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Thread: Insulin…an Undeserved Bad Reputation page 3

  1. #21
    SerialSinner's Avatar
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    agree that insulin doesn't directly drive fat accumulation without excess calories
    The problem is that we never eat exactly the same number of calories that we need. we probably swing from excess to deficit depending on what time scope we use to measure caloric requirement vs. caloric provision.

    Unless one purposefully fasts on a regular basis, I think it could be argued that, in modern days, people who eat 3 times a day until satiety would tend to stay above their caloric requirements, particularly in modern times and in the absence of nutrient dense foods.

    This is why the calories in / calories out approach fails so miserably for normal people who don't want to scrutinize every food particle they eat. It is way easier and sustainable to focus on quality, go low carb and let the body keep it's body fat set-point through it's own physiological mechanisms.
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  2. #22
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    Quote Originally Posted by JamesKrieger View Post
    Grol,

    Apology accepted.

    I want to clarify my position on Taubes. It is no doubt that he got people to take a look at the benefits of low-carb dieting, and that is a good thing. He also got people thinking about the quality of carbohydrate ingested, which is a good thing. He got people thinking about how refined carbohydrate may be a contributor to obesity, which is a good thing. And low-carb certainly has benefits. However, to me, the ends does not justify the means. What I mean by that is that Taubes's book is full of incomplete or incorrect information, which I have a problem with, even if it's helped people lose weight. For every person that has success with low-carb dieting, there is someone who is irrationally scared to death over every single gram of carbohydrate because of Taubes's book. One person on my site wrote, that for every person that has low-carb success, "there are probably hundreds of people who can’t tolerate low carb for the long term. These people agonize over falling off the wagon, think that every gram of carb is like ingesting shards of glass or rat poison and beat themselves up to the point of binging and doing more harm." And this is where I feel his book does a disservice. I think his book oversimplifies the problem of obesity, which means it also oversimplifies the solution.

    I do understand that my posts on Taubes have been too confrontational and harsh, and as I continue my review of the book, I am going to make an effort to tone that down. But I will still need to challenge the information as Taubes presents it, because I strongly feel the book can be very misleading. This doesn't mean he is intentionally misleading people, but nevertheless a more complete presentation is needed.

    James
    James - I read your piece on insulin, and am finding it difficult to reconcile it with my own personal experience. I'm a physician, and several months ago decided myself to adopt the primal blueprint diet. Wanting to do so in a semi-scientific manner, I first tracked my caloric consumption for a month eating my standard diet. I then switched to the primal blueprint diet and did the same for a month. On my pre primal diet, my average daily caloric intake was approximately 1900 kcal. On the primal diet, my average intake was 2500 kcal (I never realized how sick carbs were making me feel with every meal, and so enjoyed eating again!). And over that month, despite the 600 kcal excess, I lost 12 pounds (with no change in my exercise habits). Now I've been the same weight for 10 years or so (never overweight, always been lean), so this was a pretty significant loss. It ultimately leveled off around 14-15 pounds, and basically the ring of abdominal fat I used to have is now gone.

    I was astounded, to say the least, particularly given how clearly my own "n of 1" study completed refuted the caloric excess theory of obesity (which I'd been taught in medical school!). And to me, my data would certainly support the carbohydrates driving insulin driving fat accumulation theory laid out by Taubes. It also would seem to completely contradict the notion that people consume more calories on higher carb diets because of their lower "energy density" (which is the explanation you give in your article) - I had the exact opposite experience. Anyhow, do you have an alternative hypothesis as to what could've accounted for my results?

    Josh
    Last edited by jturk; 07-07-2010 at 11:18 AM.

  3. #23
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    @jturk

    TEF, NEAT, Water loss...

    All made possible by the lowering of carbs.

    You increased the calories in, obviously, but you also increased calories out. Exercise is not the only way to increase calories out, call it metabolic advantage or what have you but deamonizing THE INSULINZ does not help the many people who have the exact opposite effect as you experienced.

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  5. #25
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    Quote Originally Posted by Stabby View Post
    m Again, we can't extrapolate studies of healthy people to studies of insulin resistant people. That's dishonest.
    Quote Originally Posted by SerialSinner View Post
    Unless one purposefully fasts on a regular basis, I think it could be argued that, in modern days, people who eat 3 times a day until satiety would tend to stay above their caloric requirements, particularly in modern times
    +1 to the both of you.

    Quote Originally Posted by jturk View Post
    Wanting to do so in a semi-scientific manner, I first tracked my caloric consumption for a month eating my standard diet. I then switched to the primal blueprint diet and did the same for a month. On my pre primal diet, my average daily caloric intake was approximately 1900 kcal. On the primal diet, my average intake was 2500 kcal (I never realized how sick carbs were making me feel with every meal, and so enjoyed eating again!). And over that month, despite the 600 kcal excess, I lost 12 pounds (....snip.....)do you have an alternative hypothesis as to what could've accounted for my results?
    Nicely done, Josh: the tracking, the loss and the letter.



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  6. #26
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    @ jturk, I eat fewer calories on PB than I did before. Carbs make me hungry. For the last few years I had been aiming at approx 2000/day, from a starting point around 2300-2500, and rarely hitting it. I haven't been tracking so religiously lately, but when I have I've been barely hitting 2000 from the other direction, more often 1500-1700.
    Of course I haven't lost any weight yet, so I don't know if this contributes anything meaningful to the conversation.

  7. #27
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    Quote Originally Posted by jturk View Post
    I was astounded, to say the least, particularly given how clearly my own "n of 1" study completed refuted the caloric excess theory of obesity (which I'd been taught in medical school!).
    But it doesn't refute it. The problem is that your situation represents an uncontrolled environment so that there is no way to know your energy balance before and after your dietary change. Let me explain further.

    For example, you mentioned no change in exercise habits. However, exercise is not indicative of 24-hour energy expenditure. They are not the same thing. Your exercise habits may not have changed, but your 24-hour energy expenditure may certainly have changed, which would change energy balance. But there is no way to know if your 24-h energy expenditure changed unless it was measured using doubly labeled water (which is accurate within +/-5% in free living individuals). Remember that 24-hour energy expenditure consists of NEAT, exercise, resting metabolic rate, and thermic effect of feeding. So even if exercise doesn't change, all the other variables certainly can change. But most people who claim violations of energy balance haven't actually measured all of these variables.

    Also, food intake measurements can be significantly off, even when you make an effort to be accurate in your assessment. Part of this is because food labels themselves are allowed to be off by as much as 20% of what is stated on the label, and the FDA does not enforce this very well. In fact, a 2008 report by the GAO found nearly 30% of food labels to be in violation in regards to accuracy of nutrient information. There was also a study published regarding this but I've been unable to find the reference; the study found restaurant foods and processed, prepackaged foods to under-report the number of calories that the food actually contained. Thus, self-measured caloric intake assessments can be considerably off.

    It should also be remembered that the concept of energy balance refers to metabolizable energy when dealing with food intake. For example, if a 120 calorie food contains 5 grams of fiber, then only 100 calories of that food can be considered metabolizable energy. And even then, there are variations in gut nutrient absorption. So unless one is measuring fecal energy content, there is no way to know how absorption may have changed when changing from one diet to another. For example, this was demonstrated in a study on rodents which compared two high carbohydrate diets...a high glycemic and low glycemic one. Calorie intake was similar, but the metabolizable energy intake for the rodents on the high glycemic diet was significantly higher, and they lost less calories in their feces. Thus, they absorbed more calories, and gained more weight.

    Finally, simple changes in body water will partly explain weight change. This is especially true when one lowers carbohydrate intake, as it is well known that a low carbohydrate intake induces a reduction in body water.

  8. #28
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    I'm also a physician. I lost 25 pounds in three months with very little effort, cravings , or issues. I don't track calories because I don't have time. I just ate primal. Fruits regulated themselves, to be honest. As did the occasional potato. I found Taubes book brilliant, but far more palatable once I knew a sensible paradigm (evolution) rather than just carbophobia.

  9. #29
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    Quote Originally Posted by JamesKrieger View Post
    But it doesn't refute it. The problem is that your situation represents an uncontrolled environment so that there is no way to know your energy balance before and after your dietary change. Let me explain further.

    For example, you mentioned no change in exercise habits. However, exercise is not indicative of 24-hour energy expenditure. They are not the same thing. Your exercise habits may not have changed, but your 24-hour energy expenditure may certainly have changed, which would change energy balance. But there is no way to know if your 24-h energy expenditure changed unless it was measured using doubly labeled water (which is accurate within +/-5% in free living individuals). Remember that 24-hour energy expenditure consists of NEAT, exercise, resting metabolic rate, and thermic effect of feeding. So even if exercise doesn't change, all the other variables certainly can change. But most people who claim violations of energy balance haven't actually measured all of these variables.

    Also, food intake measurements can be significantly off, even when you make an effort to be accurate in your assessment. Part of this is because food labels themselves are allowed to be off by as much as 20% of what is stated on the label, and the FDA does not enforce this very well. In fact, a 2008 report by the GAO found nearly 30% of food labels to be in violation in regards to accuracy of nutrient information. There was also a study published regarding this but I've been unable to find the reference; the study found restaurant foods and processed, prepackaged foods to under-report the number of calories that the food actually contained. Thus, self-measured caloric intake assessments can be considerably off.

    It should also be remembered that the concept of energy balance refers to metabolizable energy when dealing with food intake. For example, if a 120 calorie food contains 5 grams of fiber, then only 100 calories of that food can be considered metabolizable energy. And even then, there are variations in gut nutrient absorption. So unless one is measuring fecal energy content, there is no way to know how absorption may have changed when changing from one diet to another. For example, this was demonstrated in a study on rodents which compared two high carbohydrate diets...a high glycemic and low glycemic one. Calorie intake was similar, but the metabolizable energy intake for the rodents on the high glycemic diet was significantly higher, and they lost less calories in their feces. Thus, they absorbed more calories, and gained more weight.

    Finally, simple changes in body water will partly explain weight change. This is especially true when one lowers carbohydrate intake, as it is well known that a low carbohydrate intake induces a reduction in body water.
    Hmm, it seems as if you may be guilty here of doing what Taubes describes the low fat proponents doing for years, which is to take data that contradicts their hypothesis and dismiss it on the basis of "flawed methodology" (rather than reject their hypothesis), whereas anything that supports their beliefs (however weakly) is held up as gospel. Here are my issues with your potential alternative explanations of my results:

    1. Incorrect calorie counting - to reconcile my data on the basis of caloric balance alone, you'd have to say that my caloric data was waaaaaay off, close to 1000 kcal a day over an entire month. And you'd have to say that it was consistently flawed in one direction (i.e. - almost always biased towards underestimating the caloric content of carb rich foods, or overestimating the caloric content of high fat/protein foods).

    2. Changes in energy expenditure outside of exercise - as I said, I've been the same weight, varying less than 1-2 pounds one way or the other, for 10 years. So to explain my fat loss on this basis, my energy expenditure over that one month would somehow have to have coincidentally increased multiple standard deviations beyond what it had been over the past 10 years. The probability of this would be astronomically low. (I also think I would have noticed!)

    3. Water loss. Yes, in the very beginning I could recognize a bit of water loss. This doesn't explain the continued weight loss in spite of the increased caloric consumption, nor does it explain the fat now absent from my waistline

    Now, personally, I didn't switch to this way of eating for weight loss purposes. I did so for health reasons, given how much sense the evolutionary and anthropological arguments make with respect to diseases of civilization. And only after a couple of weeks I realized I'd be eating like this for the rest of my life because of how much better I felt. However, if someone had told me I'd have this much fat loss eating this way (even after reading GCBC), I don't think I'd have believed them.

  10. #30
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    Quote Originally Posted by jturk View Post
    Hmm, it seems as if you may be guilty here of doing what Taubes describes the low fat proponents doing for years, which is to take data that contradicts their hypothesis and dismiss it on the basis of "flawed methodology" (rather than reject their hypothesis),
    If one were to rely purely on an anecdote of an n=1 in an uncontrolled environment to reject a hypothesis, then one could pretty much reject any hypothesis out there. Again, the bottom line is....you don't know what your energy balance really was....you are assuming what it was.

    I recently discussed a study here that compared weight change between a low carb, high protein diet, to a moderate carb, high protein diet. It was a very tightly controlled study, where all the food was provided to the subjects, and body composition was determined using a 4-compartment model (the gold standard for determining body composition).

    Weight loss was greater in the low-carb condition. This greater weight loss consisted of greater water loss, greater fat loss, greater fat-free mass loss, and slightly greater protein loss. The low-carb condition resulted in a greater reduction in spontaneous food intake than the moderate carb condition. Once the water loss was accounted for, all of the greater weight loss could be accounted for by differences in negative energy balance. In fact, simply increasing protein intake caused the subjects to spontaneously reduce their food intake by 1,280 calories per day. Reducing carbohydrate intake to ketogenic levels caused another spontaenous reduction of 294 calories per day.

    So, according to you, I should give your n=1, uncontrolled anecdote an equal or greater weight than this well controlled scientific study. I would be interested in hearing why I should give your experience, which is essentially low quality data, equal weight to high quality data. This is exactly my criticism of Taubes...he places great emphasis on low quality data and completely leaves out the highest quality data from his book (when in fact it's the highest quality data that conflicts with many of his assertions).

    Logic dictates that, when presented with conflicting data from various sources, that the data of the highest quality should take precedence over the low quality data. In your case, I have to accept the data from the research where all of the important variables have been measured, over your n=1 experience where all of the important variables have not been measured.


    1. Incorrect calorie counting - to reconcile my data on the basis of caloric balance alone, you'd have to say that my caloric data was waaaaaay off, close to 1000 kcal a day over an entire month.
    The research supports this. In fact, people have been found to be off by even more than that (up to 2000 - 3000 calories in individual cases).


    And you'd have to say that it was consistently flawed in one direction (i.e. - almost always biased towards underestimating the caloric content of carb rich foods, or overestimating the caloric content of high fat/protein foods).
    The research supports this too...a selective underreporting of carb-rich foods has actually been reported in studies.


    2. Changes in energy expenditure outside of exercise - as I said, I've been the same weight, varying less than 1-2 pounds one way or the other, for 10 years. So to explain my fat loss on this basis, my energy expenditure over that one month would somehow have to have coincidentally increased multiple standard deviations beyond what it had been over the past 10 years.
    NEAT has the capacity to impact 24-hour energy expenditure by several fold. In fact, when you confine people to a small room to where they don't have much space to move around, NEAT will still account for up to 700 calories per day of differences in energy expenditure between people. And overfeeding studies have found NEAT to dramatically increase to prevent weight gain in certain people who were overfed 1000 calories per day...and this is without the people even recognizing what is happening.

    Small differences in NEAT throughout the day actually add up to large differences in 24-hour energy expenditure. For example, there is approximately a 30-40 calorie/hour difference between sitting and sitting while fidgeting. Amplified over 8 hours and you have a difference of 240-320 calories. Thus, any dietary change that may have impacted your NEAT (due to feeling better on the diet, etc) could have dramatically impacted your 24-hour energy expenditure without you even recognizing it.

    Even TEF can impact energy expenditure up to 100 calories per day when switching to a high protein intake.
    Last edited by JamesKrieger; 07-07-2010 at 09:56 PM.

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