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Welcome all seeking refuge from low carb dogma!

Tuesday, November 13, 2012

Nutty Ketosis: Questions for Volek & Phinney ... and company

Jimmy Moore is clearly following the instructions of Volek & Phinney's latest book on The Art and Science of Low Carb Performance.  This follows on TA&SoLC Living.  Peter Attia followed their recommendations as well when he went nutty ketotic.  His is an even more bizarre experiment than Jimmy's, because as I understand from his JumpStartMD talks (search on YouTube) he had lost whatever little bit of extra weight already without dropping carbs severely.  The guy also works out (or did at the time) almost 3 hours a day and bragged that he increased his calories to 4500 and even more per day.  He bragged at one point in that talk about consuming upwards of 400g fat per day!!  How anyone doesn't think that is the very definition of dietary insanity is beyond me.  Still, Attia is fit and extremely active, and by all indications has not seen detrimental lipid profiles resulting from his adopted lifestyle.


Attia had to work with Phinney (and/or Volek?) to implement their concept.  As he tells it, he is/was extremely ketosis resistant, and apparently spectacularly so compared to others this duo have worked with.  Here's a thought Peter Attia M-never practiced medicine post internship-D.  Maybe your body was telling you something?   I've discussed this before, and in addition to the fact that long term ketogenic diets have been very sparsely studied, before anyone even thinks of embarking on this absurdity, they really should consider -- with their plain common sense hat on -- why it might be that their bodies invariably UN-ketoadapt in the face of any sort of diet any human in any culture in just about any climate ever, may have been consuming.    Could it possibly be that ketones are NOT a preferred fuel?

Is this diet even healthy in weight loss?  We have now learned for Jimmy Moore, that on the basis of current lipidology science, the answer is an unequivocal "NO".  Despite all manner of rationalizing, the first comment on Jimmy's lipid panel reveal was most damning from Dr. Dayspring:
Thomas Dayspring  12 days ago


Dr Lipid analysis: Using all the knowledge we possess today, all of the numbers that you are thrilled about have no meaning in the face of a 99th percentile LDL-P. You also should not say an LDL-C of 285 has no meaning. The cholesterol concentrations that often have no meaning are low levels (where an LDL-P is needed to evaluate risk). No one with an LDL-C of 285 with the exception of a Type III dyslipoproteinemia patient have a low apoB or LDL-P. If you have an LDL-C that high, particle testing is not needed. You need to significantly reduce the saturated fat in your diet and see what happens: repeat the NMR in 3 weeks and you will know if your nightmare LDL-P is sat fat related. I'll bet your LDL-P drops. If it does not, you need serious lipid-modulating medication. We have seen this paradoxical horrific rise in LDL-P in some people who are on ketotic diets.
  
Nonetheless, Jimmy is blinkered enough to think such may not be relevant to keto-adapted humans.  Now, there's a chance this is true, but it's not a safe bet in my considered opinion.  Jimmy made a comment about this being a good line of research to determine for sure.  

Which got me thinking.  Dr. Phinney's resume includes operating weight management clinics in an academic setting (to the best of my knowledge) -- not unlike Westman at Duke.  When patients enroll as subjects in studies they do sign various waivers and such, but equally, a study protocol must pass an ethics board.  Here's where I'm going with this.  Let's say Jimmy was a subject in a V&P study -- presuming his 300+ lb dyslipidemia didn't disqualify him.  And let's say he presented at 6 months with this profile, what do you think V&P would do?  

Clinical trials are ended all the time b/c of high occurrences of adverse effects.  And even if the study is not ended, individual subjects are dropped if they have significant adverse responses.  Would Anonymous Patient JM be allowed to continue in such a study?  I would venture to guess that  doing so would border on unethical, and I would hope that Volek and Phinney are not so biased that they would sign off on his continued participation.

Meanwhile, Jimmy has "moved on" to describing his lipid results as stellar in his latest update.
I’ve been observing a lot of things during this entire process, including my phenomenal weight loss success, blood sugar changes, blood ketones in both the morning and at night ..., exercise performance in a fasted and keto-adapted state, stellar lipid panel improvements, how I feel and other such markers of health.
This is what is so utterly disingenuous of Jimmy that it is better described as dishonesty. No doubt as this goes on, he'll discuss in Australia, PaleoFX and on podcasts and whatever, how his lipid panel is fill-in-exaggerated-positive-adjective-here. And as with his proclamations in the past about his and others' "spectacular", "stellar", "outstanding", "yada yada ..." changes in health markers, including lipids, there will be no specifics and 99% of the audience will take it at face value.  It is far more likely, that the low triglycerides and VLDL seen on VLC diets is nothing more than an artifact and meaningless than that his off-the-charts LDL-P count is irrelevant because he's idiotic ketotic.  

What does Dr. Phinney (MD, PhD -- but I'm asking the MD) think of all of this?  Can we get him on the record?  Doubtful.  But if Jimmy Moore was an actual patient/subject in a study, he would be outta there by now.

Speaking of Nutty Ketosis, I can't write a post like this without addressing Neely Quinn of Paleo Plan.  I am happy to see this 100 lb  friend-of-Jimmy has abandoned her own NK experiment that Jimmy enthusiastically linked to in his 6 month update.  What possesses a healthy, fit and every other positive adjective I can conjur up woman to even consider doing this nonsense, I'd rather not speculate.  What is both horrifying and aggravating beyond words is that there is a single person in this community that thinks cheering this woman on is a good idea.   The only thing that went wrong was that this woman should never have gone there at all, and I hope she's learned a valuable lesson.  To those who are encouraging her, including Jimmy, I say shame on you.  

To the paleo/primal community, and even the LC community, is this the road you want to go down?  Why is Jimmy Moore going to be speaking at PaleoFX??
The PaleoFX Ancestral Momentum - Theory to Practice Symposium, like other highly successful symposia including the Ancestral Health Symposium, is produced utilizing a hobbyist volunteer model, combining proven leadership skills from industry leaders with the strengths of various individuals who enthusiastically live their lives based on ancestral principals.
What ancestral principals is Jimmy living?  None.  And don't give me that frisbee golf would make Mark Sisson happy because Jimmy is engaging in "play".  Here's the PaleoFX 2013 bio:
The ever-energetic and enthusiastic man behind the uber-popular “Livin’ La Vida Low-Carb” blog, “The Livin’ La Vida Low-Carb Show” podcast, “Ask The Low-Carb Experts” podcast, “Low-Carb Conversations With Jimmy Moore & Friends” podcast…I think you get the idea! If you’re following a Paleo and/or low-carb lifestyle and are not currently following the work of Jimmy Moore, then you are missing out on one of the best resources for quality information online today. His passion for educating, encouraging and inspiring others in their own journey to better health is an example for all of us.
OK.  Self authored?  Near as I can figure, PaleoFX is all Keith & Michelle Norris these days (having cut ties with former partner Kevin Cottrell).   I don't think they are doing their organization any favors by staying in bed with Jimmy Moore.  Is there a single ... one single ... paleo/primal or even LC doc or practitioner who will come out and endorse Jimmy's experiment as healthy?  It might not do him damage in the long run, mind you, but these folks are rightly unwilling to speak publicly about this, and that should tell you something.  Yet the Norris' inclusion of Jimmy in PaleoFX is an endorsement nonetheless.   Again, for shame.   



78 comments:

Victor Venema said...

Why is Jimmy Moore going to be speaking at PaleoFX??

As the bio already indicates: because he has many readers and listeners and thus helps to get many people attend the meeting.

I must say, I do not like the term preferred fuel.

Carbohydrates are preferred in the sense that they are burned "first", that is, if all types of fuel are present, carbohydrates are used most. However, this does not mean that carbohydrate is the best fuel, something the term preferred suggests. It may be, but also if it wasn't, our body would likely burn it first because it cannot store much of it and conversions are costly.

Evelyn aka CarbSane said...

Oh I understand why ;) ... I just don't understand why (as in he's not paleo).

As to preferred, the claim is made for ketones and fats (over carbs) quite a lot lately. Claims about the efficiency and cleanliness of oxidation are made, but I don't see much evidence they are true.

river rance said...

Evelyn what do you think JM's basis for saying "stellar lipid panel improvements" In his recent post? I don't get it…also why is a thin 100 lb. woman experimenting with ketosis? I concur Evelyn, shame on JM and the others that posted encouragement to continue. Painfully pitiful. Oh, and frisbee golf with JM and FH…I clicked the link…Naughton is wearing a knee brace…you kidding me? Is it that strenuous? LOL

oboereedgal said...

Just out of curiosity, Evelyn, have you read/looked at Volek & Phinney's The Art and Science of Low Carb Performance?

Sanjeev said...

using carbohydrate first has been selected for because there is a specific benefit - in addition to the water produced by oxidation, for carbohydrate (not for fat or protein) there's also the water of hydration.

For any activity lasting more than a short time this can reduce the body's weight,

1. sparing small amounts of energy for locomotion later down the line
2. automatically providing a small "drink of water"

anything speaking to "preferential fuel" beyond this and related concrete mechanical/chemical effects is plain woo.

Evelyn aka CarbSane said...

To be fair to Fat Head, he had knee surgery a little while back, hence the brace. But he had a relatively minor surgery. Interesting that two early 50's guys, Tom & Fred Hahn, both required knee surgery -- Tom from a torn meniscus (maybe he should talk to Jack Kruse!) and Fred had partial knee replacement.

Painfully pitiful. Yep.

George Henderson said...

Did you write the Jimmy Moore wikipedia page, Evelyn?

In the case of rock'n'roll bands, an unstable frontman prone to attention getting stunts is good for attracting an audience, but not always for career longevity.

I think your comments on lipids and retention in trials are spot on.
If only we could separate the effects of ratios and total amounts in this case...

Don't forget that, in addition to the fat Jimmy eats, he also has the fat from his weightloss to metabolize. Which might be enough to prevent rabbit sickness on its own.

Chris said...

why is everyone suddenly into Nutty K? http://robbwolf.com/2012/11/13/flax-episode-158/ At least Robb discourages it in his answer

Unknown said...

From Peter Attia's site:

"During some of these exercises I would vomit. I would pass out after a set. I would drop the weights and collapse. Before I can get to another performance level, I suffer beyond words."

It's impressive given that he is now 39-40 years old, I think he is probably the type of person that just has the ability to push himself far harder than the vast majority of people, but it has little relevance to all but a few.

The "suffer beyond words" part is what I have trouble getting past, when I was obese and sedentary I got great results with VLC but afterwards I wanted to be physically active again and it was really difficult, often I felt I was suffering beyond words. Then I noticed that if I ate some carbs the suffering went away. I am not at a point in my life where suffering beyond words is an attractive option.

The problem with the Guru system is you are taking someone who is very atypical and applying their approach to the broader population, Peter is very atypical, Sisson is atypical. Jimmy is more typical which I think is part of his appeal.

Tony Robbins did great with the fire-walking thing but he is also atypical, if I decided I was going to become a Guru and base my business on convincing people to walk on hot coals I would go bust in the first year, because only 1 in 300,000,000 people can successfully build a business that is based on convincing people to walk on hot coals and making them pay for the privilege.

I don't think that approaches to weight/fitness/quality of life that are based on the experiences of highly atypical people bring much to the table.

bentleyj74 said...

"During some of these exercises I would vomit. I would pass out after a set. I would drop the weights and collapse. Before I can get to another performance level, I suffer beyond words."


Hopefully he's got someone handy to code him. I'm looking for the "sell" here. Wasn't the general point of diet/fitness interest to avoid suffering beyond words if possible?

George Henderson said...

Why don't you ask a football player or an olympic gold medallist? there are goals that demand suffering beyond words, it is legitimate preperation for the success of Peter Attia's tire-tossing attempts.
I didn't suffer beyond words on VVLC, but my comfort is important to me.

Hiit Mama said...

To be honest I was stunned at the DEXA scan results showing increased LBM considering the low protein overfeeding study: (http://jama.jamanetwork.com/article.aspx?articleid=1103993). I was wondering about LBM loss or gain during this high fat low protein zero carb diet considering (as far as I know) some insulin is required for LBM gain/maintenance. I always considered ketogenic diets to be somewhat wasting of LBM. Perhaps it is different in people who have less immediate energy available (less body fat? leaner people are less able to gain or keep LBM during ketogenic diets even with resistance training?)? I am curious about this result.

pbo said...

Why is everyone obsessed with these "hacks". Going into ketosis for the purposes of losing weight is attempting to hack your body into losing weight.

If you want to lose weight, find out how many calories you are currently consuming to maintain your weight, than eat less than that number without going to low. Exercise in conjunction for additional benefit.

Why don't people get this? Does it really have to be more complicated that that without attempting some "hack" or radical diet that could potentially do more harm than good. I really don't get what Jimmy is trying to prove. How to wreck your metabolism, or how to survive on an extreme diet?

Mir Writes said...

I think he's looking for the magic bullet of low-carb that lets him eat all the high fat foods he enjoys without limit. And I don't think that unicorn exists for folks (like me) who like mass quantities of food and tend to get raging high cholesterol when saturated fat intake goes up. I could eat a horse, if a horse tasted good. I have a nearly bottomless pit stomach.

But for me to lose weight, I had to curb the gluttony and eat LESS and move MORE. When I stop moving more and I eat more, I gain. Period. (I've been sedentary for 4 months, and resume exercising in Pilates classes next week. )Because this way of eating--restricting carbs to eat more saturated fat-- makes LDL skyrocket, he's gotta poo-poo the numbers away as inconsequential. He is not gonna go low-fat or increase carbs, so he's stuck in the ideology. His experiments seem to go more into the low-carb extremes, rather than a moderated route.

Is it inconsequential, the lipid test scariness? I guess time may tell. Most docs would say it matters. If it does, then the high fat route when one's body doesn't handle loads of fat well is, ultimately self-destructive.

I still need to figure out my own best way to eat, but I don't count out any possibility of how I should fiddle with my fruits/veggies/fats/protein, other than knowing that high carb/low fat left me grumpy and hungry, and moderate carb/higher-protein was pretty satiating, but more saturated fat made my cholesterol/LDL look a smidge horrifying. I refuse to believe that matters not, though. I may not subscribe to the all-out standard lipid hypothesis, or under 200 cholesterol as the dream zone, but a really high LDL just seems like something needs modifying. Somethings out of whack.

blogblog said...

To the best of my knowledge there are no world class VLC endurance athletes. However there are many vegetarian or vegan elite athletes. There is also at least one frugivore world class ultra endurance runner.

The US Army performed a trial of high fat LC diets during WW2 after being contacted by Vilhaljmur Stefansson. The high fat LC participants showed markedly WORSE endurance compared with regular diets.

blogblog said...

European polar explorers normally had a very high intake of carbohydrates such as sweetened condensed milk and chocolate.

Evelyn aka CarbSane said...

I'm befuddled. The regional stuff doesn't add up to 6.19 lbs, but I now see that's because there's some overlap there.

Supposedly in his arms, that weigh 10 lbs each, he has lost 0.84 lbs fat (about 3-1/3 sticks of butter per arm) and gained 1.025 lbs muscle (go look at what 1 lb flank steak looks like. In two months. DOES.NOT.COMPUTE.

Jimmy's arms represent 8% of his total body weight. So he lost 17% of the total fat losses while gaining 33% of the total lean gains in his arms. Man, those guns must look aMAAAAAYZZZZZing.

gunther gatherer said...

Evelyn, can you please please pretty please post pics of Moore, Naughton and Hahn playing frisbee in their XXXL champion gear?

Not only is it good for a laugh, but one pic will be all readers need to know about the failure that is the Insulin Hypothesis of Obesity.

bentleyj74 said...

Should I ask them when they are 18 or 50?

Unknown said...

This is why I don't buy the "fat adapted" argument, in endurance sports training on VLC is "bonk training" the idea is you will perform poorly and feel like hell during training but when race day approaches you carb up and feel like superman.

Which is fine in theory but as a practical matter most people want to avoid feeling like hell, that's sort of the whole point of living a healthier lifestyle.

Now along come a few gurus who say follow me and you can train on VLC without feeling like hell because you will be a Fat Adapted Fat Burning Beast, sounds like a fairy tale to me.

Evelyn aka CarbSane said...

I'm with you Mir on the LDL stuff. I don't think that the lower-is-always-better approach is well-founded. As I understand it, the normal distribution of LDL puts a goodly chunk of the "normal" population in a "high" group for whom that may have little meaning. We see this with the HbA1c for example, where we certainly have a lower-is-better crowd out there. Within normal ranges we don't see any correlation that holds up likely because all manner of factors can vary this parameter (you have glycators, varying rates of cell turnover, etc.), but it makes a big difference once you go past that threshold to diabetic. See that for FBG's too http://4.bp.blogspot.com/--M10Ibj5awY/TqqcDW4YLFI/AAAAAAAAAz4/Jj4BLcG4eSw/s1600/ScreenHunter_03+Oct.+28+08.06.gif.

So Jimmy's 2005 lipids, I would not be concerned were it me, even if they were a smidgeon higher given whatever his history is.

Y'know, I've posted a lot of information here that could be interpreted by someone with an agenda as "glucose levels are meaningless" ... I sure hope such a person doesn't exist! And yet if one looks at the LDL=meaningless folks, they hang their hats on the fact that X% of victims had normal LDL, well ... roughly 30% of patients with neuropathy did not have any demonstrable glucose intolerance too. Nobody should look at that neuropathy study and conclude that because 30% had neuropathy w/o hyperglycemia that hyperG doesn't play a role in neuropathy or that all of those studies showing extreme hyperG associated with significantly higher risk of neuropathy (almost certainty in some descriptions of the risk) are bogus. It just means there's more to the story. Same for fasting LDL-P. His is the equivalent of a Durian Rider type scoffing off an FBG of 175 as irrelevant for his banana diet.

Evelyn aka CarbSane said...

I don't get it either. It borders on pathological in some if you ask me. Guys like Attia really confuse me. He has a pic on his website where he jokes he looks pregnant, but it was taken after a race it appears, and I know even at 110 lbs all those moons ago, I could see such a picture being snapped of me under those circumstances despite my then washboard stomach. Other than that he had a little layer of pudge. So yeah, lose that weight, which he did by cutting crap out of his diet (under the guise of low carb). But then he decided to experiment on himself. Why?

I see a lot of people signing on to challenges and protocols. N=1 is the cool thing to do ... I guess even if there's no good reason to do so, and every reason not to play with fire in terms of what's working (Neely Quinn -- a little poking on that website and learn she's mid-30's, newly married and perhaps thinking of having children -- now's not the time for a 100 lb woman to experiment).

bentleyj74 said...

PS, I don't know about you but all of the achievers I've known were people who knew how to consistently and sustainably apply reasonable "push" without the backfire burnout in various areas of life.

The "push till you puke or pass out" school of accomplishment looks to me like amateurs trying to operate outside of their skill level without putting in the time and effort to lay the proper foundation.

In any case there isn't much comparison between people who are interested in their health and people who have a career based on performance with a short shelf life.

Evelyn aka CarbSane said...

Isn't that "That Paleo Guy"'s meme -- train VLC, race HC? OK ... if I'm an endurance athlete in competitions where performance truly matters (e.g. my income depends on it) maybe I'm willing to feel like shit 95% of the time. But at some point the recreational athlete needs to look at the trade offs. Some might look at me now and think I know nothing about competition and performance and all that, and I'd tell them to pound sand. I was a competitive athlete most of my young life and I've undertaken various such endeavors during my adult life. Indeed one of the reasons I've toyed with the idea of taking up power lifting is that it is one area that, especially once I pass 50, I know I could kick a little ass doing! Cycling, maybe. Running? My cat is laughing at that one!! So I digress a bit, but I do get the non-professional athlete or newly active person that wants to push themselves and improve performance for personal gratification and accomplishment. However this NK stuff seems way too large a trade off there ... to me anyway ... and I'm still not seeing it as being even relevant for the large majority of activities. Back in 2004, my own weird symptoms (hypoglycemia likely) occurred when VLC and mild exercise in the fasted state (pilates, 12 hrs). I suppose I should have forced the issue to have adapted more? Sigh.

Lesley Scott said...

"The "push till you puke or pass out" school of accomplishment looks to me like amateurs trying to operate outside of their skill level" - agree! it comes off as very juvenile & reminds of stuff I've watched on the Discovery Channel where the males strut around and butt chests as a form of display. But they're birds and the like, so I cut them some slack.

As for the "suffer beyond words" mentality, this goes back to something I've noticed about this whole VLC crowd that, even in the face of solid evidence from dreaded mainstream scientists & doctors that what they're doing is unhealthful-to-dangerous, they still persist. This "suffering for your VLC beliefs" has an element of weird blind-faith religious fanaticism to it. If anything, they probably view themselves as more "christlike" for suffering, both physically and from their critics, who are automatically dubbed "haters".

Even Leptinman and his weird fixation with sitting in ice baths & being cold as something positive strikes me as another form of suffering for your VLC beliefs. I've had legit thyroid issues & have experienced being freezing all the time, even in the middle of sweltering summer temperatures in South Florida and it sucked. An emphasis on why you should be warm, alone, makes me like Matt Stone's approach, even if he does seem to like wander the perimeter of the reservation with some of his more unorthodox stuff.

I want my diet to work for me rather than me having to a) suffer physically & socially; b) puke/pass out; c) be freezing; d) "hack" my lipids straight into some awful elevated risk-category; or e) publicly play frisbee wearing XXXL gear when my "brand" is about being healthy and slim.

Evelyn aka CarbSane said...

Well, Fat Head posted video of the latest frisbee challenge with Jimmy. He's now impressed by how JM can walk between holes (admittedly the distances add up) without getting winded. Back in May or whenever, it was impressive to him that Jimmy could play Frisbee in the heat without passing out. Seriously, I'm happy Jimmy is getting out more, and walking is walking and good for you. But in his case, that activity probably just balances out desk time blogging and such. Performance? LOL.

Unknown said...

"Should I ask them when they are 18 or 50?"

That's it exactly. When I was 18, I had no problem pushing myself until I puked, also no problem with drinking 14 beers in a single night, not about to do either now that I'm older.

river rance said...

Here is Anthony Colpo's post on a Phinney study…worth the read for sure…
http://tinyurl.com/bcr5d8y

Evelyn aka CarbSane said...

Lesley said: It comes off as very juvenile & reminds of stuff I've watched on the Discovery Channel where the males strut around and butt chests as a form of display. But they're birds and the like, so I cut them some slack.

Out-roar-rageously funny!!! Made my day!!!

Evelyn aka CarbSane said...

Oh, and the bentley comment that was in response to was spot on.

Evelyn aka CarbSane said...

@George, I think my reply elsewhere speaks to your comment. Attia is not an elite athlete. He's training to some personal goals. Personally I wonder about his wife & kid(s?) in all of this. It's one thing if he's a professional athlete and training is "work", but he was/is? in investing after leaving medicine -- both time intensive professions -- before getting into this latest kick. So there are 24 hrs in the day and I wonder how that works when 2-3 are spent working out, and how many more recovering?

ProudDaddy said...

I was a bit surprised also, but I believe he only started hitting the weights again BETWEEN the DEXA scans. Bodybuilders call it "muscle memory". When you restart weight training, you can very quickly add muscle gains until you near your previous max. Might want to ask Prof Dr Andro.

michaelbell_a said...

You should check out Tim Olson. He set a record this year in a colorado ultra marathon, and is LC (ketogenic? I don't know). Apparently one big advantage was that he did not have to take in as many calories over the course of the race (when he does indeed take in some carbs). In ultra marathons, a big problem is that people get an upset stomach from the food bouncing around hour after hour, but since he didn't need to eat as much, this problem was reduced. Here's a link to an article about him: http://www.meandmydiabetes.com/2012/08/11/western-states-100-low-carber-wins-ultramarathon-steve-phinney-and-jeff-volek-study/

He writes more about his diet in a comment.

Unknown said...

There is always a guy who enjoys great success doing the opposite of what the other competitors due, I'm sure there is someone out there who eats nothing but beans on toast and performs well in ultra marathons. And there is another guy who eats nothing but organ meats. And then there is the guy who eats nothing but fruit.

If you pick 50 ultra marathoners, let's say that 49 of them eat diets high in carbs and 1 eats a diet that is low in carbs. If you are interested in becoming a successful endurance athlete does it make sense to emulate the 49 or the 1?

The fact that someone in the world is a successful low carb endurance athlete doesn't really prove much except that a person with the right genetics could become a successful low carb endurance athlete.

michaelbell_a said...

Why not this comment in response to blogblog's description of a world class frugivore? Anecodotes only merit a rebuttal if they involve someone using low carb?

Unknown said...

Frugivore is much more likely to enjoy success as an ultra distance runner, though he is likely to need to find some convenient bushes every now and then.

It is an activity in which participants rely on glucose to keep them going, fruit is chock full of glucose, a stick of butter is not.

George Henderson said...

Unknown, I'd like to see you run an ultramarathon with a stomach full of fruit.
Post it on YouTube please.

The key to Olson's success is the low digestive load required, because he is mostly burning his fat reserves.

Having an empty stomach, in this context, more than compensates for not using the "superior" fuel.

I'd say Olson's diet is closer to PHD ratios than VLC. It's about the fat he's burning, not the fat he's eating; he restricts carbs enough to access his stored body fat easily, while also burning glycogen.
He has metabolic flexibility.

Evelyn aka CarbSane said...

Yeah, he deliberately didn't exercise the first 4 months and was "hitting it heavy" (whatever that means) this last two. So that could be part of it (and fluid shifts) ... or he could be repartitioning some fat stores to lean tissues as he levels off.

It is now indisputable that Jimmy Moore has never been "spectacularly skinny". It may well be that it is unreasonable to expect anyone who has ever been significantly obese to return to a "normal weight" (I can relate), but let's be realistic and honest about that when touting LC as the be all and end all and superior to other methods.

Mir hits the nail on the head, he (and many others) are looking for the magic diet that doesn't exist where he can eat large amounts of food and exercise minimally and be a normal weight. For anyone that has been obese, such does not exist. (Focusing on the "naturally thin" who seemingly can do that and not gain is an exercise in futility, no diet transforms one's metabolism like that either.)

Evelyn aka CarbSane said...

Welcome michael! As you say, he's LC but we don't know what he actually eats. But let me get this straight, Olson really pulled away from the field after mile 85. So who is it that benefits from NK? We're talking a small percent of a small percent of the population here to which this applies. So this promoting of NK is quite disturbing to me when we see people with negative impacts to metabolic health.

Unknown said...

George as I mentioned the fruiter would have to find some convenient bushes pretty often because eating that much fruit would result in frequent crapping, the 30BAD guy mentions that, it's no secret.

As far as Mr. Olson, okay he has metabolic flexibility, good for him it gives him an advantage over the other runners who in all probability don't have metabolic flexibility. My experience in endurance sports as a person who lacks that metabolic flexibility is that when you reach the point where you have to access that stored body fat in a big way, continuing becomes an ordeal, and what you want more than anything in the world is some sugar. Sports drink, Snickers bar, ice cream, it doesn't matter so long as it contains sugar.

This is true of most endurance athletes throughout history which is why the concept of "Bonk Training" even exists.

I think the LC people just want too much, I have testified that as an obese sedentary person I got great results with LC, but to the LC advocates that is not enough, they want people to stay LC regardless of what stage of their life they are in, whether they are overweight or lean as a whippet, whether they are sedentary or running 100 miles on a regular basis, it seems like a religion.

Even Dr. Atkins concluded that people who are physically active need more carbs.

Why can't we acknowledge that LC is a very effective diet for many people who need to lose a substantial amount of weight, without requiring that those persons continue eating LC for the rest of their lives? When did LC cease to be a diet and become a lifestyle?

I guess when they started the Low Carb Cruises.


Evelyn aka CarbSane said...

Haven't read that book, have skimmed over the first one, am familiar with a lot of their research.

Sue said...

Oh goodness Jimmy Moore coming to Australia to talk at Low Carb Down Under. What a joke and embarrassing not to mention Low Carb Down Under is about 10 years too late. I have finally let go of my low carb insanity which caused my yo-yo dieting and have lost weight 12kg to date doing lower calorie diet that includes everything I would have ditched with low carb.

Evelyn aka CarbSane said...

Very interesting comment Unknown. Here's what I saw in my two years or so frequenting Jimmy's forum. The "leaders" like Jimmy and Dana are committed low carbers ... I cannot imagine them ever eating any other way despite both having both weight and health challenges as a result over the years. They are committed. Staying LC seems easy for them because they themselves don't think of eating any other way -- and why should they when they have spouses onboard with their way of eating (though following to lesser extents) socialize with other low carbers, and have found LC substitutes for any and all prior dietary vices. Even now Jimmy says he's consuming 2-3 oz chocolate daily which is quite a lot more than those small numbers make it sound.

So at Jimmy's in 2009 when I found it, there were a lot of LC success stories still sporting significant losses "after" shots and tickers and such that slowly (finally) disappeared when they came to grips that they had gone off plan and gained most/all/then-some of the weight back.

So they rededicated. Granted there were people who disappeared for reasons of just being busy, but most of the time one could predict that when someone fell off the face of the forum for a while they had fallen off the wagon. After a cycle or few of this, you get the re-re-dedication. That is when the lifestyle pledge is made. "It's not a diet, it's a WOE or WOL" ... If it doesn't work for weight loss? Well, then, expect a series of "I'm doing this for my health as much as for weight loss anyway".

Many see that dedication to the lifestyle as a way out of yo-yo hell and let's face it, the LC propaganda is relentless on how it is the only way to eat if you've ever spiked your blood glucose over 150. The Wheat Bellys and Carbs Can Kill Sus and whatnot scare the bejeebers out of them, so when weight loss doesn't ensue, they feel at least they are doing the best thing for themselves avoiding the evil carbs. And if they're not losing weight they become convinced it is the only way they can ever lose weight. In a way they adopt one tenet of conventional wisdom, that being that in order to maintain losses, one must change habits permanently. So LC forever it must be.

That's pretty much the trap 80+% fall into. But then you have the never-really-been-overweight LCers, some of whom are in spectacular shape, I imagine get tired of being associated with the less-than-stellar outcomes for long term low carbers. These are the ones pushing the performance angle.

As you say, Atkins never said folks should stay in Induction forever. Two weeks was the prescription. It was only in the New Atkins that we heard some may need to stay under 50g/day -- I know where that came from now! LOL

Then you get the ostracizing for daring to try something different when LC stops working for you. :( sigh :(

Unknown said...

I don't see why people have such a hard time admitting

"I have a problem with food and exercise, if left to my natural inclinations it will become a problem"
"I let it go and I got to the point where I was unhealthy"
"I worked really hard at it and got better"
"I work really hard at it to keep it from happening again"

Really is it so bad to have to put some effort into it rather than relying on a "hack?" Life is not an effortless activity.

Hiit Mama said...

Okay, so wait, he stopped lifting, lost a bunch of weight on the ketogeic plan, took DEXA #1, starting lifting again, had DEXA #2 that showed lean mass increase? So, my questions are:

#1. How do we know what percentage of fat vs. lean weight was lost from the start of the diet and DEXA #1?

#2. How can we know whether this gain in LBM is simply replacing what was lost during the lifting hiatus?

#3. How do we know that this is actually a net gain of LBM? Could be an overall net loss of LBM for all we know, or it really could be a net gain. Can we tell this from the data given?

#4. From what I understand and have seen first hand in my family members, insulin resistance is quite detrimental to LBM. Since Jimmy is capable of gaining mass, even in a low insulin environment, this is perhaps a great indicator that he is not at all metabolically damaged. Rather he is quite metabolically healthy if he can have such gains in just a few weeks. I wonder what would happen if he went on a true traditional bodybuilder style diet and lifting regimen?!

I'm sort of a meathead and have always been interested in what effects lean body mass. I just can't help ponder this DEXA stuff. Scale weight is pretty meaningless to me.

George Henderson said...

Yeah. Atkins, when all is said and done, was a bright spark and had a realistic handle on how this works, especially in his early books when the message was simple.
The very first Diet Revolution book (not even the New Diet Revolution) is still a rewarding read.
If full-time ketosis had been the way to go he would have figured that out.
Too bad he'd never heard of safe starches (though the "meat and millet" diet came close).

pbo said...

It's like this awkward blend of orthorexia and ADD. Every week/few days you start some new radical diet to experiment with.

You try out on the banana diet for a month but 2 weeks in you realize the potato diet is where it's at. Who knew a "safe starch" could have such high quality protein!

Unfortunately, a few days later you feel guilty about the carbs, so you walk back to low carb camp with your tail between your legs, and realize the problem was that you did not eat enough fat and was never in deep ketosis, or better, you had not been fat adapted your last round of living the VLC, so this time you swear to lower your protein intake, no gluconeogenesis for me, and to make it more special, you spruce it up with nutritional ketosis!

Just as you are about to finish your 600th gram of fat for the day, you start hearing the sweet nothings of the peat whisperer, and you think maybe sugar is not so bad, and that glucose is the preferred fuel.

You then wonder if you can still fit in some intermittent fasting, oh wait, they are now calling it intermittent feasting. That sounds good, maybe I'll try that.

blogblog said...

If you stick to low-FODMAP fruits like bananas and oranges you probably won't need to poo very often. I can eat a kilo of bananas or six oranges a day without any problem. However a couple of apples usually causes major gastric distress.

blogblog said...

I should go to the Brsbane conference on Dec 1st to ask some very embarrasing questions!

I lost 10cm from my waist in a month after going on low fat, high-carb fruit and vegetable based diet with a small amount of meat. Interestingly I only lost 2kg weight overall so it was virtually all abdominal fat.

Leo said...

This "fat burning" concept seems kind of weird to me
The body burns its own body fat stores only as long as there isn't enough calories from external sources.

If you're on high carb and low calorie you burn your body fat
If you're on high fat and normal/high calorie you burn your dietary fat

HC/LC have nothing to do with burning body fat versus burning dietary calories in my opinion. And if the running while LC would be better because you avoid food overload by burning your body fat then running fasted would achieve the same even if you're on an HC diet.

Themovape said...

This "suffering for your VLC beliefs" has a component of strange blind-faith spiritual fanaticism to it. If anything, they probably perspective themselves as more "Christ like" for struggling, both actually and from their experts, who are instantly known as "haters".

http://www.buywartrol.org/how-it-works.html

Jane said...

blogblog
That's very interesting. So changing from a high-meat diet to a high-unrefined-carb diet corrected something that might have been fatty liver? Which has been linked to iron overload as I'm sure you know.

Evelyn aka CarbSane said...

While this time around I don't think Jimmy's being deliberately evasive, I do think not doing the DEXA at the beginning really skews these results/comparisons. He did, deliberately stop lifting, and from what I can gather, lifting was the only pretty regular thing he did over the prior year with perhaps some yoga mixed in. So he stopped it for 4 months and now we get the comparison for 2 months -- about 1/3rd of which he was gaining weight during.

Who knows, maybe he hit on something all these body builders never did, lift fasted and eat a crapload afterwards. He also says he does eat a bit more protein on lifting days. But I just tend to think what's being looked at is a bit misleading under the circumstances -- both to Jimmy and his audience.

He's done yeoman's work in shifting the goalposts this past year vis a vis his weight, etc. The reality of the matter is that although he believed a body composition analysis that said he was 11% body fat at 230 lbs several years back, even if he keeps his current lean mass and loses 20 lbs entirely off the fat, he'll be at 29.6% fat, which still has him obese. So he can't ignore the BMI that can be faulty, but isn't in his case.

I never believed that 11%, but maybe it was 22% fat, we're still at a higher percent fat after this cycle.

More concerning is that he is carrying a ton of fat in and around his abdomen and very little in his extremities. One comment was how his visceral fat was melting and about the lean mass ... I wonder what lifting and strengthening he's doing in his torso!

If he gets to 230, that DEXA will be interesting, and I wonder if anyone will note that he's still obese.

Jimmy likes to point out his height, but build is important too. He's built more like a basketball player than a lineman (as I see some trying to compare him to), and he's showing that 230 will not be a healthy weight for him.

Princess Dieter said...

One phenomenon I noted as I read the low carb forums (back when I started weight loss blogging in 2007) and then VLC blogging dieting pals (around 2010) is the gradual quest of reducing carbs into induction levels when regain or stalls happened. Saw the confused and upset post at fora. It happened so often, I wondered if this was just that they had hit their caloric equilibrium, and it didn't matter how low carb they went, if they wanted to lose more, they had better cut calories. I saw some resigned to alternating weeks of regular Lc with weeks of 500 and 800 calories to "cycle" off or keep off the weight. Cycling. Yeah. Lower carbs, no carbs, fast days. It becomes this scary thing. And part of it may be formerly significantly obese folks not accepting that they should not strive for 120 or 130 lbs, and accept a higher weight that is livable without weird-ass diet gimmicks.

On the other hand, with calorie counters--be they low-fat, high-protein, carb reducers--the weight issues always came back to burning off less or eating more. They'd look at how the were eating and go, "Yeah, I've slacked off and had more of this and more of that." It didn't become an obssession to hack the macros, but a realization that, plainly and simply, they had too much fuel going in or not enough being burned to maintain a desired weight or lose weight. No need to look for secret rites of fat exorcism.

Now, that only applies to WEIGHT. No pronouncements on what is the healthiest diet, though I subscribe to the, "If you ain't eating a good amount of produce, you ain't getting enough micronutrients" school of dietetics. I'll happily ponder how much protein and fat and which ones are best or worst, but I think Pollan is right. And so was grandma. Eat the fricken veggies and some fruit.

I shudder when I think of the bloggers who've gone to the "under 20" carb reduction camp of VLC (and these tend to be those with stubborn stalls or regain or other weight loss issues). I simply cannot believe this is even close to being normal diet for a human being. It's just too bizarre.

We do need to figure out how to help folks keep calories down. That to me is where the magic bullet needs to be aimed. How do we short-circuit the hunger? How do we make modest eating habitual and livable? Cause when those hormones of hunger go bersersk, we do, too.

Unknown said...

My name is Robert Patocchi. I am going to turn 57. 14 months ago I weighed 255 pounds. My body fat was over 30%. My triglycerides were over 1500. I wanted to oversize but had no energy. At that time I thought Dr. Atkins a nut. I then listened to an audio book. Good Calories Bad Calories by Gary Taubes. I went on Atkins and into ketosis and lost 25 pounds in two months. I felt more energetic so I began to lift weights and swim. I felt good so I decided to compete. I had not competed for 33 years. When I added anaerobic interval training exercise to my workouts I added more carbs to my workout 60 to 110 grams a day. It was mainly fruit and vegetables. I am thankful to Mark Sission and his book " The Primal Blu Print. " Now I do eat rice and bread sometimes and I drink milk. I also emailed Peter Attia. He is great guy and answered my questions I stared eating only once a day in the evening. I eat a lot of saturated fat. When I went to the doctor my triglycerides were under a 100! My cholesterol improved. My body fat is 13% now. I weigh 200 pounds I did good in my swimming. If you do not believe me look up my name under the result of last years Pacific Masters Swimming. I am a sprinter but I also did good in a open water swim to. I like to read contrary opinions, I feel when I listen to the opposing opinions I often learn something. So I am thankful for this web site.

Lerner said...

Congratulations, Robert. It sounds like you did everything right. You'd make a good case study.

But still, you didn't mention anything about calorie reduction - which is most likely at the heart of the weight loss. Let's say that a person gets acupuncture for some reason and finds a benefit. That doesn't mean that there really are invisible meridians of chi running through the body.

Btw, do you have some genetic predisposition for your trigs to have been so high?

Evelyn aka CarbSane said...

Mir this post is SPOT ON. In 2009 I had plateaued out. I was still doing what I had done all along -- although I was probably eating more cheese and fatty meats than tuna by that time. Still, a girl can only eat so much tuna. The advice I was getting was go back on induction ... heck, I was already a bit burned out eating the way I was and leveling out. Now I can't have my 7g LC pita? That still fit into most days under 20, some well under. So then what is next?

The really nasty thing is that for some, like me, LC really does tank the metabolism. I tracked food for quite a while and I really was maintaining dang dead nuts steady at 14-1600 cal/day at the time. I could get away with a few more than that w/o gaining, but not consistently, which was balanced by the fact that my body went into conserve mode just as quickly if I went down. I lost 10 lbs in the first few weeks of IF and then it stopped. Why? Because those first few weeks I ate under 1000 cal/day and I added the confounder of biking and brisk walking.

Long response short here, it's depressing with LC'ers that even those who maintain their new habits start to regain. The calorie-counters regain when they slack off. This is why I was so bothered by Dana, and especially Laura Dolson and Mary Vernon. Less so by Amy in this regard, because she mostly tries to stay LC and I know how well that works -- NOT! If you can't stay LC it is best not to even try IMO, because you will gain weight even faster.

Speaking of veggies, I'm always amazed how spinach wilts down! Forgot how yummy fresh spinach, steamed with a pat of butter and a pinch of seasoned salt tastes.

Lerner said...

Here he is:
http://www.pacificmasters.org/comp/12/12DamowOneMile.html

Btw, I'd mentioned acupuncture because I've seen people (not Unknown/Robert) saying that Taubes taught them supposedly 'why' LC works for weight loss.

Unknown said...

That's very close to the experience I had, Atkins-to-Taubes-to-Primal.

I stayed on Atkins induction for quite a bit longer because I'm a stubborn person, which is where I went wrong, eating VLC for an extended period while being physically active tends to wear you down.

Currently eating around 200g of carbs a day which seems to be the sweet spot for me, and disregarding any and all diet methods and theories.

Peter Attia said...

Hi Evelyn, I'm honored to be included in this thread, but I think you may be missing a few of the facts, at least in my case.

The reason I had so much difficulty getting into ketosis was because of my caloric requirement. 3-4 hours per day of training created quite a caloric requirement and along with this I was over-consuming protein. The gluconeogensis of which, was probably increasing hepatic glucose output too much to allow de novo synthesis of B-OHB.

More broadly, however, I think you may be missing the point of my self-experiment. I think of nutrition as a way to fix or improve 5 outcomes: physical performance, mental performance, metabolic dysregulation (and the chronic diseases that accompany it), affect/mood/energy levels, and body composition.

One of the mistakes folks make, in my opinion, is fixating too much on the body composition component. It may be entirely unlikely that any one diet allows you maximize all 5 outcomes. So the question is (or should be), what am I optimizing for? In my case, this varies all the time -- hence, the constant self-experimenting. For example, for the past 6 months I’ve been playing a lot with IF (if you’re interested: http://eatingacademy.com/personal/what-i-actually-eat-part-ii-ifik-2).

Another point worth making is that is seems impossible to me that *everyone* will do best (defined however we like) on the same diet. Clearly people respond differently to different types of training, different types of teaching, and different types of interpersonal interaction (for example, some might get really offended at being written about in a manner than was inaccurate or ad hominem in some way). Why would we expect everyone to respond equally favorably to one diet, be it ketosis or otherwise?

I could spend hours justifying my thoughts on this, but I’m not sure that’s helpful. I’d encourage you to accept that, perhaps, the best diet for you (again, I’d encourage you to ask what you’re optimizing for) is something other than what you’ve tried to date. I’m not familiar enough with what you’ve tried, so I won’t posit a point of view, but I’d be happy to troubleshoot a bit with you, if you were open to it?

Finally, I actually did 5 years of surgical residency and a 2 year fellowship in surgical oncology. Perhaps this isn't enough clinical training to be a “real” MD, in your opinion, but I'm not sure what 10 more years of clinical practice would have taught me other than the conventional wisdom I learned about in medical school was probably wrong for most people, myself included. Does one need an MD or a PhD to have a point of view on this topic, or even to have something valuable to say?

Leo said...

At the end it's a matter of everything in moderation once again
In my opinion the problems with LC arise expecially when stubbornly people don't listen to their body and instead of eating what they feel like eating or what it's needed in that moment, they choose the strict route and ignore their body signals.

I have seen many people doing pretty well with a lower-carb diet but still with carbs to fuel gym activity, with a normal amount of fat, with fruits and veggies. They were doing great when suddenly started to believe that they needed to be even more stricter: less and less carbs, no more fruits, no more starches of any kind, adding fat to everything keeping bottles of bacon fat in the fridge to put on their veggies or other foods. That's when things started to go downhill for them.

Also all this strict diet mentality prevent the natural flexibility of humans. We are not meant to eat the same thigns every day, the same macro ratio, the same foods, the same amount of carbs. We're meant to be flexible and match your food intake with our daily taste/need/physical activity/availability. We're meant to eat more carbs one day of strenuous activity and less that day we don't do any activity, we're meant to fast after a feast, to eat light foods one day and seek more caloric dense food another day. We must be flexible and listen to our body and this never occurs when eating LC becomes a duty, something you must do at all cost.

Evelyn aka CarbSane said...

Great comment Leo!

For me, the first time I did Atkins the induction losses sucked me in. I think they do for most. I didn't ever really get the "Atkins flu" and basically stayed in induction. It seems to happen to a lot of people. This time I did the same, just had "cheats" (in retrospect a poor choice of words, I just ate "normally" from time to time) interspersed, but LC was VLC. What I hoped to find in 2009 were folks who had successfully climbed up the rungs of Atkins' ladder in maintenance. I found exactly the opposite, "cut more". It's quite a militant movement and anyone who listens to their body and gives up the VLC-quest is ostracized.

I'm especially angered -- yes angered! -- by the sanctimonious jerks who accuse those who return to eating starches as addicts feeding into their addiction cycle. Shame on Cate Shanahan and her ilk for that.

Evelyn aka CarbSane said...

Welcome to the Asylum Peter! First, the reason I point out that you left medicine after residency (from now on I'll include the fellowship) is that there are many people who refer to you as a doctor with the implied clinical experience treating patients. I think that's important for people to know, as I believe that for better or worse,they should know that your initial re-learning of metabolism and physiology came from Gary Taubes instead of your own textbooks or delving into medical journals and such. I certainly don't think someone needs letters to have a point of view, but you've been out of medicine for a goodly time and I pass that information on to my readers.

How any doctor could declare war on insulin always baffled me anyway. I don't believe I've engaged in ad hominem attacks or misrepresentations of you here, though I have had some fun with Lego superheroes at your expense. I would think anyone who would declare war on a life-sustaining hormone should expect a little funning at their expense.

I admit I haven't kept up with your n=1 evolution through to intermittent fasting. Personally I found your NK experimentation unnatural. Am I wrong that you had seen most if not all of your improvements by just cutting some carbs from your diet? That when you forced the issue into ketosis your body became less efficient (required more calories)?

I guess it comes back to the doctor thing, because you would likely not have recommended to any patient to do what you did. Please tell me that if Jimmy Moore presented to you with his lipid profile you would encourage him to re-evaluate his diet?! Please tell me that you, as a doctor, wouldn't be advocating such experimentation by a Neely Quinn either!

I'm not sure what you're optimizing, nor do I particularly care. I do think that as a "name" in the community you bear some responsibility for this nutty ketosis fad that is sweeping through. Bucking conventional wisdom for the sake of it is fine, I suppose, but when it encourages an extreme for which there is little clinical evidence and almost no epidemiological evidence for humans eating a particular way, that doesn't sit well with me. Doctor.

Evelyn aka CarbSane said...

Lastly, one of the things this blog is about is exactly the point you made regarding any "the best" diet. The other biggie is presenting as much of the peer-review research as I can on the current understanding of what causes insulin resistance, diabetes and obesity. As such, a fair amount of it has had to focus on debunking your NuSI partner's "science" that is utterly unsupported by the vast majority of the research that has been done. His theories on obesity and insulin resistance only make sense until one delves into what his sources actually say, and what following the research forward has born out.

Anecdotally, low carb diets are an effective intervention for weight loss in the severely obese, and some middle aged men who were never particularly overweight to begin with seem to do well on them. But they seem to elicit some troubling health problems for many longterm adherents who have been browbeaten and convinced that this is the only way to eat and be healthy ... so they keep at it, ever searching for the more extreme n=1 "hack" to fix things. Surely you see this in the LC community? Everyone should eat LC (Vernon), no T2 should be treated with insulin (Rosedale), no diabetic does better eating more carbs (Hahn and everyone else), some people need to eat <50g/day for life (Volek, Westman, Phinney), etc.etc.etc. And then throw in the paleo and anti-grain people convincing people that a bowl of oatmeal will kill them, that drinking a quart of heavy cream is "healthy", assaulting one's bloodstream with hundreds of grams worth of triglyceride carrying chylo is irrelevant, but eating 100g of starch can be unsafe, etc.

Oh. One last thing if you might humor me. WHAT is superstarch? Amylopectin A? If it doesn't spike insulin, and it doesn't spike blood sugar, and it doesn't suppress lipid oxidation -- what does it do?

Sanjeev said...

Jimmy's interview with the doofus well known for
"I declare war !!! ATTACK !!!!!"
"I can't take it after 10 minutes ... SURRENDER !!!! RETREAT !!!"
is a howler. HOWLER.

The stuff about "being inclusive" at the 43 minute mark is especially good.

The whining is delicious in its poignancy.

"I should be free to frame the debate so starch is presumed bad but nobody, NOBODY SHOULD BE ALLOWED TO CRITICIZE ME."

Sanjeev said...

"why are you telling me stuff from 6 months ago?"

good question, thanks for asking.

Anyway, RN says he won't include studies in his "reasoning".

having just finished this (HIGHLY RECOMMENDed) book I found his justification just more funny BS.

totally safe version of that link:

http://everythingisobvious.com/

Evinx said...

Here is what Volek & Phinney state in their book, “The Art and Science of Low Carbohydrate Living.”(Chapter 13).

“There is one anomaly in clinical testing that physicians and patients should be aware of: a transient rise in serum total and LDL cholesterol that can occur with major weight loss. We reported this in 1991 [101], and our research revealed the cause. It turns out that along with the triglyceride stored in adipose tissue, our fat cell also contains a small amount of dissolved cholesterol. After about 30 pounds of weight loss, the shrinkage of these cellular fat droplets proceeds to the point that some of this cholesterol has to be released into the serum. The amount of cholesterol involved is 100-200 mg per day in someone losing 2 pounds of adipose tissue per week. Interestingly, although this represents ‘reverse transport’ back to the liver, this cholesterol rise appears in the LDL fraction. But once a person’s weight loss ceases, this expulsion of cholesterol stored in adipose tissue stops and serum LDL cholestrol returns to its new post-weight-loss baseline.

So if you or your patient experience a rise in serum LDL cholestrol as the scale passes 30 or more pounds of weight loss, don’t panic. This is a sign that your body is dumping previously accumulated cholesterol. Since this situation typically lasts only a month or two,whereas it takes decades of elevated LDL cholesterol to cause blood vessel damage, the probability of any clinical risk is very small.”

Evelyn aka CarbSane said...

Welcome Evinx! I'm reading that section now and found the paper (http://ajcn.nutrition.org/content/53/6/1404.full.pdf). Interesting it's from low calorie study, "However, another factor that could contribute to the lowered LDL cholesterol after weight loss would be the lowfat, high-carbohydrate maintenance diet that our subjects were
encouraged to follow (18).".

In Jimmy's case, I'd be surprised if this were the case. He's had "nightmare" lipids for years now. In that same paper they talk about weight fluctuations and high serum lipids. It's a possibility.

Evinx said...

I guess we'll have to wait until his weight loss levels. As he is very open about his stats, we shall see. For his sake, I hope his LDL-P "normalizes."

Evelyn aka CarbSane said...

I hope so too, but if history is any predictor, Jimmy isn't doing the single most important thing differently, so it is bound to repeat. His LDL-P may be from his years of weight cycling of now more than his former 410 lbs since 2006.

He is lying to his audience about his weight even still today. For reasons I can only speculate, but I think he's trying to move the bar on that with his newer audience that never knew a 230, 220 or even 215 lb Jimmy Moore. He was around his current weight in April of 2011 before ballooning up. So it remains to be seen if he can maintain 250'ish. It seems that for at least the past 6 or so years, he's never been doing that -- he is either gaining or losing most of the time, not weight stable, even at a higher weight. In this regard he makes a poor ambassador for low carb but he's what they got I suppose.

Still, Jimmy is not alone in seeing these lipids with LC -- weight loss or not.

Perhaps his LDL would normalize if he reverts to the low fat high carb diet Phinney used to recommend.

Lerner said...

That hyperlipidemic effect is interesting. But in the slice of the world obsessed with macros, what is glaringly missing there is any talk about associating the effect with macros during the VL-Calorie dieting. My guess is that it's mentioned because High Fay Very Low Calorie might give worse results.

Another thing: why isn't this commonly known? I'd bet that one of the top groups in dieting adherence is the highly motivated population who have survived a heart attack. They also are likely to be closely monitored, so the effect would have showed up --- unless strongly discourage crash dieting and patients willingly comply. (One paper I saw says the rate of hyperlipidemia in VL Calorie dieters is 40% -- but I lost track of the cite in yet another Firefox crash.)

Also, does Jimmy's weight loss rate qualify to be in that group that experiences the effect?

Note 1 : The efflux of cholesterol seems to come from smooth endoplasmic reticulum - the smooth ER seems involved in adipocyte DNL?

Note 2: Anorexia nervosa Pts also get hyperlipidemia, which seems counter to the notion I got from Note 1: that overeaters build up larger amounts of smooth ER

Lerner said...

and one other thing: do they take lipid panels on the extreme weight loss tv shows?

Themovape said...

Reduced carbohydrates, no carbohydrates, quick days. It becomes this terrifying thing. And part of it may be formerly considerably overweight people not recognizing that they should not endeavor for 120 or 130 lbs, and take a greater weight that is livable without weird-ass eating plan gadgets.

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Ian said...

Personally, I think the idea of the "paleo" approach to nutrition is a nonsensical one, for a variety of reasons. But, I'm interested by what you mean when you say that no culture in "any climate" ever, could have been keto-adapted? How could the Inuits not be; prior to the inclusion of westernized food-stuffs into their diet?

carbsane said...

http://www.jbc.org/content/80/2/461.full.pdf

"It may be said at once that the Eskimo on his usual dietary shows no ketosis and has high tolerance to ingested glucose. "



Most low carbers are not in a significant state of ketosis over the long term. The body adapts.

Nigel Kinbrum said...

What's interesting to me is the amount of energy lost per day as beta-hydroxybutyric acid (5kcals/g). From Table IV:-
10.5kcals

100.5kcals
7.0kcals
2.75kcals

9.75kcals
0
0

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