The Carb-Sane Asylum

S ummary: Continuing on with discussion of:   Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial Previous posts in this series: Part I: Critique of the Study Design Part II: $12 Million for 12% Weight Loss? Part III: Some "Early" Lessons Part IV: Insulin Resistance Does Not Hamper Weight Loss This post should perhaps have come first, but it has taken a while to look deeply at the data for the primary outcome -- total energy expenditure measured by doubly labeled water -- and related outcomes of intake and resting energy expenditure. In this study, all participants were paid to participate, AND provided free food for ~8 months.  Said food was professionally and meticulously prepped, weighed, measured, individualized to provide each subject with some pretty exact caloric level and macronutrient composition.  The test phase (in other words, the study proper) involved maintaining a consiste...

       C ontinuing on with discussion of: Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial No summary for this post.  Here are links to earlier parts in this series: Part I: Critique of the Study Design Part II: $12 Million for 12% Weight Loss? Part III: Some "Early" Lessons :   In this most recent post, I discussed the relationship between measures of insulin (both fasting and 30 minute OGTT response) and weight loss during the Run-In Phase.  

The Noakes Foundation has put out a new book entitled Diabetes Unpacked * , edited by Dr. Zoe Harcombe PhD.   It is a compilation of chapters written by a who's who of the low carborati.  This installment deals with Chapter 3 by Dr. Jason Fung, a nephrologist masquerading as an obesity specialist and diabetologist.  He has no formal training in either, and his grasp of some pretty basic physiology is tenuous at best.  That latter "charge" can be backed up by fact checking (or attempting to fact check that which isn't simply Fung POOP (Pulled Out Of Posterior) ) any of his various blog articles, books, podcasts or YouTube videos.   * That's my Amazon affiliate link This post will be an evolving one of sorts that I'll bump if and when content is added.  I've avoided giving Fung much "ink" here, frankly because I never thought anyone would take him seriously enough to deserve it.  Clearly I was wrong.  There's apparently no lim...

BUMP NOTICE:  I'm bumping this post due to some recent discussions on social media regarding the reversibility of Type 2 Diabetes and the role of low carbohydrate diets in the growing "curing diabetes" paradigm.  Recently Dr. Roy Taylor (the investigator I most closely associate with the crash diet, though this is an extensive group) and colleagues, who implemented a "crash diet" to cure diabetes -- by reducing pancreatic and hepatic (liver) fat concurrently with rapid weight loss -- published the following in BMJ:   Beating type 2 diabetes into remission .    The criteria are non-diabetic markers for a period following reversal of the progression.  Here is where various low carbohydrate interventions "fail", as many are able to maintain normoglycemia only by avoiding carbohydrates.  The question remains if this is effectively the same as other reversals.  I contend it is not, as normal pancreatic function -- specifically GSIS -- has not ...

Dateline:  March 26, 2016 Helloooo Inmates!! A quick update, but first a sincere thank you to each and every one who participated in my 40 Day Lenten Lentil Fast post.  As of this morning -- two months after publication -- we stand at just over 2700 comments.  No that's not a typo.  Who knew all I had to do was stop blogging?    It fills my heart to have such great interaction here at any time.  It especially filled it these past two months, months that have been more tumultuous than time-constrained, and some of the most difficult of my life.  So THANK YOU, and especially for much needed laughter along the way!  What more is there to say? I may or may not elaborate further on some unintended blog-related whys for the unplanned hiatus, but surely one of them has to be that old saying "the more things change, the more they stay the same".    While there are many examples of low carb antics I could use, there seems to be somet...

Sixteen Post Bumps for 2016 ...  No. 2 Update Notes & Summary This post discusses the section entitled  INCREASED PROINSULIN AS THE MAIN BETA CELL SECRETORY DEFECT in the following 2007 article:   PROINSULIN, PROAMYLIN AND THE BETA CELL ENDOPLASMIC RETICULUM: THE KEY FOR THE PATHOGENESIS OF DIFFERENT DIABETES PHENOTYPES .     This is but one of the papers that turned up as I was delving deeper into the progression of Type 2 diabetes and what it really involves.  It was this work that began the research and blogging journey into sorting out what insulin resistance is, if indeed it does exist as it is commonly "understood" from the standpoint of peripheral tissue glucose metabolism.   In the words of the authors of the paper: ... for three decades, the beta cell dysfunction has been shaded by the theoretical construction of peripheral insulin resistance . These researchers have access to roughly 170,000 records of everyone diagn...

Sixteen Post Bumps for 2016 ...  No. 1 Post Summary The main role of insulin in the body is to inhibit processes that release energy substrates into circulation on an otherwise "always on" continual basis.  Insulin plays a stimulatory role in the clearance of glucose from circulation, but this is secondary to its inhibitory role, and may not even be physiologically important.  The generally accepted progression of "insulin resistance" -- beginning with impaired uptake of glucose in response to insulin stimulation, leading to a "backing up" of glucose into circulation, and requiring more and more insulin to clear the glucose -- is almost certainly incorrect. Radiolabel studies have demonstrated that in both T1 and T2 diabetics, glucose uptake is not impaired , and indeed may even be greater than normal. Hyperglycemia is due to  relative insulin deficiency even if overall insulin levels are high .  This deficiency is due to failure of the pa...

I thought in the interim of doing something more formal, I'd bump this post from October of 2010.  Keith Frayn, for newer readers, is recently retired prominent Oxford scientist who wrote one of the books Gary Taubes likes to use pictures from these days in his lectures (you're welcome Gary, if only you'd read the book more thoroughly).     Metabolic Regulation.    {as textbooks go this one is relatively economical though I probably wouldn't recommend it unless you've got some scientific background in the subject ... or a lot of patience, because it should be manageable if tackled in smaller doses } He lays out the basics of Adiposopathy - pathological fat - sick fat - though doesn't use the term.  The evidence for this is overwhelming, and although this is just an outline of sorts, it only needs some clarifications and fleshing out with evidence of various components and the mechanisms involved.  In that regard, much progress has been made enfor...

Random Bump: There has been some discussion of diagnosing diabetes type going on in my comments of late and I thought this might be a good post to bump in response.  It's pretty specific, but contains links to some background blogging. I think it would be safe to say that I'm of the belief -- and the scientific evidence seems overwhelming in support -- that peripheral insulin resistance is either non-existent or plays a minor role in T2 diabetes.   Nonetheless, the concept of IR remains, but for the most part is diagnosed using a fasting HOMA-IR score based on fasting insulin and glucose levels.  This is considered a measure of hepatic IR, but even here appears to be a flawed measure.    The "swamped insulin receptor" model is flawed.  Not saying it doesn't perhaps play a role, but glucose uptake is not the first defect nor the main determinant of elevated circulating glucose.   The WHO even classified Type 2 Diabetes as such (1999): ...

I received some fanmail yesterday -- it was a nice email!! -- encouraging me to share Dr. Roy Taylor 's  presentation at the 2015 Diabetes Summit -- of Newcastle Diet aka "crash diet" for reversing diabetes.   It's too bad he ended the talk encouraging the host to keep spreading good information ... sadly his is a rare inclusion in this event. HURRY -- I thought these would be available through Thursday Noon, but it's saying 3 hours :(  -- hopefully they'll extend that.  SORRY!! This summit is the second annual event put on by the director of Sweet Life Diabetes Centers, a chiropractor turned nutrition expert and other things, Brian Mowll DC.  Last year he co-hosted the event with Jimmy Moore, and I dubbed it the Reversing Diabetes Knowledge Summit .   There are more of the same chiropractors, naturopaths, and such spreading their views on how you basically should eat a very low carb diet and avoid this or that bad food that is killing your pa...

BUMP:  This post is over four years old (original publish date:  11/17/10).  It came to mind a day or so ago when someone linked me to Sam Feltham's latest DISinfographic and accompanying video. If what Feltham is saying (and I can't for the life of me understand how he "borrows" this from Bailor w/o any complaint from Bailor ... even his book title is similar to Bailor's former one!), the results in this study shouldn't have occured. So the original (short) post, unedited, and some commentary afterwards in how some things have changed in my knowledge, understanding and thinking about all of this.

Hello all!  A quick follow-on post to yesterday's offering on the Ma-Pi2 diet for diabetes.  This diet is vegan, grain based (brown rice, millet, barley), includes legumes and copious veggies, and "macrobiotic" foods like seaweed and green tea.   Recent Post:   Vegan Ma-Pi Diet Bests "Conventional Treatment" for Diabetes in Recent RCT Previous Posts:   Carbohydrate and Diabetes , Carbohydrate and Diabetes II I want to make clear that my purpose for blogging on this particular diet is not one of advocacy.   I don't believe there is any evidence for humanity avoiding all animal derived sustenance and, sorry, but the Ma-Pi diet does seem a rather austere one to me.   Furthermore, I am offering no comment on the "macrobiotic" claims and whether the inclusion of some of these special foods is integral to the success of these programs.  When looking at the success of programs such as native Hawaiian diets (discussed here ), and others, which...

1.  It is known that the adult human brain consumes roughly 23% of total daily caloric expenditure for the "average person".  Glucose utilization by the brain has been determined to be at least 100 g/day, the most common figure I've seen is 125-130 g/day, and I've seen up to 150 g/day.  In light of this (and absent rare brain GLUT transporter deficiency disease), wouldn't EVERY human have a "carbohydrate tolerance" of at least 100 g/day?   2.  Low carb advocates like to focus on the fact that there are approximately 1 to 2 teaspoons or somewhere between 4 to 10 grams of sugar (glucose) dissolved in circulation at any given time.  However normal individuals "clear" several times that amount in fairly short order (an OGTT runs 50 to 100 grams of glucose).  The "insulin resistance" paradigm implicates a backlog of glucose in the blood stream due to cells with filled up glycogen stores.  This sounds like common sense.  Why, then, do...

If you've been around the internet the past couple weeks or so, you're aware that it is apparently Summit Season!  Lots of videos (really audios) that you get to listen to free as a marketing pitch.  Nothing inherently wrong with this, but many of the recent ones have really gotten to the point of ridiculousness.  I mean Jack Kruse was supposed to do a talk for a weight loss summit ... along side Jaminet, Bowden and the Alphabet Soup Couple (the Caltons)?  Ben Greenfield?  Mr. Keto-bonking triathlete is everywhere these days -- fat loss, thyroid, diabetes?  This man sells superencoder bracelets and magic water drops !  What the ......    So yesterday, the " 2014 Reversing Diabetes Summit " began hosted by "Dr." Mowll, and ... get this ... Jimmy Moore.  Forget Jimmy's lack of any credentials or credibility to be hosting such an event, let's look at Dr. Mowll : He graduated from Brandywine High School, the University of Delaware, ...

Previous post:   Insulin Dynamics I - Secretion vs. Sensitivity in Health & Disease/Decline This post will discuss the following paper:   Development of hyp erinsulinemia and insulin resistance during the early stage of weight gain  (Erdmann). This was yet another paper I came across thanks to this recent review: Body Weight Regulation and Obesity: Dietary Strategies to Improve the Metabolic Profile .  I'm efforting the full text of this that I can share here, but in the mean time, here's the context in which the Erdmann paper is introduced in that paper: Overweight and obesity represent a worldwide increasing health problem that seriously raises the risk for the development of severe metabolic disorders such as type 2 diabetes (T2D) mellitus and cardiovascular diseases (Erdmann et al. 2008, Klein et al. 2004). As with increasing obesity, insulin action decreases, and the system usually compensates by increasing β-cell function and consequently insul...

Over on Facebook, I caught wind of a new paper on obesity -- a review of sorts -- suggesting that reducing postprandial insulin secretion and/or increasing fatty acid oxidation rates may be promising avenues for the prevention and/or management of obesity.  So that led me to a few references that led me to yet another comprehensive review paper on the etiology of diabetes:   Type 2 diabetes: principles of pathogenesis and therapy .  A graphic in that paper reminded me of one from a paper I blogged on almost four years ago:   Mechanisms linking obesity to insulin resistance and type 2 diabetes .   (I have this paper, but the link in that post is dead, when I get a FT that doesn't have personal "imprint" I can share.) I decided not to update that old post since it focused on the role that fatty acids play in the scheme.  However I thought I'd start off a focus on hyperinsulinemia insulin in terms of hypersecretion vs. reduced insulin sensitivity.  ...

I've got the teaspoon gang on the mind after my last post, and I'm making my way through some 1960's diabetes research at the moment.  In a study older than me (that's more than a half century old!) two of Taubes' oft-cited diabetes researchers, Solomon Berson and Rosalyn Yalow, reported in the peer review literature something that might be of interest. You know the drill by now,  That's a little more than 1 teaspoon of sugar:  1 teaspoon  = 4 grams    (that would be 80 mg/dL).  

I really struggle sometimes wondering what goes on in the minds of the staunch low carb advocates.  Something comes along that's just their sort of "red meat" revelation -- you know a "what if everything you thought you knew was wrong" sort of bombshell -- and they just seem incapable of wrapping their head around it because it goes against what they've been told by their LC heroes.  Instead of even trying to reconcile the cognitive dissonance, it seems they'd rather just move the goal posts .... just one more time?   I suppose it is easier to believe in fairy tales, to convince yourself that the rebel path you chose on the word of so-called experts is the right one to optimal health and immortality.  The alternative does tend to get rather uncomfortable.   When I wrote Carbohydrates and Diabetes , my intent was to dispel one of the more common remaining myths about carbohydrates.  This is one that, sadly, is embraced by the mainstream as well. ...

Traffic Bump! Occasionally I see traffic to old posts whilst perusing stats.  I saw this was getting a few hits and decided to bump it.  Especially since the fervor for finding the single bogeyman dietary agent of all doom seems to be hitting a fever pitch lately.  Even Dr Oz is getting on board, and as the Judith Mazel of the low carb world tells us: Dr Oz is one of the most well respected conventional doctors—and he has major influence because he is educating millions of people every single day on his show. {you can stop laughing now ...}

Before Paula Deen got in hot water over racial issues, she was the subject of controversy a few years back with her belated disclosure that she had Type 2 diabetes, and then became a spokesperson for Novo Nordisk's Victoza.  The "mainstream" balked, including rebukes from fellow celebrity chefs for using so much butter in her cooking while hiding the effect it had on her health.  When the news hit the LC community, it of course went nuts.  I discussed this pretty thoroughly HERE .  A quick summary might be that the low carbers didn't like that people blamed the fat in her foods and finger pointed at the carbs (ignoring sedentary lifestyle entirely).  Further, they didn't like that she was dieting per mainstream guidelines and using Victoza rather going on a LC diet.   Stress certainly has taken a toll on Deen, but she seems to have maintained her weight loss, perhaps even losing a few more pounds.  It would be interesting to get an update on her con...