Obesity Journal study: It's not just CICO

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  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    Crisseyda wrote: »
    Dr. Fung's explanation of the 2 compartment model is still basic, but far more realistic than the CICO model.

    https://www.youtube.com/watch?v=tIuj-oMN-Fk&feature=youtu.be

    What a silly video. That's not how any of this works. If you want to get technical the body is a multi compartment storage not only liver and subcutaneous fat. CICO does not claim a single compartment storage. Adaptation has nothing to do with insulin or the type of diet you are on. It's brought about strictly by certain biological and behavioral responses to caloric restriction (like decreased spontaneous non-exercise activity without being aware of it) .

    The biggest loser contestants were not eating nearly enough to have a high insulin response and the grueling exercise routine likely burned through any liver glycogen. They were essentially fasting, exactly what this video is advocating. They also utilized dehydration and dropping water weight, so it's likely their diet was actually low carb since carbs tend to be stored along with water.

    Nah, anyone who has actually completed a prolonged fast vs a prolonged calorie restricted diet knows there is a huge difference. During a fast, after about a day or two, you don't really feel hungry at all. During calorie restriction, it's basically all you can think about not to eat.
  • CattOfTheGarage
    CattOfTheGarage Posts: 2,745 Member
    edited June 2016
    Another thing that strikes me is that people - including the doctor being quoted - always talk about "calorie restriction" as if it was all the same, but there's a big difference between a very low calorie diet and a moderate deficit, at least it terms of how it feels.

    @Crisseyda says above "During calorie restriction, it's basically all you can think about not to eat." - I don't identify with that from my experience of a 500 calorie deficit. Yes, I get hungrier than I do at maintenance, but not obsessionally so, provided I'm careful to eat filling foods. At a higher deficit, I think you probably will start to get obsessional hunger and other unpleasant effects. It's not the same experience.

    Can we assume the body sees these two situations in the same way, or is it reasonable to hypothesise that they are not the same, and that from the metabolic point of view, not all "calorie restriction" is created equal?

    And that makes me wonder if, even at low deficits, you could diet in a way that, as well as leaving you hungrier and less happy, could also have a bigger impact on metabolism?

    "More research needed ".
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    Crisseyda wrote: »
    Crisseyda wrote: »
    Dr. Fung's explanation of the 2 compartment model is still basic, but far more realistic than the CICO model.

    https://www.youtube.com/watch?v=tIuj-oMN-Fk&feature=youtu.be

    What a silly video. That's not how any of this works. If you want to get technical the body is a multi compartment storage not only liver and subcutaneous fat. CICO does not claim a single compartment storage. Adaptation has nothing to do with insulin or the type of diet you are on. It's brought about strictly by certain biological and behavioral responses to caloric restriction (like decreased spontaneous non-exercise activity without being aware of it) .

    The biggest loser contestants were not eating nearly enough to have a high insulin response and the grueling exercise routine likely burned through any liver glycogen. They were essentially fasting, exactly what this video is advocating. They also utilized dehydration and dropping water weight, so it's likely their diet was actually low carb since carbs tend to be stored along with water.

    Nah, anyone who has actually completed a prolonged fast vs a prolonged calorie restricted diet knows there is a huge difference. During a fast, after about a day or two, you don't really feel hungry at all. During calorie restriction, it's basically all you can think about not to eat.

    The video was touting the benefits of pseudo fasts in that regard as well, lumping them with a true fast. Some people on keto stop feeling hungry after a few days. Hunger has nothing to do with it. I did complete a prolonged fast by the way (and landed in the hospital for it) and the weight gain right afterwards came in astronomical numbers, part water part compensatory appetite. That has nothing to do with what was being said in the video anyway. That's not how any of this works.

    @amusedmonkey You say, "that's not how any of this works," but you're not really connecting the dots between keto and fasting. Both create almost identical metabolic and hormonal changes through the state of ketosis. That was basically his point. The body's cells need to switch between the "2 compartments," and the presence of insulin inhibits the breakdown of fat. If the body can't have access to its fat stores, it does feel deprivation and starvation... and it is smart enough to match output with available energy, resulting in a lowering of BMR--which can happen in as little as a few weeks.

    @CattoftheGarage

    To quote you:
    Can we assume the body sees these two situations in the same way, or is it reasonable to hypothesise that they are not the same, and that from the metabolic point of view, not all "calorie restriction" is created equal?

    And that makes me wonder if, even at low deficits, you could diet in a way that, as well as leaving you hungrier and less happy, could also have a bigger impact on metabolism?

    Yes, and yes. I absolutely think Dr. Fung's research and work support those ideas. Definitely, not all "calorie restriction" is created equal. While Dr. Fung is a big proponent of intermittent fasting, if you listen closely, he says both carbohydrate restricted diets and fasting have the positive effect of 1. granting easy access to the second compartment and 2. protecting BMR.

    EDIT: if you read more of his work, he goes into much greater detail into the multi-factorial etiology of obesity (and diabetes), and how the cure can be approached in a way that prevents being "hungrier and less happy." And there is a whole lot more that goes into it--ketosis is just a very big piece of the puzzle.
  • amusedmonkey
    amusedmonkey Posts: 10,330 Member
    @Crisseyda that's exactly the point.

    The insulin hypothesis of obesity doesn't hold up well against scientific evidence and his overly simplistic explanations sound more like extrapolations, taking a basic mechanism and drawing unrelated conclusions from it that I don't find particularly pertinent.

    Low carb is not particularly any more or less muscle sparing than any other diet if you control for protein and I have yet to see any consistent evidence that people with higher carb intake/insulin are particularly more prone to gaining fat than those on a lower carb/with lower insulin.

    TBL contestants were most likely low carb, in addition to being effectively in a ketogenic state due to their 4-6 hours a day exercise routine which would leave anyone on a 800ish calorie diet in a ketogenic state, even if every single one of these calories came from carbs.
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    @Crisseyda that's exactly the point.

    The insulin hypothesis of obesity doesn't hold up well against scientific evidence and his overly simplistic explanations sound more like extrapolations, taking a basic mechanism and drawing unrelated conclusions from it that I don't find particularly pertinent.

    Low carb is not particularly any more or less muscle sparing than any other diet if you control for protein and I have yet to see any consistent evidence that people with higher carb intake/insulin are particularly more prone to gaining fat than those on a lower carb/with lower insulin.

    TBL contestants were most likely low carb, in addition to being effectively in a ketogenic state due to their 4-6 hours a day exercise routine which would leave anyone on a 800ish calorie diet in a ketogenic state, even if every single one of these calories came from carbs.

    Do you have any access to this evidence?

    Dr. Fung shares clear scientific evidence that calorie restricted diets lower BMR and that fasting does not. He then explains the science behind it, which you can find in any physiology textbook. Insulin does in fact inhibit lypolysis--known fact.
  • amusedmonkey
    amusedmonkey Posts: 10,330 Member
    Crisseyda wrote: »
    @Crisseyda that's exactly the point.

    The insulin hypothesis of obesity doesn't hold up well against scientific evidence and his overly simplistic explanations sound more like extrapolations, taking a basic mechanism and drawing unrelated conclusions from it that I don't find particularly pertinent.

    Low carb is not particularly any more or less muscle sparing than any other diet if you control for protein and I have yet to see any consistent evidence that people with higher carb intake/insulin are particularly more prone to gaining fat than those on a lower carb/with lower insulin.

    TBL contestants were most likely low carb, in addition to being effectively in a ketogenic state due to their 4-6 hours a day exercise routine which would leave anyone on a 800ish calorie diet in a ketogenic state, even if every single one of these calories came from carbs.

    Do you have any access to this evidence?

    Dr. Fung shares clear scientific evidence that calorie restricted diets lower BMR and that fasting does not. He then explains the science behind it, which you can find in any physiology textbook. Insulin does in fact inhibit lypolysis--known fact.

    http://www.ncbi.nlm.nih.gov/pubmed/17130851 is one (if you have access to the full text) as well as the overall body of the current research
    Practical evidence is another, high carb intake in countries (like Japan) and populations (like high carb vegans) does not predict obesity, while high calorie intake coupled with a low calorie expenditure does.
    And then there is the use of calories, not insulin levels, in most weight related studies as a fairly predictable measure for weight loss/gain showing which model is more widely accepted in the scientific community.
  • Zella_11
    Zella_11 Posts: 161 Member
    Gamliela wrote: »
    gebeziseva wrote: »
    What does this have to do with CICO?
    CICO means that you lose weight if you eat less than you burn and you gain weight if you eat more than you burn. How much you're going to burn has nothing to do with this principle.

    Also this is the only way a person can lose weight - eat less than you burn - more out than in. This is not disputable. So it is just CICO.

    ETA: Now if you want to lose them pounds super fast and decide to eat like a mouse and then screw your metabolism as a result, well then I guess we always have natural selection at work :)

    To your question - how do we get our TDEE/BMR tested - EASY :)
    I do that for the last few month. I put all my data - the calories in, the calories out through exercise if any, and my weight in excel tables and calculate what my TDEE is as a result of that. This is my actual TDEE and it can't lie :) Fortunately for me it is very close to what the online formulas suggest it is (my calculation is experimental fitting of data, theirs is based on thermodynamics). This method can only work though if you are extra careful with your food measuring and logging.

    One doctor associated with this study is quoted as saying that calorie rstricting diets just don't work. I thought it was a bit deprssing myself, I mean the whole thing was, for obese people and sortof hopeless.

    A calorie restrictive diet is the only thing that works--restricting calories so that one is in a daily caloric deficit, consuming fewer calories than one burns. Not sure what that doctor is trying to say...
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    Crisseyda wrote: »
    @Crisseyda that's exactly the point.

    The insulin hypothesis of obesity doesn't hold up well against scientific evidence and his overly simplistic explanations sound more like extrapolations, taking a basic mechanism and drawing unrelated conclusions from it that I don't find particularly pertinent.

    Low carb is not particularly any more or less muscle sparing than any other diet if you control for protein and I have yet to see any consistent evidence that people with higher carb intake/insulin are particularly more prone to gaining fat than those on a lower carb/with lower insulin.

    TBL contestants were most likely low carb, in addition to being effectively in a ketogenic state due to their 4-6 hours a day exercise routine which would leave anyone on a 800ish calorie diet in a ketogenic state, even if every single one of these calories came from carbs.

    Do you have any access to this evidence?

    Dr. Fung shares clear scientific evidence that calorie restricted diets lower BMR and that fasting does not. He then explains the science behind it, which you can find in any physiology textbook. Insulin does in fact inhibit lypolysis--known fact.

    http://www.ncbi.nlm.nih.gov/pubmed/17130851 is one (if you have access to the full text) as well as the overall body of the current research
    Practical evidence is another, high carb intake in countries (like Japan) and populations (like high carb vegans) does not predict obesity, while high calorie intake coupled with a low calorie expenditure does.
    And then there is the use of calories, not insulin levels, in most weight related studies as a fairly predictable measure for weight loss/gain showing which model is more widely accepted in the scientific community.

    This 2006 review you shared doesn't refute the insulin theory at all. It just reviews some of the available data. The conclusion to the first section on Insulin level and insulin sensitivity in adult populations states:

    The authors failed to find a correlation between fasting insulin and weight gain (similar to the results from many other cohorts, as mentioned above), but did show that high acute insulin response during an intravenous glucose challenge was a predictor of higher weight gain, especially in insulin-sensitive subjects. This is actually not in complete discordance with earlier findings. Indeed, the predictive effect of high acute insulin response on weight gain was diminished in insulin-resistant subjects. Thus, it is possible that at the onset of the weight gain process, insulin may act as an anabolic hormone and conceivably induce fat accumulation. As adiposity increases, insulin resistance develops and may eventually protect the individual against further weight gain.

    Nothing about this refutes what Dr. Fung is saying here about the 2 compartment model. And what's really funny to me is that Dr. Fung makes the same exact observation in one of his blog posts(see 1). Insulin resistance is a protective mechanism for cells--the cells defend themselves against excess insulin at the cost of rising extracellular glucose levels to the host (to its detriment). (EDIT: if you think about what this really means, it's saying that an obese, insulin-resistant person is not going to gain as much fat from a doughnut as an insulin-sensitive person--that's in direct contradiction to the CICO model, where calories in predict weight gain exactly). And the statement here about insulin-sensitive subjects being more prone to weight gain also does nothing but support the insulin theory.

    @Zella_11
    Yes, calorie restriction is essential to weight loss-agreed. However, the process is far more complex, and limiting to that simplistic model can be detrimental to our health (the Biggest Losers' case in point). The "2 compartment model" helps explain why not all types of calorie restriction diets and eating patterns are created equal. If you want to know more, I'm happy to explain :)

    (1) https://intensivedietarymanagement.com/insulin-resistance-good-t2d-7/
  • AnnPT77
    AnnPT77 Posts: 34,175 Member
    Another thing that strikes me is that people - including the doctor being quoted - always talk about "calorie restriction" as if it was all the same, but there's a big difference between a very low calorie diet and a moderate deficit, at least it terms of how it feels.

    @Crisseyda says above "During calorie restriction, it's basically all you can think about not to eat." - I don't identify with that from my experience of a 500 calorie deficit. Yes, I get hungrier than I do at maintenance, but not obsessionally so, provided I'm careful to eat filling foods. At a higher deficit, I think you probably will start to get obsessional hunger and other unpleasant effects. It's not the same experience.

    Can we assume the body sees these two situations in the same way, or is it reasonable to hypothesise that they are not the same, and that from the metabolic point of view, not all "calorie restriction" is created equal?

    And that makes me wonder if, even at low deficits, you could diet in a way that, as well as leaving you hungrier and less happy, could also have a bigger impact on metabolism?

    "More research needed ".

    To the bolded:

    Satiety seems to be very individual . . . it seems iffy to try to generalize about it. Personally, even when at 750-1000 daily calorie deficit rates, I rarely felt hungry (and if I did, I ate), and certainly not "obsessionally hungry" or that it was "basically all you can think about not to eat" (don't really relate to the latter at all - and I'm not saying that I never overate/overeat . . . but I think that's not the reason).

    I know this is tangent to the main trajectory of the thread.

    Certainly, there are at least some suggestions that how you lose weight matters in how your metabolism reacts, like journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0004377 .
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    AnnPT77 wrote: »
    Another thing that strikes me is that people - including the doctor being quoted - always talk about "calorie restriction" as if it was all the same, but there's a big difference between a very low calorie diet and a moderate deficit, at least it terms of how it feels.

    @Crisseyda says above "During calorie restriction, it's basically all you can think about not to eat." - I don't identify with that from my experience of a 500 calorie deficit. Yes, I get hungrier than I do at maintenance, but not obsessionally so, provided I'm careful to eat filling foods. At a higher deficit, I think you probably will start to get obsessional hunger and other unpleasant effects. It's not the same experience.

    Can we assume the body sees these two situations in the same way, or is it reasonable to hypothesise that they are not the same, and that from the metabolic point of view, not all "calorie restriction" is created equal?

    And that makes me wonder if, even at low deficits, you could diet in a way that, as well as leaving you hungrier and less happy, could also have a bigger impact on metabolism?

    "More research needed ".

    To the bolded:

    Satiety seems to be very individual . . . it seems iffy to try to generalize about it. Personally, even when at 750-1000 daily calorie deficit rates, I rarely felt hungry (and if I did, I ate), and certainly not "obsessionally hungry" or that it was "basically all you can think about not to eat" (don't really relate to the latter at all - and I'm not saying that I never overate/overeat . . . but I think that's not the reason).

    I know this is tangent to the main trajectory of the thread.

    Certainly, there are at least some suggestions that how you lose weight matters in how your metabolism reacts, like journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0004377 .

    Yup, and it gets even more tricky for people who have insulin resistance at baseline. When they go on a calorie restricted diet, they have an even greater hurdle to overcome in unlocking that "second compartment." They feel hungrier than that person who can more readily and easily switch to fat metabolism for energy--which is why fasting and LCHF diets can be such a powerfully effective tool for them, while others seem to do fine without it. Like @cattofthegarage who just needs to be careful to eat "filling foods."
  • xtina315
    xtina315 Posts: 218 Member
    That show is just so unhealthy. People's of accounts of taking drugs to make weight etc. No one should lose that amt of weight in a short time, you learn nothing and you cannot continue with that lifestyle
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    Crisseyda wrote: »
    @Crisseyda that's exactly the point.

    The insulin hypothesis of obesity doesn't hold up well against scientific evidence and his overly simplistic explanations sound more like extrapolations, taking a basic mechanism and drawing unrelated conclusions from it that I don't find particularly pertinent.

    Low carb is not particularly any more or less muscle sparing than any other diet if you control for protein and I have yet to see any consistent evidence that people with higher carb intake/insulin are particularly more prone to gaining fat than those on a lower carb/with lower insulin.

    TBL contestants were most likely low carb, in addition to being effectively in a ketogenic state due to their 4-6 hours a day exercise routine which would leave anyone on a 800ish calorie diet in a ketogenic state, even if every single one of these calories came from carbs.

    Do you have any access to this evidence?

    Dr. Fung shares clear scientific evidence that calorie restricted diets lower BMR and that fasting does not. He then explains the science behind it, which you can find in any physiology textbook. Insulin does in fact inhibit lypolysis--known fact.

    It is also a known fact that perpetuum mobiles don't exist, so every living organism needs a steady supply of energy, so stopping lipolysis because insulin (which you ALWAYS have some amount of in your blood btw) is not a thing that exists in this universe. You wouldn't be able to live.

    @stevencloser

    Here's a nice physiology e-textbook I found for you from the Department of Biomedical Sciences at Colorado State University.

    http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/insulin_phys.html

    Insulin and Lipid Metabolism

    The metabolic pathways for utilization of fats and carbohydrates are deeply and intricately intertwined. Considering insulin's profound effects on carbohydrate metabolism, it stands to reason that insulin also has important effects on lipid metabolism, including the following:

    Insulin promotes synthesis of fatty acids in the liver. As discussed above, insulin is stimulatory to synthesis of glycogen in the liver. However, as glycogen accumulates to high levels (roughly 5% of liver mass), further synthesis is strongly suppressed.

    When the liver is saturated with glycogen, any additional glucose taken up by hepatocytes is shunted into pathways leading to synthesis of fatty acids, which are exported from the liver as lipoproteins. The lipoproteins are ripped apart in the circulation, providing free fatty acids for use in other tissues, including adipocytes, which use them to synthesize triglyceride.

    Insulin inhibits breakdown of fat in adipose tissue by inhibiting the intracellular lipase that hydrolyzes triglycerides to release fatty acids.

    Insulin facilitates entry of glucose into adipocytes, and within those cells, glucose can be used to synthesize glycerol. This glycerol, along with the fatty acids delivered from the liver, are used to synthesize triglyceride within the adipocyte. By these mechanisms, insulin is involved in further accumulation of triglyceride in fat cells.

    From a whole body perspective, insulin has a fat-sparing effect. Not only does it drive most cells to preferentially oxidize carbohydrates instead of fatty acids for energy, insulin indirectly stimulates accumulation of fat in adipose tissue.


    So...
    In terms of fat metabolism, Insulin 1. promotes fat storage in the liver, 2. promotes the creation of new fat, and 3. inhibits the breakdown of stored fat. Sounds to me like Dr. Fung is onto something when he says control of insulin is the key to unlocking the second compartment of stored fat!
  • gothchiq
    gothchiq Posts: 4,590 Member
    A nutritionist can test it for you. You sit still for a period of time and breathe into a machine. From your exhalations they measure your metabolism and basal metabolic rate. This way your true caloric needs can be ascertained. I had this done. It's a very valuable tool.
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    @Crisseyda It's easy to pick a single point out of a whole post and throw around studies and theoretical ideation at it picked out carefully to support your point (any point has at least a handful of supporting theories if you look carefully enough), but how do you marry your theories with practice? How do you explain TBL contestants slowed metabolism when they were effectively in a ketogenic state if being in a ketogenic state prevents slowed metabolism somehow due to some silly compartment theory?

    It takes a single case to disprove a theory. How do you explain me, insulin resistant, previously pre-diabetic, losing 90 lb comfortably with barely any hunger on a moderate calorie moderate carb diet with quite a few high glycemic foods (which happen to be the most filling for me)? How do you explain 80/10/10 vegans? How do you explain calorie consumption, but not carb consumption, being predictive of obesity? How do you explain high protein diets preserving more muscle mass, reducing hunger and helping fat loss regardless of carb levels when protein is pretty insulinemic?

    @amusedmonkey

    Nah, it's actually a lot easier to take no position and have no answers.

    And, we disagree on whether or not they were in ketosis. Insulin inhibits the breakdown of fat as well as ketone production (see http://www.ncbi.nlm.nih.gov/pubmed?term=3287950 ). In case of these contestants, who are already obese and most likely insulin resistant, their insulin levels are already higher at baseline--it is a greater challenge for them to enter ketosis. A calorie restricted diet is unlikely to be very effective. If you disagree with the theory, fine; but don't pretend the science isn't there--and you have yet to offer any direct counter evidence.

    And as far as all your other questions, did you have any specific scientific evidence to share? About vegans, protein, or the obesity epidemic? I really don't understand why you think all these concepts are mutually exclusive. Obesity and diabetes are multi-factorial diseases, and the role of insulin is one major piece of the puzzle for many people. Each individual person who suffers from obesity likely has unique combination of contributing factors from stress to addiction to culture to history to genetics to food environment and so on.
  • DebSozo
    DebSozo Posts: 2,578 Member
    annaskiski wrote: »
    People on long term weight loss journeys typically do 'refeeds' for this very reason. (Restoke their metabolism).

    This is not new information. There's a lot of good info from people who regularly cut and bulk (i.e. body builders) on how to protect your metabolism. One good book I've read is "Burn the fat, Feed the Muscle". I'm sure there are others.

    The silly show doesn't allow people time to stop and restoke their metabolism. They'd get kicked off.

    This is true. Bodybuilders know that they need to alternate bulking and cutting and do manage to restore their metabolisms. The show BL is extreme.
  • DebSozo
    DebSozo Posts: 2,578 Member
    edited June 2016
    Gamliela wrote: »
    ok - permanent as in six years. But my point is that it didn't correct itself after a few months or years

    I know. I know.
    That is the most depressing part......
    -->> when will it correct?

    Someone on the forums mentioned "18 months", but I'm not sure where their source came from.
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    Crisseyda wrote: »
    @Crisseyda It's easy to pick a single point out of a whole post and throw around studies and theoretical ideation at it picked out carefully to support your point (any point has at least a handful of supporting theories if you look carefully enough), but how do you marry your theories with practice? How do you explain TBL contestants slowed metabolism when they were effectively in a ketogenic state if being in a ketogenic state prevents slowed metabolism somehow due to some silly compartment theory?

    It takes a single case to disprove a theory. How do you explain me, insulin resistant, previously pre-diabetic, losing 90 lb comfortably with barely any hunger on a moderate calorie moderate carb diet with quite a few high glycemic foods (which happen to be the most filling for me)? How do you explain 80/10/10 vegans? How do you explain calorie consumption, but not carb consumption, being predictive of obesity? How do you explain high protein diets preserving more muscle mass, reducing hunger and helping fat loss regardless of carb levels when protein is pretty insulinemic?

    @amusedmonkey

    Nah, it's actually a lot easier to take no position and have no answers.

    And, we disagree on whether or not they were in ketosis. Insulin inhibits the breakdown of fat as well as ketone production (see http://www.ncbi.nlm.nih.gov/pubmed?term=3287950 ). In case of these contestants, who are already obese and most likely insulin resistant, their insulin levels are already higher at baseline--it is a greater challenge for them to enter ketosis. A calorie restricted diet is unlikely to be very effective. If you disagree with the theory, fine; but don't pretend the science isn't there--and you have yet to offer any direct counter evidence.

    And as far as all your other questions, did you have any specific scientific evidence to share? About vegans, protein, or the obesity epidemic? I really don't understand why you think all these concepts are mutually exclusive. Obesity and diabetes are multi-factorial diseases, and the role of insulin is one major piece of the puzzle for many people. Each individual person who suffers from obesity likely has unique combination of contributing factors from stress to addiction to culture to history to genetics to food environment and so on.

    Seriously? You need evidence that the vast majority of thin people are not on a ketogenic diet and don't practice fasting? Or that the carb consumption in countries like Japan and some African countries is relatively high while obesity in relatively low? That countries with high vegetarian populations like India do not rank high on the obesity scale? You need evidence that someone on a very low calorie, low carb diet doing 4-6 hours of exercise a day is somehow not able to enter ketosis because they are obese? You need evidence for what is common knowledge that protein is even more insulinemic than carbs (which is part of the reason why it's also very satisfying)? You need evidence that I somehow imagined losing 90 pounds on a moderate carb diet? This is starting to border on silly...

    @amusedmonkey

    No, I'd just like you to present some evidence that connects these general questions you are posing with your fundamental disagreement with what you label "the insulin theory of obesity"? Otherwise, I don't see any connection.

    1. "the vast majority of thin people are not a ketogenic diet and don't practice fasting" -- we are not talking about people who are already thin. We are talking about people who are obese. The majority of the people in the US are overweight or obese. Staying or being thin is not the issue in question; going from obese to thin is.

    2. "countries like Japan and some African countries" and "high vegetarian populations like India" eat more traditional diets--less processed foods, less sugar, more nutrients, more fiber... so they don't develop insulin resistance and obesity in the first place.

    3. "someone on a very low calorie diet doing 4-6 hours of exercise a day is somehow not able to enter ketosis because they are obese" -- I said they were more resistant to entering ketosis and even staying in ketosis due to high insulin levels and insulin resistance at baseline. I also shared the study showing that insulin independently inhibits ketogenesis even in the presence of fat metabolism. For those contestants, the constant hunger and drop in BMR corroborate this--not something you typically find in a ketogenic state. People who enter ketosis regularly know that deeper ketosis means better effects.

    4. "protein is even more insulinemic than carbs" -- the insulin response from protein is caused by incretin release, not by a rise in glucose. Incretins also slow gastric emptying and increase satiety. All things being equal, this would explain why a steak keeps you feeling fuller longer than white bread--and you eat less overall.

    5. "I somehow imagined losing 90 lbs on a moderate carb diet" -- you're experience is not in question here. The topic is why calorie restricted diets suppress BMR long-term, and why ultimately almost all diets fail (all are centered on CICO, and not the hormonal causes of obesity--your observations about higher carb traditional diets should clue you to the actual causes of obesity. You just need to take a look at what is different between those and the western diet).
  • tomteboda
    tomteboda Posts: 2,171 Member
    @crisseyda
    I was pretty sure that Japanese and other southeast Asian populations do indeed have insulin resistance, and that it shows up at lower body mass. This is believed to be related to a greater degree of visceral fast deposition, as opposed to Caucasians, who typically have higher degrees of subcutaneous fat.

    Here's a fairly recent review on the topic.

    Kodama, Keiichi, et al."Ethnic Differences in the Relationship Between Insulin Sensitivity and Insulin Response A systematic review and meta-analysis." Diabetes care 36.6 (2013): 1789-1796.
    CONCLUSIONS Our findings suggest that the genetic background of Africans and East Asians makes them more and differentially susceptible to diabetes than Caucasians. This ethnic stratification could be implicated in the different natural courses of diabetes onset.
  • MissusMoon
    MissusMoon Posts: 1,900 Member
    Crisseyda wrote: »
    Crisseyda wrote: »
    @Crisseyda It's easy to pick a single point out of a whole post and throw around studies and theoretical ideation at it picked out carefully to support your point (any point has at least a handful of supporting theories if you look carefully enough), but how do you marry your theories with practice? How do you explain TBL contestants slowed metabolism when they were effectively in a ketogenic state if being in a ketogenic state prevents slowed metabolism somehow due to some silly compartment theory?

    It takes a single case to disprove a theory. How do you explain me, insulin resistant, previously pre-diabetic, losing 90 lb comfortably with barely any hunger on a moderate calorie moderate carb diet with quite a few high glycemic foods (which happen to be the most filling for me)? How do you explain 80/10/10 vegans? How do you explain calorie consumption, but not carb consumption, being predictive of obesity? How do you explain high protein diets preserving more muscle mass, reducing hunger and helping fat loss regardless of carb levels when protein is pretty insulinemic?

    @amusedmonkey

    Nah, it's actually a lot easier to take no position and have no answers.

    And, we disagree on whether or not they were in ketosis. Insulin inhibits the breakdown of fat as well as ketone production (see http://www.ncbi.nlm.nih.gov/pubmed?term=3287950 ). In case of these contestants, who are already obese and most likely insulin resistant, their insulin levels are already higher at baseline--it is a greater challenge for them to enter ketosis. A calorie restricted diet is unlikely to be very effective. If you disagree with the theory, fine; but don't pretend the science isn't there--and you have yet to offer any direct counter evidence.

    And as far as all your other questions, did you have any specific scientific evidence to share? About vegans, protein, or the obesity epidemic? I really don't understand why you think all these concepts are mutually exclusive. Obesity and diabetes are multi-factorial diseases, and the role of insulin is one major piece of the puzzle for many people. Each individual person who suffers from obesity likely has unique combination of contributing factors from stress to addiction to culture to history to genetics to food environment and so on.

    Seriously? You need evidence that the vast majority of thin people are not on a ketogenic diet and don't practice fasting? Or that the carb consumption in countries like Japan and some African countries is relatively high while obesity in relatively low? That countries with high vegetarian populations like India do not rank high on the obesity scale? You need evidence that someone on a very low calorie, low carb diet doing 4-6 hours of exercise a day is somehow not able to enter ketosis because they are obese? You need evidence for what is common knowledge that protein is even more insulinemic than carbs (which is part of the reason why it's also very satisfying)? You need evidence that I somehow imagined losing 90 pounds on a moderate carb diet? This is starting to border on silly...

    @amusedmonkey

    No, I'd just like you to present some evidence that connects these general questions you are posing with your fundamental disagreement with what you label "the insulin theory of obesity"? Otherwise, I don't see any connection.

    1. "the vast majority of thin people are not a ketogenic diet and don't practice fasting" -- we are not talking about people who are already thin. We are talking about people who are obese. The majority of the people in the US are overweight or obese. Staying or being thin is not the issue in question; going from obese to thin is.

    2. "countries like Japan and some African countries" and "high vegetarian populations like India" eat more traditional diets--less processed foods, less sugar, more nutrients, more fiber... so they don't develop insulin resistance and obesity in the first place.

    3. "someone on a very low calorie diet doing 4-6 hours of exercise a day is somehow not able to enter ketosis because they are obese" -- I said they were more resistant to entering ketosis and even staying in ketosis due to high insulin levels and insulin resistance at baseline. I also shared the study showing that insulin independently inhibits ketogenesis even in the presence of fat metabolism. For those contestants, the constant hunger and drop in BMR corroborate this--not something you typically find in a ketogenic state. People who enter ketosis regularly know that deeper ketosis means better effects.

    4. "protein is even more insulinemic than carbs" -- the insulin response from protein is caused by incretin release, not by a rise in glucose. Incretins also slow gastric emptying and increase satiety. All things being equal, this would explain why a steak keeps you feeling fuller longer than white bread--and you eat less overall.

    5. "I somehow imagined losing 90 lbs on a moderate carb diet" -- you're experience is not in question here. The topic is why calorie restricted diets suppress BMR long-term, and why ultimately almost all diets fail (all are centered on CICO, and not the hormonal causes of obesity--your observations about higher carb traditional diets should clue you to the actual causes of obesity. You just need to take a look at what is different between those and the western diet).

    I don't know how many times the goal posts need to be shifted. The video is clearly saying insulin=weight gain because compartments, which I find absurd. It does not mention obese or thin. It does not mention the reason insulin levels are increased.

    I did not grow up on a western diet. I grew up on a traditional nutrient rich whole foods diet with very little added sugar and a minimum of 50 grams of fiber a day yet I developed severe obesity and insulin resistance (prediabetes) and reached a weight higher than some biggest loser contestants. Losing weight the majority of my decrease in calories came from fat (used to consume 50-60% calories from fat, mainly olive oil and nuts). Lost a lot of weight easily with barely any hunger and my carb consumption only saw a modest 30-40 gram decrease, if even that on some days. I consume anywhere between 150 and 350 grams of carbs depending on the day. I don't do water fasts. I have not seen any drastic decrease in metabolism like the contestants on the show. I don't believe I am a special snowflake who magically defied the 2 compartment "rule" and somehow managed to burn fat in the presence of insulin resistance and carbs without the drastic decrease shown for the contestants who were on low carb and calorie diets with lots of exercise.

    What you are basically saying is:

    "If you are obese you need to fast or eat low carb in order not to suffer a drastic decrease in metabolism, but wait! since you are obese eating low carb may not put you in ketosis so you are doomed and screwed either way"

    "Insulin causes obesity because carbs=insulin=fat storage, but protein = insulin =/= fat storage because it's not the insulin that causes obesity, it's the rise in glucose, but wait! It is the insulin after all, but if you are not already fat, insulin won't make you fat. Or you know what? Actually insulin will only make you fat if you are thin and insulin sensitive, but once you are fat it actually prohibits further gain"

    "The insulin theory of obesity only applies if the carbs you eat come from doughnuts, but not rice. The insulin response caused by rice will not make you fat because it's not sugar. It's not the insulin that makes you fat, it's sugar and processed foods."

    Indeed we need to take a look at what's different between the western diet and the diets of some of the thinner countries, and here it is:
    s5v6d1erxk2r.png
    un6myih3dhqp.png

    rkm8k4qqt832.png

    That chart really says it all. For me, that average intake would equal me gaining weight with regularity. And boy, was I ever. I was eating low carb(except booze) but at least those average calories. Fine cheeses, very large steaks for the most part.
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    Crisseyda wrote: »
    Crisseyda wrote: »
    @Crisseyda It's easy to pick a single point out of a whole post and throw around studies and theoretical ideation at it picked out carefully to support your point (any point has at least a handful of supporting theories if you look carefully enough), but how do you marry your theories with practice? How do you explain TBL contestants slowed metabolism when they were effectively in a ketogenic state if being in a ketogenic state prevents slowed metabolism somehow due to some silly compartment theory?

    It takes a single case to disprove a theory. How do you explain me, insulin resistant, previously pre-diabetic, losing 90 lb comfortably with barely any hunger on a moderate calorie moderate carb diet with quite a few high glycemic foods (which happen to be the most filling for me)? How do you explain 80/10/10 vegans? How do you explain calorie consumption, but not carb consumption, being predictive of obesity? How do you explain high protein diets preserving more muscle mass, reducing hunger and helping fat loss regardless of carb levels when protein is pretty insulinemic?

    @amusedmonkey

    Nah, it's actually a lot easier to take no position and have no answers.

    And, we disagree on whether or not they were in ketosis. Insulin inhibits the breakdown of fat as well as ketone production (see http://www.ncbi.nlm.nih.gov/pubmed?term=3287950 ). In case of these contestants, who are already obese and most likely insulin resistant, their insulin levels are already higher at baseline--it is a greater challenge for them to enter ketosis. A calorie restricted diet is unlikely to be very effective. If you disagree with the theory, fine; but don't pretend the science isn't there--and you have yet to offer any direct counter evidence.

    And as far as all your other questions, did you have any specific scientific evidence to share? About vegans, protein, or the obesity epidemic? I really don't understand why you think all these concepts are mutually exclusive. Obesity and diabetes are multi-factorial diseases, and the role of insulin is one major piece of the puzzle for many people. Each individual person who suffers from obesity likely has unique combination of contributing factors from stress to addiction to culture to history to genetics to food environment and so on.

    Seriously? You need evidence that the vast majority of thin people are not on a ketogenic diet and don't practice fasting? Or that the carb consumption in countries like Japan and some African countries is relatively high while obesity in relatively low? That countries with high vegetarian populations like India do not rank high on the obesity scale? You need evidence that someone on a very low calorie, low carb diet doing 4-6 hours of exercise a day is somehow not able to enter ketosis because they are obese? You need evidence for what is common knowledge that protein is even more insulinemic than carbs (which is part of the reason why it's also very satisfying)? You need evidence that I somehow imagined losing 90 pounds on a moderate carb diet? This is starting to border on silly...

    @amusedmonkey

    No, I'd just like you to present some evidence that connects these general questions you are posing with your fundamental disagreement with what you label "the insulin theory of obesity"? Otherwise, I don't see any connection.

    1. "the vast majority of thin people are not a ketogenic diet and don't practice fasting" -- we are not talking about people who are already thin. We are talking about people who are obese. The majority of the people in the US are overweight or obese. Staying or being thin is not the issue in question; going from obese to thin is.

    2. "countries like Japan and some African countries" and "high vegetarian populations like India" eat more traditional diets--less processed foods, less sugar, more nutrients, more fiber... so they don't develop insulin resistance and obesity in the first place.

    3. "someone on a very low calorie diet doing 4-6 hours of exercise a day is somehow not able to enter ketosis because they are obese" -- I said they were more resistant to entering ketosis and even staying in ketosis due to high insulin levels and insulin resistance at baseline. I also shared the study showing that insulin independently inhibits ketogenesis even in the presence of fat metabolism. For those contestants, the constant hunger and drop in BMR corroborate this--not something you typically find in a ketogenic state. People who enter ketosis regularly know that deeper ketosis means better effects.

    4. "protein is even more insulinemic than carbs" -- the insulin response from protein is caused by incretin release, not by a rise in glucose. Incretins also slow gastric emptying and increase satiety. All things being equal, this would explain why a steak keeps you feeling fuller longer than white bread--and you eat less overall.

    5. "I somehow imagined losing 90 lbs on a moderate carb diet" -- you're experience is not in question here. The topic is why calorie restricted diets suppress BMR long-term, and why ultimately almost all diets fail (all are centered on CICO, and not the hormonal causes of obesity--your observations about higher carb traditional diets should clue you to the actual causes of obesity. You just need to take a look at what is different between those and the western diet).

    I don't know how many times the goal posts need to be shifted. The video is clearly saying insulin=weight gain because compartments, which I find absurd. It does not mention obese or thin. It does not mention the reason insulin levels are increased.

    I did not grow up on a western diet. I grew up on a traditional nutrient rich whole foods diet with very little added sugar and a minimum of 50 grams of fiber a day yet I developed severe obesity and insulin resistance (prediabetes) and reached a weight higher than some biggest loser contestants. Losing weight the majority of my decrease in calories came from fat (used to consume 50-60% calories from fat, mainly olive oil and nuts). Lost a lot of weight easily with barely any hunger and my carb consumption only saw a modest 30-40 gram decrease, if even that on some days. I consume anywhere between 150 and 350 grams of carbs depending on the day. I don't do water fasts. I have not seen any drastic decrease in metabolism like the contestants on the show. I don't believe I am a special snowflake who magically defied the 2 compartment "rule" and somehow managed to burn fat in the presence of insulin resistance and carbs without the drastic decrease shown for the contestants who were on low carb and calorie diets with lots of exercise.

    What you are basically saying is:

    "If you are obese you need to fast or eat low carb in order not to suffer a drastic decrease in metabolism, but wait! since you are obese eating low carb may not put you in ketosis so you are doomed and screwed either way"

    "Insulin causes obesity because carbs=insulin=fat storage, but protein = insulin =/= fat storage because it's not the insulin that causes obesity, it's the rise in glucose, but wait! It is the insulin after all, but if you are not already fat, insulin won't make you fat. Or you know what? Actually insulin will only make you fat if you are thin and insulin sensitive, but once you are fat it actually prohibits further gain"

    "The insulin theory of obesity only applies if the carbs you eat come from doughnuts, but not rice. The insulin response caused by rice will not make you fat because it's not sugar. It's not the insulin that makes you fat, it's sugar and processed foods."

    Indeed we need to take a look at what's different between the western diet and the diets of some of the thinner countries, and here it is:
    s5v6d1erxk2r.png
    un6myih3dhqp.png

    rkm8k4qqt832.png

    @amusedmonkey

    1. "The video is clearly saying insulin=weight gain because compartments, which I find absurd." --nope, he says insulin inhibits the breakdown of stored fat.

    2. "I don't believe I am a special snowflake" -- You got obese and pre-diabetic on on a whole foods, virtually sugar free diet. Sounds pretty darn special to me. Granted, all we have is your subjective experience, no data on this phenomenon.

    3."'If you are obese you need to fast or eat low carb in order not to suffer a drastic decrease in metabolism, but wait! since you are obese eating low carb may not put you in ketosis so you are doomed and screwed either way'" -- nope, if you are insulin resistant, it will be harder to get into ketosis. Things that drop insulin levels dramatically--like especially fasting, restricting carbs, but also eating more protein, switching to whole foods, lowering stress, the list goes on and on--will be much more beneficial than simple calorie restriction plus exercise. You want to protect the BMR by helping the body tap into the virtually unlimited supply of energy in fat tissue. It that fat is blocked by high insulin levels, the body is going to feel like it is starving--and so will the person dieting.

    4. "'Insulin causes obesity because carbs=insulin=fat storage, but protein = insulin =/= fat storage because it's not the insulin that causes obesity, it's the rise in glucose, but wait! It is the insulin after all, but if you are not already fat, insulin won't make you fat. Or you know what? Actually insulin will only make you fat if you are thin and insulin sensitive, but once you are fat it actually prohibits further gain'" -- you sure are confusing a lot of concepts here. I know: science is hard. I quoted directly from the review that you shared. If it doesn't make sense to you why insulin-sensitivity would be predictive of weight gain, and why insulin-resistance would actually inhibit weight gain, I think we may reached a threshold. Part of the problem here is that you are consistently trying to make things black and white. It really blocks critical thinking. Why don't we just stick to the topic at hand: which is how to lose weight without dropping BMR like the biggest losers did. Also the topic of Dr. Fung's talk, and NOT the causes of obesity.

    5. "'The insulin theory of obesity only applies if the carbs you eat come from doughnuts, but not rice. The insulin response caused by rice will not make you fat because it's not sugar. It's not the insulin that makes you fat, it's sugar and processed foods.'" -- you got me there. I do believe processed foods and especially sugar are uniquely fattening and obesogenic. But what are we talking about here? The etiology of the obesity epidemic? Or how to lose weight if you are obese and insulin resistant?

    6. In regards to your chart, I'm seeing an obvious non sequitir. "The US has a obesity epidemic. The US eats too many calories; therefore, the US obesity epidemic is caused simply by eating too many calories." You are confusing proximate with ultimate cause. Of course, they ate too many calories. The question is why. The factors are certainly many, but undeniably a major factor is inflammatory, nutrient-devoid, fiber-devoid, non-satiating, rapid-blood-glucose-inducing processed foods.
  • Crisseyda
    Crisseyda Posts: 532 Member
    edited June 2016
    Also do you know why insulin "inhibits lipolysis"?
    Because if it's high it means you've just eaten and have plenty of energy available in your blood stream.
    Calories.

    @Stevencloser

    yeah, maybe--if you're healthy. Or maybe it's high because your cells are insulin resistant and you haven't actually eaten in hours.
    Science.
    If your theories get regularly shot down by others it should tell you something about yourself.

    Your statement actually tells me a whole lot more about you.

    And please don't give me so much credit, Steven! These are not my theories. I just read reliable evidence from doctors, nutritionists, and researchers--pioneers who have taken far more risks than I have. And I continue to learn more every day. I promise you, there are hundreds, maybe thousands more just like me, and we are growing. One day, you won't be able to keep up with squelching us, even on these forums.
  • stevencloser
    stevencloser Posts: 8,911 Member
    Crisseyda wrote: »
    Also do you know why insulin "inhibits lipolysis"?
    Because if it's high it means you've just eaten and have plenty of energy available in your blood stream.
    Calories.

    @Stevencloser

    yeah, maybe--if you're healthy. Or maybe it's high because your cells are insulin resistant and you haven't actually eaten in hours.
    Science.
    If your theories get regularly shot down by others it should tell you something about yourself.

    Your statement actually tells me a whole lot more about you.

    And please don't give me so much credit, Steven! These are not my theories. I just read reliable evidence from doctors, nutritionists, and researchers--pioneers who have taken far more risks than I have. And I continue to learn more every day. I promise you, there are hundreds, maybe thousands more just like me, and we are growing. One day, you won't be able to keep up with squelching us, even on these forums.

    Another piece of science, insulin resistance means your cells don't respond to the insulin as well as they should which leads to more being produced to reach the desired effect, meaning the effcts of it get diminished. All effects.
  • Crisseyda
    Crisseyda Posts: 532 Member
    Crisseyda wrote: »
    Also do you know why insulin "inhibits lipolysis"?
    Because if it's high it means you've just eaten and have plenty of energy available in your blood stream.
    Calories.

    @Stevencloser

    yeah, maybe--if you're healthy. Or maybe it's high because your cells are insulin resistant and you haven't actually eaten in hours.
    Science.
    If your theories get regularly shot down by others it should tell you something about yourself.

    Your statement actually tells me a whole lot more about you.

    And please don't give me so much credit, Steven! These are not my theories. I just read reliable evidence from doctors, nutritionists, and researchers--pioneers who have taken far more risks than I have. And I continue to learn more every day. I promise you, there are hundreds, maybe thousands more just like me, and we are growing. One day, you won't be able to keep up with squelching us, even on these forums.

    Another piece of science, insulin resistance means your cells don't respond to the insulin as well as they should which leads to more being produced to reach the desired effect, meaning the effcts of it get diminished. All effects.

    In other news, water is also wet.
  • Crisseyda
    Crisseyda Posts: 532 Member
    @amusedmonkey

    I think you might enjoy this article by Dr. Fung entitled, "The Carbohydrate Insulin Hypothesis is Wrong." It made me think of you and how you seemed so stuck on defending carbohydrates. I guess you've been exposed to this theory and found problems with it? Well, I wasn't talking about that theory; hence, my confusion as to why you kept simplifying the discussion... anyway... you might find you agree with him more than you initially thought.

    https://intensivedietarymanagement.com/carbohydrate-insulin-hypothesis-wrong-hormonal-obesity-vi/