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Dr. Jack Kruse (on PaleoHacks formerly known as Dr. K and now known as The Quilt) is interviewed at Jimmy Moore's: http://www.thelivinlowcarbshow.com/shownotes/4119/474-dr-jack-kruse-low-carb-neurologist/

I enjoyed the entire podcast and appreciated his thoughts about context in terms of leptin.

Listen to the bit between 37 minutes to 38:54 -- wherein he talks about the importance of increasing carb consumption IN THE RIGHT CONTEXT i.e. after you have solved your leptin resistance via Paleo diet.

So -- how does one:

a) solve leptin resistance problems in your muscles and liver?

b) know when they have solved leptin resistance problems in your muscles and liver?

c) what the next steps are?

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 in a week I will show you exactly how to do it......at www.jackkruse.com Not live yet but as promised I will help you if I can. – The Quilt May 26 2011 at 22:29
The interview went well -- fits right into my thoughts about Paleo Diet as a meta-rule. – Patrik♦ May 26 2011 at 22:59
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 Yes my only question was about exercise normalizing liver and muscle leptin resistence issues. You are saying exercise does both? So you will tell us more about this? Is it all exercise or specific? Overall a very good listen. You communicate much better in a less restricted environment. I often struggle to understand your thoughts and ideas here because of your truncated writing style but you were very clear in the podcast. Anyway, good job! Congratulations! – Shari Bambino May 26 2011 at 23:28
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 Exercise in the face of leptin resistance actually makes the problem worse......I promise I will explain it! – The Quilt May 27 2011 at 14:35

5 Answers

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Awesome! Jimmy's site is being lame right now so I haven't listened yet.

I already knew about leptin resistance for the most part, although I am always revising exactly what I believe like with the carb thing. Dr. Quilt and I agree on many points although I suspect that I will learn plenty more once I listen. The thing is that leptin is an incredibly slippery issue. If someone hasn't looked deeply enough into the issue they're going to be mightily confused. Some people think that since elevated leptin produces leptin resistance, and in fact you need elevated leptin to produce leptin resistance that leptin resistance is the effect and not the cause of obesity. Compound that with the fact that adipose tissue secretes the cytokine Il-6 which increases SOCS-3 expression in the hypothalamus and causes leptin resistance, it all seems plausible. But you don't need any adipose tissue at all to elevate your leptin levels or your Il-6 or CRP. That's the thing about metabolic syndrome. Every effect in metabolic syndrome acts as a cause in worsening and perpetuating the metabolic syndrome, and one day one finds oneself at 300 pounds and is flabbergasted, hungry, and looking for answers.

The mechanisms that raise systemic inflammation in the body do not need adipose tissue or leptin resistance to arise, they can be produced by a disequilibrium of polyunsaturated fats, wheat lectins, nutrient deficiencies, endotoxemia, and plenty of other things. Inflammation will increases Il-6 and c-reactive protein and this can cause leptin resistance prior to obesity http://www.ncbi.nlm.nih.gov/pubmed/16582918 Sugar also raises leptin quite a bit, triglycerides can interfere with leptin signaling and there is just a lot of things that the paleo diet remedies that help things. I suppose the tendency to eat addictive foods to excess like Whole Health Source has been talking about plays a role, although I think that leptin resistance likely plays a role in that. They tend to be inextricable from each other so it's hard to tell.

Basically once metabolic syndrome gets a foothold we gain some weight, that fat makes things worse, and everything causes everything in a horrible downward spiral of death and doom. I'm not going to ramble about the issue here and I'm not particularly knowledgeable with the nuts and bolts, but I will say that there are definite things that people can do, but it takes some time to get everything right so they can lose weight and keep it off.

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 This is an excellent interview. Plenty of insights into the world of medicine. I'm more sympathetic to old and erroneous paradigms now. – Stabby May 27 2011 at 1:32
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 SOCS3 is but one way we become leptin resistant. this pathway is driven by IL6 TNF alpha NFkappa beta and ALE's from PUFA's. This is why you hear me constantly talk about omega 6/3 index and ultra sensitive CRP as biomarkers. This is not the only way one become resistant to leptin. Most people think leptin is about high or low......its not. Its about what happens at the receptor level. And that is quite complex. – The Quilt May 27 2011 at 1:43
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 here is some insight why I dont agree with Stephen......The taste of food at the brain level is a sensory compeonent that occurs through three cranial nerve. These sensations only allow the brain to have an idea of what is coming to the gut for the engine to use (liver) Stephen talks of food rewards but guess what......there is no neurotransmitters that effect the dopaminergic tracts in the lateral hypothalamus for fats or protein. Only for carbs. That neuro modulator is Neuro peptide Y. When you eat carbs....NPY goes through the roof in the brain regardless of leptin status. – The Quilt May 27 2011 at 11:15
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 Leptin is just the brains energy thermostat.....it tells it what the overall energy status is for the animal. If that thermostat is not working......for any reason......with more carbs introduced into ones diet it continues to drive NPY elevation and causes the animal to crave more of what drives NPY......it becomes a positive feedback loop. No other macronutrient is wired that way. Moreover this wiring is tied directly to sleep in the lateral hypothalamus. The key to stopping the positive feedback loop is fixing the leptin receptor. That immediately changes the perception of taste by – The Quilt May 27 2011 at 11:19
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 altering cravings of the reward centers in the ventral tegmental tract. There is no setpoint and there is no obesity driven by reward. Its driven by a unfettered positive feedback loop and a problem in firing of certain reward tracts. The exact same mechanism occurs in the hypothalamus in cataplexy. And it uses the same modulating neurons. I will cover this in my blog. Its complicated but interesting. – The Quilt May 27 2011 at 11:21
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That's the thing, pat: every person out there says Leptin is the problem! But no one ever says what to do. It's always the same old story: whole body fat releases leptin so the more fat you have the more should release and thus you're not hungry and you lose that fat. But then of course there are the leptin receptors and everyone says well the receptors have lost sensitivity like for insulin and thus even with sky high amounts of leptin, your Body isn't "hearing" it. Fairly straight forward. Byron Richards has been saying this for years. Even Taubes acknowledges it. But no one can figure out what to do.

I'd love to see what the big reveal from the good doctor is

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 I agree and have said the same thing! Pretty soon people are going to start saying "everyone says that everyone says the same thing about leptin ..." – Paul May 26 2011 at 23:10
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 Byron Richards is not a clinician. He is an author and a supplement hawk. I treat people. I eradicate leptin resistance one patient at a time. – The Quilt May 27 2011 at 0:09
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 It's not that I'm a fan of Byron. Just saying that he's been shouting leptin for quite some time. He hawks all his product, agreed. Ipso facto what he says is not right? I will not agree to that. Besides, my point was only that nothing you said was new at all. Leptin before insulin as society's main concern? Ok fine no problem. – ben61820 May 27 2011 at 0:41
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 i think much of what he says about leptin is close to correct.....but he never talks about what happens at the brain level. And that is where the rubber meets the road for clinical medicine. – The Quilt May 27 2011 at 1:45
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Dr. Kruse is the man. I was born in Nashville, still have family there. Need to check him out next time I'm down there. I really liked the point he made about the need for different diets for people based upon context. This is a good point and one that differentiates him from much of the Low Carbers. I could imagine these types of broadcasts turning into a Low-Car love-fest, but Dr. Kruse set himself apart politely on this point. Would like to know more about what these different dietary approaches look like in practice, so I'll read his books and look forward to his website going live. I also liked what he said about the relationship between medicine and research science. If X is true for 99.90 percent of the population, what if I belong to that .01 percent.

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 Thomas I think when you see my thesis laid out you will get it. I shared it with Dexter, Jimmy Moore Robb Wolf and others and quite frankly they said it was too GCBC like in how deep I went into the science. So I rewrote the damn thing the last two weeks. I had an author friend of mine edit it for 60 bucks an hour because this document that I call "The Quilt" will lay out my thesis. Each blog will add a piece to this skeleton document. It will grow horizontally and vertically. The original document is not short. It wont be in blog form. Its a treatise that give you 30 levees to live by – The Quilt May 27 2011 at 0:04
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 Each one will be explained by the subsequent blogs. As you read the more you will learn. The more you learn the more you will understand why people get confused. Because they know bits and pieces but dont understand how it fits together. Kinda like buying a ferrari by mail order getting all the parts and then having to figure out how to assemble it so you can drive it. The leptin post that will be blog one will cover a specific part of the leptin story that I think confuses many. Once I explain it I also tell you the questions I ask of the patients to check their sensitivity as they go. – The Quilt May 27 2011 at 0:07
here i was think you were calling yourself "The Quilt" because of that little green icon thingy on Paleohacks. Great show, Dr. K. Enjoyed it very, very much. Looking forward to learning more about a few points you made. I think the point about paleolithic diet working up until a point and then people maybe needing to switch it up a bit is pretty great too. Speaks back to what Thomas was saying about his frustrations with "paleo narrative". – tartare May 27 2011 at 0:15
As pretty healthy going into "paleo" I've been finding eliminating gluten has actually been the most helpful thing for me, but going low carb has been debatable. My issue is that I've never been crazy about "paleo" carbs, not even white potatoes really, so I go low carb by palate more than plan. I'm going to start playing with cycling carbs into my diet, as I still maintain variety is important for optimal health. – tartare May 27 2011 at 0:19
Thomas I'm sending you and Dr. K. FB requests. – tartare May 27 2011 at 1:12
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I really enjoyed the podcast, and I look forward to more info. I seriously need all the help I can get regarding inflammation and leptin. I've been at this for a while, and no matter how much I tweak my eating and exercise doing Paleo/Primal, I cannot seem to lose a significant amount of weight. Thanks Dr Kruse, I look forward to your blog.

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I love the low carb message. But I seemm so addicted to sugar, I just don't know how I'll ever get started.

Here's the wikipedia article

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Wean yourself slowly over a month. But replace the energy from sugar you are not going to get with fat and meat. If you don't have any tempting neolithic products around you...it is much easier. But in the office environment, doughnuts and the like abound. Just resist. It is hard, but for your long term survival, kick the sugar and the wheat products. You can do it. It is not like you are the only one out there that has become addicted. Enlist friends to be your sounding board. – Dexter May 27 2011 at 19:46

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