I downloaded Mastering Leptin last night. It has some additional information in it about leptin, insulin and ghrelin which is good. They also had some information that they haven't filtered all that well, so their recommendations don't make sense.I found it really interesting to look at where the citations and rationales are absent from the Quilt and ML. ML has few good supports, for example, for their section on saturated fat and exercise. The Quilt has few around the hard and fast rules that are promoted. But the basic science underpinning both approaches works.
Carbs: this is an area where I struggled with both ML and the Quilt. ML points out that 'some' carbohydrates are necessary for normal ghrelin activity - which includes gastric motility, the release of stomach acid to digest protein, and efficient stomach emptying. (These are problem areas in my IBS). They don't quantify 'some' carbs though, and they haven't qualified the type of carbs at all; grains are acceptable for them. The Quilt is very restrictive with a limit of 25g of carbs within paleo guidelines. This level of carbs tends to create problems with my gut that I hadn't traced back to ghrelin issues before today. I can't find any citations or rationale that support very low carbs specifically to heal leptin resistance - and ML and the Jaminets have some convincing arguments that fit with my own (n = 1) experience. I'm open to convincing, but it's not an area I'll experiment with any more. I need evidence before I take that on again.
Meal timing: ML doesn't emphasise the 'within 30 minutes' rule, and later in the book (the fighting disease section) actually say that 3 meals a day is maximum, not optimal, and that the main point of the meal timing is to prevent snacking. They say that 2 meals a day is fine for some people. The Quilt's rationale is also about preventing snacking, and Jack doesn't make any allowances for individuals who have previously healed enough for this to not be an issue. The key point they both agree on is that to encourage a healthy cycle of leptin, insulin, ghrelin and NPY, you need to have at least 5 hours between meals and at least 12 hours of fasting between dinner and breakfast, during which you sleep. The timing of dinner at least 3 hours before sleep is also consistent and well supported.
Fat: ML is against high or even moderate fat, but later says that 'the primary neurotransmitter relating to leptin is dopamine. Dopamine is involved with reward behavior. The fastest way to increase dopamine is to eat fat; this in turn raises leptin and shuts off NPY'. Fat intake isn't quantified or particularly well qualified. The Quilt includes fat - not quantified, but paleo, however there is little (so far) in the way of rationale. However, for most paleo folk the rationale isn't needed as we've done lots of reading about it already. I'm very interested in Paleobird's experiences of limiting her fat intake to take off the last percentages of her overweight, though - it's something that should be revisited in the context of women and obesity as most of the literature focuses on normal weight and/or men. In particular, peri and postmenopausal women challenge the received paleo wisdom of 'eat more fat'.
Exercise: ML supports chronic cardio, but in spite of their citations from CW, they emphasise the feeling of being refreshed during and after exercise - which kind of shoots down their recommendation until a person is metabolically fixed and lean. They need to revisit this section with an open mind as to what kind of movement will provide the benefits of improved muscle efficiency.
One thing I like about the Quilt is the assumption that this eating plan can be tailored after 6 - 8 weeks. ML treats it like a life sentence. I suspect this is because of the paleo underpinnings for the Quilt which provide lifelong eating and lifestyle guidelines so stopping after a couple of months doesn't revert to the SAD. Stopping the ML eating plan leaves no backup at all, and SAD eating will no doubt resume.
So at this point in my reading, I'm going to try the protein and fat in the morning, abstain from eating after about 7pm, keep dinner light, and go at least 5 hours between eating. I'm not low-carbing beyond the natural levels that paleo tends to create, nor am I going to restrict fat. It'll be interesting to see where this goes!