After the recent fireworks at AHS, perhaps this should not come as a surprise. Neurobiologist and popular blogger Stephan Guyenet has posted on why he does not believe in (refined) carbohydrates as an important cause of obesity. Although he does acknowledge that a low carb diet is effective for making you lose weight.
Sound complicated? It is:
Whole Health Source: The Carbohydrate Hypothesis of Obesity – a Critical Examination
This makes me think of a common saying regarding forests and trees (thus the illustration). Let’s untangle this mess.
The basic premise
The Carbohydrate Hypothesis, as attacked by Guyenet, looks basically like this:
Excessive amounts of carbohydrates (especially refined carbs / sugar) increases insulin and results in fat gain.
Guyenets argues in his post that carbs are not necessarily the cause of increased insulin, and insulin certainly do not result in gaining weight (maybe the opposite!). Basically he says that while low carb works, the theory to explain it is wrong.
However, as every doctor who has ever treated diabetics with insulin (and their patients) probably knows, injecting insulin certainly does tends to increase fat gain. And in untreated type 1 diabetics, with no insulin, weight plummets. Guyenet does not mention that.
Thin people usually have low insulin levels, obese people usually have high levels of insulin. Guyenet does not believe that is significant.
My answer to Guyenet’s post
Stephen,
Very interesting post (as always), but several surprisingly unconvincing arguments.
First of all: You state that low carb diets do indeed work well for weight loss most of the time, and that you see that as a fact. Kudos to you for acknowledging it. However, you can’t say for sure why they work, if not through insulin, so maybe we should not rush to conclusions yet.
You also claim that obesity and metabolism researchers do not take the carbohydrate theory seriously. Well, as they have so far failed spectacularly to come up with anything useful for obesity I’m not sure that is a bad thing.
In the face of massively increasing obesity rates there is only one drug approved in Europe (where I work as a doctor treating obese patients), orlistat, and everyone pretty much agrees that it sucks. The only solution proposed is to cut away healthy stomachs to stop fat people from eating. Yikes.
The failure of obesity and metabolism researchers (however smart) during the last decades is of epic proportions. It makes the Hindenburg look like a success story. Please don’t tell me we should care about what they believe in.
On to your three so called “falsifications”:
1
You argue that leptin is more important than insulin in obesity. Take a look at Robert Lustig’s lecture during AHS. Hyperinsulinemia results in leptin resistance.
Problem solved. Moving on:
2
Insulin results in fat being pushed into fat cells BUT insulin also signals satiety in the brain… problem? No. Like most hormones (cortisol is a good example) insulin has short term and long term effects:
Short term it increases satiety in the brain. Makes perfect sense as it normally means that we just ate.
Long term hyperinsulinemia, on the other hand, increases fat storage and makes us eat more. At least partly through the resulting leptin resistance, like professor Lustig pointed out.
Again, problem solved. Nothing “falsified”.
3
You claim that not just (especially refined) carbohydrates increase insulin, so does protein to some degree. Sure. But we all need protein and low carb diets are mainly about switching carbs to fat. Carbs release lots of insulin, fats do not.
There are plenty of studies showing that low carb diets drastically reduce insulin levels during the entire day. If you’d like references just say so.
Again, nothing falsified.
To summarize:
Of course not all carbs are evil all the time. But refined carbs (sugar, easily digested starch) can be a huge problem for sensitive people (obese, diabetics). It seems we agree on that, as well as that low carb diets can be most helpful in those conditions.
What is really being questioned here is the explanation behind the way the world works. And perhaps it is not quite so simple as Taubes and others once thought.
However, if we complicate the theory just a little bit it still works fine. Let’s not rush to prematurely “falsify” a working hypothesis when we have nothing better to replace it with.
Thus
Whether we bother to add the step with leptin or not, this still seems to be true:
Excessive amounts of carbohydrates (especially refined carbs / sugar) increases insulin and results in fat gain.
Of course, what “excessive amounts” means vary from person to person, and it also depend on what carbs we are talking about. Two examples: Young fit men often tolerate a lot of carbs, even sugar, without gaining much weight, but middle-aged obese women with type 2 diabetes do not.
Bottom line
Some very smart people disagree why low carb works. But we all seem to agree that it does work.
More
AHS showdown: Gary Taubes vs Stephan Guyenet
78 Comments
This is a swedish version of hard debating.
http://www.youtube.com/watch?v=oM2Sp5fs3Q4
Let me just illustrate with my own n=1 observations: I went low-carb back in April of this year, and when I stick to it, I do not get that gnawing empty hunger feeling in the pit of my stomach that I used to get when I would, say, start my day with a blueberry muffin and a cup of coffee with sugar in it. The hunger on a LCHF diet, for me, is mild and far from desperate. I've read the comments of other folks at various blogs who say the same thing.
Now, I would bet that many others who have struggled with their weight in the past have had the 'drug-like' experience that comes along with bingeing on ice cream or cake frosting or some other sugary treat - I mean, I literally would go into a trance-like mental state on such a binge, and engage in almost ritualistic eating. You even stop thinking about or noticing how your stomach feels and instead focus on the taste and texture and the immediate pleasure sensation of putting the spoonfuls of sugar-laden stuff in your mouth. Like others have said (Lustig, Taubes, etc.), sugar is addictive - it is a drug.
So, I see a useful synthesis of Taube's recognition of an insulin-driven, hunger-based carb-seeking behavior, coupled with a reward-system based drive to just eat and eat and eat sugar in its various forms. Maybe this is what you were getting at? The insulin traps the fatty acids in the fat cells, the other cells kick into starvation mode, send signals to your brain to go get some carbs, then, especially if you are sucking up the sugar, the reward system response (is it dopamine-based, in your pre-frontal cortex?) kicks in to drive the bingeing.
30% of weight loss is muscle loss,because of this you lessen the ability to store glucose & gycogen,this trends u to Diabetes.
There is a increase in the lypogenic enzymes which store body fat.Since your depriving your body of carbs your liver has to convert necessary proteins into carbs to run your body.This sacrfices the protein u need to repair your body.
What does this all mean ? instead of getting thinner,your actually getting.....fatter
Love Your Body
People on keto lose weight. Fact.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1373635/
That's my update...the breath thing concerns me.
http://www.phlaunt.com/lowcarb/19063904.php
More fat in the diet do have a side effect, it is comon to lower the blood pressure.. I do think this is related to rising HDL levels, who is related to more vasodilation.
If one do have problems with hypothyroidism.. its always gonna be a problem to lose weight.. but not imposible, more of a long time to seek whats optimal for your body.
That symptoms is very good, not only becuse you feel fine, its mayby is becuse your metabolic rate have rised?
jab
Its calculate your absolute mini demand of protein (0,8grams/kilo a day).. buth other LC experts do say that on a ketogenic diet the protein should be higher then minimum!
And at least 1 gram/kilo for a sedentry person and at least about 1,5 for more active peopel!
Wee do use som extra protein for glukoneogenes, and if one is typical an active person then you use som extra glukos thats come from this gluconeogenes!
You can find a lot of those calculators on different sites, and they do get different answers.. do use them to play with, and to give you something to think about, but they are only GUIs for some matematics.. that not do take individual conciderations!
"The LCHF way of eating is a high Fat and not a high Protein diet. [See article of Professor John Yudkin at the back of this book.] Fat – including saturated fat, excluding transfat – is extremely important in the LCHF way of eating. Do not ever try to limit fats [or calories,] thinking that you are going to lose more weight if you do. It’s not going to happen. Fat is the one element that is going to determine your success or not of this way of eating. The usual ratio of protein/fat/carbs is 70% fat 20% protein and 10% carbohydrate. Or put another way, as it is difficult to work out percentages in this way, fifty to seventy-five grams of carb and the rest from meat, fish, eggs, cheese, and their natural fats, OR, to make it even easier… a ratio of one part carb to two parts protein to between three and four parts fat, by weight.” Simply weigh the portions once to get an in idea of how much it is by sight OR If you’re a calorie freak, put it to good use in this case:
Go to http://www.fatsecret.com/Diary.aspx?pa=fjrd&rid=1444779 to calculate your personal calorie intake according to your weight, length etc. Each gram of protein or carbohydrate is equal to 4 calories. Each gram of fat is equal to 9 calories. So, if you have a calorie intake of 2000 per day, 10% carbohydrate would be 200 calories; 20% protein would be 400 calories; 70% fat would be 1400 calories.
Are you afraid that you might not loose weight on so much fat?
Although eating way too much fat can stall your weight loss because the body can utilize the dietary fat for its glucose needs instead of your body’s fat stores, you can put your heart to rest. This is only a biological fact but not applicable to the LCHF way of eating. I can assure you there is no way of eating so much fat that it stalls your weight loss – see what Barry Groves has to say:
“Experiments show that our bodies are very sensitive to fat in the sense that, as soon as they have had enough, they switch off the appetite for it. Try to eat more fat and you will feel sick. And when the appetite for fat is switched off, it switches off the appetite for other things as well. In this way, eating fat controls the total amount of food eaten and, thus, it limits total calories eaten. On a high-fat diet, you cannot eat so much that you put weight on.” [Barry Groves – Eat Fat, Get Thin.]
2. The human body requires no carbohydrate at all. Your body can manufacture all the carbohydrate it needs from protein and fat!
A scientific fact that was extremely well researched about LCHF that was a real eye opener for me was a statement in the book Life Without Bread by Drs. Allan and Lutz that
“To our knowledge, there has never been an essential carbohydrate discovered. Every carbohydrate your body needs can be made from either protein or fat.”
3. There are more vitamins and minerals in animal foods than in fruits and vegetables!
“The truth is, vitamins and minerals are abundantly available in animal foods, and generally animal foods supply more of them per individual serving than does any single serving of a fruit, vegetable or grain.”
4. Eating too much protein can stall your weight loss because surplus protein can metabolise as glucose in the body and therefore “artificially” up your “carbs”. You might be convinced that you eat only 10% carbs, but if you eat too much protein you will in fact be eating much more “carbs.” Best is to keep to the ratios given above under pt. 1. Whatever you do, don’t eat less fat than 70%.
Having said that, of course we – emotionally - need the crisp freshness of salads and vegetables for pleasurable eating and balance as well as for fibre [and for feeling virtuous of course .] Fibre is good but fibre is not the all and everything of a properly functioning digestive system. Once your body has adjusted and accepted the fact that its source of energy has become your body fat, fat in your diet causes the food that you eat to pass quite naturally and smoothly right through your digestive system, even without any fibre. But keep in mind, if you are doing only 20 g carbohydrate per day as in Induction, there won’t be much bulk to assist with pushing food along, so don’t think you are constipated if you don’t have a bowel movement every day. Every 2nd or 3rd day will be quite normal.
I started the LCHF way of eating with the Atkins Induction Diet. I lost 17,6 pounds in two weeks, which was a wonderful motivation to carry on but apparently this drastic measure is not supported by all of those who are really knowledgeable about LCHF. In fact, I am still on the Induction. So you have to decide. I would say that if you are healthy and youngish your body could probably handle the more drastic switch-over from carbohydrate-driven energy to fat-driven energy inherent in the Atkins Induction diet better than someone who is older and – most probably – unhealthy with the usual chronic high blood pressure, type 2 diabetes, abnormal cholesterol levels, insulin resistance etc. that plague obese people. [I, personally take one asperin per day to keep my blood nice and thin and flowing.] Drs Allan and Lutz warn that there is a risk of blood clots forming for some people when the switch-over is too drastic. So be careful and… consult your doctor – if he is open-minded, otherwise find a doctor who is - but whatever you do, don’t stop this way of eating for any reason if you care about gaining optimum health and energy and lose lots of weight.
For those who feel that they want to start off with the Induction, I include the eating plan, although it is best to get the book of Dr Atkins – The Diet Revolution. If you do decide to do the Induction, carbohydrate intake is 20g or less per day but needs not to be counted because it is already done. Simply eat the quantities you re allowed. Every rule has to be adhered to very strictly."
Hope this helps a bit.
"It's important to eat at least three meals a day and never go more than six hours during the day without eating. Meals should consist of five to seven ounces of protein, from sources such as poultry, pork, red meat, fish, eggs or cheese. Eat no more than 20 net carbs a day, with at least 15 of these net carbs coming from nutrient rich vegetables."
If I were to eat 7 ounces of protein 3 times a day that would be well over...well, well, over an approximate 20% of calories coming from protein you mention, I think. Of course cuts of protein have fat on them already. I'm still utterly confused...to get the fat load and not over do the protein ...what exaclty do I eat? hard cheeses? What do I eat when I'm really really hungry. I loaned the Atkins book to a friend, but do need it back. Just ate one of his Carmel Nut Chocolate Bars and then reading it realized it has the 20 g carbs in the bar, so I'm over my day's total because I had some carbs this morning...
Could you provide me with a simple view of the day plus snacks that add fat but not carbs?
I've been eatting 2-3 eggs in the morning..around 5 am...a hunk of brie at 8 or 9, lunch at 11:30 consisting of a chicken breast and mayonaise, a hunk of brie in the afternoon, and some cold salmon with a tablespoon of coconut oil in the evening with possibly some raw green beens to munch on......
I'm a 61 year old female and exept for hypothyroidism in pretty good shape,...do yoga once a week and do some light resistance training 2-3 times a week for 20 minutes. I'd like to loose about 10 pounds and get back to my college days weight...but the chief aid of the LCHF diet is freeing me from my sugar addiction....It all makes sense, but I've gone astray just in the week I've been trying it. Now I'm really off....I get your message about fat being the most importnat but fat is difficult to separate from protein (or sugar) unless you're just eating pads of butter alone. Atkins prefers no snacking during the induction phase-which is really difficult for me given how early I get up and how long my day is. Two messages..no snacking, but never be hungry. Don't eat too much protein but eat 5-7 ounces of protein 3 times a day. Those are the double messages which still confuse me.
I feel really close to getting it conceptually. Any last gems to get me on track would be really appreciated. Thanks.
jab
To get more fat… I presently drink one cup of coffee when I get up in the morning with a large spoon of cream in it. This dampens my appetite until I eat breakfast. Then I have 3 fresh eggs, scrambled with two – 3 tablespoons of butter. In between I eat cheese with thick butter spread onto it. Lunchtime I have two sausages [bangers] and once again, I take every bite of the sausage with thick slivers of butter on it [I LOVE butter] and just a few slices of cucumber. Sometimes I eat the protein without any salad at all. Just the meat. I drink Slimsy squash – a Weight Watchers make – in between and if I get hungry, another cup of coffee with a large tablespoon of cream in it. I have my dinner early – round about 5 0 clock in the afternoon. That would be some very fat meat like brisket, slow cooked until very tender or chicken with fat on or fat ground beef etc. Sometimes, not even every night, I eat some Induction vegetables with lots of butter on it. If the meat is not fatty enough, I eat it with butter. So basically most of my fat needs is made up of butter that I eat with my meals. Here is a recipe that I got from this forum a day or two ago that I pass on to you.
“I found that if I need extra fat at the end of the day I can get an easy fix with the following recipe:
8 tblsp coconut oil, 3 tblsp butter, 4-6 tblsp raw cacao powder, stevia to taste, warm fats whisk in other ingredients let it set in the refrigerator. Almost chocolate!”
Here is the Atkins Induction that I copy/paste for you. But you can make it easier for yourself by just forgetting all about any carbohydrates and not to worry about too much protein or too much fat. Don’t even try to calculate it. The important thing is to eat as much fat/butter/cream/eggs/cheese etc as you can. You will get nauseous if you eat too much fat. In the absence of carbohydrate you would need enormous amounts of protein for the body to start metabolising your protein as glucose. So don’t worry about it. Simply cut out carbohydrates as much as you can.
[You have so little fat to lose, you can loos it in one or two weeks with Atkins Induction! Lucky you.]
ATKINS INDUCTION [First level]
The Rules of Induction
This phase of the Atkins Induction must be followed precisely to achieve success. If you do it at all incorrectly you may prevent weight loss and end up saying, "Here is another weight-loss plan that didn't work."
Eat either three regular-size meals a day or four or five smaller meals. Do not skip meals or go more than six waking hours without eating.
1. Eat liberally of combinations of fat and protein in the form of poultry, fish, shellfish, eggs and red meat, as well as pure, natural fat in the form of butter, mayonnaise, olive oil, safflower, sunflower and other vegetable oils (preferably expeller-pressed or cold-pressed).
2. Eat no more than 20 grams a day of carbohydrate, at least 12 – 15 grams of which must come in the form of salad greens and other vegetables. (see Acceptable Foods).
3. Eat absolutely no fruit, bread, pasta, grains, starchy vegetables or dairy products other than cheese, cream or butter. Do not eat nuts or seeds in the first two weeks. Foods that combine protein and carbohydrates, such as chickpeas, kidney beans and other legumes, are not permitted at this time. If you feel you must eat bread or some other grain product, only high fiber low-carb products with 3 net carbs or less per serving are allowed, and you can eat only one serving a day. Be aware that even that amount may slow or stall your progress, and if that happens, drop the product immediately.
4. Eat nothing that isn't on the Acceptable Foods list. And that means absolutely nothing. Your "just this one taste won't hurt" rationalization is the kiss of failure during this phase of Atkins.
5. Adjust the quantity you eat to suit your appetite, especially as it decreases. When you're hungry, eat the amount that makes you feel satisfied, but not stuffed. When you're not hungry, eat a small controlled carbohydrate snack to accompany your nutritional supplements.
6. Don't assume any food is low in carbohydrate—instead, read labels. Check the carb count (it's on every package) or use a carbohydrate gram counter. Be aware that the law allows manufacturers to round off if a product has fewer than 0.5 grams of any carbohydrate, so that will show up as zero. The only way to detect some fractional carbs is to look for them in the ingredients list, where they must be listed if they’re added to a product, regardless of the amount.
7. Eat out as often as you wish but be on guard for hidden carbs in gravies, sauces and dressings. Gravy is often made with flour or cornstarch, and sugar is sometimes an ingredient in salad dressing.
8. Use sucralose or saccharin as a sweetener. Be sure to count each packet of any of these as 1 gram of carbs, because of the fillers and bulking agents which are added.
9. Avoid too much coffee, tea and soft drinks that contain caffeine. Excessive caffeine has been shown to cause low blood sugar, which can make you crave sugar.
10. Drink at least eight 8-ounce glasses of water each day in addition to anything else you may drink, to hydrate your body, avoid constipation and flush out the by-products of burning fat.
11. If you are constipated, mix a tablespoon or more of psyllium husks in a cup or more of water and drink daily. Or mix ground flaxseed into a shake or sprinkle wheat bran on a salad or vegetables.
12. At a minimum, take a good daily multivitamin with minerals, including potassium, magnesium and calcium, but without iron.
Atkins Induction Acceptable Food List
Protein [unlimited]
Limit organ meats, oysters and mussels to four ounces per day. No processed meats.
fish,
fowl,
shellfish,
meat, and
eggs
Cheese – [4 x 1x1” cubes per day]
Cheddar
cream cheese
Gouda
mozzarella
Roquefort, and
other blue
Swiss cheese
Dairy: [2 – 3 tablespoons per day]
Sour Cream
Heavy or Light cream
Light meal: Salad Vegetables [2 cups or 1 cup + 1¾ cup cooked veg.]
If you eat mushrooms at breakfast, deduct from light meal vegetables.
Radish,
mushrooms,
parsley,
peppers,
celery,
fennel,
radishes,
chives,
lettuce,
cucumber,
spinach
Main meal: Vegetables [1 cup cooked]
OR you can eat 1 cup of salad greens [light meal] and 1¾ cup cooked vegs [main meal] If you use onion, tomato, eggplant at breakfast, deduct from main meal vegetables.
Artichoke,
celery root,
pumpkin,
artichoke hearts,
rhubarb,
asparagus,
bean sprouts,
beet greens,
broccoli,
Brussels sprouts,
cabbage (red, green, Savoy),
cauliflower,
eggplant,
leeks,
onion
spinach,
string or wax beans,
gem squash
tomato,
turnips,
zucchini
olives [10 – 20 olives]
Avocado [1/2 small]
Snacks:
Be aware that these foods occasionally slow down weight loss in some people, and may need to be avoided in the first two weeks. If you seem to be losing slowly, moderate your intake of these foods.
Coffee with cream [2-3 tablesp p.d. allowed]
Biltong [fat]
Cubes/slices of deli ham with fat
Cheese cubes [no more than 4x3cm cubes p.d.]
Cream cheese [2-3 heaped tbsp p.d.]
Boiled eggs with regular mayonnaise or butter
Breakfast muffins [eggs, cheese, cooked broccoli, cream]
Pepperoni sausage
Sugar-free diet jelly with cream
Herbs and Spices
Use all herbs and spices to taste, but make sure that spice blends contain no added sugar.
Salad Dressings: [2 – 3 tablespoons per day]
Oil and vinegar (but not balsamic vinegar, which contains sugar) or
lemon juice and herbs and spices.
Prepared salad dressings without added sugar and no more than two carbs per
tablespoon serving are also fine.
Mayonnaise 2 – 3 tablespoons [Nola Regular]
Fats and Oils [unlimited]
Don’t restrict fat: Remember that trying to do low-fat will interfere with fat burning and derail your weight loss.
NO Trans-fats, hydrogenated fats or margarine. Do not cook polyunsaturated oils at high temperatures or allow to brown or smoke.
Butter
Lard
Chicken fat
Olive Oil [cold-pressed]
Canola oil
Artificial Sweeteners: [not more than 3 per day]
Sucralose is best; it’s made from natural sugar. Natural sweeteners ending in the suffix "-ose," such as maltose, fructose, etc., should be avoided.
Sucralose [Splenda]
Saccharin
Cyclamate
Acesulfame-K
Maltitol
Beverages: [Be sure to drink a minimum of eight eight-ounce glasses of water each day] including:filtered water, mineral water, spring water, and tap water
Clear broth/bouillon (not all brands; read the label or make your own)
Club soda
Decaffeinated coffee or tea*
Diet soda made with sucralose (Splenda™); be sure to count the carbs
Good luck!
But.. if you do get a big part of your carbs a day from junk, then you do eat less vegetables.. who can give you som vitamins and minerals.. that can be good for your healt in the long turn!
If you do have cravings for some sweet to eat ocassionaly, do take an apple or som berries!
You aint gonna die of an appel a week!
Hi there. New to site. Suggestion...??? Candida. Your symptoms certainly suggest that it is an issue. The negative symptoms you have could be related to the dieoff effect that occurs when the candida is killed off due to lack of sugars.
All info is available on the web...key words: Candida Albicanis, Coconut oil diet
God Bless!
Carbohydrate restriction generally causes weight loss. However, this does not prove that carbohydrates cause obesity. There are many other ways lo lose weight than low carb although in my mind low carb is generally very effective.
Many people don´t gain weight on "high carbohydrate diets". There is a lot of individual variation which is why dietary recommendations have to be tailored to the individual needs. We can not allow ourselves to be to dogmatic.
The metabolic syndrome is becoming increasingly common. It is associated with increased risk of type 2- diabetes and cardiovascular disease. Apart from inducing weight loss in individuals with the metabolic syndrome, carbohydrate restriction positively affects many of the metabolic aspects of this disorder.... http://www.docsopinion.com/2012/10/11/ten-benefits-of-a-low-carbohydr...
Therefore, carbohydrate restriction may be an important tool to fight the serious complications of the increasingly common metabolic syndrome, which indeed can be found both among obese and normal weight people.... http://www.docsopinion.com/2012/10/29/metabolic-syndrome-and-health-d...
Do you count/measure your fat / protein / carb intake per day? Are you losing fat with all of the fat that you are eating? I'm still trying to get over my fat fear, even though I've really managed to up it but I think I've been under eating - between 1100 and 1500 cals, 120gr fat, 70-80gr pro. I keep carbs to Atkins levels.
Any comments on how to get past this.
I would love to lose 50 lbs, be healthier and feel better.
This way of life sounds great, I just cannot get thru this part which has become a major struggle for me.
If they are big one remove them.. its often a matter of time becuse they are growing.
If its not stones your doctor mayby can tell wy you get pains?