Paleo Wars at AHS!

The Calorie Strikes Back

The Ancestral Health Symposium 2012 starts in a few days. Everyone who’s anyone in the Paleo world will gather in Boston.

My talk from last year is the most viewed one from AHS 2011. I’ll attempt to bring something interesting again. A new presentation called The Carb Controversy – and how Paleo could save America.

Pictured above is a slide from it. What’s this about “calories striking back” you ask? Well, check out the next slide:

Next slide

TheCalorieStrikesBack-PaleoWars650b

Let me explain this with a short story:

Paleo Wars IV: A New Hope

There is an obesity epidemic spreading everywhere. People are told to count their calories (while eating their fast food) yet they get more obese every year.

Luckily the Paleo movement shows up. All the “founding fathers” – like Loren Cordain, Robb Wolf and Mark Sisson – emphasized avoiding high glycemic load carbs (like sugar & flour) to avoid too much insulin and weight gain.

That’s revolutionary and unconventional advice. Also, it works. I think it’s one of the major reasons why Paleo has rapidly become so popular.

The Calorie Strikes Back

Some influential people in the Paleo blogosphere are now claiming that carbs, macronutrients or insulin have nothing to do with weigh gain. They say it’s really all about calories (again).

I think this is a return to the same old simplistic calories in/out thinking that has failed us during the entire obesity epidemic. Only this time the calories in/out idea is wrapped in something called the “Food Reward” theory.

The Return of Low Carb

In my talk I’ll show how there’s no reason to choose between insulin or food reward to explain obesity. These two theories work beautifully together.

I’ll also show how much insulin has to do with weight control and how the common objections keep missing the point.

Hopefully this way the galaxy can live happily (and thinner) ever after.

What do you say?

Who’s who in the picture above?

PS

If you’re going to be at the AHS my talk is at 4:40 pm Saturday, August 11. Don’t worry, it will feature not only movie posters but some exciting science as well.

Hopefully a high-quality video of the presentation will be posted online later.

Earlier posts on this topic

The #1 Cause of Obesity: Insulin

Beyond gluttony and sloth

The Real Cause of Obesity

Guyenet, Taubes and why low carb works

AHS showdown: Gary Taubes vs Stephan Guyenet

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80 comments

  1. Andy
    Hi, very funny but watch out for Lucasfilm law suits as the likenesses are probably copyrighted, anyway I'll start with the obvious casting for the film.

    Princess Lea is Denise Minger
    Chewbaca is Jimmy Moore
    Diet doctor as Han Solo
    Gary Taubes as Obi Wan Kenobi
    Dr Briffa as Boba Fet
    Rob Wolfe as Luke

  2. Jerry
    Big surprise, Gary Taubes stalker "carbsane" won't be at the AHS after all: http://carbsanity.blogspot.co.at/2012/08/ahs-2012.html

    I should have placed a bet on it. People like that are usually too insecure and scared to face the people they badmouth in real life.

  3. Erika
    I am new to Paleo and starting on the journey. I recently watched last years presentation and was blown away. Such a brilliant presentation. I look forward to this one.
  4. Paul
    This looks good, I've been waiting for the 'Why can't Taubes and Guyenet just be friends' speech for ages.

    Well done on being the marriage counselor for this fight!

  5. Majoren
    Great approach Doc with the Star Wars story as a theme for your ideas how to bring the theories together! Since Sweden have "the lead" as a low carb high fat- eating country, i think its nice that you also take "the lead" with a speak about bringing things together!

    Good luck!

  6. I agree, the two theories can work just fine together.

    The food reward theory doesn't change a thing in my mind about the effectiveness of low-carb/paleo. The effectiveness is strong and that is a scientific fact, but the way I see it the exact mechanism is up for debate. They probably both matter somewhat, in my opinion.

    I'm looking forward to your talk, I liked the first presentation.

    I'm a little late with the news but I just posted about your first talk on my blog this morning: http://www.kriskris.com/dr-andreas-eenfeldt-swedish-food-revolution/

  7. Food reward is such a fascinating subject. I'm looking forward to seeing your talk!
  8. HighlySkeptical
    Yes it will be interesting to see Eenfeldt try to square the circle: how you can be LCHF while still eating cold boiled potatoes without salt, seasoning or fat. I'd like to see the blood glucose measurements that prove bland potatoes don't spike blood sugar.

    And any explanation of how injecting insulin makes you lose weight as Guyenet says will be fascinating. How much insulin should Jimmy Moore be injecting to drop his last 100? Since insulin is now apparently a weight-loss hormone, why don't we all inject the maximum amount every day and get thin?

    It'll be interesting to hear him struggle to explain why sugar is good for you, as Guyenet claims. The Kitavans - all 1,500 of them - are of course the answer for the human race, naturally. Be sure to bring a lot of popcorn.

  9. Jordan M.
    Doc,

    So you are saying the first law of thermodynamics doesn't apply to humans? Well...

    And you realize there is plenty of evidence showing that it's about calories, no matter what the diet composition? Sure low carb followers in studies where they're told to eat ad libitum, they eat less- but look at their caloric intake, it's lower, usually by huge amounts.

    Furthermore, Guyenet said that whole food sources of sugar aren't bad for us, it's the added sugars we should worry about due to hyperpalatatability and energy density.

  10. Jerry
    It's not that the laws of thermodynamics don't apply to humans, of course they do. But they are descriptive. They don't tell you anything. Eating more than you burn is the proximate cause of obesity, not the ultimate cause. WHY did you eat more than you burn, and WHY did you store them as body fat as opposed to burning them off through thermogenesis. And we are talking about 20kcal per day. Can you consciously overeat that much? Is that really overeating? Weight gain leading to obesity is usually very slow, just a couple of pounds a year.

    But I stand by this: Type 1 diabetics cant gain fat, and people with insulin secreting tumors get hungry and get fat. Thats enough for me...

    Also, think about this: Are carbs neccessariy or sufficient to get fat? Is their hyperrewarding food without refined starches or sugar?

  11. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Jordan M.,

    So you are saying the first law of thermodynamics doesn't apply to humans?

    Of course not. Don't be silly.

    Sure low carb followers in studies where they're told to eat ad libitum, they eat less- but look at their caloric intake, it's lower, usually by huge amounts.

    Exactly. So people eating low carb in these studies spontaneously eat fewer calories than they burn (with no need to count them) and lose weight without hunger.

    Isn't that exactly how a smart weight loss diet should work? It's not cheating to lose weight without hunger, is it?

  12. Mike
    This is quite amusing:

    http://high-fat-nutrition.blogspot.co.uk/2012/08/insulin-in-brain-off...

    I think a section of the "paleosphere" may back itself into this particular corner. I doubt many Swedes, or many others around the globe, who've found what works will be taking much interest

    And it's particularly silly that people who know little or nothing about physics -- unlike a certain author who wrote another book on the attempts at cold fusion -- think it an adequate argument for an obviously broken theory to keep citing laws they don't understand. While it may massage a few egos it does nothing to help diabetics or the obese.

  13. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    HighlySceptical,

    I'd like to see the blood glucose measurements that prove bland potatoes don't spike blood sugar.

    A temporary spike of insulin, within the physiologic range, shouldn't be any problem in a metabolically healthy person.

    Since insulin is now apparently a weight-loss hormone, why don't we all inject the maximum amount every day and get thin?

    Since any doctor with experience in patients (read: humans) injecting large doses of insulin knows they don't get thin. They get very obese.

  14. Jordan M.
    Doc,

    Then say it's because they eat less calories, not because it has anything to do with insulin. Unless you really think there isn't any other explainable way such as cholecystokinin or whatnot that is responsible for lowered hunger. Where do you think insulin comes into play? Insulin is a satiety hormone last time I checked.

    "emphasized avoiding high glycemic load carbs (like sugar & flour) to avoid too much insulin and weight gain."

    So is it calories or insulin that causes fat gain again? Last time I checked we ate over 500 grams of carbohydrates per capita in the early 1900's, and correct me if I'm wrong, but we didn't have an obesity epidemic then.

  15. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Jordan M,

    Then say it's because they eat less calories, not because [of X, Y or Z]

    That's an oversimplification I'm afraid. Obesity isn't caused by a positive energy balance any more than constipation is caused by a positive fecal balance.

    Insulin is a satiety hormone last time I checked.

    If so, like someone asked above, why isn't it used as a weight loss drug? Why is massive weight gain a common side effect?

    Last time I checked we ate over 500 grams of carbohydrates per capita in the early 1900's

    Sure, it's possible to handle that. IF you are eating unrefined high-fiber carbs (mostly starch and not sugar) and you're thin, metabolically healthy and physically active. Your insulin will then stay in the normal range (with temporary peaks after meals).

    Switch to refined carbs high in sugar and commute to an office job and now your insulin will shoot through the roof and you could gain a couple of pounds or more every year.

  16. Jordan M.
    "That's an oversimplification I'm afraid. Obesity isn't caused by a positive energy balance any more than constipation is caused by a positive fecal balance."

    Even Taubes said there needs to be a caloric surplus in response to George Bray's review of the insulin hypothesis. He claimed that calories in - calories in was driven by insulin, which of course, makes no sense if insulin is a satiety hormone.

    "If so, like someone asked above, why isn't it used as a weight loss drug? Why is massive weight gain a common side effect?"

    Because there's a difference between endogenous and exogenous insulin.

    "Sure, it's possible to handle that. IF you are eating unrefined high-fiber carbs (mostly starch and not sugar) and you're thin, metabolically healthy and physically active. Your insulin will then stay in the normal range.

    Switch to refined carbs high in sugar and commute to an office job and now your insulin will shoot through the roof and you could gain a couple of pounds or more every year."

    Correlation =/= Causation. We just established the first law of thermodynamics, now you're back to insulin. If you're talking about soda and other non-food crap, they're also hyperpalatable. Does insulin make you thirsty for soda or something?

    Also, if I'm not wrong, potatoes were quite the staple in America, which have one of the highest glycemic indexes of any food. If fiber is so pivotal to making people stay thin, and caloric surpluses are in your mind not a problem (which boggles my mind), why not recommend a high fiber diet?

  17. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    It seems I don't get my point across. Of course a positive energy balance equals weigh gain. That's just the first law. But that says absolutely nothing about what caused the weight gain.

    I know its "mindboggling" at first, I thought so too. But that's just because we've been so brainwashed with the old simplistic calorie thinking.

    Because there's a difference between endogenous and exogenous insulin.

    Well, it's the same molecule. Furthermore if you have an insulin-producing tumor you can get the same effect: massive weight gain. And most obese people have abnormally high insulin - produced by their own bodies. That's hardly a coincidence.

    why not recommend a high fiber diet?

    Besides the obvious gas issue? It's not as effective and a high fiber diet á la what poor people ate in the early 1900's is not very tasty. They ate it because it was all they could afford.

  18. FrankG
    "Obesity isn't caused by a positive energy balance any more than constipation is caused by a positive fecal balance."

    For a person to become obese a positive energy balance must occur, just as for constipation a positive fecal balance BUT in neither case is the positive balance the CAUSE

    There have been overfeeding studies which prove this -- well motivated participants (paid students or prisoners offered early parole, as examples) have overeaten with the clear aim of gaining excess fat mass to the point of obesity. Not only did it prove far more difficult than the simple maths so often quoted would suggest but in many cases it did not work AND within a very short time after the study all the participants readily and spontaneously returned to their pre-study weights.

    These people had the same difficulties gaining weight by forced overeating as so many of us have demonstrated when trying to lose weight by forced under eating.. it is not sustainable and IT DOESN'T WORK.

    You toss off the role of insulin with this one liner "Because there's a difference between endogenous and exogenous insulin." Why don't you explain the difference.. despite decades of research and genetic manipulation to make injected insulin as close to human as possible? I'd especially like to hear how you think this difference makes one an appetite suppressant and the other an appetite stimulant?

  19. Jordan M.
    Doc,

    It seems we come to a point where we aren't going to agree on anything. I'm not against low carb at all, I just think saying "we've been brainwashed with calories in/out" sounds like you're saying it's false, that's all. The rest of the conversation was simply more disagreements. So I'll respectfully stop defending insulin as it is going nowhere fast.

  20. Galina L
    It was a big simplification to say after the statement "The #1 Cause of Obesity: Insulin" that all you have to do is lowering you carbs in order to loose unnecessary fat. Now LC movement pays for that now. How many times I read "Just eat more butter" advice, or bragging about overeating of LC foods.There are more things that cause the release of insulin - just eating anything, eating any very big meal (Dr. Bernstein's Chinese buffet effect), eating too much of protein, some people have problem controlling weight eating too much even full fat milk products. Eating diet low in calories causes less insulin to be released, so in some way calories matter too (it doesn't mean we have to count it). Practicing intermittent fasting helps because less frequent eating causes less frequent insulin spikes. Weight loss is complicated. On the top of everything, it looks like that after initial weight loss on LC diet some people (not me) are able to reintroduce more carbs back into their diet without bringing back hunger, weight gain and energy fluctuations. Richard Nicoley's blog is a good example of such situation http://freetheanimal.com/2012/02/synthesis-low-carb-and-food-rewardpa....

    I commented many times about how I stalled for two years after initial 20 lb loss on a LC diet, and only addressing other factors in my diet besides counting carbs moved me from the weight-loss plateau. I keep my weight-loss by eating less than before using LC diet and IF as tools to do so. LC often is a very important first step, but not all you need to do .

  21. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Jordan M,
    That's fine! And I don't consider "calories in/out" to be false, just an oversimplification that's not very helpful.
  22. FrankG
    "...t's the added sugars we should worry about due to hyperpalatatability and energy density."

    Isn't it strange that "food reward" seems to rely on foods that always contain sugars or refined starches... yet its proponents are so quick to deny the role of insulin?

    In terms of "energy density" fat has more than twice the calories per gram when compared to sugar... so why don't we have young people chugging down bottles of brightly labeled and highly marketed olive oil?

    Surely if the only thing that mattered was excess calories, why dilute your food with carbs?

    And yet it seems the most widely cited culprit when it comes to obesity is soda-pop; which is ALL sugar and NO fat ???

  23. FrankG
    @Galina L: "It was a big simplification to say after the statement "The #1 Cause of Obesity: Insulin" that all you have to do is lowering you carbs in order to lose unnecessary fat."

    Did anybody actually say that or have any been misquoted as saying that? I know there are some on the web who love to put words in others mouths and then try to shoot them down for what they didn't say ;-)

    What I read in GCBC was an alternative theory worthy of further investigation, not a final statement on the one true diet to rule them all :-)

    I do agree with you that: while LCHF may just be the starting point for many, there are some (many, but certainly not all) who benefit from further self-experimentation/discovery.

    In these cases I'd hope that the LCHF experience (plus books like GCBC and people like Doctor Andrea's) has already freed them from the bounds of conventional wisdom, such that they feel able to continue their own quest for health.. I know that has been my own experience.

    I'm far from perfectly healthy (after decades of metabolic damage) but so very much better than I was when I started this journey.. with hopefully a long ways to go yet...

  24. Zepp
    I rather have this "Food reward" renamed.. to sugar adiction!

    Becuse when eating the moste rewarding and tasty real food on a verry good resturant one cant eat any deserts and one is unhugry for a lot of ours!

    Bur its easy to eat and overeating on junkffod with coke!

    Soo in the end.. reward teorie.. boils down to an dopamin reaction.. its addiction almost!

    Insulin is not an bad hormon.. its just doig its jobb.. its hyperisulinemia thats bad.. and anybody do know the causes of that?

    If not.. Doc can explain.. ur juste Google!

    And of course calories do counts.. but our energi intake are regulated by a lot of mechanismes.. so the question is whats make it not functional?

  25. moreporkplease
    @HighlySkeptical:

    Of course i don't know you and I don't want to judge you. So may I ask if you supplement with B12? Because while the online interface is naturally brusque, please forgive me if I observe that you seem really really angry. Are you perhaps vegetarian?

    Otherwise, I agree with your point about insulin. People don't inject it for weight loss because - as every single biochemistry textbook says plainly - it's the fat-storage hormone, even more so than leptin. Those who say otherwise are in denial of established scientific fact.

    As an aside to Andreas about potatoes, you say insulin spikes are fine for "metabolically healthy" people. I think we now know that almost no one in any modern culture over 18 is really metabolically healthy any more. Do you honestly feel comfortable with this advice?

    Further, even if it were so, don't you worry about the long term effects of AGEs - cataracts, etc? Decades of "normal" insulin spikes may be the cause of many problems in the elderly. Wouldn't you want people to have a healthier old age?

    On your point about hunger, Andreas - that's precisely the problem. The "argument" about calories isn't scientific - it's a thin mask for a Calvinist hatred of fat people. Thin people are the naturally virtuous, chosen by God (given good genes). Fat people are damned lazy sinners (given bad genes) who must be punished, punished, punished if thin people want to stay in the Grace of God.

    The thin MUST make the fat SUFFER for their evil, fallen nature lest they share the pains of Hell with them. You will never end the fake debate until you directly address the irrational Calvinism underlying the calorie discussion. I suggest you bring scarlet letter Fs to your talk and pass them out for the fatties to wear. That will please the Paleo/Crossfit crowd.

    Make sure any mothers who can't quite shed the baby weight or women over 40 feel specially humiliated for their disgusting sinful carnal natures that have resulted in the disgusting Mark of Fat (Eve). Only you can uphold the moral order of Nature, Doc!

    @Jordan

    "Because there's a difference between endogenous and exogenous insulin."

    And what is it, pray tell? They are similar enough to successfully function in the body and keep diabetics alive, but are suddenly somehow also simultaneously different in what way so as to cause obesity? Please do explain in detail. References to peer-reviewed research and biochem texts will be most appreciated.

    "potatoes were quite the staple in America"

    No, actually, they were not outside of wartime and they are not now: to conclude that something that comprises only about 3% of our calories is a staple surely cannot be correct (see 2012 consumption study below). The secret is that people really don't seem to like them much - throughout history. Really.

    Before the USDA pushed wheat, they pushed potatoes. There used to be ads on TV discussing the wonderful benefits of potatoes! This program is still going on, actually with the United States Potato Board. (http://www.uspotatoes.com/pressRoom/pr.php?id=184 and https://docs.google.com/viewer?a=v&q=cache:uxOKyOXsa1kJ:industry...). The USDA has an official potato marketing plan (http://www.ams.usda.gov/AMSv1.0/FVResearchandPromotionPotatoes).

    Your idea that potatoes were a staple food before the beginning of government programs is false and is exactly what the marketing program was established to lead you to believe. Altho' some potatoes were grown in the Eastern United States since colonial times, they were not a staple crop for most Americans, just as they were not for most Europeans until a couple of hundred years after their introduction there. And then only due to the force of sheer starvation.

    Remember, European people, esp. the English, were at first very suspicious of potatoes, as they were members of the nightshade family. In fact the Swiss botanist Caspar Bauhin warned of their poisonous and unhealthy nature in 1598.

    It took quite a while for Europeans to adopt the potato. They really weren't adopted widely in Europe until a disastrous winter in 1740 that caused a famine, and which only potatoes survived. Germans(!) were especially slow to adopt the potato until the famine of 1817, even tho' Frederick the Great had ordered them to be planted (mostly to feed his armies).

    Even the Irish didn't come to depend upon potatoes until they were forced to by changes to the "conacre" system, imposed upon them by their British landlords. Russians refused to plant potatoes as late as 1843, calling them Devil's Fruit. The czar had to send force to make the serfs plant them.

    So you see potatoes have a long history as an unloved food begrudgingly used only in times of utmost misery and sometimes planted only at the point of an emperor's bayonet! Seriously, I'm not making this up.

    The US government began encouraging potato agriculture in 1866. The varieties we know today like Early Rose and Russet actually didn't even arrive the in the USA until 1876 (Civil War times). Potatoes have been heavily subsidized in various ways at different times since the 1920s, altho' the current program goes back only to the 70s.

    Even today the government frets that Americans don't eat "enough" potatoes! (http://www.redorbit.com/news/health/1112518791/study-finds-surprisingly-low-potato-consumption-in-the-us/). We just don't love them, even as fries - they are only 3.3% of our calories. So now the government is seeking to find ways to make us eat "enough."

    You have to ask yourself why and how "Idaho" somehow became synonymous with "potato." It wasn't due to an inevitable law of physics, you know.

    The mountains of potato oversurplus we suffer from today, just as we suffer from oversurplus of corn, were intentionally created by government policy to buy farm votes and accidentally ended up allowing the creation and endurance of the fast food culture. 1/3 of the potato crop goes to animal feed and processed starches. . . again, think "corn."

  26. Galina L
    Frank, I don't have a hobby of collecting citations who was wrong about something. Probably, Evelyn (Carbsane)'s blog could be more helpful in the regard of finding necessary evidence. However, I remember reading some blog post or article by G.Taubes, where he said that if somebody wanted to loose weight that person should cut as much carbs as necessary(even eliminate blueberries) to reach the minimal possible weight for such person, but such weigh could be still more than desirable because of previous personal history .I hold no grudge against GT for not being a god who is always right. His work pushed me in the right direction. I slightly pocked around internet and found couple citations, not the one I remember. GT always addresses only carbs in one's diet as a insulin-regulating factor(according to what I read).

    http://garytaubes.com/wp-content/uploads/2012/02/WWGF-Readers-Digest-...
    "If you’ve been fat for a long time, getting rid of carbohydrates might not make you lean. But the leanest you can be is on the diet with the fewest carbohydrates."

    http://garytaubes.com/2011/03/dose-of-intervention-land-of-dr-oz/

    "There are a few obvious dietary means to reduce the amount of insulin we secrete and ultimately the level of insulin in our circulation day in and day out. One is to eat fewer carbohydrates; one is to improve the quality of the carbs we do eat, which means eating carbs that are less refined (their glycemic index is low or at least lower) and carbs that come with a lot of fiber attached (green leafy vegetables), and then eating less sugars, by which I mean both sucrose and high fructose corn syrup."

    "I think that if we’re so predisposed to fatten that we’re already obese, we’re probably among those who have to restrict carbs far more severely – have a much greater dose of the intervention – to get even relatively lean, which means relatively healthy. "

    I want to add that I have never ever before got so much health benefits from changing a diet when I went on the LC one. It eliminated at least 95% of all my health concerns I had prior to the diet, and made remaining issues totally manageable. It was nice to loose modest 30+ lb, but the health effect was disproportionally HUGE. My mom totally normalized her blood pressure and managed GERG by not eating grains and sugars. It annoys me that diets get mostly compared as weight-loss tools. LCarbing is much more than a cosmetic remedy.

  27. Galina L
    Frank, it looks like Blogger ate my long response. If I don't see it tomorrow, I will give you another one.
  28. Galina L
    @Frank, in short, Gary Taubes said that in order to loose weight you have to cut as much carbs as necessary, even holy blueberries, and it is all that could be done. I 'll right more details if necessary. I have no grudge against GT for not being God who is always right. He pushed too many people in the wright direction, me included.
  29. FrankG
    @Galina L: "Gary Taubes said that in order to lose weight you have to cut as much carbs as necessary, even holy blueberries, and it is all that could be done."

    I realise there are some (CS springs to mind) who delight in overstating what Gary Taubes has "said" but I'd appreciate a direct quote rather than a personal [mis-]interpretation of what was actually said ;-)

    My reading of GCBC and understanding of the many presentations and articles since was: firstly that we have been seriously misled by the low-fat message of recent decades and that it is more likely carbs than fat which is leading to obesity and potentially the whole gamut of so-called Western diseases.

  30. Alex Fields
    looking forward to see your talk Andreas!

    Just read a good post regarding diet inflammation and low-carb: http://www.naturalnews.com/036701_inflammation_weight_loss_food.html

    Reduced inflammation from low-carb seems to be very important in weight loss...

  31. Galina L
    Unlike Evelyn (Carbsane) I don't have a hobby of collecting citations about who said something wrong about LC issues. I pocked around GT blog a little bit in order to find something suitable . I am sure you read posts there too and probably noticed that Gary has never ever advised anything else for a weight loss other that addressing carbs in a diet. His post about his appearance on a Dr.OZ show http://garytaubes.com/2011/03/dose-of-intervention-land-of-dr-oz/ is a good example.

    "There are a few obvious dietary means to reduce the amount of insulin we secrete and ultimately the level of insulin in our circulation day in and day out. One is to eat fewer carbohydrates; one is to improve the quality of the carbs we do eat, which means eating carbs that are less refined (their glycemic index is low or at least lower) and carbs that come with a lot of fiber attached (green leafy vegetables), and then eating less sugars, by which I mean both sucrose and high fructose corn syrup."
    "And nuts and fruit are fine if your body can tolerate them. If you’re still heavier than you’d like, maybe it can’t. It’s a trade-off. If I eat fruit, other than maybe a handful of blueberries a day, I start to gain weight, so I don’t eat it. If I was fatter than I wanted to be — which I’m not — I’d consider giving up both the blueberries and the almonds I eat and see what happens. If it didn’t make any difference, I’d go back to them. If it did, I could decide how much I missed them and whether the trade-off of weight vs. fruits and nuts was worth it."

    There are not exactly citations I wanted to find, but it is close. In the one I remember and wanted to find he was saying that by cutting carbs in one's diet the person can became as lean as he/she is able to , but not necessary as lean as he/she wants to be due to personal metabolic history .

  32. It boggles the mind that people who wish to discredit the insulin hypothesis come on here and bandy about all the old and tired ideas that have been refuted time and again. I sincerely wish they could offer some new perspective or insight to further our understanding of insulin's role (or lack thereof) in weight gain. Sadly they only offer minor annoyance.
  33. BA
    I think that the reason that ideas like bashing the insulin hypothesis gain traction to some degree is because endocrinology is very complex and nuanced. It's exactly as Dr. Robert Lustig has said, that insulin has both an acute and a chronic effect. Human physiology is not so simple as every hormone having one simple function in all physiological states, and in the physiology of hormones there are a lot of counter-intuitive effects based on physiological state.

    For example when Leptin was discovered, there was a lot of excitement about delivering Leptin directly to obese patients (as the experimental mice were damaged in such a way to not make Leptin at all and became massively obese, analagous to a type 1 diabetic and insulin). Unfortunately, once it came time to look at actual obese patients, it was found that they had high Leptin levels, and from those conditions came the notion of Leptin resistance (analagous to a type 2 diabetic and insulin).

    Another good example in physiology is the properties of ROS compounds. On the one hand, having very high levels of oxidative stress causes cell damage that the body cannot keep up with. However a lot of clinical studies have found counter intuitive results with respect to antioxidant supplementation, because it appears that once ROS compounds drop below a certain level, that may suppress gene expression for various cell repair functions that are triggered by at least a threshhold level of ROS.

    Insulin itself obviously does have a satiety-signalling function in the acute case, but human physiology is incredibly robust such that the satiety-inducing function of acute insulin does not actually in any way contradict the reality that being chronically-hyperinsulinized is the cause of excess fat accumulation.

  34. Absolutely. It is also not well known by people trying to discredit the insulin hypothesis that tissues have drastically different levels of sensitivity to insulin. So you are looking at acute vs chronic exposure to insulin, as well as each different tissue's sensitivity to both states. It's a multidimensional problem to say the least.
  35. Galina L
    I can't believe my eyes , my second post with citations disappeared , I can't bring myself to write it third time. I took the citations to support my point from the GT blog , post about his appearance on the Dr.Oz show. If I don't see that comment as well, I will answer Frank, on another blog he visits regularly.
  36. FrankG
    Thing is Galina, even if you found a quote that directly supports what you claim Gary Taubes says, I'd still want to read it in context and apply my own critical thinking, as a responsible adult, before deciding for myself whether it should be taken at face value.

    If anything, for me at least, the nutrition side of GCBC was less important that his approach to debunking bad science... the way we have been misled by the conventional wisdom and its gatekeepers. I no longer take anything on trust from an expert, simply because he has letters after his name. I want to see the evidence and make up my own mind if their interpretation is convincing to me, or not.

    Yes it is easy to misrepresent (or oversimplify if you prefer) what he says as "all carbs drive up insulin and insulin makes you fat" the implications being that all carbs are bad and insulin is even worse...And there are some who make a great fuss about debunking this nonsense which it clearly is because: insulin is essential for life (see untreated Type 1 Diabetes for example) and as opportunistic omnivores, humans have clearly evolved and adapted to eat pretty much anything and everything that comes from life... including carbohydrates!

    BUT I didn't read GCBC, or Why We Get Fat, or watch any of his lectures, or read any of his articles and come away with the impression that he was ever telling me that all I had to do was cut out all carbs and that was the end of it. As I recall he was quite clear that GCBC was NOT a diet book, and it was only editorial pressure that led him to add dietary advice to Why We Get Fat.

    I read GCBC and decided for myself that perhaps this approach was worth trying, perhaps this was finally a way for me to work WITH my own body instead of constantly fighting against it as I had been for the previous 25 years. The evidence he presented made sense of my own experiences up to that point and still does today.

    Was that the final word for me? Heck no... I keep reading, keep learning, keep self-experimenting, keep asking impertinent questions.

    Those who claim that Gary Taubes tries to offer a simplistic answer are clearly deluded, or (more likely) do so purely for effect, as he has said no such thing... but if he had not opened the door with GCBC etc... I very much doubt that I would be as healthy as I am today (nor you from what I have read, not Richard Nikoley etc... etc...) and I especially doubt that you and I would be having this discussion about how we can be our own best health advocates.... instead we would probably still be mired in the morass of the conventional wisdom and I would likely be facing a shorter and painful life with a chronically progressive Type 2 Diabetes and significant long-term complications.

  37. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Galina L,
    Your two posts above got stuck in the spam filter, sorry about that. I approved them now.
  38. FrankG
    It looks like your posts have finally got through Galina ;-) Maybe they were delayed because of the links?

    I don't see anything to convince me to change my stance.

    Are you perhaps expecting too much from Gary Taubes; by looking to him to provide you with the complete answer? Why does he have to do that? Does our health establishment have any role in this? Is his primary focus on sugars and refined starches hurting more than it is helping people?

    Take the Reader's Digest interview for an example... when asked for the best single approach to weight loss what would you suggest? Low carb? But watch out for too much protein as well? And get your Thyroid checked? Oh and you might try IF and HIIT and cold immersion etc... etc... and I'll bet I missed quite a few there as well ;-)

    And BTW I sincerely hope you are not seriously suggesting that I should waste any more of my time over in the asylum? Evelyn's agenda is quite transparent to me... I am sorry of you cannot yet see it.

  39. Diane
    I am looking forward to your new presentation. You always have such great slides and your presentations never suffer from the boring reading of bullet points of other people's presentations.
  40. Galina L
    Well, I found what I was asked to find. I never said that all valuable destruction of the fat-phobia GT did and the whole content of his books are nullified by few things he didn't put 100% right. It is how the life is, there are always some flaws in everything humans do, and I can't get into a fit because GT is not a superhuman. What he did destroying "eat less, move more" bad science is big enough. I didn't advise you to go to the Carbsane blog and dig it in, I was merely explaining why I don't have all citations at mine fingertips. I normally don't need it. I am busy with finding things which may work for me, and don't worry much about nit-picking or other people making various diet mistakes, I have different hobbies.

    Yes, GCBC is not a diet book, yes, it gives a lot of information, motivation and a food for thoughts. The main thing I see problematic is turning insulin theory into solely low-carb theory. At the beginning it was not important, the priority was ditching carbs and starting eating eggs for breackfast without a fear. Nowadays such detail creates main rift between Paleo and LCarbing, and I want that rift to disappear. Paleo in my mind is a LC diet for metabolically healthy people. Many paleo diet recommendations (like fasting, IF) fit quite nicely into insulin theory of a weight-loss, but many, who understand insulin theory as a LC theory see Paleo as a contradiction to what GT wrote in his books, while it is not, and btw he addresses it in the Dr.Oz blog post.
    To tell you the truth, your perception of what I said in my comments as an attack on GT makes me upset. Please, look again in what I said without any pre-judgement and don't jump on defense just out of loyalty. It would be more constructive to find some middle-ground between paleo and LC.

  41. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Diane,
    Thanks! And I promise there won't be a single bullet point.
  42. Patrik Hägglund
    Don't forget about other health issues, besides obesity. I think one of the strongest long-term driving forces behind the low-carb (LCHF) movement, is its broad health perspective.

    This new segment from 60 minutes, with Robert Lustig (among others), may serve as a good example:

    http://www.cbsnews.com/video/watch/?id=7417238n

    "Is sugar toxic? Sanjay Gupta reports on new research showing that beyond weight gain, sugar can take a serious toll on your health, worsening conditions ranging from heart disease to cancer."

  43. Andy
    These comments are all very interesting but can't we get back to selecting low carb and paleo Heroes to fit well known star wars characters! How about R2B12 and LCHF as the two comedy robots.
  44. FrankG
    Thank you for your reply Galina I do appreciate your comments.

    I was not responding just out of loyalty to Gary Taubes. On the contrary I dislike using such terms as LC or Paleo other than descriptive of how I eat, NOT as descriptive of who I am am or what sect I belong to. If I have to describe how I eat I'd say "LCHF" but I do not consider myself an "LC'er" and I intensely dislike being called such by others who seek to marginalise me.

    There are now several individuals who purposely misrepresent Gary Taubes; so far as I can tell, in an effort to discredit him. I think that this approach is destructive to the future health of many people out there. When I see one blogger constantly posting against him I seriously wonder how she has the time and the money to keep up that level of effort.. who is funding her and what would they have to gain by discrediting the move to avoid processed and packaged foods high in sugars and refined starches?

    Unfortunately I see the same spite, venom and vitriol seeping out onto anyone who seems to support Gary's viewpoint and it is too often from folks like this that labels are attached because they help to define "us" and "them" -- without an "us" and "them" we cannot have division. If we were allowed to focus on what we share, or what we have in common, there would be no "them" at which to aim our spite. You must see how it works?

    So I am fully in support of any move to break down perceived barriers between folks who see themselves (or are accused by others) as representing different ideas.

    I have absolutely no issues with concepts like Paleo.. it makes perfect sense to me that what humans have eaten through most of our evolution (real whole foods) is at the very least, a safe "fall back" position to take when faced with often contradictory nutritional advice from the mainstream.

  45. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Andy,
    How about R2D3?
  46. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Patrik #42,
    It's absolutely great, but it's not new, it was originally aired in April:
    http://www.dietdoctor.com/must-see-toxic-sugar-on-60-minutes
  47. moreporkplease
    I find the widespread anger at Gary Taubes interesting. It's almost all concentrated among 2 groups: the Crossfitting young men who follow Guyenet and who, following his advice, are now adding lots of rice and potatoes back to their diet; and the middle-aged women (post-menopausal or with PCOS) who somehow blame Taubes for not solving all their health issues.

    It's as if both groups have off-loaded their health onto a science journalist. They're angry, angry, angry and for some reason choose to crucify Taubes. It's really irrational.

    Taubes' simple advice works for about 80% of the general population -the mass for whom his publisher aims his works. The remaining 20% have special health issues that they in general seem to complain about on blogs, but never seem willing to address.

    Dudes, if it's not working for you, get your genes and hormones tested. This is your responsibility not Taubes'! :)

    If you're post-menopausal and stop losing, go ketogenic - 85-88% fat. If that doesn't work, stay ketogenic and limit calories to 1600. If that doesn't work, then take hormones because you have a hormone problem, not a weight problem.

    If you're deeply, deeply insulin-resistant, also try ketogenic, and if that doesn't work, check to see if you have fatty liver or pre-diabetes. Then take metformin and start lifting weights.

    If you have PCOS, you're probably on metformin already; if not, check with your doctor.

    If you're diligent about low-carbing but your cholesterol skyrockets and doesn't come down within 6-12 months, get tested for FH or APOE4 and check your particles.

    If you're diligent about low-carbing but your blood pressure explodes, get a hormone test, a mineral balance test and a kidney ultrasound. Talk to your doctor to discover your health issue. Start yoga, meditation, biofeedback. If lowering stress doesn't help, get your genes tested - if you discover a genetic problem, talk to your doctor.

    If you're diligent about low-carbing and can't lose weight or gain muscle, get your hormones checked. You may have a thyroid problem; talk to your doctor about hormones.

    I very rarely see those with problems follow through on resolving these problems. Why is this? Why instead do they haunt the blogs stalking, complaining, and trolling? :) Why do people project their health problems onto Taubes? He's not Jesus - only you can save yourself. :)

    @Galina

    How much has changed in Paleo! Paleo as currently practiced by the majority of people is not low-carb. The overlap of the Crossfit community to the Paleo community is very large now. They are not low-carbing. As can be seen on Paleohacks, a good website to judge current Paleo practice, the majority appear to be eating more than 200 total carbs a day (moderate carbs), and many of the younger weight-lifting males are pushing that to 250.

    Further, the Paleo majority mocks you. Sorry to be blunt. They have zero interest in being associated with "broken" fat middle-aged women. They are more than happy to "hack" you in a mean-spirit, just as they do Jimmy Moore. Why don't you start Crossfit? ;) If you wish to heal the breach with Paleo, that's great; just know they are defining themselves as everything *not* you. So that will be a very hard, hard road.

    Best wishes, and I hope you resolve your weight issues.

  48. Andy
    I agree R2D3 is much better than R2B12 I would go with that. I hope you get more engagement with the star wars theme at the conference than on this thread, Best of luck I hope it all goes well from an x jaba the hut which is how my daughter described me before I lost 30lb following your LCHF advice.
  49. sten bj
    Hi moreporklease!
    Agree with most of what you say "if it doesnt work". I thought I was ketogenic but I wasn't losing weight any more. This is the way I understand it, please advise where you think I am wrong!
    1/ I started LCHF and the weight started dropping and a load of positive symptoms come along including cleaner skin.
    2/ After 1-3 months no weight loss any more. After 6 months patience many give up if weight loss stops. I couldn't stop as I had very bad effort angina that resolved after 1st month!

    But why the stagnation?
    Is it that after 1-3 months the body "re-learns" the dormant(?) skill of the liver converting proteins to blood glucose? Trying to "get back to historical values" ? This results in higher blood sugar, especially in the mornings, because during nights the slow BG production can exceed consumption. This results in raised insulin, which immediately puts the brakes on fat metabolism. The plateau is reached.
    If this is right, which I believe, the remedies are as you say: go ketogenic. But can be easier said than done! I guess it is the protein that creates the problems.

    Eat normal amounts of protein early in the days so that whatever important needs are filled on a daily basis. That means for breakfast and lunch. But reduce/avoid proteins at evening meal and for any LCHF snacks before bed time. The results should be obvious, no blood sugar increase during the night as little excess protein available. Also when possible add some light exercise or walks in the early evenings to help to burn off any spare blood glucose.
    Will it work? Am I missing something? I have a diabetic-2 friend too that have arrived in a similar dead end as me. If the theory is right I think it would be really good for him too. His HbA1C was higher than before when he checked it recently and after a great start with insulin usage dropping to 50% he is now stagnant or moving backwards!
    All comments/replies welcome!

  50. Galina L
    @moreporkplease,
    Thank you for your good wishes, my weight issues are actually resolved, I don't know why I sounded if it didn't. I continue my LC diet, it could be labeled a LC Paleo if it is necessary to find some label. My main reason to be close to ketosis or in ketosis is it keeps me in the best possible health I can get at 51 years old. I am lucky not to suffer a pre-menopause heat flashes, insomnia and to be still wrinkle-free and sagging skin-free at my age. Probably, my exercise routine and genes are helpful as well. I take a thyroid replacement hormone since 35 years old.

    It doesn't bother me that a young Paleo crowd has some arrogant attitude toward people in my age group. "They have zero interest in being associated with "broken" fat middle-aged women." They should not. It is natural for young people to be arrogant , and most young healthy guys do not need to eat LC diet or be careful about avoiding overeating. It is enough for them to avoid junk foods most of the time . My son eats a grain-free, sugar-free self-cooked food. Actually, 250 grams doesn't sound so bad, it looks like they avoid sugary drinks and grain snacks and don't try to carb-load. Sounds like a progress for me. However, it is not so that I live on the planet where all middle-aged females are segregated, while such guys gloriously and carelessly exist on another planet where they would be young and carefree forever. Probably they feel now like the life BS and injuries would never happen for then, but it is not so. What would exercise freak would do when unavoidable injury happens? Freaking out in the orthopedic doctor waiting room about how not to gain weight while getting through recovery? Paleo guy would know what to do. How many guys would be able to lift heavy objects regularly in a gym when they get small children? What if their job gets too demanding? Surviving stress in ketosis helps managing stress a lot. I impersonally could control my weight with the standard diet advice and a lot of exercise till the age of 45. It kept me too hungry most of the time, I wish I would start LCarbing sooner, but I could manage without. In my mind me and young Paleo guys are still walking the same road, but I am at the more challenging part, and it requires from me more self-limitations. not 200 grams of carbs but less than 50. The difference is in the degree. I am here, but they will hit that part of the road some day in a future.

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