July 18, 2013 Over the Hump Bump II: Insulin Wars II: Mark Sisson

Part II of my CarbSane is so cruel and vitriolic in her criticisms of Mark Sisson bumpfest today.  Crying Wolf II , Bump I

This one is especially  ironic given point 9-of-12 of Mark's email to Grashow blamed lack of dietary discipline and sloth for my weight.   Here he says that doesn't work anyway!  {shakes head}

Be sure to notice how I misquoted, misrepresented and ridiculed Mark Sisson, took pot shots at his appearance and denigrated him on a personal level.  Oh wait.  That didn't happen.  This post was originally viewed by around 400 people and didn't even crack the Top10 list at the time.

Original publish date:  12/15/10

I thought I would share some thoughts on some of the responses of LC "experts" to James Krieger's excellent series on insulin.  For any who missed them, here are the links  “Insulin…an Undeserved Bad Reputation”, Part 2,Part 3, Part 4Part 5.

Jimmy Moore asked an array of people in LC circles for their thoughts HERE

A recent undercurrent in the blogosphere is discounting the importance of insulin, instead pointing toward leptin, among other hormones, as the “master hormone.” I disagree with this slightly, not because I discount the importance of leptin, or grehlin, or any of the nearly innumerable myriad hormonal players in this crazy, complex amalgamation of meat and bones we call the human body, but because it misses the point of what I’m trying to do: maximize buy-in and discuss what works for the largest amount of people that come looking for the type of help I provide.  .....
..... Even if “eat less, move more” is ineffective advice that rarely works over the long-term, it makes intuitive sense to someone who isn’t steeped in this stuff every day. We need simplicity.
That’s why I like focusing on insulin – because it simply works, and it’s easy to understand.  
This response just floored me, but I have to admire Sisson for his honesty.

The low carb "movement" needs a simplistic gimmick to maximize "buy in" for the cause.  Who cares, ultimately, if the LC message is as wrong or moreso than the old ELMM??  Sisson is, and has for a very long time been in the business of selling supplements, protein powders and the like.   His 80/20 rule for primal eating certainly allows for an awful lot of flexibility, yet he's peddling the highly processed Primal Fuel as an acceptable meal replacement (e.g. it is an 80% food).  This not only contains whey powder (that is highly processed folks) and powdered coconut milk (again, highly processed) but also maltodextrin (due to the coconut powder, but so what?  it's an additive) and sucrose (sugar!).  But natural starches?  Get away from me with those, right?  He seems to have come around a bit on some of those, but it seems to me that Sisson makes up a lot of this stuff as he goes along.

If carb restriction really worked any more in the long haul for the majority of people, wouldn't the obesity epidemic amongst adults have been "cured" by the 2003/2004 surge of Atkins?  Yet there are prominent people in LC circles who have regained substantial amount of the weight they've previously lost.   And, of course, we simply can't ignore the elephant in the room:  prominent, committed low carbers who have regained weight or continuously struggle to maintain while staying true to their carb restriction.

Discussing ASP and insulin and leptin and all the nitty-gritty details in the comment sections of blogs seems like second nature for many of us, but we run the risk of forgetting that it all looks like chemistry textbook gibberish to the average dude or lady who just wants to fit into the jeans they wore in high school. At this point, they don’t need to – nor, probably, could they effectively – worry about carb refeeds or boosting leptin or fine tuning macronutrient ratios in accordance with activity. It all gets to be way too much for the newbies. They want something as simple to understand as “eat less, move more,” except one that works.
When has ELMM not worked?  It does work, it's just that it is difficult to maintain over the long run.  Just as carbohydrate restriction is.   The whole Paleo/Primal thing is quite popular right now, but I believe we'll begin to see that, like other plans before it, this will wane as we inevitably have the people who find the more restrictive forms untenable for the long run.  
If you’re trying to lose a lot of weight, eat fewer carbs to lower insulin spikes and mobilize fat stores. Exercise with intensity to improve insulin sensitivity, so that when you do refuel your glycogen stores with carbs, less insulin is required for the job. Get plenty of sleep, because mismanaged cortisol due to lack of sleep induces insulin resistance. You do those things to manage insulin, and you’ll lose weight. Then, once it works ... "you can become a nutritional and fitness geek" (paraphrased that last part in "").
This is a common thought progression I see around the LC web.  Boils down to large numbers of "followers" who default to the notion of "I don't really care how it works so long as it does".  This is just fine by me for the individual, but it is not an excuse for an "expert" or anyone seeking to educate people on a healthy diet.  It doesn't seem to be of any concern to Sisson or others peddling insulin theory that there are many people for whom carbohydrate restriction doesn't work for weight loss.  These folks are often encouraged to go more and more extreme and become, as Dr. Michael Dansinger called them, "carb cripples".  This is the needless outcome for too many who buy-in to the overly simplistic, and ultimately flawed, insulin theory. 

What is so difficult for the layperson to understand about eating more protein and fewer carbohydrates will lead to a spontaneous reduction in intake, and subsequent weight loss, in many people?  That's hardly a difficult concept, and it's not propagating misleading science either.  Honestly I didn't take much of an interest in how or why LC worked for me, although I did read the original Atkins back in the late 90's.   I do believe that Atkins perpetuated my "diet mentality" with his claims about how one bite of potatoes could undo days of low carbing, etc.  Atkins did delve into insulin a bit in that book, but his was the first "fad diet" presentation to the public.  Atkins CLEARLY acknowledged energy balance, but he was WRONG that it boiled down to massive amounts of caloric energy excreted unused as ketones in the urine.  And yet, to this day, I see Atkins acolytes make the claim that "he was right all along".  No he wasn't, and his "in your face" attitude towards the mainstream and wild unsubstantiated claims ultimately undermined his message and relegated low carbing to the "fad diet" status so many of his successors strive to overcome.  

With the simplistic insulin theory, many modern-day "leaders" of the LC movement are making the same mistake.  Is this the way towards mainstream acceptance of carbohydrate restriction?  I would say no.


Anonymous said…
ahhhhhhhhh amazing and refreshing post to read!!!!!!!!!!!
MM said…

It really annoys me that low carb experts won't even acknowledge that people can and have regained eating a low carb or often a very low carb diet. The attitude seems to be, "If you regain you must be doing it wrong." If they won't acknowledge it, how will they ever figure out how it's happening? It does happen! I so appreciate your blog. I thought I must be crazy to not be able to lose weight on very low carb, and gaining if I wasn't extremely careful. I kept reading about how it's all about keeping insulin low. Well, maybe it's not. I think ASP is very much ignored or down-played in the low carb community. Todd Becker totally discounts it on Jimmy's page you linked to: "There is another enzyme, Acylation Stimulating Protein (ASP) which allows fatty acids to be taken up into fat cells, even when insulin levels are low and no carbohydrate is present. However, this is a highly reversible process, and the fat comes out of storage as easily as it goes into storage" So, what if it's "highly reversible"? If you're eating too much fat it's going to be going in faster than it's coming out. I've now switched to a sort of Schwarzbein Principle type of diet. It's kind of been two steps forward, one step back, but I've lost 5 pounds in about two months, when previously I spent 18 months desperately trying to lose on very low carb with no results what-so-ever.
CarbSane said…
MM, I plan to address Becker in another post, particularly that part on ASP. Thing is, insulin's role, however significant or insignificant it actually is, would also be "highly reversible"

I'm glad to hear Schwarzbein is working for you. I've seen it mentioned by quite a few over at Jimmy's forum. The weight loss may not be fast, but, as you say, it sure beats a year and a half of nuttin'!!

Hi Mal :)
LynMarie Daye said…
Excuse me for being a bit nit-picky (I can't help it; it's a character flaw), but ASP is not an enzyme. It functions much like a hormone but is more accurately called a paracrine/autocrine factor. Just wanted to point that out. :`)
Frank said…
God. Bless. You. You need much more exposure.
Sanjeev said…
(please excuse the tone ...)

attributed to Becker:"... (ASP) which allows fatty acids to be taken up into fat cells, even when insulin levels are low and no carbohydrate is present. However, this is a highly reversible process, and the fat comes out of storage as easily as it goes into storage" So, what if it's "highly reversible"?
based on any research? As if individual fat molecules are tagged with the information "I got stored into this fat cell via ASP, now I'm queued up, spring loaded, the head of the queue, ready to be catapulted out of the fat cell way ahead of anything that got stored by insulin ... I'll probably be catapulted out of the body completely with no calorie deficit required ('coz of metabolic advantage, squire)"

Sisson: "it just works"

really? REALLY?
No qualifiers on that?
"for many"
or even "for most" ?
"for those with ..."

That must be why the research is showing that for the population as a whole it works slightly better ... that must be why so many dropped off the Atkins bandwagon.

Granted, many were not doing Atkins correctly ... but since the same criticism applies to Ornish and Pritikin and Shangri La diet, based on the evidence "it just works" ...

Can't wait for Nikoley to come & support Sisson with "you're lucky he's giving you this premium information, like his other premium products (like the PALEO[0] whey that costs 10 times as much as any other, you should be paying 100x as much, it's THAT GOOD)"

[0] <guffaw> PALEO WHEH !!!! </guffaw>
CPM said…
Speaking of Nikoley, he is actually counting calories now following Martin Berkhan's Leangains program.
Melchior Meijer said…
I agree with Frank. I would expect the otherwise vocal low carb elite (from whom I learned a lot, don't get me wrong) to eagerly dissect and answer the interesting and thought provoking questions CarbSane poses. Instead there is a deafening silence (if you don't count the occasional shouter). Cognitive dissonance, anyone?

I don't always like your messages ;-), but I don't like to fool myself (and others) neither. Do you monitor your traffic, CarbSane? I would be surprised if 'they' just haven't found you yet.

By the way, I really want the experiment Gary Taubes suggests to be done. Take some very overweight people, feed them isocaloric diets with different macronutrient ratio's and see what happens, cross over. I have no emotional interest in the outcome, I just would like to see what happens. It struck me that the potatoe guy (who lost a significant amount of weight on an eucaloric very high starch diet, wich ought to be impossible according to the lc community) reported to have felt so satiated all the time.
CarbSane said…
Thanks Melchior. I have politely commented over at GT's blog and he has let those comments through. I doubt he will address them, however, and I believe the reasons for that are fairly obvious. Still, that other folks can read some of what I've discovered and still accept his theories as fact is disturbing to me to say the least.

Blogger does have stats, and some visitors have come here from his blog and other "pro" type sites. GT has obviously been aware of my criticisms since fairly early on when Fred Hahn found me (from weightology)and he spread the word about this raving lunatic to his buds ;)

I believe that study has been done keeping protein constant and varying the carb and fat in a metabolic ward. Can't recall the name off-hand.
CarbSane said…
Yes indeed LMD. As far as I know, a peptide that behaves in the manner of ASP would be called a hormone were it, like insulin, to be generated in another site for action on remote tissues. Leptin is classed a hormone because it is produced by fat but acts elsewhere. ASP is produced by fat but acts on fat. For all intent and purposes its action is insulin-like so whatever we want to call it, the classification is a moot point.
Frank said…
You made some pretty valid clames in the last GT blog post. Funny how no one commented on it. You're basically showing that his interpretation of the data is plain wrong. Kudos to him for letting this trough. Too bad most of his followers probably can't understand what you're talking about - or don't want to.
CarbSane said…
Thanks Frank and welcome to my blog! Feel free to spread the word :D

As to your last comment, I suspect for many it is "don't want to". It is hard to accept when our heroes fall, and I've seen GT described as "my hero" too many times to count. For those, it doesn't matter what he's done, he's responsible for changing their lives. I just still haven't gotten over this one.

I discussed the Newsholme and Frayn texts and the contradictions in my interview with Jimmy Moore back in November. He approximates a 20th of January-ish airing of the interview.
Nigel Kinbrum said…
Leibel et al did a Metabolic Ward study. See Energy intake required to maintain body weight is not affected by wide variation in diet composition.

My comments on GT's blog are attracting a lot of visitors, too!
Melchior Meijer said…
From Nature (2001). Nice overview of ‘metabolically controlled’ weight loss trials, albeit written in the typical arrogant, highly biased tone.


Well, I must confess I’ve called Gary ‘my heroe’ too. Even if I no longer agree with his purely insulinocentric view on weight gain/loss, his notion that strong (neuro)hormonal signals govern calorie intake and energy expenditure (and thus weight) still appeals to me. There is a reason people overeat and that reason might well be purely biological. Why am I skinny ‘no matter what I eat’? Willpower? Ha, ha, ha. Something is tightly governing my appetite and makes me gag or explode if I eat too much. My obese neighbour lacks the signal to either stop eating or exploding. She is still ravenous when she has covered her needs. If anything Gary Taubes has forced the world to think about why the obese eat as much as they do. Because they eat too much is a stupid answer, I think.
Frank said…
@Melchior Meijer

There are behavorial, psychological, environmental and biological reason to overeating. It's clearly not just biological. NEAT explain to a high degree why some people are skinny no matter what they eat. Some individual can waste up to 700 calories a day by NEAT.

And that being said, all those neuro-hormonal regulation system don't invalidate the calorie-in/calorie-out equation, they simply influence one side or another.

Taubes clearly said, wether in the post of somewhere in the comment, that it comes down to know if it's the calorie theory or the insulin theory that prevails. lol. That guy is way too deep down into his own fantaisies.
Melchior Meijer said…

The energy has to go somewhere and it has to come from somewhere, we totally agree about that. I'm willing to accept that non purely biological factors play in as well. Carbs and insulin cannot explain obesity, although I would say it is easier to accumulate fat in the precense of hyperinsulinaemia.

NEAT is an important factor, as is being sedentary, living in a constantly heated environment, etc. But how do you explain that slim people often fail to gain a significant amount of weight in overfeeding experiments. And why do they lose the small amount they gained as soon as the force feeding ends? I bet the excess energy turns up their NEAT like crazy. But how do you explain such differences?

Gut flora can have an enormous effect on body composition and weight.

ELMM works if you consistently do it, but why do so many people fail to do it?
CarbSane said…
I remain unconvinced of the notion that gut flora have a significant effect on human body composition and weight, let alone an enormous one. Just as de novo lipogenesis is a major pathway in rodents but not in humans, hindgut fermentation and corophagy in rodents are significant contributors to caloric intake but not for humans.

Re: ELMM works if you consistently do it, but why do so many people fail to do it?

Because it requires a deliberate effort, the same as committing to a low carbohydrate or paleolithic/primal approach. I'm convinced that the EL part is mostly due to the misguided approach of keeping macro %'s constant thus reducing protein consumption to unsatiating levels, especially at the caloric levels women require to lose on a CRD.

Also, with EL, at some point the body reacts by slowing down, so it's a balancing act. Most responsible CRD's, therefore, produce deficits to yield a pound or two per week loss. When someone is 50 lbs overweight, we're talking looking at a year of disciplined eating. That can be quite daunting on its own, but if someone is 100 lbs overweight, now their facing still being fat after a year ... all the more daunting!

For many, like me, LC is like a magic pill. But when I look back at how much I was eating during my rapid loss periods, it was probably at "starvation levels" many days. There are LC days where I've simply forgotten to eat at all! I think many fall off the wagon because almost inevitably the body "checks up" and then the low carber faces that same daunting task the traditional dieter faces.

I'm willing to cop to being lazy in this regard. I've often been asked why if I don't believe this or that about LC I still eat this way. Because it's the easiest way I've found to lose weight. But until I shed my diet mindset and figured out a doable plan for the long haul, it only worked as temporarily as any other diet did.

I do believe that Mark's 80/20 prescription is a positive in his overall philosophy of Primal eating. I don't see why we need to be misled about carbs and insulin to embrace it. The basis in real foods (hawked supplements aside) and the results of those for whom it works should be more than enough.

I didn't embark on this research to figure out why/how low carbing works. In the end, I could really give a flip. Whatever may have been unhealthy about my particular reducing diet was still bound to be more healthful than lugging around some 80-100+ extra pounds and feeling like I was 60 in my early 40's. I have no regrets. But I do have those lingering concerns moving forward.
CarbSane said…
Melchior, I would echo Frank's sentiments regarding NEAT and other reasons for overeating. Every now and then I do some people watching and it is really no mystery why some are fat and others not. It is unfortunate that it appears that rising obesity rates of mothers seems to be predisposing more children towards obesity, but it need not be an inevitable outcome.

I think when we "artificially" fatten a lean person, they lose the weight because they return to their former eating habits. That's not much different from why we see obese people who have lost weight regain it if they return to their former habits. Kinda points heavily towards eating habits after all.
Melchior Meijer said…
Hi CarbSane,

I do a lot of people watching too ;-), especially on the ferry during my annual bicycle trip Holland-Sweden vice versa. It seems to get worse every year and the reason - I have to admit - is pretty obvious. Folks drag themselves from the fastfood restaurant to the tax free shop, a few liters of Coke and several high calorie snacks at hand. When we ride our packed bikes up the ramp quite effortlessly, these same people often make the 'you are just completely insane' gesture. They eat constantly and they hate, just really hate to move their asses more than strictly nesseccary to accomplish basic things like wiping their butts and reproducing.

But why is that so? I just don't believe it is pure lazyness (but I'm willing to change my mind, in which case I would come full circle round in 20 plus years). I too listened to Jimmy's interview with Zoe this morning. However unscientific it sounds, I tend to believe that some of our very common foods can be highly 'addictive' (I hate the word, but Nora Volkow is using it too, so I dare to). It has nothing to do with carbs though. Carbs in general are not 'uniquely fattening', as Zoe states.

Did you see Denise Minger's new post on wheat in China? I know we were eating a lot of wheat in the sixties as well (while being lean), but the total amount of wheat lectins in our food supply has probably risen.
Sanjeev said…
>> don't believe it is pure lazyness

Did you know anorexic women exercise like heck? Turns out starving people get more active until the deficiencies won't allow it any more.

If one gets excess calories I suppose the opposite happens. The drive to move is reduced.

Purely chemically, reduced calories lowers serotonin, and raises dopamine and norepinephrine in the brain's locomotor and reward-for-motion areas. And epinephrine in the remainder of the body.

And excess calories probably reverses all of that. certainly excess carbohydrate calories increases brain serotonin incredibly for some (this effect is repeatably dramatic for me).
Sanjeev said…
> Denise Minger's new post on wheat in China

is great stuff, thanks for the tip

read it once, getting the details now ...
Anonymous said…
What EL, ELM and ELMM stand for?
CarbSane said…
Melchior when one looks at the calorie counts on prepared foods, for many it is what they've even coined a term for: Passive Overeating. It's a combination between that and this whole bigger = better value and all you can eat and whatnot. It's almost like if you go to an all you can eat buffet, even if you eat well and got your money's worth with one helping, you feel like you just have to go back for more. Where kids are concerned the problem is giving them too much freedom to choose what they eat. In a few generations we've gone from a society of mostly two parent homes where if the second parent worked outside the home it was part time to mostly either two income earner homes or single parent homes. Combine that with the availability of junk food and ...

I don't think it's laziness per se, but I do see people drive around endlessly until they find a spot close to the door somewhere or wait several minutes to take an elevator up one flight of stairs. Even microwaves have cut several minutes a day or more out of being on one's feet cooking. Food processors, remote controls, etc. etc. Just about nobody in my neighborhood mows their own yard, etc.

Back to the eating, I think we under estimate the effect "dieting" has in the long run.
kds said…
Hi CarbSane,

In regards to basal and feeding levels of insulin and how that relates to fat mobilization and utilization, what are your thoughts on studies like this one (discussed at HyperLipid) wherein obese subjects on an insulin-release inhibitor like diazoxide lost significantly more fat/weight compared to control subjects on isocaloric diets?

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Jason Sandeman said…
I bought the Schwartzbein principle a LONG time ago but never really got into it. That was way before my diagnosis as a T1D.
Evelyn, have you much experience with that book? Perhaps I need to dig it up here.
PatriciaINS said…
If you have to sell something other than food to make your "plan" work, you're no longer believable. Hello, Mark "Never Been Fat, My Wife Is A Vegetarian So I Know How To Advise" Sisson. Hello, Jimmy "I Pimp Every Frankenfood Known To Man, Cry When People Remark On My Diet, Happily Watch My Chronically Sick Wife Eat Junk Food, Only Lose Weight When I Go Extremely Low Carb" Moore.
crankybastard said…
Hi kds,
the trouble with diazoxide is that it has a directly lipogenesis-inhibiting effect independent of its insulin-lowering action; thus, the study HyperLipid refers to doesn`t necessarily tell us much about the allegedly fat-blasting effects of lower insulin, which the study authors even admit somewhere in the full text.
crankybastard said…
...study`s authors...
carbsane said…

One of the problems with bumping old posts is that I don't really have time to go back through old comments. I do try to answer most but KDS's comment slipped through the cracks. I have since weighed in on a few blog posts: http://carbsanity.blogspot.com/search?q=diazoxide
carbsane said…
Hi Jason -- Sorry no experience with Schwartzbein. I think MM's approach has changed over the years or might be based on this. She was never diabetic to my knowledge, just at risk with family history.