Is overeating carbs worse than overeating on an LCHF diet?

October 12 2013 by in Calorie counting, Success stories

The result of 5,800 calories of junk food daily

The result of 5,800 calories of junk food a day

Sam Feltham carried out an experiment a few months ago that caught a lot of attention. For three weeks he pigged out on low-carb LCHF foods, 5,800 calories a day.

According to simplistic calorie counting, Feltham should have gained 16 lbs (7.3 kg). But in reality, he only gained less than 3 lbs (1.3 kg).

Now Feltham has repeated his experiment with exactly the same amount of calories, but from carbohydrate-rich junk food. On the same amount of calories he gained more than five times as much weight: almost 16 lbs (7.1 kg)!

The difference in waist circumference was even more significant: 5,800 calories of LCHF food for three weeks reduced his waist measurement by 1 1/4 inches (3 cm). The same amount of junk food led to a 3 1/2 inch (9.25 cm) increase in his waist. And you can see the difference visually.

A picture is worth a thousand words

Above are photos from the junk food experiment. Below, the LCHF experiment (with the same amount of calories) as a comparison:

The result of 5,800 calories of LCHF foods daily

The result of 5,800 calories daily on an LCHF diet

Conclusion

A calorie is not a calorie. This has already been proven in study after study, but Feltham provides us with a nice real world illustration.

Here’s his final report: Day 21 Of The 21 Day 5,000 Calorie CARB Challenge

What do you think about the outcome?

What Happens if You Eat 5,800 Calories Daily on an LCHF Diet?

A Calorie Is Not a Calorie

Doctor: “No Fat People in Auschwitz”

Why Calorie Counters are Confused

Is Your Dietitian Educated by The Coca Cola Company?

How to Lose Weight

LCHF for Beginners

104 comments

Top comments

Sam Feltham
October 13 2013 10
Hi All, Thank you so much for your support along with all of the questions, concerns and comments! I will be addressing as many as I can in my post experiment conclusion, but in the mean time I would appreciate it if those that feel it's all just a publicity stunt would be a little more courteous and perhaps be a little more humble in their assumptions about my motivation to do all of this. I only wish to help people and I don't think it's particularly constructive for anyone to go on rants about people's character you only know in the online world, in fact it is destructive to all of our overall aim of helping people be healthy.

Ondrej, briefly in regard to your questions above:

1) Where were the controls and safeguards of this experiment? As I keep on saying, this was not a randomised controlled trial but is a clear demonstration of the different effects of different foods on 1 healthy individual. I would love to have it controlled by a University, however I am a very busy man and would not be able to take off 6 weeks of my life to do this properly as I am the leader of a growing business that helps 1,000s of people live a healthy lifestyle.

2) Where is the independent confirmation that he actually ate what he claims he ate? Again this would require me to take 6 weeks off of a busy schedule and be placed in a metabolic ward, but it would just be a N=1 and we want large RCT's to study, which NuSI are planning. Unfortunately, in the case of my self-experiments you will just have to trust that I am an honest person with the integrity to practice what I preach.

3) Why hasn't he addressed the issue of what his actual weight maintaining caloric-intake would be prior to an overfeed? I don't know why this question has arose and the accusations that I have never addressed it, but I have and did in the LCHF experiment. Normally my maintenance caloric intake is approximately 3,500 k/cals depending on my levels of activity, pretty much what I am currently eating on my fake food rehab diet to try and maintain the weight I put on.

Be well and smash it out :) Sam

Reply: #19

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Reply to comment #13 by Ondrej
FrankG
October 13 2013 7
Yes Ondrej... I can (and have) actually read the blog post for myself. You may note that I ALSO used the word "experiment".

In your tiny little world are we to believe that "experiment" is always synonymous with "SCIENTIFIC experiment"?

You honestly think that Dr Andreas posted this here believing it to have the same scientific rigour as an RCT? Because that is the basis under which you "attacked" him.

I think you are mistakenly judging people by your own intellectual standards. Many of us aspire to thinking for ourselves and I am gratified to see that people like Dr Andreas do not try to spoon feed us every tiny piece of redundant minutia; which it seems necessary to provide you.

Once again the point (ably demonstrated) is that "Calories are NOT all equal". Do you dispute that? Do you have studies showing that protein, carbs and fat are all metabolised in exactly the same way in the body? Because there are plenty showing that they are not.

Of course in an over-simplistic, abstract world you might say that calories ARE all the same to a bomb calorimeter. Are you a bomb calorimeter Ondrej? In which case that might explain a great deal. :-P

Yes it is a unit of measure but we are talking here about the "real world"... where at least I live -- not so sure about you Ondrej. Is a mile walked on foot over level ground, the same as a mile biked uphill; in the real world application?

Get over yourself and deal with the fact that your paradigm has failed and is no longer helpful.

Replies: #17, #22

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All comments

51
Reply to comment #44 by FrankG
Paul
October 14 2013 1
.....with an IQ equalled or lower than temperature inside an igloo.
52
grinch
October 15 2013 1
greensleeves,

Why don't you post the actual refuting statement(s) instead of a citation that I can't access.

Reply: #53
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Reply to comment #52 by grinch
FrankG
October 15 2013
You mean like when you posted this (comment #25) in response to a request for your references?

"Chapter 1, The Fat Loss Bible by Anthony Colpo. He analyzes about two dozen of these studies with full references. You can look them up individually yourself."

Such a waste of everyone's time.

Reply: #54
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Reply to comment #53 by FrankG
grinch
October 15 2013 1
That is totally different. I stated an argument and then cited my source if they want to look into it themselves. All I'm asking for is an argument. You can't say "oh you're wrong because I read this book that says so, oh but I'm not even going to tell you why you're wrong".

Reply: #55
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Reply to comment #54 by grinch
FrankG
October 15 2013
Not at all different.

You are seriously taking the position that you have never read the basic functions of insulin as available in ANY biochemistry textbook and are repeated on this blog (usually for the benefit of folks like you) every couple of weeks? Functions which YOU dispute because Stephan is pissed at being upstaged by a "journalist"?

Reply: #57
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FrankG
October 15 2013
OK grinchy.. you like to throw out challenges right?

Above you made this non-specific statement to justify why you think chronically raised insulin is NOT the reason why people overeat...

"I believe LCHF works because of the effects of increased protein, but also it lowers the variety and overall palatability of the foods enough to prevent overconsumption. I do not think insulin causes people to eat more, if anything it has the opposite effect. I think people eat too much because of the brain's reward center coupled with genetics, the body's homeostatic system (ie. settling point), and the modern western food environment"

So once again I am asking for examples of foods that meet all these criteria but keep insulin out of the mix. No sugar or refined starches allowed. Name me some "highly palatable" or "high reward" (or whatever SG is calling it this week) foods that do NOT quickly and significantly raise insulin levels. Examples of food that are generally overeaten -- not just your own personal likes and dislikes.

Should be easy enough for you if insulin is not a factor at all, or at least not the main one. Even easier if, as you say, insulin suppresses appetite... food that doesn't raise insulin ought to be more appetizing right?

Straightforward challenge with the expectation of a straightforward response.. no prevarication or beating about the bush. Do that and maybe I will have to eat my words.

Reply: #58
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Reply to comment #55 by FrankG
grinch
October 15 2013

Not at all different.You are seriously taking the position that you have never read the basic functions of insulin as available in ANY biochemistry textbook and are repeated on this blog (usually for the benefit of folks like you) every couple of weeks? Functions which YOU dispute because Stephan is pissed at being upstaged by a "journalist"?

I do not see how the basic functions of insulin in any way prove that it causes obesity. What matters is not only what occurs right after carbohydrates are consumed, but what about during the hours of the day that you aren't eating? Fat is being released and oxidized continuously regardless of whether you eat carbohydrates are not.

Consider this. When you eat a LCHF diet, you are storing far more dietary fat in your fat cells than if you eat a high carb diet. That fat is almost all stored after consumption. It doesn't even require insulin, it is stored by ASP. Why is this not the cause of obesity? Again because fat is released and oxidized continuously. As far as the fat stores go, its the net change in energy that determines whether obesity occurs.

Its perfectly reasonable to suggest that the brain's reward system is overloaded by the environment, causing our body's homeostatic system to become less effective at regulating our intake, leading to obesity through excessive calorie consumption.
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Reply to comment #56 by FrankG
grinch
October 15 2013 1

So once again I am asking for examples of foods that meet all these criteria but keep insulin out of the mix. No sugar or refined starches allowed. Name me some "highly palatable" or "high reward" (or whatever SG is calling it this week) foods that do NOT quickly and significantly raise insulin levels. Examples of food that are generally overeaten -- not just your own personal likes and dislikes.Should be easy enough for you if insulin is not a factor at all, or at least not the main one. Even easier if, as you say, insulin suppresses appetite... food that doesn't raise insulin ought to be more appetizing right?Straightforward challenge with the expectation of a straightforward response.. no prevarication or beating about the bush. Do that and maybe I will have to eat my words.

pork rinds, maybe

Anyways I don't see how this is meaningful anyways. In order to eat a diet with a low insulin response, you need to avoid protein foods as well as carb foods. You'd basically be eating all fat, which sounds like a horrible diet. Given my stance that food variety within a meal heavily influences its palatability, I would say it'd be nearly impossible to even consume a highly palatable diet that is low in insulin response.

Here's a question for you. Since refined carbs are often blamed for causing obesity due to their fast absorption and insulin response, why is it that eating refined carbs and fats together does not prevent obesity by slowing down that absorption of nutrients?
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FrankG
October 15 2013
Yeah.. I expected as much.. you've got nothing new to discuss. This is all the same old ground, covered many. many times. So why even bother.
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FrankG
October 15 2013 1
Basically your understanding of the science and your "theory" suck.

I asked for examples of "foods that do NOT quickly and significantly raise insulin levels"

Yes protein raises insulin levels but not quickly and significantly.

You have still to respond to Murrays narrative above about why he thinks (and I agree) that glucose is not the "preferred" fuel. I guess because by ignoring that comment you can feel free in future to use that same line again.

You asked "why is it that eating refined carbs and fats together does not prevent obesity" -- do you think that because fat does not raise insulin it somehow suppresses its release in response to the sugar and refined starches?

By your reasoning insulin suppresses appetite so how is it that every single goddam "highly palatable" foods RAISES insulin levels quickly and significantly... pure coincidence?

Why is it that the the most widely recognised cause of obesity is basically just flavoured sugar water? No fat or protein or anything else to give it "variety".. and yet it seems some teenagers (for example) can drink it by the gallon per day?

Why is it the Professor Lustig has a study where children where "primed" with soda before a buffet-style meal but instead of naturally eating less (because they already had all those calories from the sugar water, plus your supposed insulin appetite suppression... right?), or even just the same, instead they ate MORE than the controls? Same foods, same "variety" and yet something had increased their appetites for it.

The fact that we can all easily list foods which are generally overeaten and contain significant amounts of sugar and/or refined starches (some are ONLY sugar and/or refined starches) but you struggle to even find one that is only fat and/or protein speaks volumes for your ideas and imagination.

Surely you have heard of Occam's razor grinch? Instead you reach for some vague, ill-defined, complex "multi-factorial" solution.

The answer is staring you right in the face.

And by the way... if you quote someone, do them the courtesy of quoting it "as is".. without editing, unless you clearly show what you have edited. Unless that is just another part of your "game".
61
Murray
October 15 2013 1
Grinch's minor slip up referring to a "preferred" fuel (I hold him to a high standard) leads to an interesting inquiry concerning metabolic flexibility. I should add up front that I don't think fats or ketones are preferred fuel in any teleological sense either. Rather, our ancestors spent a couple of million years evolving adaptations to become pursuit hunters. Tim Noakes has a wonderful section in Waterlogged on how exquisitely evolved humans are for endurance running in mid-day conditions. This gave us an advantage over four legged, furry animals, who could not cool by sweating. We are two legged, upright which minimizes surface exposed to noon sun. We are hairless and perspire. Our morphology changed remarkably. Noakes goes through the metabolic adaptations regarding water and salt. So we must have gained significant advantages chasing game. (My dog was headstrong one hot day and would not come, so. Started pursuit hunting him. He would dash ahead contemptuously, but after 20 minutes pursuit in heat, he collapsed and gave in. I could have done him in with a small spear, arrow or rock at that point. I was tempted.)

So why so much selective pressure for pursuit hunting. The food, apparently. So we evidently evolved from primarily carb diet to primarily fat and meat. Evidence suggests early hominids fed off carcasses left by large cats, using stones to crack open bones and skulls for precious marrow and brain. The omega 3 rich brain helped hominid brain development, and stone selection evolved into tool craft. The digestive tract shortened, allowing better running, and weaning off prolonged fermentation of vegetable matter as part of digestion, out-sourcing that work to the ruminants. We lost fructose enzyme.

So we gained a host of adaptations for fat heavy diet, including metabolic. We evolved the large brain in the context of ketones. It was not under selective pressure to withstand heavy loads of sugar and insulin (witness current research on carbs, insulin and cognitive decline with age).

Where did the fat metabolism come from. Back to Nietzsche, genealogy of morality, on how evolution takes old forms and commandeers them to new purpose. Kenyon identifies two modes, grow-reproduce-die and conserve-repair. Sugar and insulin trigger the former, their absence the later. This goes back as far at least as worms. In bears we see hibernation--the ultimate LCHF diet. It seems early hominid evolution commandeered hibernation metabolism to evolve a metabolic state suitable for pursuit hunting of fat and protein animals. The glycogen capacity of the liver was commandeered from fuel reservoir to safety buffer. But, as Lieberman observes, we did not evolve to have perfect health. And we were carbovores not long before. So the fat metabolism is great for endurance, repair and brain, but it is not perfected. Also, we have residual carb metabolism, in a sense giving us the best of both, but vulnerabilities with both.

The story continues with high carb agrarian society with its remarkable benefits in terms of enabling more complex civilization and adaptations to tolerate grains and dairy. Lactose tolerance has been identified as the most highly selected genetic change in the past 10,000 years. I just read a report on research showing Québécois are genetically distinct, having lived as a distinct society for 400 years with large families. Plainly many people tolerate grains, dairy and high-carb well. Québécois cuisine is delightfully enhanced with maple syrup and artisan cheeses. But many in the world do not.

So it is misleading to speak in terms of ideal diet patterns without accounting for strengths and weaknesses. Keto is not starvation. It is highly sustainable and is an advantage for endurance. Sugar seems to give burst advantages, drawing on more primordial metabolic pathways in the cell, but at some cost. It is a performance enhancing drug in a lot of ways. I used to think which you drew on most and trained for depended on the sport, but now I see Kobe Bryant has gone grass-fed beef and butter, and the Lakers generally have gone low-carb. So apparently it can be managed. High performance in the short term, however, does not imply long-term health.

I wonder to what extent the Hatfield and McCoy differences between the low carb and carb worlds reflects different positions on the evolutionary pendulum swing among individuals. I have to say I find I risible to claimLCHF is not highly palatable. Almost every LCHFer I know is a foodie.my daughter is away as a freshman at a US university and is pining for the meals she had at home. So the carb-centred fare (at a US university) is markedly less palatable for her. Cheque a son gout, a québécois might say.

Reply: #62
62
Reply to comment #61 by Murray
FrankG
October 15 2013
I agree Murray and did not intend to imply any preferred fuel. I think that the body just "does what it does", usually very well... at least when fed our natural diet. I also think that much of this occurs relatively simply, at the cellular level; without any overarching "control" by the brain. I sometimes find it helpful to consider the human organism, along the lines of a vast and complex ant colony.

I was using the term "highly palatable" as it applies in the "food reward" hypothesis.. so far as I can tell this is circular and means food which tends to be overeaten*. I agree completely that my LCHF fare is very tasty, varied and nourishing. Sometime I even forget how good it is until I have to travel for my work and eat out at restaurants.

*I realise that proponents of this hypothesis will vehemently deny the circular nature of this definition but when pressed they "uumm" and "aaaah" and seem unable to come up with anything more specific.

and lastly... http://www.youtube.com/watch?v=HPnJM3zWfUo

Reply: #64
63
grinch
October 15 2013 1
FrankG,

So much wrong with your arguments. First off, sugar water does not cause obesity by itself. It causes obesity because it means you are consuming empty calories on top of your meals with no added satiety. This will only cause you to become obese if you are genetically predisposed and homeostatic system cannot adapt. Otherwise your body will adjust by decreasing your appetite for the next meal(s). There are studies demonstrating if you take two meals with equal macro-nutrient composition and make one more palatable than the other, the subject will eat more of the palatable meal.

And correlation does not equal causation as you all would like to remind us. If overconsumed foods are associated with high insulin levels, that does not mean the insulin levels are causing the overconsumption.

Occam's razor. If it applied here, then there wouldn't be billions of high carb eaters on the planet that do not have a weight problem.

Here's a question for you. What causes a metabolic healthy obese person to be obese? Is it insulin or something else?
64
Reply to comment #62 by FrankG
Murray
October 15 2013 1
Frank, I don't think we land that far apart. Maybe via different routes. The data, based on recent epidemics of obesity, etc., analysis of hunter gather diets (showing carbs maxing at 40% of calories) and Norwegian research showing people in a continuous state of inflammation above 40% calories from carbs, that the recent recommendations to increase carbs (over 40%) is the main source of the problem. Taubes shows how it happens metabolically, but that is an existence proof that does not resolve the issue of what is a safe dose of carbs. It seems fructose and wheat have special addictive properties to propel this along, above the apparent safe dose of 40%. Of course there is variability and once one is metabolically broken from excess carbs, LCHF may be the only way to go. Indeed, LCHF may be the better long term health diet, but plainly the jury is still out on that. In the meantime, one has to eat, so I have cast my lot in LCHF because I seem to respond well to it (including 30 pounds weight loss to the same waist size as high school and zero colds or flus since starting LCHF) and the science seems to point more strongly in that direction the more science I review.
65
Paul
October 15 2013
Neuroscience. 2013 Aug 30;253C:110-122. doi: 10.1016/j.neuroscience.2013.08.044.
66
grinch
October 16 2013 1
Here's a question for you all. If you were locked in a concentration camp where you were fed the bare minimum essential fats as well as protein, but the only thing else you could eat is plain baked potatoes but at an unlimited quantity, do you honestly think you wouldn't lose weight because the insulin response is causing you to overeat baked potatoes?

Reply: #71
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FrankG
October 16 2013
Good grief! You really don't have a clue do you.

Reply: #68
68
Reply to comment #67 by FrankG
Paul
October 16 2013 1
I repeat: grinch is mighty confused whether by nature or nurture.

Reply: #69
69
Reply to comment #68 by Paul
Ondrej
October 16 2013
If it looks like rat, walks like a rat and smells like a rat, it's...Paul.

Reply: #70
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Reply to comment #69 by Ondrej
Paul
October 16 2013 1
Absolutely. Spot on !!! - just another one of your indisputable facts Ondrej. You are one of a sharp-minded observer. A truly rare gift to humanity. We all admire you here.
71
Reply to comment #66 by grinch
FrankG
October 16 2013
Disregarding for now the obvious fact that you think it fine to keep on throwing out "questions" without ever bothering to answer the questions asked to you...

But when all else fails you fall back on the same strawmen:

I have literally lost count of the times you have made your comment based on the false premise that you say the Carbohydrate->Insulin Hypothesis states: ANY and ALL carbs will make a person immediately ravenously hungry and unable to stop eating. ANY level of raised insulin will do the same.

How many times have you been reminded that this is just not so? Oh sorry you only ASK the question never answer them.. my mistake :-P

Rephrase your question. Keep it realistic (that one may be hard for you) and make the food as bland as you like BUT you have to be using sugar and/or refined starches. Do you think baked potatoes are sugar or refined starches??

Here's a tip if you want bland.. try the glucose tablets they sell for Diabetic Hypoglycemia emergencies at pharmacies. Who knew that pure glucose tastes like chalk!

I guess Sam Feltham's n=1 was not realistic enough for you.... so you had to up the ante with a concentration camp scenario. VERY real world!

---

BTW nice to see your buddy Ondrej "liking" your comments eh? Must make you feel all warm and fuzzy to be associated with such a sharp mind and all round nice guy. Oh but does he know you subscribe to MAD?!? :-P
72
Paul the rat
October 16 2013 1
Did we circulate this paper? - just in case

(From now on I shall be called Paul the rat - my rats finally get revenge. )

Systematic review with meta-analysis
Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials

Nassib Bezerra Buenoa1 c1, Ingrid Sofia Vieira de Meloa1, Suzana Lima de Oliveiraa1 and Terezinha da Rocha Ataidea1
a1 Laboratório de Nutrição Experimental, Faculdade de Nutrição, Universidade Federal de Alagoas, Campus A. C. Simões, BR 104 Norte, Km 97, 57.072-970 Tabuleiro do Martins, Maceió, AL, Brazil

Abstract
The role of very-low-carbohydrate ketogenic diets (VLCKD) in the long-term management of obesity is not well established. The present meta-analysis aimed to investigate whether individuals assigned to a VLCKD (i.e. a diet with no more than 50 g carbohydrates/d) achieve better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (LFD; i.e. a restricted-energy diet with less than 30 % of energy from fat). Through August 2012, MEDLINE, CENTRAL, ScienceDirect, Scopus, LILACS, SciELO, ClinicalTrials.gov and grey literature databases were searched, using no date or language restrictions, for randomised controlled trials that assigned adults to a VLCKD or a LFD, with 12 months or more of follow-up. The primary outcome was body weight. The secondary outcomes were TAG, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), systolic and diastolic blood pressure, glucose, insulin, HbA1c and C-reactive protein levels. A total of thirteen studies met the inclusion/exclusion criteria. In the overall analysis, five outcomes revealed significant results. Individuals assigned to a VLCKD showed decreased body weight (weighted mean difference − 0·91 (95 % CI − 1·65, − 0·17) kg, 1415 patients), TAG (weighted mean difference − 0·18 (95 % CI − 0·27, − 0·08) mmol/l, 1258 patients) and diastolic blood pressure (weighted mean difference − 1·43 (95 % CI − 2·49, − 0·37) mmHg, 1298 patients) while increased HDL-C (weighted mean difference 0·09 (95 % CI 0·06, 0·12) mmol/l, 1257 patients) and LDL-C (weighted mean difference 0·12 (95 % CI 0·04, 0·2) mmol/l, 1255 patients). Individuals assigned to a VLCKD achieve a greater weight loss than those assigned to a LFD in the long term; hence, a VLCKD may be an alternative tool against obesity.
73
Paul the rat
October 16 2013 1
Here is another one - both of these papers not pertaining to rats, unfortunately - my apologies Ondrej. Will try not to disappoint you next time.

Eur J Clin Nutr. 2013 Aug;67(8):789-96. doi: 10.1038/ejcn.2013.116. Epub 2013 Jun 26.

Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.

Paoli A, Rubini A, Volek JS, Grimaldi KA.
Source
The Physiological Laboratory, Department of Biomedical Sciences, University of Padova, Padova, Italy. antonio.paoli@unipd.it

Abstract
Very-low-carbohydrate diets or ketogenic diets have been in use since the 1920s as a therapy for epilepsy and can, in some cases, completely remove the need for medication. From the 1960s onwards they have become widely known as one of the most common methods for obesity treatment. Recent work over the last decade or so has provided evidence of the therapeutic potential of ketogenic diets in many pathological conditions, such as diabetes, polycystic ovary syndrome, acne, neurological diseases, cancer and the amelioration of respiratory and cardiovascular disease risk factors. The possibility that modifying food intake can be useful for reducing or eliminating pharmaceutical methods of treatment, which are often lifelong with significant side effects, calls for serious investigation. This review revisits the meaning of physiological ketosis in the light of this evidence and considers possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases. The present review also questions whether there are still some preconceived ideas about ketogenic diets, which may be presenting unnecessary barriers to their use as therapeutic tools in the physician's hand.
74
grinch
October 16 2013
Which question do you want an answer to?

Also why wouldn't baked potatoes be a problem, as they do have a high glycemic index?

Reply: #77
75
Paul the rat
October 16 2013
High-Fat and Ketogenic Diets in Amyotrophic Lateral Sclerosis
. Sabrina Paganoni, MD, PhD1,2
. Anne-Marie Wills, MD, MPH1⇑
. 1Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
. 2Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, USA
Anne-Marie Wills, MD, MPH, Massachusetts General Hospital, Wang ACC 835, 15 Parkman St, Boston, MA 02114, USA. Email: awills@partners.org

In summary, there are strong epidemiologic data showing that malnutrition is a common symptom of amyotrophic lateral sclerosis both in humans and in mice and may contribute to disease progression. There is also epidemiologic evidence that increased dietary fat and cholesterol intake might reduce the risk of amyotrophic lateral sclerosis and the rate disease progression. Finally, data from animal studies strongly suggest that increasing dietary intake of fat ameliorates disease progression. However, determining whether amyotrophic lateral sclerosis patients should be treated with a high-fat or ketogenic diet can be based only on randomized double-blind placebo-controlled interventional trials.
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Paul the rat
October 16 2013
Let the data speak. (still no rats, deep apologies Ondrej, by the way when I was feeding my rats today they told me that they do not like you)

J Child Neurol. 2013 Apr;28(4):479-83. doi: 10.1177/0883073813476140. Epub 2013 Feb 20.
Can children with hyperlipidemia receive ketogenic diet for medication-resistant epilepsy?
Liu YM, Lowe H, Zak MM, Kobayashi J, Chan VW, Donner EJ.
Source
Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada. christiana.liu@sickkids.ca

Abstract
The very-high-fat ketogenic diet can worsen lipid levels in children with pre-existing hyperlipidemia by increasing serum lipoproteins and reducing antiatherogenic high-density lipoproteins. A retrospective chart review of 160 children treated with the ketogenic diet from September 2000 to May 2011 was performed. Twelve children with pre-existing hyperlipidemia were identified. Lipid levels including total cholesterol, low-density lipoprotein, triglycerides, high-density lipoprotein, and total cholesterol/high-density lipoprotein were measured pre-diet and at 3, 6, and 12 months of treatment. During treatment, there was a significant reduction in mean total cholesterol, low-density lipoprotein, and total cholesterol/high-density lipoprotein. Total cholesterol and low-density lipoprotein were normalized in 8 and 7 children at 6 months; and 9 and 9 children at 12 months respectively. At 6 and 12 months, tot cholesterol/HDL ratio was normalized in 5 and 7 children respectively. Diet modifications were made to achieve healthy lipid levels. By extrapolating the data, it suggests lipid levels can be controlled in children and adults with ketogenic diet treatment.
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Reply to comment #74 by grinch
FrankG
October 16 2013
This is all just a game to you right? Playing the innocent? ALL the questions I have asked you in recent comments of course. You seem to enjoy having others run around in circles, spoon feeding you. Best stick to WHS and let Stephan tell you what you think.

Quite apart from the absurdity of the scenario you presented, baked potatoes are real whole food.. they are NOT sugar or refined starches. While someone like myself, whose glucose tolerance is now shot, could not tolerate them, that is not to say that they need to be avoided by everyone. Why is that such a tricky concept for you?

They way these facts need to be repeated time and time again for you, leads me to only two possible conclusions: either you truly are this ignorant or incapable of grasping basic principles, or you are a troll who is being consciously obtuse.. perhaps for financial gain. I don't know and I don't care. You are a waste of valuable time in either case.
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grinch
October 16 2013
FrankG, I thought the reason refined starches were bad was because of the glycemic index, no?

Also if I was a diabetic, I would've stayed on a low carb diet. Doesn't mean I think the science behind it is right or that the benefits you receive as a diabetic are the same as someone who is not.

Reply: #95
79
NS
October 18 2013 1
Yes Sam and fellow LCHFrs, keep that bacon coming; it'll do wonders for your health - and sperm count.

http://www.fertstert.org/article/S0015-0282(13)02544-2/fulltext

Reply: #81
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NS
October 18 2013 1
Murray,

As a Nietzsche admirer, you may want to consider one of his more meaningful passages:

"The hermit will doubt whether behind every one of his caves, there is not, must not [always] be, another one, richer, deeper, and more comprehensive in its meaning than the one before it, and behind the second yet still another one, richer, deeper, and more comprehensive in its meaning than the ones before it and which serves as the grounds for all those prior [and which finally] shakes even the idea of grounds."

Religion, i.e. LCHF ideology, and Nietzschean critical intellect are strange bedfellows.

Reply: #86
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Reply to comment #79 by NS
bill
October 18 2013
NS:

Re: your link

It came up with this:

"We're sorry, but the URL you have requested is not valid"
82
Zepp
October 18 2013
"Processed meat intake was associated with lower percent morphologically normal sperm while white meat fish intake was associated with higher percent morphologically normal sperm. Dark meat fish intake was related to higher total sperm count."

http://www.fertstert.org/article/S0015-0282(13)02544-2/fulltext

Processed food is not that good for anything!

I wonder.. why should anyone eat processed food??

Must be a contraceptive goal by doing that!?
83
Z.M.
October 18 2013
Bill, copy the full link then paste in address bar - http://www.fertstert.org/article/S0015-0282(13)02544-2/fulltext

This was a cross-sectional study...one of the weakest designs available i.e. only associations can be tested not cause and effect. It's extremely weak evidence even against processed meat.
84
FrankG
October 18 2013
The bacon I buy is from a local, small, butcher and farm combined. The pigs are pasture-raised and the bacon is made fresh each week, with minimal process as compared to store-bought. They can barely keep enough in stock, to tide them over the busy weekend market days.

As with so many other things there is "bacon" and then there is "bacon". I have no health concerns with the way I am eating... and I seriously doubt that sarcastic comments from an anonymous internet troll are going to convince me otherwise.
85
Zepp
October 18 2013 1
In Sweden with our demands for more LCHF and real food some big stores marketing real bacon.. only three ingrediens.. pork, nitrit salt and ascorbic acid!

Its dry salted and smoked.. its real bacon!
86
Reply to comment #80 by NS
FrankG
October 18 2013 2
"Religion, i.e. LCHF ideology, and Nietzschean critical intellect are strange bedfellows."

Considering that so much of LCHF is based in science and critical thinking, I find it very gratifying when the naysayers reach for this disingenuous characterisation of it as an "ideology". This just convinces me even more that they have no valid response to the scientific basis for LCHF and are left futilely, grasping at rhetorical straws.

Reply: #87
87
Reply to comment #86 by FrankG
Maggan A
October 18 2013
naysayers

there are two kinds of naysayers - those who have not tried it - and those who have tried and failed
88
NS
October 19 2013
Disingenuous? Grasping? That's amusing coming from you, zealot in chief, uberalles. Best of luck in your LCHF cave. You'll need it, especially as you age.

While I disagree with much of Evelyn's comments here, particularly, her predictable distasteful mannerisms/language, you might actually learn something, presuming such willingness exists.....

http://carbsanity.blogspot.kr/2013/10/disgusted-with-diet-doctor.html

Andreas Eenfeldt • 4 days ago
Lastly: Yes, I do have patients. I work at a clinic two days a week treating people with obesity and diabetes, among other problems.

Andreas Eenfeldt • 4 days ago
One more thing: If my writings offend anyone with weight issues I apologize. That is not my intention.

Andreas Eenfeldt • 4 days ago
Hi Evelyn!

Thank you for your kind attention.

Regarding the "no, we did not say LCHF is always best" article I agree completely and I posted on it on my Swedish blog:
http://translate.google.com/tr...

Regarding people with weight issues and metabolic health problems I'm doing the best I can to help.

I think if we all spent less time ranting and more time helping the world would be a better place for it.

Best,
Andreas

carbsane Mod Andreas Eenfeldt • 4 days ago
Hi Andreas, Sometimes ranting is helpful. It got your attention didn't it? So I presume based on that report you will now be posting articles promoting the traditional Mediterranean diet. I hope so!

http://journals.cambridge.org/...

Speaking of helping people, however, how does it help to continually misinform people? I don't think that is helpful.

http://a.disquscdn.com/uploads/mediaembed/images/656/6231/original.jpg

The original Mediterranean Diet may be thought of as having eight components:

1. High ratio of monounsaturated to saturated dietary lipids (mainly olive oil);
2. Moderate ethanol consumption;
3. High consumption of legumes;
4. High consumption of non-refined cereals, including bread;
5. High consumption of fruits;
6. High consumption of vegetables;
7. Low consumption of meat and meat products:
8. Moderate consumption of milk and dairy products.

Fish intake is also a desirable characteristic of the Mediterranean diet, but has depended on the proximity to the sea.

Andreas Eenfeldt carbsane • 4 days ago
Evelyn,
Sure. A traditional Mediterranean diet, like any traditional diet, has many benefits compared to processed Western junk food.

I share the best information I can. Any possible "misinformation" is of course unintentional and solely based on imperfect knowledge on my part.

carbsane Mod Andreas Eenfeldt • 4 days ago
Why do you call LF diets criminal and even perpetuate the nonsense that is Feltham's "low fat" experiment that made him fatter? No intellectual honesty there I'm afraid.

I fail to see where many that promote LF -- like McDougal, Fuhrman and others are promoting refined garbage foods.
.
Cereals and bread are part of the Mediterranean diet that has a proven track record and is far lower in fat than the unproven macro ratio of fat you promote.

Reply: #89
89
Reply to comment #88 by NS
Paul the rat
October 19 2013 1
"...Cereals and bread are part of the Mediterranean diet that has a proven track record and is far lower in fat than the unproven macro ratio of fat you promote...."

Unproven? - it is proven by my personal experience of over 7 years. It saved my father's life and made him robust and healthy out of really sick man. It is proven by the health of over 20 of my close friends who follow very low carb high fat (animal fat) diet for many years. LCHF diet changed our lives for better beyond our wildest expectations. My friends and I do not need studies, analysis, comparisons showing that say '...mediterranean diet lowers the rate of heart diseases by 10%....". I work in scientific field, I know (as many who read this blog I am sure can attest as well) what can be done with statistics, especially when it comes to nutritional research. No amount of statistically valid data published in Nature showing that saturated fat is going to kill me, will make me abandon my LCHF diet - because my long, PERSONAL experience tells me otherwise. By the way I presented my experiences several times on this blog previously. What is it that you vegans do not get it?.
90
FrankG
October 19 2013
"presuming such willingness exists....."

Willingness to learn? Me? Always open to convincing new evidence, especially if it relates to my somehow killing myself with my diet -- despite all my personal evidence to the contrary. A person would need to be pretty brain dead not to have a vested self-interest in their own health don't you think? Should I ignore the evidence from all my health markers that are relied on for every study out there... all on the word of some anonymous twit on the interweb?

Speaking of which: if you have been reading my comments (and although you skulk around anonymously you seem to think you know me) you'd be well aware by now that the last person I would turn to for advice, is that shrieking harpy Carb Insane AKA Evil-Lyn.
91
Z.M.
October 20 2013 1
"Cereals and bread are part of the Mediterranean diet that has a proven track record and is far lower in fat than the unproven macro ratio of fat you promote."

There is no evidence whatsoever that a Mediterranean diet is healthy because of cereals and bread or lower saturated fat consumption.
92
NS
October 20 2013 1
1. I am neither vegan nor vegetarian, but I have personally found extremely high raw vegetable and moderate fruit intake - not entirely dis-similar to low carb advocate Denise Minger's eating

http://rawfoodsos.com/2010/01/20/my-current-diet/

regimen - to be most beneficial in terms of bio-markers and overall feeling of good health. With this way of eating, I have lowered my A1c levels to the high 4 range, blood pressure, weight, uric acid levels, and CRP, last measured at 0.8. I eat limited amounts of animal protein and fats. I do not eat grains. LCHF is one option and perhaps a good one, but it does not come without risks. There are other routes to health and disease reversal.

http://www.youtube.com/watch?v=vG3V22cLUF0

2. The simple fact is that no one knows the long term health effects of LCHF. What is known however is that replacing saturated fat with monounsaturated ones, olive oil, nuts, avocado, etc.. have tremendous efficacy in lowering levels of lipoproteins, which, as Dr. Dayspring has noted, is perhaps the best predictor of CVD within our current technology.

http://www.youtube.com/watch?v=an6L9VY0v8A.

For those interested, Dayspring has counseled Jimmy Moore directly on his LLVC blog to 1. dramatically lower his saturated fat intake 2. consider statin therapy in lieu of JM's astronomical lipoprotein levels.
93
Z.M.
October 20 2013 1
NS: " What is known however is that replacing saturated fat with monounsaturated ones, olive oil, nuts, avocado, etc.. have tremendous efficacy in lowering levels of lipoproteins, which, as Dr. Dayspring has noted, is perhaps the best predictor of CVD within our current technology."

Replacing saturated fat with other fats or reducing saturated fat intake have been tremendously ineffective in lowering CHD, cardiovascular and total mortality. These endpoints matter, changes in surrogate markers such as lipoprotein levels do not.

Dayspring promotes saturated fat restriction despite a total lack of evidence that saturated fat is harmful, overestimates the benefits and underestimates the harms of statins and thinks that ezetimibe is an effective drug even though it has miserably failed in every trial to date. IMO Dayspring is not credible.
94
FrankG
October 20 2013 1
"LCHF is one option and perhaps a good one, but it does not come without risks."

List these risks and cite RCTs to back up your claims. Otherwise these are just empty words.

"2. The simple fact is that no one knows the long term health effects of LCHF."

Or did you just contradict yourself there? What? You mean you don't know if there are any long-term risks of LCHF?

Meantime ALL my health markers are significantly improved since eating LCHF. And by the way, I am in my mid-50s and in better health that I have been since my late 20's. When should I expect all your doom prophesies to kick in exactly?

And then you go on to promote this quack Gabriel Cousens and still have the gall to call me a zealot?!? Z.M. If you thought Dayspring lacks credibility, you might look into this charlatan as well.

Tell you what.. I'll stick with Dr Eenfedlt.. he gives good practical advice, grounded in science.
95
Reply to comment #78 by grinch
PhilT
October 20 2013
"I thought the reason refined starches were bad was because of the glycemic index, no?"

No, it's because they're carbohydrates with no other significant nutrition. The difference between 50 and 75 GI isn't worth getting excited about.

Reply: #96
96
Reply to comment #95 by PhilT
grinch
October 20 2013

"I thought the reason refined starches were bad was because of the glycemic index, no?"No, it's because they're carbohydrates with no other significant nutrition. The difference between 50 and 75 GI isn't worth getting excited about.

So how does that make them fattening? Should mixing these refined starches with healthy fats add nutrition and make them less fattening?
97
FrankG
October 20 2013 1
Recognising that dietary fat does not raise the BG nor stimulate insulin secretion, is not the same as saying it suppresses insulin secretion.

If there is still sufficient sugar and/or refined starch to spike the BG and stimulate insulin, then the additional dietary fat will be even more readily stored.

Remove the dietary sugar and/or refined starches, then the picture is quite different.

How many times a day do you test your BG? How much do you know about what different foods and daily activities do to your BG, how quickly and by inference, your insulin levels?

Reply: #98
98
Reply to comment #97 by FrankG
grinch
October 21 2013
Does eating fat along with refined starches not slow the gastric emptying rate, causing the GI to lower and resultant insulin spike to also be lower? Sounds like you are saying that is not the case. So for the purposes of fat gain and/or insulin response does it matter whether you eat refined or whole unrefined starches?
99
FrankG
October 21 2013 1
How many times a day do you test your BG? How much do you know about what different foods and daily activities do to your BG, how quickly and by inference, your insulin levels?
100
Shawn
November 10 2013
You have a fascinating articles about proper diet. I'd been struggling versus overeating before until I found this article Stay Slim that help me loss weight naturally.
101
Steve Bergman
February 7 2014
Sam Feltham is at it again. This time with a 5000 kcal per day vegan diet. He's on day 18 of 21. And in addition to fat gain that's following the calories in/calories out formula pretty closely, as seen with the junk food diet, he's experiencing cognitive and memory problems. The vegan diet is faring more poorly than the junk food diet.
102
Eric Anderson
March 22 2014
An example from the real world that shold be better known is the sumo wrestler diets in Japan.
The diet of the top level is high carb moderate to low protein and low fat. The result is weight gain and higher body fat. The next (Not top tier) eat a higher carb diet and hve an even higher body fat content.

30 years ago one might have question this ; but the SAD the average american eats is more and mor Sumo like and the results in looks, body fat, and biomarkers support a high carb diet is the root of he problem.

Read Taubes good calories bad calories
Eric
103
Dave
November 20 2014
Feltham didn't gain much weight on the high carb vegan diet either.

I asked Feltham a while back if he kept track of his body fat %, as weight itself isn't a very accurate indicator. No response.
104
Kathy
February 13
I think calories do still matter. You can’t change the basic laws of science and biology just cos you aren’t eating carbs. Eat more energy than you need, you’ll store some and therefore gain weight. Eat less, you’ll lose.

However... the impact of hormones especially insulin and it’s associated fat storage when eating/not eating carbs is very significant, as this study strongly shows (assuming his calories were accurately and scientifically measured independently and not self reported, as we all know you feel fuller with LCHF and can easily overreport what you eat, and exactly the opposite for high carb diets).

It’s been my observation in closely following and moderating several and various keto FB groups over the last 3.5 years that most men usually do not need to think about calories when eating keto. They almost all seem to naturally eat to a deficit and lose weight easily. Women, especially women over approx 30 years old, and especially after being on keto medium/long term, mostly do not naturally eat at deficit, and deficit often becomes quite hard to achieve, and weightloss stalls, and they find they must carefully watch count and restrict calories in order to lose. Even while in ketosis yes, especially as they trend towards goal weight (say with 10kg more to go).

This I think could be due to damage/changes to older women’s metabolism due to frequent previous dieting, or more likely I think is at least partly due to the very different hormones between men and women.

I’d love to see this study repeated with both women and men under very strictly controlled conditions.

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Is overeating carbs worse than overeating on an LCHF diet?

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