Cutting carbs is more effective than cutting fat...apparently.
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Perhaps I am misunderstanding you, but i think you are wrong. IR makes it easier to store fat because you end up with excess glucose in the blood and that glucose has to go somewhere. It ends up getting made into fat because the insulin resistance makes it hard for the cells to use the glucose for fuel.
That was once believed, but is now known to be false. Cells have no difficulty at all using glucose for fuel, because of the four well-characterized glucose transporter proteins, only glucose transporter 4 (GLUT4) is regulated by insulin, and that is found only on fat and muscle cells. Other cells of the body get glucose for metabolism by either GLUT1 or GLUT3, neither of which are affected by insulin at all (nor is GLUT2, which is the two-way glucose transporter used in the liver). It's true there are other glucose transporters and transporters for other sugars that are less well understood, but none so far are known to respond to insulin. The reason for elevated blood glucose in t2 diabetics and in prediabetics is not a reduction of glucose metabolism, but a failure to regulate glucose storage and regeneration.
One way you can prove that even type 2 diabetics are using significant amounts of carbohydrates for fuel is to measure the respiratory exchange ratio (the amount of CO2 produced compared to O2 consumed) which roughly tells you how much the body is metabolizing fat versus carbohydrate, since fat metabolism produces only about 0.7 molecules of CO2 for every molecule of O2 consumed, while carbohydrates are always 1:1. There's no significant difference at all between obese non-diabetics and obese diabetics, and in fact both groups have a higher amount of calories coming from carbohydrates compared to non-obese people on a typical diet.
Insulin is only needed for fat cells to uptake glucose, and in muscle cells it can increase the amount of glucose taken up - muscle can still take up glucose without insulin, but it takes it up more rapidly in the presence of insulin.Yes, eating at a deficit will help with insulin sensitivity, but so will low carb. I guess it is a choice between eating at a deficit for life, or eating low, or at least lowered, carb.
For many people, simply losing enough weight will restore insulin sensitivity if they keep it off.0 -
rankinsect wrote: »Perhaps I am misunderstanding you, but i think you are wrong. IR makes it easier to store fat because you end up with excess glucose in the blood and that glucose has to go somewhere. It ends up getting made into fat because the insulin resistance makes it hard for the cells to use the glucose for fuel.
That was once believed, but is now known to be false. Cells have no difficulty at all using glucose for fuel, because of the four well-characterized glucose transporter proteins, only glucose transporter 4 (GLUT4) is regulated by insulin, and that is found only on fat and muscle cells. Other cells of the body get glucose for metabolism by either GLUT1 or GLUT3, neither of which are affected by insulin at all (nor is GLUT2, which is the two-way glucose transporter used in the liver). It's true there are other glucose transporters and transporters for other sugars that are less well understood, but none so far are known to respond to insulin. The reason for elevated blood glucose in t2 diabetics and in prediabetics is not a reduction of glucose metabolism, but a failure to regulate glucose storage and regeneration.
One way you can prove that even type 2 diabetics are using significant amounts of carbohydrates for fuel is to measure the respiratory exchange ratio (the amount of CO2 produced compared to O2 consumed) which roughly tells you how much the body is metabolizing fat versus carbohydrate, since fat metabolism produces only about 0.7 molecules of CO2 for every molecule of O2 consumed, while carbohydrates are always 1:1. There's no significant difference at all between obese non-diabetics and obese diabetics, and in fact both groups have a higher amount of calories coming from carbohydrates compared to non-obese people on a typical diet.
Insulin is only needed for fat cells to uptake glucose, and in muscle cells it can increase the amount of glucose taken up - muscle can still take up glucose without insulin, but it takes it up more rapidly in the presence of insulin.Yes, eating at a deficit will help with insulin sensitivity, but so will low carb. I guess it is a choice between eating at a deficit for life, or eating low, or at least lowered, carb.
For many people, simply losing enough weight will restore insulin sensitivity if they keep it off.
I have not heard this. You've given me something to google.
I'm a prediabetic who developed IR when not even overweight (perhaps at the high end of a normal BMI). I am one of the less common people with IR who was no fat, although I gained weight before I switched to low carb. LCHF has completely fixed my blood glucose levels for me... I imagine that would mean we have no issues with glucose regeneration since my carbs are usually under 20g.0 -
I have not heard this. You've given me something to google.
I'm a prediabetic who developed IR when not even overweight (perhaps at the high end of a normal BMI). I am one of the less common people with IR who was no fat, although I gained weight before I switched to low carb. LCHF has completely fixed my blood glucose levels for me... I imagine that would mean we have no issues with glucose regeneration since my carbs are usually under 20g.
Yeah, in your case, the low carb diet is probably truly important, as if you don't really have any significant fat (particularly visceral fat) to lose, you can't hope for much improvement by weight loss. While obesity is a major risk factor for insulin resistance, as you unfortunately know, it's not required, and sometimes even if you have no risk factors you can get the disorder. Sometimes it can be genetic, or it can just be the sad truth that "no risk factors" isn't the same as "no risk".0 -
lindsey1979 wrote: »rankinsect wrote: »lindsey1979 wrote: »The problem is that not every solution will be the optimal solution for everyone. There is no doubt that some will fare MUCH better with less carbs (like insulin resistant people), but there is also evidence out there that some will fare MUCH better with more carbs. It really depends on the individual and his/her needs.
Calorie reduction is a simple concept, so that's why most people stop there. However, quite a few likely would do better to adapt a strategy that applies more than calorie reduction alone -- perhaps adjust macros based on insulin sensitivity/resistance, adjusting food groups based on adherence, etc. It really is quite a multi-factorial problem.
But, most people want a simple solution. So they opt for calorie reduction, reduction/elimination of carbs, etc. Most people generally don't like to think too much about such things -- they want simple solutions. I think simple solutions are great when they work. But, if you're struggling to lose or maintain a healthy weight, then it's probably time to look beyond the simplest of solutions to finding a more customized solution. But, not everyone wants to put in this sort of effort (and there is a lot of contradictory, confusing information out there).
Unless there is a good reason that you do poorly on a calorie counting diet, the simplicity is a huge bonus. It's not just people not wanting to deal with complexity - there are a lot of different studies showing how the quality of decision-making drops dramatically when people have more factors to consider.
For example, they gave doctors a case study with two suggested treatment options, one which was better than the other, but both were reasonable. The doctors did pretty well at choosing the better option. They gave a similar group of doctors the same case study and same options, but they added a third, obviously wrong option. Even though no doctors choose the wrong option, it significantly reduced the number that picked the best option - the mere existence of another option reduced people's ability to choose between the two reasonable options.
There are other studies on cognition that show adding additional criteria for evaluation drops decision-making performance in the same manner.
The goal of any good plan is to keep things as clear and simple as possible without being too simple to be useful.
True, but considering that 90%+ of people regain the lost weight in 5-10 years, it would seem that it is not an effective longterm solution on its own for the vast majority of people. If you want to yo-yo forever, go for it -- it's really common. But I think that's far from an ideal solution. Plus, if you found out that you could lose the weight twice as fast if you adjusted your carbs, wouldn't you want to know that.
I think it's about working smarter (and what that means for any individual varies) rather than just working perpetually harder. But part of working smarter is that you have to be willing to figure out what the optimal (or at least better) strategy is for you. Otherwise, yo-yo forever.
Your 90% stat probably comes from the 1950s study on the subject, which I believe actually just said 90% fail to lose weight.
That 1950s study was cutting edge - they gave people a whole diet pamphlet to take home and checked on them in a year. I'm guessing modern success might be better.0 -
rankinsect wrote: »
I have not heard this. You've given me something to google.
I'm a prediabetic who developed IR when not even overweight (perhaps at the high end of a normal BMI). I am one of the less common people with IR who was no fat, although I gained weight before I switched to low carb. LCHF has completely fixed my blood glucose levels for me... I imagine that would mean we have no issues with glucose regeneration since my carbs are usually under 20g.
Yeah, in your case, the low carb diet is probably truly important, as if you don't really have any significant fat (particularly visceral fat) to lose, you can't hope for much improvement by weight loss. While obesity is a major risk factor for insulin resistance, as you unfortunately know, it's not required, and sometimes even if you have no risk factors you can get the disorder. Sometimes it can be genetic, or it can just be the sad truth that "no risk factors" isn't the same as "no risk".
I believe she also was on steroids even though at normal BMI, so that is a confounding factor.0 -
Good memory. I was on mild steroids in the year before discovering my BG was high. Could have been coincidence or not.0
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glisteninglight18 wrote: »natboosh69 wrote: »http://www.telegraph.co.uk/news/health/news/11963385/Cut-out-carbs-not-fat-if-you-want-to-lose-weight-Harvard-study-finds.html
This was also one of the main stories on the news in the UK this morning, cue mass of low carb diets!
Why is it not mainstream information that cutting calories is all that is needed, not carbs or fat or whatever? Frustrates me so much reading cr*p like this.
So wait... I don't get it ? It's best to just Calorie count then cut carbs ? I thought it just depends on body type because not all the same things work for everyone.
Noooo.......
As to weight loss, a calorie is a calorie. Body type has nothing to do with weight loss. Science proves you lose weight by eating less calories than you burn. This is the same for everyone.
However, the jewel in all this is that cutting down on carbs often helps people cut down on calories because they feel more satiated and don't eat as much. That's CICO.0 -
lindsey1979 wrote: »rankinsect wrote: »lindsey1979 wrote: »
True, but considering that 90%+ of people regain the lost weight in 5-10 years, it would seem that it is not an effective longterm solution on its own for the vast majority of people. If you want to yo-yo forever, go for it -- it's really common. But I think that's far from an ideal solution. Plus, if you found out that you could lose the weight twice as fast if you adjusted your carbs, wouldn't you want to know that.
I think it's about working smarter (and what that means for any individual varies) rather than just working perpetually harder. But part of working smarter is that you have to be willing to figure out what the optimal (or at least better) strategy is for you. Otherwise, yo-yo forever.
1. People who continue to count calories in maintenance tend to be very successful at keeping it off. Much better than other groups, that's one of the habits of successful losers.
2. It isn't possible for me to lose twice as fast on an isocaloric diet that happened to be low carb. Physics is physics, my body is not capable of creating or destroying energy. The energy I expend comes from my food or my body's stores. It also actually wouldn't be safe for me to lose twice as fast as I am. Yes, if I went low carb and a higher deficit is lose more, but I could do the same with high carb and higher deficit.
1. Sure, but who wants to count calories for the rest of their lives? If that's part of the required solution, that seems less than ideal as I don't think most people want to do this and from what I've seen, most people don't. So there is a disconnect on adherence and that's a problem why it's not an effective longterm solution.
2. That's not correct. There have been studies showing significantly different weight losses with different macros for those with different levels of insulin sensitivity/resistance -- on isocaloric diets with the same amount of protein -- only fat/carb levels shifts. If you understand how insulin resistance works, this actually makes a lot of sense because those people don't metabolize carbs (especially fast acting carbs) the same way an insulin sensitive person does. Their bodies have a different hormonal response which shifts the energy equation/fat stores.
http://onlinelibrary.wiley.com/doi/10.1038/oby.2005.79/full
This is also a limitation of CICO -- great initial guideline, but it presupposes that certain factors and coefficients are in place to produce the same results. When those factors/coefficients shift (like insulin resistance, thyroid, etc.), the results shift and CICO appears to not work as well in its simplest application.
It's not really an issue of CICO not working, but that the application of CICO (a simple physics equation) to a complicated system (the human body) for weight loss is not actually that simple. It just can appear that way when certain factors/coefficients are constant but that's just an illusion.
That's why a lot of people will say things like "barring a medical condition, CICO, etc." -- but a lot of people have these medical conditions and just don't know it. Like nearly half of the US adult population has insulin resistance at prediabetic or diabetic levels, and the vast majority do not know it.
Lindsey, you don't have to literally count calories at any time, you can test through trial and error. If you cut back on food, step on the scale on a weekly basis, or even a monthly basis, and your weight decreases in a consistent manner, you are practicing CICO.
If you can see in the mirror you look slimmer and your clothes are looser, you are practicing CICO.
There are many successful people practice CICO without literally counting.
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lindsey1979 wrote: »rankinsect wrote: »lindsey1979 wrote: »
True, but considering that 90%+ of people regain the lost weight in 5-10 years, it would seem that it is not an effective longterm solution on its own for the vast majority of people. If you want to yo-yo forever, go for it -- it's really common. But I think that's far from an ideal solution. Plus, if you found out that you could lose the weight twice as fast if you adjusted your carbs, wouldn't you want to know that.
I think it's about working smarter (and what that means for any individual varies) rather than just working perpetually harder. But part of working smarter is that you have to be willing to figure out what the optimal (or at least better) strategy is for you. Otherwise, yo-yo forever.
1. People who continue to count calories in maintenance tend to be very successful at keeping it off. Much better than other groups, that's one of the habits of successful losers.
2. It isn't possible for me to lose twice as fast on an isocaloric diet that happened to be low carb. Physics is physics, my body is not capable of creating or destroying energy. The energy I expend comes from my food or my body's stores. It also actually wouldn't be safe for me to lose twice as fast as I am. Yes, if I went low carb and a higher deficit is lose more, but I could do the same with high carb and higher deficit.
1. Sure, but who wants to count calories for the rest of their lives? If that's part of the required solution, that seems less than ideal as I don't think most people want to do this and from what I've seen, most people don't. So there is a disconnect on adherence and that's a problem why it's not an effective longterm solution.
2. That's not correct. There have been studies showing significantly different weight losses with different macros for those with different levels of insulin sensitivity/resistance -- on isocaloric diets with the same amount of protein -- only fat/carb levels shifts. If you understand how insulin resistance works, this actually makes a lot of sense because those people don't metabolize carbs (especially fast acting carbs) the same way an insulin sensitive person does. Their bodies have a different hormonal response which shifts the energy equation/fat stores.
http://onlinelibrary.wiley.com/doi/10.1038/oby.2005.79/full
This is also a limitation of CICO -- great initial guideline, but it presupposes that certain factors and coefficients are in place to produce the same results. When those factors/coefficients shift (like insulin resistance, thyroid, etc.), the results shift and CICO appears to not work as well in its simplest application.
It's not really an issue of CICO not working, but that the application of CICO (a simple physics equation) to a complicated system (the human body) for weight loss is not actually that simple. It just can appear that way when certain factors/coefficients are constant but that's just an illusion.
That's why a lot of people will say things like "barring a medical condition, CICO, etc." -- but a lot of people have these medical conditions and just don't know it. Like nearly half of the US adult population has insulin resistance at prediabetic or diabetic levels, and the vast majority do not know it.
Lindsey, you don't have to literally count calories at any time, you can test through trial and error. If you cut back on food, step on the scale on a weekly basis, or even a monthly basis, and your weight decreases in a consistent manner, you are practicing CICO.
If you can see in the mirror you look slimmer and your clothes are looser, you are practicing CICO.
There are many successful people practice CICO without literally counting.
Not to mention, literal calorie counting isn't even that hard, particularly if you plan meals in advance.
I spend more time every day brushing my teeth compared to logging my food, and I don't plan to give that up, either.0 -
rankinsect wrote: »lindsey1979 wrote: »rankinsect wrote: »lindsey1979 wrote: »
True, but considering that 90%+ of people regain the lost weight in 5-10 years, it would seem that it is not an effective longterm solution on its own for the vast majority of people. If you want to yo-yo forever, go for it -- it's really common. But I think that's far from an ideal solution. Plus, if you found out that you could lose the weight twice as fast if you adjusted your carbs, wouldn't you want to know that.
I think it's about working smarter (and what that means for any individual varies) rather than just working perpetually harder. But part of working smarter is that you have to be willing to figure out what the optimal (or at least better) strategy is for you. Otherwise, yo-yo forever.
1. People who continue to count calories in maintenance tend to be very successful at keeping it off. Much better than other groups, that's one of the habits of successful losers.
2. It isn't possible for me to lose twice as fast on an isocaloric diet that happened to be low carb. Physics is physics, my body is not capable of creating or destroying energy. The energy I expend comes from my food or my body's stores. It also actually wouldn't be safe for me to lose twice as fast as I am. Yes, if I went low carb and a higher deficit is lose more, but I could do the same with high carb and higher deficit.
1. Sure, but who wants to count calories for the rest of their lives? If that's part of the required solution, that seems less than ideal as I don't think most people want to do this and from what I've seen, most people don't. So there is a disconnect on adherence and that's a problem why it's not an effective longterm solution.
2. That's not correct. There have been studies showing significantly different weight losses with different macros for those with different levels of insulin sensitivity/resistance -- on isocaloric diets with the same amount of protein -- only fat/carb levels shifts. If you understand how insulin resistance works, this actually makes a lot of sense because those people don't metabolize carbs (especially fast acting carbs) the same way an insulin sensitive person does. Their bodies have a different hormonal response which shifts the energy equation/fat stores.
http://onlinelibrary.wiley.com/doi/10.1038/oby.2005.79/full
This is also a limitation of CICO -- great initial guideline, but it presupposes that certain factors and coefficients are in place to produce the same results. When those factors/coefficients shift (like insulin resistance, thyroid, etc.), the results shift and CICO appears to not work as well in its simplest application.
It's not really an issue of CICO not working, but that the application of CICO (a simple physics equation) to a complicated system (the human body) for weight loss is not actually that simple. It just can appear that way when certain factors/coefficients are constant but that's just an illusion.
That's why a lot of people will say things like "barring a medical condition, CICO, etc." -- but a lot of people have these medical conditions and just don't know it. Like nearly half of the US adult population has insulin resistance at prediabetic or diabetic levels, and the vast majority do not know it.
Lindsey, you don't have to literally count calories at any time, you can test through trial and error. If you cut back on food, step on the scale on a weekly basis, or even a monthly basis, and your weight decreases in a consistent manner, you are practicing CICO.
If you can see in the mirror you look slimmer and your clothes are looser, you are practicing CICO.
There are many successful people practice CICO without literally counting.
Not to mention, literal calorie counting isn't even that hard, particularly if you plan meals in advance.
I spend more time every day brushing my teeth compared to logging my food, and I don't plan to give that up, either.
I agree. For me pre-planning is a great tool, as are weighing food and logging, but I acknowledge this does not work for everyone. It would not work for me to just fly by the seat of my pants, so to speak, but this works well for others.
CICO as a requirement of weight management never changes no matter what we do.0 -
rankinsect wrote: »lindsey1979 wrote: »That's not necessarily accurate. Being overweight is a risk factor, but it's not a sole cause. Because then everyone that is overweight would have insulin resistance and they don't. And no one would have insulin resistance if they were normal weight and yet some normal weight people do. I'm sure being overweight contributes to it, but there are other factors as well.
The single biggest determining factor is actually the average size of individual fat cells. Some people who are obese have a larger number of smaller fat cells, and some have a smaller number of larger fat cells."There is no question that insulin causes weight gain. Insulin is a hormone secreted by the pancreas in response to sugar intake usually in the diet. Its role is to drive sugar into the cells of the body where it is used as a source of energy (measured in calories). Insulin therefore pumps calories into cells. If this energy (sugar) is not used by the cells or is more than is needed, it is converted into an energy storage form known as fat. Because of these actions insulin is called an “anabolic” hormone"
http://www.dailystrength.org/health_blogs/squevedo/article/insulin-weight-gain
First, that assumes a non-resistant individual. The goal of insulin, in a non-resistant individual, is to store excess glucose as fat or glycogen, and to stop processes that produce more glucose. Insulin itself doesn't cause weight gain - the calorie surplus is the cause, insulin is the mechanism to take a surplus and put it somewhere that isn't going to be toxic to the body (as your blood can only have a very tiny amount of glucose it it at any time - only a couple of grams in a normal individual).
Second, insulin is not needed for any tissue to take up glucose for the cell to use for energy. Of the four types of glucose transporters that cells have, only the GLUT4 transporter is insulin-dependent (in that insulin causes more GLUT4 transporters to move to the cell surface, increasing the rate of glucose uptake). GLUT4 is expressed only in fat cells and skeletal muscle cells. These are the only cells that can increase or decrease their uptake of glucose in response to insulin.
All the rest of your cells use the transporters GLUT1 (for most of your body), GLUT2 (for the liver), or GLUT3 (for your brain) to bring glucose into the cell, and insulin has no effect on these transporters; they can move glucose into the cell equally effectively with or without insulin. Even your muscle cells have enough glucose transporters to meet their normal energy needs - the GLUT4 transporter is used so that muscle can take a big influx of surplus glucose and store it as glycogen.
Okay, let's just cut to the chase then because this seems largely an argument about semantics. I believe I've given the shorthand answer and you've launched into a partial discussion of the longhand answer.
If insulin is not necessary to shuttle glucose into cells, then why do we need? Why will people die without it?
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lindsey1979 wrote: »Okay, let's just cut to the chase then because this seems largely an argument about semantics. I believe I've given the shorthand answer and you've launched into a partial discussion of the longhand answer.
If insulin is not necessary to shuttle glucose into cells, then why do we need? Why will people die without it?
Insulin is necessary to move glucose into fat cells, and it increases the amount of glucose that moves into muscle cells - that is, it's needed in order to store glucose as fat or glycogen. It also acts on the liver to suppress metabolic processes that create new glucose, and acts on the brain to reduce appetite. Since your blood can only hold a few grams of glucose without it being toxic, it's necessary that free glucose be stored and the amount of glucose regulated.
Insulin has nothing to do with regulating the use of carbohydrates as fuel for the cells, and everything to do with regulating the storage, release, and creation of carbohydrates in order to keep your blood sugars in a healthy amount.0 -
rankinsect wrote: »lindsey1979 wrote: »Okay, let's just cut to the chase then because this seems largely an argument about semantics. I believe I've given the shorthand answer and you've launched into a partial discussion of the longhand answer.
If insulin is not necessary to shuttle glucose into cells, then why do we need? Why will people die without it?
Insulin is necessary to move glucose into fat cells, and it increases the amount of glucose that moves into muscle cells - that is, it's needed in order to store glucose as fat or glycogen. It also acts on the liver to suppress metabolic processes that create new glucose, and acts on the brain to reduce appetite. Since your blood can only hold a few grams of glucose without it being toxic, it's necessary that free glucose be stored and the amount of glucose regulated.
Insulin has nothing to do with regulating the use of carbohydrates as fuel for the cells, and everything to do with regulating the storage, release, and creation of carbohydrates in order to keep your blood sugars in a healthy amount.
Fair enough. I thought that is essentially what I was saying in more straightforward, laymen terms. I guess I just disagree with your differentiation between "regulating the storage, release and creation of carbohydrates in order to keep your blood sugars in a healthy amount" but then saying it has nothing to do with the "use of carbohydrates as fuel for the cells". To me, those are inextricably related. How much energy your cells need is inextricably linked with the regulation of your blood sugar.0 -
It's a good article, and a valid study. For a lot of people, eating more fat and decreasing carb consumption is the best way to eat fewer calories overall.0
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there are 'good' carbs and 'bad' carbs from point of view of dieting/insulin issues-low gi carbs avoid spikes and crashes in blood sugar which avoids follow on insulin response to regulate.
manufactured fructose,a high gi carb common in most processed foods,actually increases blood ghrelin,the hormone that makes you feel hungry.
also,fibre is a carb whose calories are not absorbed but which is essential for a healthy gut.
there is also the thermic effect of food-the energy the body uses to absorb that nutrient,
which means that 100 calories of fat results in 98 calories net,whereas 100 calories of protein gives 75 calories net-and protein reduces appetite by making you feel 'full'
whatever study you look at,there is agreement that eating the macros as unprocessed as possible is best-fresh fruit/vegetables,legumes,nuts,fresh cuts of meat,poultry,fish,cold pressed oils,etc.
also,metabolic rate slows up to 30% within 48 hrs of strict calorie reduction,so need to exercise to compensate.
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lindsey1979 wrote: »lindsey1979 wrote: »lindsey1979 wrote: »peter56765 wrote: »lindsey1979 wrote: »rankinsect wrote: »lindsey1979 wrote: »
True, but considering that 90%+ of people regain the lost weight in 5-10 years, it would seem that it is not an effective longterm solution on its own for the vast majority of people. If you want to yo-yo forever, go for it -- it's really common. But I think that's far from an ideal solution. Plus, if you found out that you could lose the weight twice as fast if you adjusted your carbs, wouldn't you want to know that.
I think it's about working smarter (and what that means for any individual varies) rather than just working perpetually harder. But part of working smarter is that you have to be willing to figure out what the optimal (or at least better) strategy is for you. Otherwise, yo-yo forever.
1. People who continue to count calories in maintenance tend to be very successful at keeping it off. Much better than other groups, that's one of the habits of successful losers.
2. It isn't possible for me to lose twice as fast on an isocaloric diet that happened to be low carb. Physics is physics, my body is not capable of creating or destroying energy. The energy I expend comes from my food or my body's stores. It also actually wouldn't be safe for me to lose twice as fast as I am. Yes, if I went low carb and a higher deficit is lose more, but I could do the same with high carb and higher deficit.
1. Sure, but who wants to count calories for the rest of their lives? If that's part of the required solution, that seems less than ideal as I don't think most people want to do this and from what I've seen, most people don't. So there is a disconnect on adherence and that's a problem why it's not an effective longterm solution.
A: People who want to keep the weight off for the rest of there lives. There's a reason folks on MFP discourage people thinking they need to go on this diet or that diet and instead try to emphasize making lifestyle changes that will last for the rest of your life. Counting calories isn't really that onerous of a thing to do, especially with all the technology available to help you. If you can't spare 5 minutes a day to track your food, then perhaps you really aren't that serious about losing weight after all.3. That's not correct. There have been studies showing significantly different weight losses with different macros for those with different levels of insulin sensitivity/resistance -- on isocaloric diets with the same amount of protein -- only fat/carb levels shifts. If you understand how insulin resistance works, this actually makes a lot of sense because those people don't metabolize carbs (especially fast acting carbs) the same way an insulin sensitive person does. Their bodies have a different hormonal response which shifts the energy equation/fat stores.
http://onlinelibrary.wiley.com/doi/10.1038/oby.2005.79/full
This is also a limitation of CICO -- great initial guideline, but it presupposes that certain factors and coefficients are in place to produce the same results. When those factors/coefficients shift (like insulin resistance, thyroid, etc.), the results shift and CICO appears to not work as well in its simplest application.
It's not really an issue of CICO not working, but that the application of CICO (a simple physics equation) to a complicated system (the human body) for weight loss is not actually that simple. It just can appear that way when certain factors/coefficients are constant but that's just an illusion.
That's why a lot of people will say things like "barring a medical condition, CICO, etc." -- but a lot of people have these medical conditions and just don't know it. Like nearly half of the US adult population has insulin resistance at prediabetic or diabetic levels, and the vast majority do not know it.
CICO still holds, but as you say, the values we get from food labels and exercise apps may not be accurate for everyone. So knock 5% to 10% off your calorie goal for the day and try again. Repeat as necessary. Eventually you will find the equilibrium that matches your needs. Obviously if you have some sort of medical condition that restricts categories of food, of course you must follow that too but IMHO, far too many people read articles like the one above and then self-diagnose all manners of illnesses and syndromes. More often than not, these becomes their excuses for why they've never been able to lose weight: It's always the fault of those dastardly carbs, or fats, or gluten, or their thyroid, or gut bacteria, or chemicals, or whatever the latest fad is.
I'm not saying that CICO doesn't hold true (though it's theoretical at that point), but that it's usefullness as a weight loss tool becomes more and more limited is such situation. In fact, it gets to the point, where it is nonsensical and/or dangerous if certain factors shift.
So, from my perspective, it's a great starting point. If you're measuring correctly and being reasonable in your estimates about output (and granted, this where most people probably make their mistake), and the expected CICO calculations aren't working, then it's time to look into something else that's causing the shift (i.e. medical issues).
But, for people to just repeat the mantra CICO and a deficit are all you need is simply incorrect and can be dangerous in certain situations. Continuing to cut calories is not always the answer.
For example, if you have a thyroid issue, and you need to cut below 800-1000 to lose or maintain, that's not an example where CICO should be reinforced if it's meant to be just keep cutting. That's a time when you say, okay, the calculations aren't working as expected, something is off -- time to figure out what that is. They'd just tell a person that they're not in a deficit and need to cut more or exercise more -- which is the exact opposite of the advice that should be given/followed.
But some CICO purists on this site don't understand the difference between the simple physics equation and the APPLICATION of that equation to the human body for the purposes of weight loss. They just ASSUME that a body will only store fat when you eat more than you burn. They don't understand that for some, the equation doesn't work that way because their metabolism is off and they can't manipulate the equation the same way a person without such issues can. That such people need the underlying problem TREATED before applying the conventional CICO wisdom.
But, sometimes, when all you have is a hammer, all you see are nails.
As for the self-diagnosis issues, sure there are people with those issues. And I don't doubt that the most common errors are really in measuring/calculating. I totally agree with you on that. But, medical issues that affect these calculations are incredibly COMMON. Just look at insulin resistance. Nearly HALF of the American adult population has IR at prediabetic or diabetic levels. I bet you if you look at over weight people, the percentage is higher. So, when things like this are so incredibly common, you've got to understand that CICO is not going to apply to them necessarily in the same way -- that there is a reason beside failures in measuring/calculating that the expected CICO calcalations aren't working. And it's not necessarily because they're stupid, lying, in denial, looking for excuses, can't measure/calculate, etc.
CICO is always, always true. It's science. If you burn more calories than you consume, you will lose weight. (Hold on, quote-ee, I'm about to agree with you.)
And a large majority of CICO failures are certainly due to mis-estimating or mis-recording on the "calories in" side, or over-reporting exercise.
However, I think what a lot of CICO stalwarts fail to take into account is that the "CO" side of the equation is NOT one size fits all. There are so, so, SO many individual factors that affect how many calories we burn per day. You can't just pop your age, sex, height, weight, and body fat percentage into a random website or an activity tracker and expect that the number it spits out is going to work perfectly for you. It's an average. It's an estimate. It's what's "typical."
When your rate of gain/loss isn't what you want it to be and you've corrected the "CI" side to be as accurate as possible, it's time to start examining the "CO" side. Unfortunately, there's a lot of information out there - some of it bunk, some of it good science, a lot of it somewhere in-between - on what drives your body to burn fewer (or, heck, more; though you don't really hear about that, at least not as part of this particular conversation) calories than what you'd expect and how to "fix" that. So people throw anything and everything at the wall to see what will stick. It's a desperate feeling to not understand why your hard work isn't paying off.
It's not the science that I have a problem with -- it's the poor application of folks who think they correctly understand the underlying biochemical mechanisms involved in that science and then spout off half-truths not understanding when they apply and when they don't apply. You do realize that there is a REASON that PHYSICS, CHEMISTRY and BIOLOGY are different separate fields of study?
What I think a LOT of people get confused on is the ivory tower abstract concept of CICO and the practical application of CICO to WEIGHT LOSS. The first is a pretty simple discussion on the laws of thermodynamics, the second is not necessarily that simple and can be painfully complex. It literally involves 1000s of biochemical reactions. So, to simplify, we make certain assumptions for the calculations/applications. If you get a situation where those assumptions or variables change, the straightforward application changes dramatically or fails. It doesn't mean necessarily that CICO fails, but the straightforward application of CICO to weight loss can fail (at least based on our limited ability to measure the CO part of the equation these days).
So, you can argue CICO is always true, but that's the beside the point -- it's not always a valuable tool for weightloss. It's value as weight loss tool is limited for folks where the underlying assumptions and variables are not typical -- whether it's thyroid, insulin resistance, etc. Let me give you an example to better illustrate this. And it's not disproving CICO, but it's showing how the simple application of CICO to weightloss is flawed and/or limited in certain circumstances because the underlying assumptions shift.
CICO Assumptions
So, your basic CICO equation looks like this: CI = CO + FS (fat stores) or if you shift the CO to the other side, it looks like CI - CO = FS. So if you burn more than you eat (i.e. your CO is bigger than your CI), your fat stores will go down (i.e. lose fat). That's the basic idea behind eat less and move more, which does work for a LOT of people.
But, and here's the big caveat: this assumes that your metabolism is functioning in a way where your body is able to access all of the energy in your CI for energy needed in CO. But what if that wasn't the case? What if you couldn't access some of it and your body automatically turned some of it into fat stores even though you needed more? What would be the result? Your body would shut down non-essential functions to drop you CO to compensate -- things like fatigue, lower body temp, hair growth stops, get dry skin/hair, brittle nails, etc. Pretty much a lot of the very things you see with an underperforming thyroid. Or you'd eat even more to get the energy you need and more would be stored as fat -- resulting in that "unexplained weight gain" -- a symptom of hypothyroid.
So, to put this into tangible numbers, let's say your TDEE (or CO) should be 1700 or so per the normal CICO calculators. So, if you eat only 1400, you should have a 300 deficit and lose weight. But, let's say your body has this problem and can't fully access the 1400 for energy. Let's say your body can only access 1200 of the 1400 and the other 200 goes towards fat storage. So even though you're eating less than your expected CO, some is still going into fat storage (which wouldn't be the case with a normal person). Then your body compensates and drops your actual CO to account for the lower energy of only 1200. And how does the body do that? By lowering non-essential functions. What would those be? Things like awful fatigue, hair loss, lower body, temp, etc. The exact symptoms of hypothyroid!! So now you have these horrible symptoms and you're not losing weight -- because that 200 is going to fat storage.
CICO Weight Loss Application Limitations
So, if you've got this going on, you just can't manipulate the CICO equation like normal people do -- so saying things like "it's always true -- it's science!" misses the point. You can keep cutting, but you'll just feel worse and worse (and possibly develop worse issues and it can become dangerous). Most of my doc's thyroid patients (including me) lost when they got into the 800-1000 calorie range, but they feel horrible, can't function like a normal person because of the fatigue, etc. and so continuing to cut isn't the correct solution. Instead, you've got to figure out why your body isn't metabolizing things correctly like a normal person -- whether that's from thyroid, insulin resistance, liver issues, etc. Then, you figure that out and treat them, you'll start responding to the normal CICO calculations.
But some CICO fundamentalists don't understand this difference and get into fights over the laws of thermodynamics. And this doesn't violate CICO at all -- in fact, it's totally in line with it. It simply means that the application is different with people with these issues because the assumptions are different about being able to metabolize all your CI for CO.
To me, this shows why people with medical issues may need to adjust strategies. Or the converse is true -- that those who aren't getting the expected results from the traditional CICO calculations, then it may be time to investigate if they have a medical/metabolic issue in play that they didn't know about. They definitely need to figure out the underlying issues and get them treated. And part of that may require diet changes -- such as eating more or less carbs --HOW they create a deficit may result in dramatically different results. This is exactly what led me to finding out about my issues. And it doesn't mean CICO is wrong or invalid, just that it can't be applied to someone with a medical issue in the same way it is to people without those issues -- at least not for weightloss purposes.
Common Medical Conditions
And before someone goes on about how rare medical conditions are, that's simply inaccurate. Thyroid issues affect 8-10% of the population. Insulin resistance affects almost HALF of the US adult population -- over 46% have insulin resistance at diabetic or prediabetic levels. These are not 1 in a 1000 special snowflakes. For overweight people (since weight gain is a symptom of both), I'd imagine the percentages are even higher. These are incredibly common.
Conclusion
I think CICO is a great guideline. I think it's where everyone should start -- including accurately measuring their CI (by weighing all their food). But, it has its limitations in regard to practical application of weight loss. If people are applying it correctly, it's possible that there is something else going on. Inaccurate measuring, lying to themselves, being delusional, making excuses, etc. aren't the only possibilities. They could legitimately have an undiagnosed or undertreated medical condition.
So saying "CICO is always, always true. It's science." misses the point and just shows how you little you understand in how to correctly apply that science to weightloss.
Dude. DUDE. Did you read one single word after my first sentence? Because I even let you know right frigging there in that very first paragraph that I AGREED with you. And I do. Or did you get all rage-blinded and start typing without hearing me out?
I literally said exactly what you did, but in far fewer than 12 rant-y paragraphs and with far fewer shouty bolds and capitals. I maybe didn't include as much detail as you did and worded it a bit differently, but I'm absolutely a supporter of the concept that while the laws of thermodynamics do apply to everyone, people MUST take into account the concept that everyone's "calories out" side of the equation is extremely unique to each individual and there are many factors that could drive it down. I believe that was quite clear.
It's really, really good information that I think a lot of people should read. I was also happy to read it because it contained a lot of good info and some perspectives I hadn't considered. But, your ire is mis-directed at me. Please re-read what I wrote before you tell me "how little I understand science," because that was quite uncalled for.
My apologies for focusing on not all of your message, but I still think you missed some of the point of my example -- and it's not just that the CO part is hard to calculate or measure, but also that the underlying assumptions change, the simple application can fail because the fundamental application shifts considerably. But, perhaps we are closer than I first thought we were.
I just think arguing that CICO is always correct (when we're talking about weight loss) is a poor starting point. Although it is likely true from a technical standpoint, the practical purpose of it is very different and/or not applicable. And, here, we're really only interested in the practical understanding as it applies to weightloss.
I think it's just semantics at this point. We're saying the same thing. For a variety of reasons, the traditional CICO equation as it is typically referenced and described in these forums (aka, using whatever TDEE estimation that exists for your stats and eating less than that), can break down, such that ultimately even though you "should" be burning fat (or LBM), your body is no longer (or never was) using more calories than you're eating and your rate of gain/loss does not reflect what you would expect based on the surplus/deficit that you believe is being created.
I don't think anyone non-stupid assumes that the calculator is truth. What I always tell people not losing is to tighten up the logging (because that usually is the culprit and its helpful for a doctor visit) and to visit a doctor if that does not help. And for obese people the calculator overestimates calories, whereas most people underestimate them.
And if someone reports an issue with compliance I recommend experimenting with macros. (For example, if someone is always hungry.)
Totally disagree with the idea that poor logging isn't the main reason people don't lose or it wouldn't be helpful to log for people with medical issues (as that helps identify the issue and a doctor should be involved, not just self help low carbing). Also, disagree with the idea that anyone with the slightest degree of IR cannot lose with CICO, that's silly (and what Lindsey seems to be claiming). In reality few people have a TDEE much off their expected one, and those people likely have thyroid issues. People with IR likely have compliance problems.0 -
rankinsect wrote: »Perhaps I am misunderstanding you, but i think you are wrong. IR makes it easier to store fat because you end up with excess glucose in the blood and that glucose has to go somewhere. It ends up getting made into fat because the insulin resistance makes it hard for the cells to use the glucose for fuel.
That was once believed, but is now known to be false. Cells have no difficulty at all using glucose for fuel, because of the four well-characterized glucose transporter proteins, only glucose transporter 4 (GLUT4) is regulated by insulin, and that is found only on fat and muscle cells. Other cells of the body get glucose for metabolism by either GLUT1 or GLUT3, neither of which are affected by insulin at all (nor is GLUT2, which is the two-way glucose transporter used in the liver). It's true there are other glucose transporters and transporters for other sugars that are less well understood, but none so far are known to respond to insulin. The reason for elevated blood glucose in t2 diabetics and in prediabetics is not a reduction of glucose metabolism, but a failure to regulate glucose storage and regeneration.
One way you can prove that even type 2 diabetics are using significant amounts of carbohydrates for fuel is to measure the respiratory exchange ratio (the amount of CO2 produced compared to O2 consumed) which roughly tells you how much the body is metabolizing fat versus carbohydrate, since fat metabolism produces only about 0.7 molecules of CO2 for every molecule of O2 consumed, while carbohydrates are always 1:1. There's no significant difference at all between obese non-diabetics and obese diabetics, and in fact both groups have a higher amount of calories coming from carbohydrates compared to non-obese people on a typical diet.
Insulin is only needed for fat cells to uptake glucose, and in muscle cells it can increase the amount of glucose taken up - muscle can still take up glucose without insulin, but it takes it up more rapidly in the presence of insulin.Yes, eating at a deficit will help with insulin sensitivity, but so will low carb. I guess it is a choice between eating at a deficit for life, or eating low, or at least lowered, carb.
For many people, simply losing enough weight will restore insulin sensitivity if they keep it off.
I have not heard this. You've given me something to google.
I'm a prediabetic who developed IR when not even overweight (perhaps at the high end of a normal BMI). I am one of the less common people with IR who was no fat, although I gained weight before I switched to low carb. LCHF has completely fixed my blood glucose levels for me... I imagine that would mean we have no issues with glucose regeneration since my carbs are usually under 20g.
Weren't you on steroids when you developed IR? That's important, as it's a risk factor if one is susceptible at all.
[Ed. now that I've read to the end I see others pointed this out. It's relevant. The current US cut off for IR is (likely overly) low too. That said, I wasn't IR when really fat. Based on the study Lindsey loves so, many of us should be being told to do a higher carb diet, which I still have not tried. Weird that it's always posted as a low carb thing.]0 -
About 30% of the population falls outside of +/-10% of the predicted BMR so anyone not getting expected results should initially use their weight loss experience to estimate their own TDEE or get it measured.
The US has a lower cut point for "pre diabetes" than the UK but when it comes to insulin resistance I don't think there's a standard ? Several studies seem to rank the upper quartile as insulin resistant and the lower as insulin sensitive leaving 50% in the middle, or similar approaches.0 -
lemurcat12 wrote: »I don't think anyone non-stupid assumes that the calculator is truth. What I always tell people not losing is to tighten up the logging (because that usually is the culprit and its helpful for a doctor visit) and to visit a doctor if that does not help. And for obese people the calculator overestimates calories, whereas most people underestimate them.
And if someone reports an issue with compliance I recommend experimenting with macros. (For example, if someone is always hungry.)
Totally disagree with the idea that poor logging isn't the main reason people don't lose or it wouldn't be helpful to log for people with medical issues (as that helps identify the issue and a doctor should be involved, not just self help low carbing). Also, disagree with the idea that anyone with the slightest degree of IR cannot lose with CICO, that's silly (and what Lindsey seems to be claiming). In reality few people have a TDEE much off their expected one, and those people likely have thyroid issues. People with IR likely have compliance problems.
I don't think that anyone at all said that poor logging isn't the main reason that people don't lose. I know that I said in my first comment that "And a large majority of CICO failures are certainly due to mis-estimating or mis-recording on the "calories in" side, or over-reporting exercise." I completely agree that that's the first assessment that should be made. When you hear hoofbeats, think horses not zebras, right?
But, so, so, so many times I see in these forums people say "I'm eating 1,500 calories per day and not losing!!" and most, if not all, of the responses are "well, then you're not really eating 1,500 calories" like that's the only possible solution, even after all of the usual culprits have been addressed. I've been on MFP since May 2012, and I've had a Fitbit linked to my MFP account for that entire time. I've taken a couple of breaks from logging on MFP, one for a couple months when I tried Weight Watchers and then a few for just a few days here and there, but I've got complete food and activity logs for almost all of that time. When I compare what I've logged as food to what I've supposedly burned using Fitbit's calculations, I should have lost something like 165lbs in that time, even when I plug in like 5000 calories consumed on days I didn't log, assuming that they must have been holidays or something. I've actually lost about 20. I'm not going to sit here and say that I'm not willing to accept that there must be some degree of logging error there, but not to the tune of over 400 calories per day, every single day, for 3.5 years. I use a food scale and I'm honest with my intake, and I never log any additional exercise over and above what my Fitbit tracks. I've had my thyroid tested twice in that time and was told it was normal. I have no symptoms of insulin resistance, PCOS, metabolic syndrome, anything like that - I'm obese, but I have relatively little visceral fat and better than normal cholesterol, blood pressure, blood sugar, etc. So, what's my deal? Am I lying to myself, making excuses, delusional? Or does the possibility exist that my TDEE is significantly lower than the calculators would suggest for no reason that is easily identifiable? I really should go get an RMR test done, but there's just nowhere that I've found that can do it a a time/place that I can conveniently get to without taking time off work. I think it's time to make that a priority.0
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