpower.com/drmike/2016/05/06/contradictions-and-cognitive-dissonance-the-kevin-hall-effect/
One thing Eades didn't mention is that increased energy expenditure can also be achieved by more body heat. I wonder if they measured that too in the chamber.
Interesting take on it. Thanks.
The interview and the abstract do seem to focus on different things. I'm looking forward to reading more!
I expect perhaps this spin from Dr. Hall may be related to the reason Dr. Peter Attia pulled out back in Jan 2016 because he would have known what was coming out and who funded it.1 -
That could be.1
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Two things that really jump out at me since I listen to a guy describe pseudo-scientific studies and their characteristics. 1) 30 days??????? It took me 44 days before low carb had any impact on my weight. It had an impact on my swelling and RA immediately but that was Not studied. 2) 17 men??? very small sample it can easily be screwed.
I really didn't believe that low carb would raise energy expenditure. I'm glad he proved it. At least it wont raise it in only 17 days.
But it's good to see people studying weight and diet. So few good studies out there.1 -
30 days seems short to me too. Getting fat adapted is viewed in different ways, I think. The study seems to look at fat adaption as the time that it takes to start using fat oxidaton as the primary fuel. I am pretty sure that I have read about other physiological adaptations that take longer - many months - like the amount of glucose being relied on by the brain dropping a lot, and how the body uses fuel for exercise.
It was an interesting result, not entirely what I expected based on my n=1, but longer would have been better... It's just hard to do. And pay for.
I think he did show that a keto diet does raises CO though. It wasn't much, only 100kcal/day, but it was slightly raised. Slightly. It would be worth an extra 12 lb loss per year between isocaloric overweight men with moderate protein.1 -
cedarsidefarm wrote: »Two things that really jump out at me since I listen to a guy describe pseudo-scientific studies and their characteristics. 1) 30 days??????? It took me 44 days before low carb had any impact on my weight. It had an impact on my swelling and RA immediately but that was Not studied. 2) 17 men??? very small sample it can easily be screwed.
I really didn't believe that low carb would raise energy expenditure. I'm glad he proved it. At least it wont raise it in only 17 days.
But it's good to see people studying weight and diet. So few good studies out there.
But the funniest thing is what he actually proved was that it does in fact have a metabolic advantage. Even if his numbers only reflect it as being about 100 calories a day, it's an advantage. And I actually doubt it's only 100. Maybe just in the first month it is. But isn't part of the "adaptation" all about developing new mitochondria? That doesn't happen in a couple weeks. It happens over months. And what we know from the FASTER study is that we need to exercise to really take advantage of that.3 -
I really wish there were more studies on the full effects of the normal insulin state versus the hyperinsulemic state when talking about insulin. That's been hands down the biggest correlation between the times I've been able to lose weight (insulin down in the middle of normal range) and not (insulin running high), even when calories are the same.
I've never thought that low carb increased BMR significantly beyond the 100 or so that can largely be explained by the increased requirements for processing fats and proteins. However, my personal experience indicates that there's something that changes when the insulin drops that allows/encourages the body to use the fat stores when caloric intake is reduced, and I'd love to see that studied.2 -
Dragonwolf wrote: »I really wish there were more studies on the full effects of the normal insulin state versus the hyperinsulemic state when talking about insulin. That's been hands down the biggest correlation between the times I've been able to lose weight (insulin down in the middle of normal range) and not (insulin running high), even when calories are the same.
@Dragonwolf -
That's interesting. I would have naively guessed that if your insulin resistance is high, you wouldn't be storing more energy than if you're IR is milder and your insulin level proportionally lower.... Where does IR fit in, do you suppose?
How often do you have your insulin level checked, and do you do anything to prepare for/time the tests? How about cortisol?
Thanks!0 -
Dragonwolf wrote: »I really wish there were more studies on the full effects of the normal insulin state versus the hyperinsulemic state when talking about insulin. That's been hands down the biggest correlation between the times I've been able to lose weight (insulin down in the middle of normal range) and not (insulin running high), even when calories are the same.
@Dragonwolf -
That's interesting. I would have naively guessed that if your insulin resistance is high, you wouldn't be storing more energy than if you're IR is milder and your insulin level proportionally lower.... Where does IR fit in, do you suppose?
How often do you have your insulin level checked, and do you do anything to prepare for/time the tests? How about cortisol?
Thanks!
I don't do anything special to prepare for getting insulin tested except to fast the night before (as required by the test). Unfortunately, the best I've been able to get is every three months or so, due to the issues getting doctors to actually work with me about it. However, with the tests I have, there's a pretty clear correlation with my weight loss and insulin levels (as in, every single time I've been successful at losing weight, my insulin levels have been lower; the mechanism by which has varied, but that correlation has remained constant).
I've only ever been able to get one cortisol test done, and it was the one where you take a pill the night before that lowers your cortisol, then get it measured the next morning. The test supposedly came back "negative," which I only half buy -- as in, I don't have a tumor on my pituitary or adrenal glands -- but there was such a huge difference between how I felt the night before and how I felt the next morning (I felt like Peter Gibbons after seeing the hypnotist in Office Space), that I wouldn't be surprised if a better test would have turned something up (however, getting doctors to run that test is next to impossible, and as far as I can tell, my cortisol hasn't gone back up that high again). However, I'm pretty sure that's a newer thing, whereas my insulin issues have been persistent for at least 6 years.
My hypothesis is that the hyperinsulinemia causes a sort of "wires crossed" type of situation -- the high level of insulin tells the body that there's food to process even when there isn't (shutting down stored fat mobilization), but the resistant state of the cells aren't getting fuel (because of lack of food and lack of mobilized stored fat), so they send out the signals to get more energy, and since the body seems to think there's no fat to mobilize, it turns on hunger. When we do eat, the high insulin and resistant state of the cells tells the body to store the vast majority of it. The end result is the body basically thinking it's starving, even when it's not, but also not using the energy stores it has and storing any food that comes in.
Exactly at what point that happens probably depends on the person and the state of their metabolism. For me, it seems to be after about 15 units (while that does fall into the reference range of under 25, there's some contention as to what's actually ideal; from what I've found, 8 is the average, and 5 is truly ideal). Higher than that, and the scale and all weight loss measurements stall out, even if my caloric intake is the same. Below that, and I lose weight as expected.
This is all based on my n=1 experience after years of logging my food, getting insulin tested as often as I could, and a lot of experimenting to find something that works. When I first joined MFP, I simply counted calories. I used the macronutrient ratio that MFP gave me, and I found myself having to fight against feeling like I was constantly starving (and yes, I mean starving, not just the "oh, I'm getting kind of hungry," type of thing, but the "cannot physically ignore it" type of thing). The cases where I lost weight were when certain things successfully lowered my insulin (in my case, the first round of Metformin, the hormonal changes that came with being pregnant that lasted for a short while afterward, and going carnivore), whereas when my insulin was high, no amount of (sane) calorie restriction or exercise had any effect (I say "sane" calorie restriction, because I did happen to find the point at which my body would, in fact, start releasing weight -- consuming 800-1200 calories a day, while exercising every day at moderate to high intensity -- suffice to say, I crashed and burned after about 3 days of that, though I wasn't intentionally trying to starve myself that much).
The role of cortisol is tricky without being able to easily get more data. The problem is that elevated cortisol is also a result of insulin resistance, according to the medical authorities. I suspect it's a bit of a chicken-and-egg thing with it, too, since they both increase one another.
But yeah, that's why I wish people would stop getting hung up on the idea that low carb "increases metabolism" or whatever, and look more into the other effects of low carb and insulin, because as long as they focus so much on metabolic rate, they miss other things that are going on. They're not just missing the forest for the trees, but they're basically just staring at one tree.5 -
I think most are looking more for a gimmick/quick fix diet vs an new way of eating that leads to better health for life. Diet books and the marketing of many supplements seem to be more about gimmicks than science.0
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SUNNYB said: But the funniest thing is what he actually proved was that it does in fact have a metabolic advantage. Even if his numbers only reflect it as being about 100 calories a day, it's an advantage.
RIGHTO! And haven't we seen all the silly advice to "just eat 50 less calories a day and lose 10 lbs this year". My RD group leader was handing out a book on the same topic of "make tiny changes…..to your high carb diet, i.e. eat 2 less fries, 1/2 slice bread for amazing results! ( I refused the free book, sorry, how rude of me)
Just read this by Dr Fung: The Women’s Health Initiative study of 50,000 women proved this in 2006. Those women reduced their caloric intake by 350 or so calories per day. They expected to lose upwards of 30 pounds per year. Over 7 years, they lost …. 0.25 pounds! That’s like the weight of a good sized bowel moment, for goodness sake. Hmm. 7 years of Eat Less, Move More dieting or have a good BM? Same diff… "
How many of us will ever CUT 350 out calories a day…for years???? I'll take the advantage of LCHF/Keto quietly doing its thing, and not worry over it!2 -
KETOGENICGURL wrote: »SUNNYB said: But the funniest thing is what he actually proved was that it does in fact have a metabolic advantage. Even if his numbers only reflect it as being about 100 calories a day, it's an advantage.
RIGHTO! And haven't we seen all the silly advice to "just eat 50 less calories a day and lose 10 lbs this year". My RD group leader was handing out a book on the same topic of "make tiny changes…..to your high carb diet, i.e. eat 2 less fries, 1/2 slice bread for amazing results! ( I refused the free book, sorry, how rude of me)
Just read this by Dr Fung: The Women’s Health Initiative study of 50,000 women proved this in 2006. Those women reduced their caloric intake by 350 or so calories per day. They expected to lose upwards of 30 pounds per year. Over 7 years, they lost …. 0.25 pounds! That’s like the weight of a good sized bowel moment, for goodness sake. Hmm. 7 years of Eat Less, Move More dieting or have a good BM? Same diff… "
How many of us will ever CUT 350 out calories a day…for years???? I'll take the advantage of LCHF/Keto quietly doing its thing, and not worry over it!
I'm with you! I much prefer to achieve my calorie deficit with a natural reduction in hunger and if it only gives me a 100 calorie a day advantage, then I'll take it! That's pretty damn impressive to me!3 -
And now a response from Ludwig:
https://medium.com/@davidludwigmd/defense-of-the-insulin-carbohydrate-model-redux-a-response-to-kevin-hall-37ea64907257#.1efidk90s1 -
Dragonwolf wrote: »Dragonwolf wrote: »I really wish there were more studies on the full effects of the normal insulin state versus the hyperinsulemic state when talking about insulin. That's been hands down the biggest correlation between the times I've been able to lose weight (insulin down in the middle of normal range) and not (insulin running high), even when calories are the same.
@Dragonwolf -
That's interesting. I would have naively guessed that if your insulin resistance is high, you wouldn't be storing more energy than if you're IR is milder and your insulin level proportionally lower.... Where does IR fit in, do you suppose?
How often do you have your insulin level checked, and do you do anything to prepare for/time the tests? How about cortisol?
Thanks!
I don't do anything special to prepare for getting insulin tested except to fast the night before (as required by the test). Unfortunately, the best I've been able to get is every three months or so, due to the issues getting doctors to actually work with me about it. However, with the tests I have, there's a pretty clear correlation with my weight loss and insulin levels (as in, every single time I've been successful at losing weight, my insulin levels have been lower; the mechanism by which has varied, but that correlation has remained constant).
I've only ever been able to get one cortisol test done, and it was the one where you take a pill the night before that lowers your cortisol, then get it measured the next morning. The test supposedly came back "negative," which I only half buy -- as in, I don't have a tumor on my pituitary or adrenal glands -- but there was such a huge difference between how I felt the night before and how I felt the next morning (I felt like Peter Gibbons after seeing the hypnotist in Office Space), that I wouldn't be surprised if a better test would have turned something up (however, getting doctors to run that test is next to impossible, and as far as I can tell, my cortisol hasn't gone back up that high again). However, I'm pretty sure that's a newer thing, whereas my insulin issues have been persistent for at least 6 years.
My hypothesis is that the hyperinsulinemia causes a sort of "wires crossed" type of situation -- the high level of insulin tells the body that there's food to process even when there isn't (shutting down stored fat mobilization), but the resistant state of the cells aren't getting fuel (because of lack of food and lack of mobilized stored fat), so they send out the signals to get more energy, and since the body seems to think there's no fat to mobilize, it turns on hunger. When we do eat, the high insulin and resistant state of the cells tells the body to store the vast majority of it. The end result is the body basically thinking it's starving, even when it's not, but also not using the energy stores it has and storing any food that comes in.
Exactly at what point that happens probably depends on the person and the state of their metabolism. For me, it seems to be after about 15 units (while that does fall into the reference range of under 25, there's some contention as to what's actually ideal; from what I've found, 8 is the average, and 5 is truly ideal). Higher than that, and the scale and all weight loss measurements stall out, even if my caloric intake is the same. Below that, and I lose weight as expected.
This is all based on my n=1 experience after years of logging my food, getting insulin tested as often as I could, and a lot of experimenting to find something that works. When I first joined MFP, I simply counted calories. I used the macronutrient ratio that MFP gave me, and I found myself having to fight against feeling like I was constantly starving (and yes, I mean starving, not just the "oh, I'm getting kind of hungry," type of thing, but the "cannot physically ignore it" type of thing). The cases where I lost weight were when certain things successfully lowered my insulin (in my case, the first round of Metformin, the hormonal changes that came with being pregnant that lasted for a short while afterward, and going carnivore), whereas when my insulin was high, no amount of (sane) calorie restriction or exercise had any effect (I say "sane" calorie restriction, because I did happen to find the point at which my body would, in fact, start releasing weight -- consuming 800-1200 calories a day, while exercising every day at moderate to high intensity -- suffice to say, I crashed and burned after about 3 days of that, though I wasn't intentionally trying to starve myself that much).
The role of cortisol is tricky without being able to easily get more data. The problem is that elevated cortisol is also a result of insulin resistance, according to the medical authorities. I suspect it's a bit of a chicken-and-egg thing with it, too, since they both increase one another.
But yeah, that's why I wish people would stop getting hung up on the idea that low carb "increases metabolism" or whatever, and look more into the other effects of low carb and insulin, because as long as they focus so much on metabolic rate, they miss other things that are going on. They're not just missing the forest for the trees, but they're basically just staring at one tree.
@Dragonwolf This seems so strange to me. My endo did the suppression test, immediately followed by the urine test (well 4-7 days later, so the suppression drug was out my system), but my levels have been at the high edge of the threshold as far as can tell, with ACTH hitting the middle threshold. I hate that it's so hard to understand what this all means.
It is also particularly frustrating that my doc has never asked me to not take my thyroid or BCP in the am, etc. Skews all results, from what I can tell. But how do you get around that, if you have to take the BCP at the same time daily, and so your time is 5:30 am, postponing it until 8-9 am to get to the lab is ludicrous... Medications and blood tests are so frustrating!
And my insulin was all wacky this past time, so was my hormone panel, and my cycles... I felt light a total mess...0 -
KnitOrMiss wrote: »Dragonwolf wrote: »Dragonwolf wrote: »I really wish there were more studies on the full effects of the normal insulin state versus the hyperinsulemic state when talking about insulin. That's been hands down the biggest correlation between the times I've been able to lose weight (insulin down in the middle of normal range) and not (insulin running high), even when calories are the same.
@Dragonwolf -
That's interesting. I would have naively guessed that if your insulin resistance is high, you wouldn't be storing more energy than if you're IR is milder and your insulin level proportionally lower.... Where does IR fit in, do you suppose?
How often do you have your insulin level checked, and do you do anything to prepare for/time the tests? How about cortisol?
Thanks!
I don't do anything special to prepare for getting insulin tested except to fast the night before (as required by the test). Unfortunately, the best I've been able to get is every three months or so, due to the issues getting doctors to actually work with me about it. However, with the tests I have, there's a pretty clear correlation with my weight loss and insulin levels (as in, every single time I've been successful at losing weight, my insulin levels have been lower; the mechanism by which has varied, but that correlation has remained constant).
I've only ever been able to get one cortisol test done, and it was the one where you take a pill the night before that lowers your cortisol, then get it measured the next morning. The test supposedly came back "negative," which I only half buy -- as in, I don't have a tumor on my pituitary or adrenal glands -- but there was such a huge difference between how I felt the night before and how I felt the next morning (I felt like Peter Gibbons after seeing the hypnotist in Office Space), that I wouldn't be surprised if a better test would have turned something up (however, getting doctors to run that test is next to impossible, and as far as I can tell, my cortisol hasn't gone back up that high again). However, I'm pretty sure that's a newer thing, whereas my insulin issues have been persistent for at least 6 years.
My hypothesis is that the hyperinsulinemia causes a sort of "wires crossed" type of situation -- the high level of insulin tells the body that there's food to process even when there isn't (shutting down stored fat mobilization), but the resistant state of the cells aren't getting fuel (because of lack of food and lack of mobilized stored fat), so they send out the signals to get more energy, and since the body seems to think there's no fat to mobilize, it turns on hunger. When we do eat, the high insulin and resistant state of the cells tells the body to store the vast majority of it. The end result is the body basically thinking it's starving, even when it's not, but also not using the energy stores it has and storing any food that comes in.
Exactly at what point that happens probably depends on the person and the state of their metabolism. For me, it seems to be after about 15 units (while that does fall into the reference range of under 25, there's some contention as to what's actually ideal; from what I've found, 8 is the average, and 5 is truly ideal). Higher than that, and the scale and all weight loss measurements stall out, even if my caloric intake is the same. Below that, and I lose weight as expected.
This is all based on my n=1 experience after years of logging my food, getting insulin tested as often as I could, and a lot of experimenting to find something that works. When I first joined MFP, I simply counted calories. I used the macronutrient ratio that MFP gave me, and I found myself having to fight against feeling like I was constantly starving (and yes, I mean starving, not just the "oh, I'm getting kind of hungry," type of thing, but the "cannot physically ignore it" type of thing). The cases where I lost weight were when certain things successfully lowered my insulin (in my case, the first round of Metformin, the hormonal changes that came with being pregnant that lasted for a short while afterward, and going carnivore), whereas when my insulin was high, no amount of (sane) calorie restriction or exercise had any effect (I say "sane" calorie restriction, because I did happen to find the point at which my body would, in fact, start releasing weight -- consuming 800-1200 calories a day, while exercising every day at moderate to high intensity -- suffice to say, I crashed and burned after about 3 days of that, though I wasn't intentionally trying to starve myself that much).
The role of cortisol is tricky without being able to easily get more data. The problem is that elevated cortisol is also a result of insulin resistance, according to the medical authorities. I suspect it's a bit of a chicken-and-egg thing with it, too, since they both increase one another.
But yeah, that's why I wish people would stop getting hung up on the idea that low carb "increases metabolism" or whatever, and look more into the other effects of low carb and insulin, because as long as they focus so much on metabolic rate, they miss other things that are going on. They're not just missing the forest for the trees, but they're basically just staring at one tree.
@Dragonwolf This seems so strange to me. My endo did the suppression test, immediately followed by the urine test (well 4-7 days later, so the suppression drug was out my system), but my levels have been at the high edge of the threshold as far as can tell, with ACTH hitting the middle threshold. I hate that it's so hard to understand what this all means.
It is also particularly frustrating that my doc has never asked me to not take my thyroid or BCP in the am, etc. Skews all results, from what I can tell. But how do you get around that, if you have to take the BCP at the same time daily, and so your time is 5:30 am, postponing it until 8-9 am to get to the lab is ludicrous... Medications and blood tests are so frustrating!
And my insulin was all wacky this past time, so was my hormone panel, and my cycles... I felt light a total mess...
It was my PCP that ran the test, not my endo, which is probably part of the problem. You know how PCPs tend to be.
Oh, also, @RalfLott -- while under normal circumstances, the presence of insulin resistance does mean energy storage is lower, there's a breaking point to it when chronic hyperinsulinemia is present. Additionally, it's not just a storage issue, but also a mobilization issue. When insulin is chronically at a "post meal" level (ie - high), then the body's internal fat mobilization mechanisms are impaired. If the body can't mobilize the stored fat, it's not even there, as far as the body is concerned, thus turning on the hunger hormones. Eating (particularly a SAD diet) raises insulin even further, allowing the body to force more fat into the cells, and the cycle continues.
You see a similar, though inverted process in people who cannot make their own insulin -- without insulin, the body cannot store the fuel and the lack of insulin tells the body that there's no sugar in the blood stream, so it prompts gluconeogenesis (to regulate blood sugar) and ketosis (to provide the body with energy) in response to the lack of insulin. However, without insulin, these processes are not regulated, and DKA ensues. Even short of DKA, though, this lack of insulin is why a hallmark of Type 1 Diabetes is unexplained weight loss and/or the inability to gain weight -- the exact opposite of the hyperinsulinemic's issue of unexplained weight gain and/or the inability to lose weight.1 -
This sounds very interesting. I haven't had a chance to check it out yet though.
What is the margin of error for the method of determining expenditure?
I know when @FIT_Goat did the ground beef challenge his data indicated a possible metabolic advantage, but I never took the time to calculate it. Even then though, his expenditure estimates would most likely come from Fit Bit which I would think would have a pretty high margin of error.0 -
What is the margin of error for the method of determining expenditure?
The paper hasn't been published yet, but they used indirect calorimetry. They calculate EE from O2 consumed and CO2 exhausted. As Dr; Eades pointed out, we don't know if they included ketones lost in the urine, for example. They do collect urine, but I think it's mostly for nitrogen analysis to determine protein balance.
In any case, it's about as good as we can get. Much better than a FitBit.
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