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Dr Sarah Hallburg: Calories in vs calories out pet peeve

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  • ndj1979ndj1979 Posts: 29,021Member Member Posts: 29,021Member Member
    nvmomketo wrote: »
    I haven't watched much of her stuff, but what I have seen makes perfect sense for those with insulin resistance: high ( or even moderate) carb intake raises insulin which will eventually lead to IR for many people. Insulin is a fat storing hormone. Those who take insulin know that high levels of insulin will eat to weight gain; this appears to be true even if CI are kept the same. It won't be massive weight gain if calries are not increased but it will be there.

    People with IR have high levels of insulin. Insulin (high evels) leads to weight gain. It makes sense that those with IR gain weight if they eat too any carbs for their health.

    I completely agree that CI must be less than CO in order to lose weight. Where many of us with IR get excited is when CO seems to (seemingly magically) go up so we can lose weight easier. Some may not need to count calories because we can lose at a higher level of caloric consumption.

    And then there is the lowered appetite. Most experience a drop in appetite when they go LCHF. If you aren't hungry, it makes it easer to lose weight by eating less. For those who experience this, carb intake is a main driving force behind appetite. Does our appetite drop becase of lower resultant insulin? I don't know. It is a possibility.

    CICO does not need to be the focus for many with IR on a LCHF diet. If I keep carbs below 20g my appetite drops. If I follow her rule to not eat when not hungry, I lose weight. I naturally eat around 1400-1800 kcal and low a couple of pounds per week. Lately my carbs are higher, closer to 30g and my appetite is up. I am eating way over 2000kcal per day ( no exercise) and I am not gaining a thing... This appears to often hold true for those with IR who keep carbs low - it is harder to gain weight.

    From past experience I know that if I ate a lot of carbs and a 2000+ kcal diet, I would be gaining weight and very hungry every couple of hours.... Perhaps this is what she she means when she says calorie counting is not needed?

    And she is completely right, there are no essential carbs. There are only a few systems that will use glucose for fuel when someone has adjusted to using fat for fuel: red blood cells, portions of the brain and... Oops, I've forgotten (liver?). The rest easily switches to fat. Many organs, like the brain, seem to show a preference for fats (with better functioning) after becoming fat adapted after a few months.

    One theory about why glucose is used so quickly by the body is because high levels of glucose in the blood is toxic nd quite damaging over time. The body makes a large effort to keep glucose levels steady by using it for fuel, the fastest way to "get rid of it".

    OP, you are fortunate that losing 10% of your body weight helped your IR. perhaps you were not too IR or the carbs you cut when reducing calories was enough to have an effect on your health. I was not so lucky.

    I had prediabetes, lost over 20% of my body weight to get to a midrange, normal BMI and it had almost no effect on my IR. As my carbs approach 30g my blood glucose goes up. Her advice is spot on for me. I'll skip most carbs since they do almost nothing beneficial for my health. I would be dumb to eat carbs at moderate or high levels, unless I want my disease to keep progressing.

    so what?

    it is not essential to consume more than your fat minimum either, and people seem to have no problem blowing out their fat macro and not worrying about potential cardiovascular health impacts….
  • yarwellyarwell Posts: 10,573Member Member Posts: 10,573Member Member
    ndj1979 wrote: »
    it is not essential to consume more than your fat minimum either, and people seem to have no problem blowing out their fat macro and not worrying about potential cardiovascular health impacts….

    back to that unproven fiction as part of the war on carbohydrate restriction are we ?
  • auddiiauddii Posts: 15,410Member Member Posts: 15,410Member Member
    yarwell wrote: »
    it would be interesting to know what drives satiety - a big lump of anything (potato) or specific components. Seems water content comes out as a big part of it, so would (for example) a croissant + 300 ml of water (or coffee ?) match a potato.

    Otherwise we don't know if a potato is a satiating food per se, or just low in calorie density so that you have to eat a lot to hit the calorie goal of the test.

    I think having large volumes of something in your stomach in general helps. Everyone talks about no negative calorie foods, but during WWII, many people would feed their children (and themselves) wood pulp that was ground to resemble flour. It fills you up and would stop you from feeling hungry, but is indigestible by humans. It could help you feel satiated while still allowing you to starve to death.
  • T1DCarnivoreRunnerT1DCarnivoreRunner Posts: 9,853Member Member Posts: 9,853Member Member
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.
  • senecarrsenecarr Posts: 5,377Member Member Posts: 5,377Member Member
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).
  • nvmomketonvmomketo Posts: 12,031Member Member Posts: 12,031Member Member
    ndj1979 wrote: »
    nvmomketo wrote: »
    I haven't watched much of her stuff, but what I have seen makes perfect sense for those with insulin resistance: high ( or even moderate) carb intake raises insulin which will eventually lead to IR for many people. Insulin is a fat storing hormone. Those who take insulin know that high levels of insulin will eat to weight gain; this appears to be true even if CI are kept the same. It won't be massive weight gain if calries are not increased but it will be there.

    People with IR have high levels of insulin. Insulin (high evels) leads to weight gain. It makes sense that those with IR gain weight if they eat too any carbs for their health.

    I completely agree that CI must be less than CO in order to lose weight. Where many of us with IR get excited is when CO seems to (seemingly magically) go up so we can lose weight easier. Some may not need to count calories because we can lose at a higher level of caloric consumption.

    And then there is the lowered appetite. Most experience a drop in appetite when they go LCHF. If you aren't hungry, it makes it easer to lose weight by eating less. For those who experience this, carb intake is a main driving force behind appetite. Does our appetite drop becase of lower resultant insulin? I don't know. It is a possibility.

    CICO does not need to be the focus for many with IR on a LCHF diet. If I keep carbs below 20g my appetite drops. If I follow her rule to not eat when not hungry, I lose weight. I naturally eat around 1400-1800 kcal and low a couple of pounds per week. Lately my carbs are higher, closer to 30g and my appetite is up. I am eating way over 2000kcal per day ( no exercise) and I am not gaining a thing... This appears to often hold true for those with IR who keep carbs low - it is harder to gain weight.

    From past experience I know that if I ate a lot of carbs and a 2000+ kcal diet, I would be gaining weight and very hungry every couple of hours.... Perhaps this is what she she means when she says calorie counting is not needed?

    And she is completely right, there are no essential carbs. There are only a few systems that will use glucose for fuel when someone has adjusted to using fat for fuel: red blood cells, portions of the brain and... Oops, I've forgotten (liver?). The rest easily switches to fat. Many organs, like the brain, seem to show a preference for fats (with better functioning) after becoming fat adapted after a few months.

    One theory about why glucose is used so quickly by the body is because high levels of glucose in the blood is toxic nd quite damaging over time. The body makes a large effort to keep glucose levels steady by using it for fuel, the fastest way to "get rid of it".

    OP, you are fortunate that losing 10% of your body weight helped your IR. perhaps you were not too IR or the carbs you cut when reducing calories was enough to have an effect on your health. I was not so lucky.

    I had prediabetes, lost over 20% of my body weight to get to a midrange, normal BMI and it had almost no effect on my IR. As my carbs approach 30g my blood glucose goes up. Her advice is spot on for me. I'll skip most carbs since they do almost nothing beneficial for my health. I would be dumb to eat carbs at moderate or high levels, unless I want my disease to keep progressing.

    so what?

    it is not essential to consume more than your fat minimum either, and people seem to have no problem blowing out their fat macro and not worrying about potential cardiovascular health impacts….

    So.... I was stating a fact that was being questioned. Simple.

    A LCHF diet is proving to be beneficial to cardiovascular health. Fat does not appear to cause heart disease according to more recent thinking, so eating high levels of fat does not contribute to heart disease.

    To be fair, a very low fat diet (ornish style) can help heart disease too. Sugars, refined carbs and high insulin levels appear to contribute to CAD. A love of broccoli will not.
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    Have you considered a LCHF diet? It could help with keeping your insulin requirements lower and make weight loss more of a possibility if you are relying on fats for fuel more than glucose. Dr Bernstein's Diabetes Solution is a LCHF plan for T1Ds that can be beneficial to T2Ds too. It really helped me with my insulin resistance. He is a T1D too so he knows what he is talking about.
  • T1DCarnivoreRunnerT1DCarnivoreRunner Posts: 9,853Member Member Posts: 9,853Member Member
    @nvmomketo Yes, that is something I've just recently started trying... though I'm more interested in LC and don't care so much for the HF part as I can't get to both my protein goal and stay within calorie goals with high fat. I'm also trying a medication that will reduce insulin needs and should improve satiety.
  • ndj1979ndj1979 Posts: 29,021Member Member Posts: 29,021Member Member
    yarwell wrote: »
    ndj1979 wrote: »
    it is not essential to consume more than your fat minimum either, and people seem to have no problem blowing out their fat macro and not worrying about potential cardiovascular health impacts….

    back to that unproven fiction as part of the war on carbohydrate restriction are we ?

    nope, just making a point that it is not necessary to blow out your fat minimum because one thinks carbs are evil..

    not sure what is fiction about that statement...
  • T1DCarnivoreRunnerT1DCarnivoreRunner Posts: 9,853Member Member Posts: 9,853Member Member
    senecarr wrote: »
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).

    I think it is more about the actual conversion of calories into energy. For example, those of us who are type 1's can get together and talk about how much 15g of net carbs will affect our blood glucose. We will all take different amounts of insulin, and part of that comes down to insulin resistance, but part of it is due to individual differences. All net carbs should be converted to glucose, and if a calorie is exactly the same for everyone, then 15g of net carbs will increase all of our BG's by the same amount. We will take different amounts of insulin to bring it back down again (and deliver as energy to cells or convert to fat) due to varying levels of insulin resistance, but the rise is exactly the same, right? Well... actually that is wrong. Put 100 type 1 diabetics in a room, give each of them the exact same number of net carbs, give no insulin bolus for the carbs, and measure blood glucose levels before and after full digestion. Chances are good that you will get 100 different numbers (though it is possible a few might be the same, by luck). So then for each individual, the same number of calories in does not result in the same amount of energy. Further complicated is the movement of that glucose to glycogen and/or fat. Now consider that protein and fat are digested differently to begin with, and they don't go directly to glucose either.
  • yarwellyarwell Posts: 10,573Member Member Posts: 10,573Member Member
    ndj1979 wrote: »
    yarwell wrote: »
    ndj1979 wrote: »
    it is not essential to consume more than your fat minimum either, and people seem to have no problem blowing out their fat macro and not worrying about potential cardiovascular health impacts….

    back to that unproven fiction as part of the war on carbohydrate restriction are we ?

    nope, just making a point that it is not necessary to blow out your fat minimum because one thinks carbs are evil..

    not sure what is fiction about that statement...

    the fictional reference bolded. FUD.

    worrying about potential cardiovascular health impacts
    edited March 2016
  • ndj1979ndj1979 Posts: 29,021Member Member Posts: 29,021Member Member
    yarwell wrote: »
    ndj1979 wrote: »
    yarwell wrote: »
    ndj1979 wrote: »
    it is not essential to consume more than your fat minimum either, and people seem to have no problem blowing out their fat macro and not worrying about potential cardiovascular health impacts….

    back to that unproven fiction as part of the war on carbohydrate restriction are we ?

    nope, just making a point that it is not necessary to blow out your fat minimum because one thinks carbs are evil..

    not sure what is fiction about that statement...

    the fictional reference bolded. FUD.

    worrying about potential cardiovascular health impacts

    that is why I used the qualifier "potential" ....potential means could happen not will happen...

  • amusedmonkeyamusedmonkey Posts: 9,684Member Member Posts: 9,684Member Member
    You are NOT a special snowflake in your results. It happens all the time when people actually listen. I was only a couple of ticks away from being diagnosed as officially diabetic. I lost a lot of weight by counting calories and consume about 60% of my food in carbs. Blood sugar is now normal. Not even in the higher end of norma, smack in the middle.

    I did fall for the low carb IR stuff, but ended up being extremely hungry on a high calorie intake so decided to lose weight first, manage carbs later. As it turned out the weight loss took care of it and I didn't need to manage carbs.

    Hornsby wrote: »
    The most satiating food of all is potatoes in my opinion.

    I wholeheartedly agree. It's the first food I reach for when I have a "bottomless pit" kind of day and it tends to take care of it.
  • stealthqstealthq Posts: 4,307Member Member Posts: 4,307Member Member
    senecarr wrote: »
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).

    I think it is more about the actual conversion of calories into energy. For example, those of us who are type 1's can get together and talk about how much 15g of net carbs will affect our blood glucose. We will all take different amounts of insulin, and part of that comes down to insulin resistance, but part of it is due to individual differences. All net carbs should be converted to glucose, and if a calorie is exactly the same for everyone, then 15g of net carbs will increase all of our BG's by the same amount. We will take different amounts of insulin to bring it back down again (and deliver as energy to cells or convert to fat) due to varying levels of insulin resistance, but the rise is exactly the same, right? Well... actually that is wrong. Put 100 type 1 diabetics in a room, give each of them the exact same number of net carbs, give no insulin bolus for the carbs, and measure blood glucose levels before and after full digestion. Chances are good that you will get 100 different numbers (though it is possible a few might be the same, by luck). So then for each individual, the same number of calories in does not result in the same amount of energy. Further complicated is the movement of that glucose to glycogen and/or fat. Now consider that protein and fat are digested differently to begin with, and they don't go directly to glucose either.

    I think you mean the conversion of macros into energy.

    Also, put 100 type 1s in a room, and probably all 100 have slightly different levels of severity of type 1 diabetes. That would explain the varying results with a more likely scenario than that the conversions are all significantly different (those pathways being very highly conserved). It would not change the effect that you observe, which is that the same amount of insulin for the same amount and type of macros does not produce the same results in different individuals.
  • senecarrsenecarr Posts: 5,377Member Member Posts: 5,377Member Member
    senecarr wrote: »
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).

    I think it is more about the actual conversion of calories into energy. For example, those of us who are type 1's can get together and talk about how much 15g of net carbs will affect our blood glucose. We will all take different amounts of insulin, and part of that comes down to insulin resistance, but part of it is due to individual differences. All net carbs should be converted to glucose, and if a calorie is exactly the same for everyone, then 15g of net carbs will increase all of our BG's by the same amount. We will take different amounts of insulin to bring it back down again (and deliver as energy to cells or convert to fat) due to varying levels of insulin resistance, but the rise is exactly the same, right? Well... actually that is wrong. Put 100 type 1 diabetics in a room, give each of them the exact same number of net carbs, give no insulin bolus for the carbs, and measure blood glucose levels before and after full digestion. Chances are good that you will get 100 different numbers (though it is possible a few might be the same, by luck). So then for each individual, the same number of calories in does not result in the same amount of energy. Further complicated is the movement of that glucose to glycogen and/or fat. Now consider that protein and fat are digested differently to begin with, and they don't go directly to glucose either.

    Calories are energy. That's literally what a calorie means.
    And 15g of carbs should affect blood glucose the same if all calories are equal? That statement does not follow at all. Your blood glucose is a measure of how much glucose there is in a sample of your blood. I'm assuming you and those individuals all have varying sizes, and probably varying volumes of blood? Different rates of flow in blood? There's absolutely nothing concordant in those ideas - that a the amount of net carbs will also represent equal blood glucose levels in the body. Do you think glucose levels are the same in individuals who aren't diabetic, even if you were to block beta cells from producing insulin? Not how any of that works. Your argument is like saying a 5' person won't live as long if you give them 100 calories as someone who is 6', therefore calories aren't calories.
  • T1DCarnivoreRunnerT1DCarnivoreRunner Posts: 9,853Member Member Posts: 9,853Member Member
    stealthq wrote: »
    senecarr wrote: »
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).

    I think it is more about the actual conversion of calories into energy. For example, those of us who are type 1's can get together and talk about how much 15g of net carbs will affect our blood glucose. We will all take different amounts of insulin, and part of that comes down to insulin resistance, but part of it is due to individual differences. All net carbs should be converted to glucose, and if a calorie is exactly the same for everyone, then 15g of net carbs will increase all of our BG's by the same amount. We will take different amounts of insulin to bring it back down again (and deliver as energy to cells or convert to fat) due to varying levels of insulin resistance, but the rise is exactly the same, right? Well... actually that is wrong. Put 100 type 1 diabetics in a room, give each of them the exact same number of net carbs, give no insulin bolus for the carbs, and measure blood glucose levels before and after full digestion. Chances are good that you will get 100 different numbers (though it is possible a few might be the same, by luck). So then for each individual, the same number of calories in does not result in the same amount of energy. Further complicated is the movement of that glucose to glycogen and/or fat. Now consider that protein and fat are digested differently to begin with, and they don't go directly to glucose either.

    I think you mean the conversion of macros into energy.

    Also, put 100 type 1s in a room, and probably all 100 have slightly different levels of severity of type 1 diabetes. That would explain the varying results with a more likely scenario than that the conversions are all significantly different (those pathways being very highly conserved). It would not change the effect that you observe, which is that the same amount of insulin for the same amount and type of macros does not produce the same results in different individuals.

    Please explain exactly how type 1's can have "a different severity" of type 1.

    Hint: It is only possible during the "honeymoon" period when one is in the process of developing type 1. Once all the pancratic beta cells are dead, all type 1's are of the same "severity."
  • T1DCarnivoreRunnerT1DCarnivoreRunner Posts: 9,853Member Member Posts: 9,853Member Member
    senecarr wrote: »
    senecarr wrote: »
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).

    I think it is more about the actual conversion of calories into energy. For example, those of us who are type 1's can get together and talk about how much 15g of net carbs will affect our blood glucose. We will all take different amounts of insulin, and part of that comes down to insulin resistance, but part of it is due to individual differences. All net carbs should be converted to glucose, and if a calorie is exactly the same for everyone, then 15g of net carbs will increase all of our BG's by the same amount. We will take different amounts of insulin to bring it back down again (and deliver as energy to cells or convert to fat) due to varying levels of insulin resistance, but the rise is exactly the same, right? Well... actually that is wrong. Put 100 type 1 diabetics in a room, give each of them the exact same number of net carbs, give no insulin bolus for the carbs, and measure blood glucose levels before and after full digestion. Chances are good that you will get 100 different numbers (though it is possible a few might be the same, by luck). So then for each individual, the same number of calories in does not result in the same amount of energy. Further complicated is the movement of that glucose to glycogen and/or fat. Now consider that protein and fat are digested differently to begin with, and they don't go directly to glucose either.

    Calories are energy. That's literally what a calorie means.
    And 15g of carbs should affect blood glucose the same if all calories are equal? That statement does not follow at all. Your blood glucose is a measure of how much glucose there is in a sample of your blood. I'm assuming you and those individuals all have varying sizes, and probably varying volumes of blood? Different rates of flow in blood? There's absolutely nothing concordant in those ideas - that a the amount of net carbs will also represent equal blood glucose levels in the body. Do you think glucose levels are the same in individuals who aren't diabetic, even if you were to block beta cells from producing insulin? Not how any of that works. Your argument is like saying a 5' person won't live as long if you give them 100 calories as someone who is 6', therefore calories aren't calories.

    Good point - blood volume can make a difference (rate of flow does not). Let's say we put 100 type 1 diabetics with the same volume of blood and give all of them 15g of carbs. Are you saying each person's BG will rise the exact same amount then?

    Alternatively, if we can adjust for blood volume, are you suggesting those results will be equivalent for everyone? It won't be.
  • senecarrsenecarr Posts: 5,377Member Member Posts: 5,377Member Member
    senecarr wrote: »
    senecarr wrote: »
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).

    I think it is more about the actual conversion of calories into energy. For example, those of us who are type 1's can get together and talk about how much 15g of net carbs will affect our blood glucose. We will all take different amounts of insulin, and part of that comes down to insulin resistance, but part of it is due to individual differences. All net carbs should be converted to glucose, and if a calorie is exactly the same for everyone, then 15g of net carbs will increase all of our BG's by the same amount. We will take different amounts of insulin to bring it back down again (and deliver as energy to cells or convert to fat) due to varying levels of insulin resistance, but the rise is exactly the same, right? Well... actually that is wrong. Put 100 type 1 diabetics in a room, give each of them the exact same number of net carbs, give no insulin bolus for the carbs, and measure blood glucose levels before and after full digestion. Chances are good that you will get 100 different numbers (though it is possible a few might be the same, by luck). So then for each individual, the same number of calories in does not result in the same amount of energy. Further complicated is the movement of that glucose to glycogen and/or fat. Now consider that protein and fat are digested differently to begin with, and they don't go directly to glucose either.

    Calories are energy. That's literally what a calorie means.
    And 15g of carbs should affect blood glucose the same if all calories are equal? That statement does not follow at all. Your blood glucose is a measure of how much glucose there is in a sample of your blood. I'm assuming you and those individuals all have varying sizes, and probably varying volumes of blood? Different rates of flow in blood? There's absolutely nothing concordant in those ideas - that a the amount of net carbs will also represent equal blood glucose levels in the body. Do you think glucose levels are the same in individuals who aren't diabetic, even if you were to block beta cells from producing insulin? Not how any of that works. Your argument is like saying a 5' person won't live as long if you give them 100 calories as someone who is 6', therefore calories aren't calories.

    Good point - blood volume can make a difference (rate of flow does not). Let's say we put 100 type 1 diabetics with the same volume of blood and give all of them 15g of carbs. Are you saying each person's BG will rise the exact same amount then?

    Alternatively, if we can adjust for blood volume, are you suggesting those results will be equivalent for everyone? It won't be.

    Rate of flow doesn't? Your body doesn't move glucose to the extremis of one's finger (where they are usually tested) faster if the heart is beating faster?
    Even if you could get people with equal volumes, control for differences in rate of digestion (people with extra amylase genes would probably break down complex carbs faster), you'd still have differences in types of carbohydrate. Fructose would either need conversion hepatically, which slows things down slightly, more so than some other carbs, or the fructose might be taken up intestinally. Various individiuals will have more GLUT expression even in the absence of insulin - while insulin is the primary driving of glucose being drawn into the cells, it isn't the only mechanism.
    Consider:
    http://www.ncbi.nlm.nih.gov/pubmed/9435517
    The ability of exercise to utilize insulin-independent mechanisms to increase glucose uptake in skeletal muscle has important clinical implications, especially for patients with diseases that are associated with peripheral insulin resistance, such as non-insulin-dependent diabetes mellitus.


    Now at the deep down, will every bite of food or even every particular molecule of glucose result in the exact same energy expenditure? No. It will be an average, based on various activities, various states of cells, including possibly the calories out. It doesn't matter over the average to calorie counting. Unfortunately @stevencloser had a diagram in another thread that I think is lost that showed a good example of the window of certainty that weight loss will happen. I won't deny the window will get harder for someone with medical conditions, and having T1D and T2D is quite the difficult combination of conditions to have. A person would need to be a lot more dilligent in both monitoring calories in and tracking that TDEE remains consistent to get an accurate window, but it still is heuristically possible to do back calculating TDEE calculations.
  • T1DCarnivoreRunnerT1DCarnivoreRunner Posts: 9,853Member Member Posts: 9,853Member Member
    senecarr wrote: »
    senecarr wrote: »
    senecarr wrote: »
    I have an insatiable appetite, and find that satiety isn't just how much volume I eat, but how many calories I eat. There was a time when I was so burdened with hunger and could never achieve calorie goals. Users would tell me to eat light (i.e. not calorie dense) foods because it would keep me full. One day, I ate more than 9 lbs. of salad and was still very hungry.

    As for insulin, insulin resistance, and CICO, I believe the truth lies somewhere in the middle of the extremes (one extreme is that CICO is infallible, the other that CICO doesn't matter as long as your macros are the right percentages). I know there have been a lot of points made that weight loss is strictly about CICO and that there is no possible way that how your body moves energy around between glucose, glycogen, and fat will change without a change in CICO. Of course that is a simplistic view because most of us know that net carbs become glucose right away while protein and dietary fat do not. So immediately after eating (actually, while eating because some of that glucose is absorbed through capillaries in the mouth), energy is already affected by which macros you consumed. Continuing on for the next several hours, there are differences with how energy gets into your body, where it goes first, and where it goes next. These differences are not only based on the particular macros consumed, but also what amount and to what degree energy is needed within the proper time frames. And ultimately, timing is an important part of macro consumption and exercise - something that both the CICO method and the LCHF using macro percentages fails to consider.

    As a double diabetic (meaning I have both type 1 and type 2 diabetes), I take a lot of insulin. I've also always had serious challenges losing weight, some of which no MFP user can explain. My endocrinologist says the reason I find it so hard to lose weight is because I need so much insulin. If I weighed less, I would be less insulin resistant and would need less insulin. So if I lose some weight, I will find it easier to lose weight. But it is nearly impossible to lose weight to get to where I can find it more possible to lose weight. It's a frustrating situation to encounter, to say the least. It is, on the other hand, really easy to gain weight. When I was first diagnosed with type 1, I was a healthy weight (to some standards, even slightly underweight... that isn't unusual because undiagnosed type 1 causes weight loss). I gained 20 lbs. in the first month after diagnosis and was already a bit overweight at that time. Over the next year, the gains slowed to where I gained 60 lbs. in the year and then another 60 lbs. over the next 1.5-2 years for a total of 120 lbs. of gain in 3 years. I can't lose anywhere near that fast. I really struggle to lose 1 lb. per month. So I agree that insulin does have an impact on weight gain and weight loss because my own experience has been impacted significantly by that exact issue.

    CICO isn't a weight loss method, it is a fact of nature. Insulin can't create or destroy energy. Calorie counting is a method. There is no perfect way to track what someone's calories out are, which would include any energy costs of converting glucose into glycogen, or even de novo lipogensis. Your own physiology might be different such that normal calories out predictors are off for you. That doesn't mean there doesn't exist a level of activity that if you consistently stay above and a certain amount of calories that you consistently stay below that will cause weight loss (assuming otherwise proper nutrition).

    I think it is more about the actual conversion of calories into energy. For example, those of us who are type 1's can get together and talk about how much 15g of net carbs will affect our blood glucose. We will all take different amounts of insulin, and part of that comes down to insulin resistance, but part of it is due to individual differences. All net carbs should be converted to glucose, and if a calorie is exactly the same for everyone, then 15g of net carbs will increase all of our BG's by the same amount. We will take different amounts of insulin to bring it back down again (and deliver as energy to cells or convert to fat) due to varying levels of insulin resistance, but the rise is exactly the same, right? Well... actually that is wrong. Put 100 type 1 diabetics in a room, give each of them the exact same number of net carbs, give no insulin bolus for the carbs, and measure blood glucose levels before and after full digestion. Chances are good that you will get 100 different numbers (though it is possible a few might be the same, by luck). So then for each individual, the same number of calories in does not result in the same amount of energy. Further complicated is the movement of that glucose to glycogen and/or fat. Now consider that protein and fat are digested differently to begin with, and they don't go directly to glucose either.

    Calories are energy. That's literally what a calorie means.
    And 15g of carbs should affect blood glucose the same if all calories are equal? That statement does not follow at all. Your blood glucose is a measure of how much glucose there is in a sample of your blood. I'm assuming you and those individuals all have varying sizes, and probably varying volumes of blood? Different rates of flow in blood? There's absolutely nothing concordant in those ideas - that a the amount of net carbs will also represent equal blood glucose levels in the body. Do you think glucose levels are the same in individuals who aren't diabetic, even if you were to block beta cells from producing insulin? Not how any of that works. Your argument is like saying a 5' person won't live as long if you give them 100 calories as someone who is 6', therefore calories aren't calories.

    Good point - blood volume can make a difference (rate of flow does not). Let's say we put 100 type 1 diabetics with the same volume of blood and give all of them 15g of carbs. Are you saying each person's BG will rise the exact same amount then?

    Alternatively, if we can adjust for blood volume, are you suggesting those results will be equivalent for everyone? It won't be.

    Rate of flow doesn't? Your body doesn't move glucose to the extremis of one's finger (where they are usually tested) faster if the heart is beating faster?
    Even if you could get people with equal volumes, control for differences in rate of digestion (people with extra amylase genes would probably break down complex carbs faster), you'd still have differences in types of carbohydrate. Fructose would either need conversion hepatically, which slows things down slightly, more so than some other carbs, or the fructose might be taken up intestinally. Various individiuals will have more GLUT expression even in the absence of insulin - while insulin is the primary driving of glucose being drawn into the cells, it isn't the only mechanism.
    Consider:
    http://www.ncbi.nlm.nih.gov/pubmed/9435517
    The ability of exercise to utilize insulin-independent mechanisms to increase glucose uptake in skeletal muscle has important clinical implications, especially for patients with diseases that are associated with peripheral insulin resistance, such as non-insulin-dependent diabetes mellitus.


    Now at the deep down, will every bite of food or even every particular molecule of glucose result in the exact same energy expenditure? No. It will be an average, based on various activities, various states of cells, including possibly the calories out. It doesn't matter over the average to calorie counting. Unfortunately @stevencloser had a diagram in another thread that I think is lost that showed a good example of the window of certainty that weight loss will happen. I won't deny the window will get harder for someone with medical conditions, and having T1D and T2D is quite the difficult combination of conditions to have. A person would need to be a lot more dilligent in both monitoring calories in and tracking that TDEE remains consistent to get an accurate window, but it still is heuristically possible to do back calculating TDEE calculations.

    No, blood flow rate won't make a difference. Glucose is not distributed into a single patch of blood as it flows, and then distributed throughout your blood by flow rate. That isn't how it works.

    I acknowledge that very small amounts of glucose can be taken up by cells without insulin. So what if that could be controlled for as well and the volume-adjusted amount of glucose created from 15g of carbs could be measured. Would you argue that to be the same for everybody? I'm not talking about how that glucose is later used... just whether CI by itself means that a calorie of carbs equals the same amount of glucose energy for everybody.
  • nvmomketonvmomketo Posts: 12,031Member Member Posts: 12,031Member Member
    @nvmomketo Yes, that is something I've just recently started trying... though I'm more interested in LC and don't care so much for the HF part as I can't get to both my protein goal and stay within calorie goals with high fat. I'm also trying a medication that will reduce insulin needs and should improve satiety.

    I hope it works for you. :). Come join the Low Carber Daily group if you want to find ideas or support for low carbing it.
  • T1DCarnivoreRunnerT1DCarnivoreRunner Posts: 9,853Member Member Posts: 9,853Member Member
    nvmomketo wrote: »
    @nvmomketo Yes, that is something I've just recently started trying... though I'm more interested in LC and don't care so much for the HF part as I can't get to both my protein goal and stay within calorie goals with high fat. I'm also trying a medication that will reduce insulin needs and should improve satiety.

    I hope it works for you. :). Come join the Low Carber Daily group if you want to find ideas or support for low carbing it.

    I already did, but have just been lurking mostly.
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