Fast or Feltham III

This will be the last of the post with this title, until perhaps sometime in September when Sam Feltham plans to do another publicity stunt the oh so insightful will fawn over and promote as science and whatnot.  However, the post title is a play on "Feast or Famine" and intended to highlight the great disparity between the claims about calories in the "alternate" community and the actual practices engaged in by long time converts to the "opposite of everything we've ever been taught about nutrition" folks.    See: Fast or Feltham and Fast or Feltham II.


Sam Feltham becomes the latest to proclaim that the obesity epidemic has nothing to do with us eating more or moving less, but rather that we are eating less and weigh more.  He did an "experiment", and here's more proof!   There has always been a strong promotional message of LC (paleo or otherwise) that not only does ELMM not work, but it actually makes you fat.  Instead you should EMML so long as you keep the insulin stimulating, fat trapping, holy hell raising carbohydrates low. 

The "you can eat a ton of LC food and lose weight" meme has been around ever since the subtitle of Atkins' first book used the words "high calorie".  The "at least you won't gain weight" meme is a little newer, but it is still a promise that falls far short of reality.  THIS is the purpose of this post series because it's like Groundhog Day in this community on this issue!

I don't know ... Sam's made a bit of a splash and there's always marketers out there looking for something different ... but I think it's a little early to bring back this version of low carb schtick as there are too many castaways from the last wave still around to bear witness to its failure.  I understand people being generous with presumptions, etc., but seriously, if you saw this dude on an infomercial would you take this seriously?  How about now?

But yeah ... just now I see on paleobuzz.com that the Diet Doc has weighed in on this, and compared it to Morgan Spurlock's more believable stunt.  

There is a difference between overeating and overeating.

When eating bad carbohydrates it’s easy to gain weight quickly. You’ll get plenty of the fat-storing hormone insulin in your blood.

It’s generally hard to gain weight on an LCHF diet. It’s even difficult to eat too much food, as you then usually have to eat more than you want. Even if you force down large amounts of LCHF-food, against your will, the result is usually as it was for Feltham. It’s a constant struggle and weight gain will likely be modest.

Overweight people eating as much as they want on an LCHF diet will typically lose weight.

Which segues us nicely into the "fast" part of this post.  I've alluded to this woman a few times because I knew her from Jimmy's forum.  Someone on FB asked me about her site last year.  Most here probably don't know her, but contrary to Andreas' version of LCHF, Ellen Davis of Ketogenic Diet Resource is pretty representative of what happens to a lot of low carbers.  Her's was the first blog on the stalker's blog roll, so she might even be behind that blog itself, still I have no intention of making fun of her.  A shout out to ItstheWooo and anyone else who wishes to misrepresent what I'm saying here:  I am NOT mocking any of these POOR PEOPLE who are now trapped!   Because if you look at pictures or spend any time reading the stories of so many, mostly women but the men too, this is what you have to look forward to.  The Atkins books always held the promise of adding back carbs, and doing so was part of the program.  Atkins was a genius when he came up with the Fat Fast, it was intended to keep folks hooked because just about anyone will lose weight on 1000 cal/day so what better ruse to sell people on?   He knew it would produce a little dip, but he also knew that it was not a long term solution.

The New Atkins in 2010, was more forthcoming.  For the first time, it was "official" that some would have to stay under 50g of carbs/day for life.  Does anyone believe for one minute that Atkins would be a household name today if the 1972 original had been so bold?  I mentioned this back when but haven't had access to my copy due to software issues for years now.  But  I recently got the Kindle version of TNA.  Despite being written by Westman, Phinney & Volek, it only contains one reference to ketosis within the text.  The term is used twice:

However, there is more than a tenfold difference between the ketone levels seen in ketoacidosis and those achieved with a carbohydrate-restricted diet, which we call nutritional ketosis. Equating the two is comparable to confusing a major flood with a gentle shower. Far from overwhelming the body’s acid-base defenses, nutritional ketosis is a completely natural adaptation that is elegantly integrated into the body’s energy strategy whenever carbs are restricted and fat becomes its primary fuel.   (Kindle Locations 4793-4796)

Fine and well enough, but there is no mention of trying to attain this.  I imagine this may have been a point of contention and why the Art and Science books were written by Volek & Phinney independently.  The term ketogenic is used several times, all but one referring to treating epilepsy, the last being a small 5 person study on Type 2 diabetes.  There's no talk of peeing on ketostix, let alone pricking one's fingers ... that would have to wait until Volek and Phinney's Art and Science books.  Yet now, it's all about eating fewer and fewer carbs for all eternity ... and more and more fat.  I don't think that would sell to the wide masses, in fact I'm sure it wouldn't.  THIS is the point of these posts.

Ellen Davis' story is a cautionary one.  It is more typical than atypical and if you don't believe me, I think there are probably some   She began improving her diet in 2008 and went low carb and lost around 25 lbs ... and then hit a long plateau.  Years long.  I can relate, though it happened to me after a longer ride down the scale. It took her a longer lead in to get down to 20g carb/day because of hypoglycemia.  At under 50g/day the weight wouldn't budge, even reducing calories to 1500/day.  Late in 2011 she had a milestone birthday vacation as incentive.  She had an epiphany.  Discussing hindsight reasons for the plateau:

2.  I also didn't want to admit that calories counted, at least for me. Yes, I know that I'm only 5'3" and that my job is sedentary. But when you don’t want to “see” something, you can really come up with some nifty rationalizations. My reasoning followed the brilliant line of "other low carbers didn't have to count calories, darnit".

Yet folks like myself were shouted down on over and over on Jimmy's forum for saying something so simple.  Calories count for everyone, there are just those who don't have to count them and there are those that can get away with more all their lives and vice versa.  And, there are those like Feltham with better defenses against fattening than others.    So what did Ellen do?  She went on a VLC diet, only C is for Calorie in that acronym now.  Good thing I had the foresight to screenshot it, somehow I just knew this detail would disappear:

This part is no longer there in Ellen's updated page.  I ask the audience here, why would she take this out?  What is it about the current trend sweeping this community that makes them want to hide the details?

I think many don't want to admit even to themselves, that long term carb restriction depresses metabolic rate -- with or without weight loss.  I think it's more than just the RMR, however, I think it accentuates the "starvation adaptation response".   Yes, to some degree some still can eat a bit more, perhaps within a 500 cal/day or so range (seemed that way for myself), but reduce the calories and it was almost instant slowdown.  It's the only explanation, even if you believe the insulin hypothesis because at some point your fat should be flying off you ... right?   

So Ellen went on a crash diet and lost 60 lbs.  She herself states she had weight left to lose.  I looked at the diet, and 1000 cal/day with 120g C+P = 480 cal so that leaves 520 of fat = just under 60g/day.  This is just a little more than Sam's Breakfast ... for an entire day.

Breakfast 15g of coconut oil; 135 calories, Carbohydrate=0g, Fat= 15g, Protein=0g
200g of salmon; 374 calories, Carbohydrate=0.4g, Fat= 19.8g, Protein=48.2g
180g of green beans; 60 calories, Carbohydrate=18g, Fat= 0g, Protein=2g
250g of eggs; 390 Calories, Carbohydrate=3g, Fat=26.5g, Protein=31.5g
Total; 959 Calories, Carbohydrate=21.4g, Fat=61.3g, Protein=81.7g

If that doesn't put things into stark contrast, I don't know what will.  According to her update, Ellen ate this way (calorie wise, not sure about the foods, don't really care) for 5 months to lose 60 lbs.  Which is great and I was happy for her for the weight loss, but could just see what later came in this update:

Well, it's been eight months since I returned from my Costa Rica trip. During that time, I've managed to regain 20 pounds, a few pounds at a time. Disappointing, and annoying, but there it is. It's been frustrating but I've learned some things as well.

The lower calorie diet that I adopted to lose the weight worked well, but it did have the expected effect of slowing my metabolism. When I returned to eating my normal calories levels, I gained back some of the lost weight. 

First ... did you see her sub-5 insulin levels?  It's pretty close to the limit of quantification (see:  PQL/LOQ here here)

I'm not sure what this normal metabolic rate is, and if you're going to promote a diet and use your weight loss story, why NOT be up front about the calories? Will the low carbers not be happy until they've trapped every overweight/obese person in this metabolic maze?? People say they don't get me, well I don't get what compels a person to promote something that's not working for them in the name of "helping others".  That is just bizarre beyond words, but I digress.  If normal is 2000 cal/day, and her weight has stabilized at -57 lbs from high, that is still quite a low metabolic rate.  But I suspect it's lower than that even, and as Ellen herself states, she remains considerably overweight.

However, since I've stayed with the low carb, high fat, ketogenic diet, that effect has finally stabilized, and I'm now maintaining my weight at normal calorie intake. It took about the same time I was on the lower calorie diet (5 months) to regain my normal metabolic rate.

So ... Ellen has regained weight despite eating a LCHF diet.  In her own words, it was fat that she restricted to get to the weight-loss-enabling 1000 cal/day level.  What does Sam Feltham, and Tom Naughton, and Andreas Eenfeldt, and Gary Taubes, and Mike Eades, and .... etc.etc.etc. ... have to say about this?  What would THEY tell Ellen?   They lied, and they continue to lie to you.  Fat is not fattening, right?  We know what Gary Taubes would say because in interviews for WWGF he laid the truth bare:  You, Ellen, are just unfortunate and will have to give up the three blueberries or that small spinach salad or resign yourself.   You, have been the victim of ...

The Cruel Low Carb Bait & Switch 

For all the knocks against CICO-ELMM approaches, it has always been the mantra of responsible weight loss advisors to NOT reduce calories too far.  Just about every woman is well familiar with the caution not to go below 1200 calories or 1000 calories.  The 500 cal/day deficit was ALWAYS a guideline, never a rule.  It is painfully obvious that metabolic adaptation is not only not evaded by low carb vs. conventional calorie restriction, it may indeed be worse in the long run.  The thing is ... since this hasn't been studied formally, we only have the anecdotes to go by.  Those don't look good for the low carber.  Most especially those that eschew exercise.  

The low carb folks like to blast The Biggest Loser, and I want to reiterate that I am not a fan of the approach, but let's look at the fate you are supposedly avoiding with the low carb diet. On TBL they use the ELMM approach. It works. It fails many ultimately because of reasons outside of CICO and metabolic rate. Here is what has been measured:

Looking at the completers, in 30 weeks, they went from 286 lbs to 191 lbs for a weight loss of almost 100 lbs (95).   Over 80% of their losses were of fat mass -- they went from almost 50% FM to under 30% FM.  Their measured RMR went from 2258 down to 1763 cal/day.  That is the resting metabolic rate.   For even the most sedentary person, this translates to a TDEE of over 2300 cal/day.  

Now the authors of this study did some extrapolations to figure out what the metabolic rates of these participants should have been and estimated the RMR's were depressed by about 500 cal/day.  This sounds like a damning indictment of the ELMM approach of TBL.  I'm not sure this is "fair" for any weight loss method as it is impossible to control for.  They would have needed to be prescient of the impending obesity and measured RMR years ago ... and then you still have age to deal with.  It matters not the equation, everyone's metabolism changes differently with age and formulas are ultimately only estimates for the "mean" and not indicative of the what is entirely possible for the individual.

The Promise of LCHF

Let's say you are obese (I'll get to the merely overweight in a minute) and have stumbled across any one of the websites, etc. advocating LCHF.  You will hear:

The Set-Up:

• You did not get that way by overeating or being sedentary
• You overate because you are a carbohydrate addict
• The carbs are trapping the fat in your fat cells and that is why you eat so much and can't lose weight.
• The mainstream doesn't know what they're talking about, everything "they" or "we" know about weight loss is wrong.  You need to eat more and forget the exercise.

The Promise:  If you eat LCHF, you are promised

• You can eat as much as you want.  Yes, the word gluttony has been used, in serious context, by Gary Taubes himself.  
• Fat doesn't make you fat.  Witness the latest stunt by Sam Feltham!  
• Calories don't count.  
• Exercise is useless for weight loss so forget that chronic cardio and exercise the right way:  10 minutes a month or something like that (yes this is an exaggeration for effect).
• LCHF beats out all other diets every time for weight loss.  Look at all of these studies (don't pay attention to that fine print)   .... And today?
• Look at Jimmy Moore, he's lost 80 lbs (the word again will not appear in that boast) ... And if it's been a while since this post has been written ...
• Look at So and So who just lost 100 lbs in 3 months eating 4000 calories a day when they couldn't lose an ounce after a month eating 1500 calories a day.  This can be you!
• Ultimately you are promised that by eating more and moving less you will lose weight in dramatic and effortless fashion ... all while eating BACON!

Reality Sets In:  

Here is where I must reiterate where I was 4 years ago.  Having lost a lot of weight but plateaued out (I'd be the darling of this community if I'd just go along with the scam and sell the books!) , I went looking for solutions.  At the very least, I was looking for assurances that my diet was healthy.  The men were interesting cases, but for me I was more interested in the women.  The truth is there is not a single case of a woman near my age group and starting weight for which the above promises have held true.  I think the people being fed these lines deserve the truth about these diets.  They are no panacea, and just about every advocate out there that has been around for a while tells us the opposite.  In their reality, anyway, not in the public proclamations.   Because:

• After all of that carb counting, you might just have to count calories after all.
• The 1500 cal/day diet for weight loss is a pipe dream now.  Remember that 1000 cal/day crash diet?  Get used to it.  We'll try to disguise it as a kitchy thumb your nose at the man fat fest, but it is a "fast" not a "feast" after all.
• Yeah, it turns out you can't eat as much fat as you'd like and still lose weight.
• Heck, it turns out (see Ellen, Jimmy and countless others) you can't even eat as much fat as you'd like and not gain weight!
• You fall far short of goal
• You gain weight if you eat a LC wrap with 10g carbs
• Your fasting blood glucose is on the rise.
• Many "cured" health issues return (though you probably don't notice as you are in denial)

The Switch:

Sorry ... It's all been a big fat lie.  

As it turns out, you've just been doing it wrong.  I cannot think of anything more damning to the good ol' fashioned Atkins diet than what Jimmy Moore has had to resort to this past year.  Granted he's 8 years older, but in 2004 he lost 180 lbs on Atkins in 1 year.  In 2012 it that same year's time resulted in 80 lbs loss.  Not too shabby, but much slower, and it required an extremely extreme diet of 80+% fat and routinely going 18-24 hours between meals.   If someone told you 8 years ago that you would have to do this sort of extreme diet in several years to stem the tide of weight gain, would you?  Make NO mistake.  Jimmy blames "LC Mistakes" ... forget the use of urine ketostix and stabilizing blood glucose, those are irrelevant.  No, he claims he consumed too much protein, and not enough fat (which he claims was a relic from his low-fat propaganda days, that anyone who has ever read Jimmy's blogs knows is a ridiculous joke) ... but eating too much is acknowledged, if only in the discussion of "forgetting to eat" and fasting for lengthy periods.  Further (and folks didn't appreciate my take on this), we now learn that the "healthiest ever" (at all times folks) Jimmy Moore actually suffered all manner of maladies (not to mention those that persist ...) as eating a "regular" LC diet allowed weight to accumulate against his will on his body.  

Do we need a rundown of long term low carbers that report intake and how they are faring?  I'm not going to do one here, but it's all out there on the blogs.  What will Ellen do next?  There's not much she can do other than increase TDEE through exercise.  She can't lower carbs more ... lowering fat worked well but that extreme was unsustainable so she increased it and the weight came back.

Before you fall for the next one ..........

I hope the next tweek is not restricting protein.  Low carb is purported to do many things, but the only reason it comes out on top of low fat diets in comparisons is because gross protein intake tends to be higher.  As usual, the men will fare OK (far from optimally, but OK) because they generally don't need to resort to 1000 cal/day.  So the Jimmy's will be fine for now so long as the other reasons why he regains are kept at bay.  The women?  They will eventually suffer.  It doesn't matter if your circulatory system is screaming with ketones, your body cannot turn fat to protein, and there's not enough glycerol from fat to provide all the substrate to make glucose via gluconeogenesis.  To make matters worse, we don't absorb protein as well as we age.   

The sad thing is, this fat fasting is dangerous.  Especially for women.  Double especially for women of a certain age.  Nature/evolution/God/whatever was kind to humans and ketones quell hunger yet increase cortisol for a reason -- you are being "wired" to seek something, but spared the gnawing hunger your cells are actually feeling.   But there is no final glory in never being hungry.  That is for the end stages of life in the elderly and infirm, who, by the way, are your ultimate "fat burning beasts" consuming that most nutritious and healthy of cannibal diets  When eating becomes a chore and interest in food is gone.  Is this really what we've come to?  That trying to mimic the diabetic hormonal milieu wasn't sufficient?  

Nothing will protect you from the reality that when intake falls short, your lean tissue will be catabolized.  Oh you'll lose weight alright.  But don't let Jimmy's selective DXA's fool you (another smoke screen as he hasn't reported the full DXA from January when in one month he lost 3.5 of the supposed 6.l lbs lean mass he gained the two months prior nor has he had another since).  The weight you will lose will not all be fat, not anywhere close.  And then you can kiss goodbye your remaining metabolic rate.   It may take another year or so for this to happen ... then what?  Will your blog still have the blinking Come On In sign at the door?  

Somehow I don't think this is going to go over big as a selling point to the uninitiated.  Which is what really makes that Fat Fast cookbook so disturbing.  Low carbers who have backed themselves into the most unworkable metabolic corner making money off of other low carbers desperate for the "Success" of stories trumpeted on sites like Atkins and CarbSmart and others.   And STILL, the ridiculous falling all over each other to promote the big LIE.  

Now go forth and shoot the messenger ... or maybe you'll realize I'm just speaking the truth to those that want to listen, and if you don't, move on.