Have you been following the great carb debate?
This debate has elicited excellent opinions from Stephan Guyenet, Peter at Hyperlipid, and Kurt Harris. In a nutshell, they discuss the "carbohydrate hypothesis of obesity", with respect to the interplay between ingested carbohydrate (refined or not), insulin, and bodyfat. Some of the best insight has been from J. Stanton, regarding lack of metabolic flexibility in obese and formerly obese.
Let's take a step back from the science, and apply Occam's razor. Let's say all of humanity was part of a trial conducted by an alien race. How would they describe the food available to us? It is not rat chow separated into high carb and low carb. It is a cafeteria diet. But that term doesn't really capture the gist of it. The most abundant foods, that are the easiest to overeat, are made up of primarily...
Doritos. Cheetos. Oreos. Mike and Ikes. Coke. Dr. Pepper.
So what happens when you put someone on a low-carb diet? They can't eat the above foods. Weight loss happens. But what if grocery store shelves were stocked not with Doritos and Oreos, but with coconut pancakes and pork rinds? These easily eatable, palatable foods would be fat-laden and fairly "paleo". And for many people (me), the only thing stopping me from overeating on high-fat low carb paleo is that I have to cook the food myself. If stores and restaurants had delicious fat-bomb paleo concoctions, I'd gain 20 pounds in a New York minute. The literature on carb vs fat satiety is conflicting, but fat is typically not magically satiating.
What does this mean? One implication is that perhaps some low-carbers paleos are being unnecessarily hesitant to up their carbs. Sure, metabolic derangement does mean something. But it does not mean that the laws of physics get circumvented. Treat your experimental higher-carb period as if you were in a metabolic ward. My hunch is that a few extra grams of carbs will not lead to gaining ten pounds in a month. The reason is that paleo folks cannot use "higher carb" as an excuse to eat Doritos. They still must eat paleo foods.
The crux of the issue might be to make sure your extra carbs are not hyperpalatable. Eat a plain sweet potato. Aravind and I are 1.5 months into a low-reward experiment, and find it almost impossible to overeat bland carbs. Weight loss if effortless, regardless of macronutrient ratios. But food reward is a whole other ball of wax...
I truly wish it were that simple for me. My diet before going ZC was essentially the same as it is now, except I had homemade salads and low carb vegetables. I was stuck at 50 lbs heavier than where I am now.
I've always loved to cook and use "real" ingredients. I never really liked or ate much of the foods you mentioned. I find soda, oreos, Mike and Ike's, and Cheetos disgusting, and pretty much always have. I do have an ice cream weakness, but I don't think that was the crux of my problem.
Also, I don't have trouble overeating plain starch. Plain unsalted unbuttered boiled potatoes were one of my favourite foods as a child.
I'm sure cutting out refined foods explains the effectiveness of LC for some people, but not for me.
Kamal, you've loaded this question from many, many directions. So, I am going to be selective and give you some information or food for thought, on just a couple. I partciularly take issue with this statement:
"Sure, metabolic derangement does mean something. But it does not mean that the laws of physics get circumvented."
I'd love to know just what that "something" is in your mind, that metabolic derangement means.
I am largely going to use an example of 2 or 3 other paleo women here, all much younger than myself, who are radical weight loss maintainers. This means, for my definition here, that we have lost in excess of 100 lbs and kept *it* off. This puts us in the 3% club off ALL who lose weight, meaning that only 3% are able to keep it off. 3 of us were never "doritos, cheetos, Dr. Pepper" etc consumers. Two of these battled the weight beast from early childhood. Two others of us, including myself, did not have issues until our early teens and then they were not "big weight" issues. Both of us had events or series of events in our growing up that are well known to affect neurobiology, which I would say figured heavily in our eventual obesity.
During the time I first became signifcantly overweight, I was on the board of an all organic co-op and lived in an area where the local supermarket also had abundant organic foods, free range chickens and grassfed beef. This was in the mid 1980's. I cooked primarily from scratch and ate all foodgroups, with grains being very sparing. I did use cooking oils like safflower, oliveoil and canola oil. I rarely ate fried food that was flouered . I ate frozen food if fresh of what I wanted was unavailable. I ate potatoes, corn, all kinds of legumes, and meat. I also raised my own chickens and ate them and their eggs. Compared to average Americans, I ate very little preprocessed stuff, though i did eat some, and ate some pretty dense caloric stuff like trail mix and dried fruit, along with regular fresh fruit. I grew up never having sodas and during these years drank diet sodas at a rate of probably a sixpack over two weeks. I drank some fruit juice. I juiced alot of fruit juice myself.
I also worked a work schedule during these years where I constantly flipped between dayshift, swing shift and nightshift. I was a single parent and had to pick my child up from his school up in the mountains at about 2:30P and it was a 30min trip up the mountain. i have never been a great sleeper and any noise wakes me up and once I am awake, typically, no matter how tired i am, there is no returning to sleep. During this time, which was several years in duration, I probably averaged 4-5 hours of broken sleep a day.I soon found myself about 30lbs overweight. I was in my early and mid thirties. I got the weight off doing a "food combining" diet that gradually transitioned into a vegetarian diet, whihc became a pescatarina diet for me as hypoglcemia made its entrance into mylife. I believe this is when my metabolism first began becoming deranged.
Second bout was when I was in the Arctic. At least 50% of the meat i ate, and often a greater percentage of that was caribou that was given to me in whole backquarters, abundantly supplemented with salmon that my s/o got from Kodiak +crab.There was also seal and whale organ meat, whale fat +skin as available. Again, eating from all food groups, relying very heavily on frozen veggies often, some fruits, and all kinds of corn, potatoes, legumes, as well as trail mix stuff I ate at work and organic tear off the top soups which were typically beans. Pasta in the form of spahghetti, homemade, about every wek to two weeks. Bottle cranberry juice. Bananas and peanut butter sometimes for breakfast.
And years of very hairy work schedules(never less than a 10-12 hour work day over 9 years) and other BIG stressors. Did I overeat sometimes? Indeed I did. And what I remember most, is how quickly the fat came on, and then how I was "ever-hungry." And I mean EVER-HUNGRY. I have rarely eaten candy in my entire life. I do like choclate and would sometimes have a chocolate bar as an "event" or ice cream.
All of this blabbing is to say that my diet looked pretty darned stunning, as far as REAL FOOD compared to about 95% of America at that time (in the 80's or 90's) as well as now. I didn't get fat on doritos. Obesity is absolutely a heterogeneous disorder and there is certainly a substantial and growing, in my opinion, "doritos group." But to suppose that this is the only or even primary group is a very facile assumption.
Metabolic derangement is very, very real. And indeed, it ends up defying the laws of physics. You are well read and you have read JS Stanton's work, Peter's work and others. If you don't read Arya Sharma's blog, you should. Sharma gets what we, the obese and post obese in particular, have learned through effort most cannot even comprehend. When UCSF treats obese people, and they usually don't even consider ppl for "diets" who are over about the 70lb or so overweight range, they treat them with either an 800cal , 1200 or 1400 cal diet. The very obese who might reject surgical interventions are always put on the 800cal diet because they are going to have to live on a 1200-1400 cal diet for the rest of their lives, and at least this will be a step up!(You are talking about people who if not formerly obese or weight reduced, would eat an average of 2000 cals and if exercising, add 300 or so to that.) If they don't, they will regain. And we are not even talking about people who necessarily get to an optimum weight. We are talking about anyone who is obese/morbidly obese and loses a substantial amount of weight. Those who go to optimal are the very, very, very rare. And as the National Weight Registry tells us (which was originally full of low-fat, high carb losers, but now has substantial numbers of low carbers) the typical amount of time spent in exercise daily is in excess of one hour, seven days per week to prevent regain. This is REALITY.
To answer your foolishly reductionistic fat-person-with-an-iv question, I have taken care of two obese people I will never forget. One was a 500lb woman who had been starving herself for two years. Her husband was older than she and retired and was with her 24/7. He purchased all food. He cooked. She never went anywhere other than from the bedroom to livingroom or bathroom. For two years, she starved herself, to the tune of NO food for as many days as she could stand, with only water, and then only broths and if he could stuff it down her some cottage cheese. When she was admitted to the hospital, she was a horribly ill person with constant diarrhea. In TWO years of constant starvation, she had lost 50lbs. She was in horrifying nutritional condition. How much would YOU lose if you ate maybe, at most, 800cals a WEEK for TWO YEARS?
Another man was a 600lber who was placed in a room with a camera and was on about an 800cal diet. He lost about one to two lbs a month. How much would YOU lose if you ate 800cals a day?
Your "fat-person-with-theIV" example makes me livid. These are real, suffering people.
Here's some interesting info to consider as well:
"This result, once again, kills the simplistic notion that body fat is determined exclusively by voluntary food consumption and exercise behaviors (sometimes called the "calories in, calories out" idea, or "gluttony and sloth"). In this case, a multivitamin was able to increase resting energy expenditure and cause fat loss without any voluntary changes in food intake or exercise, suggesting metabolic effects and a possible downward shift of the body fat "setpoint" due to improved nutrient status."
"He is currently investigating the contribution of biochemical, neural, hormonal, and genetic influences in the expression of the current obesity epidemic both in children and adults. He has defined a syndrome of vagally-mediated beta-cell hyperactivity which leads to insulin hypersecretion and obesity, and which is treatable by insulin suppression. This phenomenon may occur in up to 20% of the obese population. He is interested in the hypothalamic signal transduction of insulin and leptin, how these two systems interact, and how hyperinsulinemia contributes to leptin resistance."
"We are currently concentrating our research on the molecular mechanisms implicated in the hypothalamic effects of the adipocyte secreted, weight-regulating hormone, leptin. After describing the first leptin receptor mutation in severely obese humans, we found that genetic alterations in the Melanocortin 4 receptor (MC4R), a mediator of the hypothalamic effects of leptin, are responsible for a more common form of human obesity. Using large scale automated screening procedures we now further investigate the frequency of mutations in the MC4R gene in large cohorts of obese patients. In parallel we also search for obesity causing mutations in additional candidate genes downstream the leptin pathway. Finally, both through in vitro and in vivo studies we are aiming to understand how these mutations cause obesity and what the implications are for the treatment of this condition."
"His research into the role of stress hormones (glucocorticoids) in energy balance and obesity that originated during his graduate studies was continued in the Department of Physiology at UCSF, where he worked with Mary Dallman.
His research uses integrative physiological approaches to study the reciprocal interactions between brain and body in the regulation of metabolism and in the development of metabolic diseases, such as obesity, diabetes, and hepatic steatosis. His work explores two interrelated streams:
The interplay between, and sites of action of, glucocorticoids and insulin in the regulation of energy balance, glucose homeostasis and the stress response and the effects of disrupting the ratio of these two hormones in the development of obesity and insulin resistance.
The role of signaling in specific neuronal populations within the hypothalamus in the regulation of peripheral lipid metabolism, glucose homeostasis and energy balance, with special emphasis on the metabolic responses to different dietary conditions and stress."
I would say that the role of insulin in obesity is far, far from dead.
Lastly, I am 10 years out in radical weight loss maintenance. I won't be eating any ##$%^!! potatoes, especially since all of Stephan's food reward theory work. I have decreased my reward over the last 5 years as far as it is going to go. Along with many other tools in my toolbox, it has been very helpful in my maintenace and the decrease of another 10lbs in the last year. But I've decided I will be dead and gone before I sit down to dinner with dry potatoes. You can eat mine!!! I'll stick to rutabagas, beets and nuts for my "carb up" days!
If we go on personal experience i have absolutely no reason to eat bland carbs. I've tried eating higher carb via potatoes and such and basically I just think it sucks. Not much taste AND displaces vegetables with higher nutritional value that I actually enjoy. Not scared of weight gain at all, its a matter of taste and nutrient displacement for me.
I can MAYBE stomach one potato a day, and thats still forcing myself to eat it. I would much prefer a variety of other vegetables to these starches. If I want carbs I call it a cheat meal and get some real pizza or pasta dish.
I have been following along in this "great" debate. What I conclude, and what I have always followed is to listen to your body. We will continually be overloaded with new information, many of which conflict w/ each other. So it can be tough at times to know what the "right" thing to do is.
I don't think there are anything wrong w/ carbs, but as you say foods that are heavily processed, convenient, have a high food reward and happen to be mostly carbs. These foods are thus easy to become addicted to and probably account for adjusting our body's set-point.
Calories matter in the end, but our bodies are not closed static systems. We are dynamic, we change, we evolve. Our bodies adjust to the environment we give them. That is why restricting calories too low wont work, or doing too much exercise never work in the long term.
I think for many, going "low carb" is the easiest way to mange the situation. This does not mean low carb is the only way however. I think a high carb paleo diet could work too. Depends on the individual. Depends on your lifestyle, your genes, etc.
I think you have to listen to your body and put yourself in the best situation to control your environment. I think at a base you start with eating real food, cook it yourself, and too make sure you are not overdoing it (calorie restricting, overeating, exercise, anything that would increase cortisol), and to get plenty of sleep. I definitely agree with Dr. Harris' post on hormesis.
Also this all assumes you are relatively healthy already. Otherwise, there are specific diets that might target a particular issue/deficiency.
Does low-carb “work” simply because packaged foods are high-carb?
I think that may be true for some people, but is not true for me. I lost weight on a low calorie, moderate carb diet (I was 50% carb, 30% protein, 20% fat) that included quite a bit of packaged food. I especially liked all the extra fiber crap including snack bars and completely processed "muffins" and other junk like that.
When I went lower carb, higher fat whole foods (50% fat, 20% carb), I had good results with some weight loss and body comp changes. The sad thing that seemed to happen, is I have now lost my tolerance to eat more carbs. If I eat more now, I gain weight. If I would have know that would happen I never would have dropped the carbs down so far. Now I'm stuck here.
I never did eat industrialized food nor is that typical in this part of the world. Just lot of potatoes, bread and little protein. I lost 40lbs without hunger or too much effort by doing 50 < CHO < 75 low carb and providing some supplements needed for beta oxidation and toxin clearance.
This is the lowest weight since I had since I was 15 and I have 34 now. I am also far less active now then before.
The same thing happened to pretty much everybody I know who started this type of life style seriously. The range of fat loss goes from 10lb - 100lb in circles around me. The diet could fail because of malnutrition mostly
before paleo i had at least 3 years of eating a relatively healthy diet that was 1400 calories a day of mostly fish, lean chicken, loads of fruit, raw vegetables, low fat dairy, sprouted grain bread, nuts, brown rice, beans and kashi cereal. i was at the gym 5 days a week- my bench press was 90lbs, squat 220lbs and i could run the treadmill 1.5 mile in 10 and 1/2 minutes. and i still had belly fat left over from all those years of being over weight.
i have been paleo since may; tried a bunch of different combinations of macros and have just now started to trim down on LC IF with fat and protein consumed in equal amounts.
another possible explanation for the fat loss is that i may have become metabolically flexible, but i want to lean out some more before i test that theory.
Satiety has a lot to do with nutritional contents. Non-animal fats tent to have very low nutritional profiles, so eating high fat doesn't guarantee satiety. Regardless of whether its fat, protein, or carbs your body is going to get hungry again quickly if you are foods that were devoid of micro-nutrients, especially the essential ones that meat has lots of. When you eat nutrient devoid food your body reaches its calorie needs long before it meets its nutritional needs, thus you end up hungry even after you've eaten enough calories.
Gnolls.org has some great info on this subject: http://www.gnolls.org/2407/when-satiety-fails-why-are-we-hungry-part-4/
As long as you aren't insulin resistant it's ok to eat some carbs. When the majority of your diet is meat with a few green vegetables it is easy to reach your nutritional needs long before your calorie needs, so eating a few grains won't cause you to overeat. Everyone has their own tolerance threshold for carbs, but pretty much everyone is in for some trouble if they're eating 50-60% carb and avoiding animal products long-term. There are many ways to get your insulin down, but a very low/no carb diet is one of the best ways to get it done quickly.
I would like to put a bit of a different tack on this, if I can.
Sometimes, it is kinda interesting to take a step out of the Western food paradigm and look at the rest of the world. My husband's family comes from the Middle East and we have recently just been out there.
Now, these are cultures where, compared to the West, there are very few packaged foods consumed on a daily basis. Mothers tend to cook meals from scratch using fresh ingredients. Though there is some fast food, it is few and far between -- a treat, rather than daily consumption and even then, the "fast food" isn't some Frankenstein corporate product.
This time is the first time I have been out there since I went paleo, and as such, I noticed something rather fascinating.
We travelled to two towns, each in a different country. They are about 100 miles apart, have the same weather system, and the people share, mostly, the same genetic heritage. Lifestyles are similar (neither are big exercise cultures), their traditional food stuffs are pretty similar, and, in the areas I observed, the religious/cultural make-up of the areas were similar as well (this is important in terms of alcohol consumption).
Yet, in country X, the young people (ie. from 11 to 25) carried noticeably more body fat than in country Y. While a non-paleo might not notice it so much, my paleo radar picks up on these things these days and the difference was fairly apparent. In fact, one particular day, in country X, I found myself sitting across from a young man, under 25, who would be classed as clinically obese; it made me realise that I had never seen a clinically obese young person in country Y.
This absolutely intrigued me, and, after a while, I began to suspect a possible cause.
Country X, as a rule, eats more carbohydrates on a daily basis than country Y, and country Y eats a lot more meat and fat. It is a pretty subtle dietary difference that probably only becomes apparent when you compare the diets of one against another over a period of time in two countries that are not particularly different in other ways (I have lived in both over the years).
When I say more carbohydrates, I mean that country X will serve five sources of carbohydrates with a meal whereas country Y will serve maybe two. Country X will serve a salad that contains a bread product and serve it with bread as well; country Y will serve a salad that contains an animal fat product instead. Again, if you order what we would call a kebab and salad, in country X, your meat will come in a flat bread and your salad will come with bread as well, whereas in country Y, your meat and salad will come on a plate with bread served on the side.
Now we are talking here about generally "unmessed about with" carb sources: we are talking about traditional flat breads that are essentially the same and bear little relation to Western bread products, dips that are essentially the same, potatoes from the same source. Country X just eats more of them -- to my rough eye, possibly twice as much as country Y.
That really was the only thing I could find to explain why young people had more body fat in country X. There was no other difference I could find.
Note: I have refrained from naming the countries ... I don't really want to label people in any way.
The Technobable of Ketosis. 6 Answers