The Carb-Sane Asylum

Hello World .. and anyone still reading this blog!! Yes, it's been forever.  I've been generally pretty well.  Knocking about on social media (Facebook and some Twitter) ... occasionally getting the urge to blog, write something, get to 80% then lose the mojo.   What has turned into a long hiatus wasn't planned, but it happened due to running out of steam and still seeing the same old, same old.  I may or may not discuss more at some point, but if I don't just jump back in and blog, I probably never will again! And so, with that said ... 𐩘𐩘𐩘𐩘𐩘𐩘𐩘𐩘𐩘𐩘𐩘 The following editorial in JAMA has been making the rounds on my Facebook feed, and I have a bit of a different take and reaction to it ... one that comes from roughly a decade now of delving into dietary recommendations wars from where I "stand". The Editorial:   Backlash Over Meat Dietary Recommendations Raises Questions About Corporate Ties to Nutrition Scienti...

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...

S UMMARY Continuing on with discussion of: Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial In Part I , I discussed some issues with methodology, mostly focusing on the reduced Run-In Phase that likely compromised the outcomes irreparably. In Part II ,  I highlighted a serious issue with the Run-In Phase, the purpose of which was to produce a somewhat homogeneous "reduced weight state" to test various diets in maintenance of that state. Ultimately,  randomization to the various test diets occurred after weight loss (PWL) all subjects lost weight on the same 45% Carb / 30% Fat / 25% Protein diet targeting a weight loss of 12% ± 2% initial body weight. The researchers do not appear to have made many adjustments in the weight loss phase to produce a more uniform weight loss.   Rather than 12% ± 2%  (from 10% to 14%)  losses, the actual outcome was roughly 10.5% ± 5% (actual ...

U PDATE:   12/17/2018      Original Posting: 12/3/2018    During the writing of a new installment in this se ries, I revisited the following paper: A randomized study of dietary composition during weight-loss maintenance: Rationale, study design, intervention, and assessment Yes, folks, so full of themselves were these researchers, that they felt the need to write an entire paper (submitted approx. one year in advance of the "real study") outlining their amazing study. Regarding this post, focusing on the OUTRIGHT FAILURE TO IMPLEMENT THEIR STUDY DESIGN AS STATED , I stress the following from the previous paper. ONCE AGAIN, the stated goal of the weight loss run in is 12% ... not 10 or 5 or 15 or whatever ... 12%.  I'm just going to quote the relevant part here (cleaned of references, etc. and formatted for readability, all emphasis mine) Energy intake was restricted to 60% of estimated needs to achieve a target weight loss equ...

S UMMARY The results of the $12 Million Dollar NuSI-sponsored study, headed up by Dr. David S. Ludwig, are finally out.   Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial While the good doctor is making the rounds touting them as evidence in support of the Carb-Insulin Hypothesis (TWICHOO in these parts), a review of the raw data made available to the public casts grave doubts on his victory lap.  This study built upon the "promising" results of the 2012 study:   Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance    This post focuses on comparisons of Study Design between these two studies, some improvements, and the ultimate failure that renders the primary outcome data suspect, if not outright useless.  (And I don't say that lightly!) Improvements: Study size Length of time on one test diet (20 weeks) vs. 4 weeks crossover on each...

April 2018 Update: Here in the year 2018, it's fair to say that #Paleo is pretty much over. Nothing tells us this more succinctly than a quick trip over to Mark's Daily Apple, a website I rarely frequent these days. I'd heard rumors that Mark had "gone keto" ... given the seemingly meteoric rise of #Keto of late, is anyone really surprised?  This is the same man who developed the "more addictive than crack " P90X recovery drink and other things,  Ever the businessman (can't fault him for that), Mark seems to have transitioned from using his blog to sell paleo/primal-related books (did he ever find a proper ghostwriter for his wife's book?) to selling over-priced avocado oil products.   The whole "primal" thing is about as downplayed as possible for someone whose signature product is The Primal Blueprint, can be.    Poor Grok.  Now it's Keto Reset time!  Can these marketeers PLEASE make up their minds?   Wh...

W ith publication of the results of the second of the "Original 3" NuSI funded studies, I'm finally getting around to publishing up this post (and perhaps a second one shortly) regarding the Nutrition Science Initiative (NuSI), founded in 2012 by Peter Attia, MD and "science journalist" Gary Taubes. Bottom line ... for NuSI, it was "all over but the crying" a couple of years ago now. 

Bump Again! I've bumped this before.  I'm still alive and working on blogging, finishing off an installment about the Sugar Slammers. I think this post is worth a read or re-read.  The Laura and John Arnold Foundation funds several non-profits all engaging in targeting sugar as the ultimate cause of everything. Such funds are obscured as donations to universities.  Additionally other non-profits with clear agendas present themselves as taking no industry funding.  It's a dense mess. ORIGINAL CONTENT PUBLISHED MARCH 16, 2015 I'm working on another post regarding conflicts of interest and such, and this came up on the background gathering.  A number of journals are adopting "noble" policies of no longer accepting industry funded studies. Mind you, many of these same journals appear to have no qualms publishing the works of individuals with clear biases and conflicts. I think this hard line on industry funding is wrong-headed.  Not that I'm...

This was initially going to be a monster post, but I'm still struggling to organize it all!  The things uncovered at every turn last week and continuing through this one are astounding, and the hypocrisy of those touting this as some "smoking gun" of great importance is seemingly boundless.  This was all still swirling in my head when I went on Angelo Coppola's Latest in Paleo podcast ... in retrospect not a good idea when I'm wound up! I decided to break this in two to publish something up.  This installment will be linking to background to get something that blogging rock rolling on this.  Unless you've been living under a rock, this happened in the JAMA Internal Medicine : Sugar Industry and Coronary Heart Disease Research A Historical Analysis of Internal Industry Documents Cristin E. Kearns, DDS, MBA 1,2 ; Laura A. Schmidt, PhD , MSW, MPH 1,3,4 ; Stanton A. Glantz, PhD 1,5,6,7,8

Is Gary Taubes losing it?  His grip on reality, that is?  I submit that it is the only "innocent" explanation for his behavior of late. Gary Taubes and Mike Eades in Better Days for Low Carb "Science"  8/13/2008 direct image link I'll have more to say when I can recoup from the busy time of year in my real job coupled with traveling weekend before last.  But if you haven't heard, two studies conducted by NIH scientist Kevin Hall: The unveiling of the results of the NuSI funded multi-center study at an obesity conference.  See Nutrition Wonk for the most info.  This was a 2 month metabolic ward study. The followup results of a study on The Biggest Loser with some confusing metabolic outcomes.  I say confusing as the numbers don't add up, but that hasn't stopped pretty much everyone from painting a picture of doom and gloom topped with a large dollop of CICO/ELMM is going to destroy your metabolism fatalism.    I will have more...

I just came back from a trip to Kansas City to meet the public (grin) and was immediately bombarded from several sides with the above video.   Nutrition Wonk has transcribed the talk so head on over to see that and the poster!

Sixteen post bumps for 2016 ... No. 3 I think this post from around a year ago, in light of the new book by David Ludwig is a necessary bump. It's not every diet guru that is a principal investigator on a "groundbreaking" study that directly debunks the thesis of their book.  In this regard, Ludwig is, if not one of a kind, the leader of the pack. Originally published on January 19, 2015 The former British colonies/territories may be known for a lot of things, but in the nutrition world, I'm going to go out on a limb here and state that the Glycemic Index - GI - is the trifecta. In Canada, David Jenkins pioneered the concept, for applications in diabetes treatment.  This cause was picked up and concurrently championed in Australia by Janette (Jenny) Brand-Miller.  A little late to the party, in one of the original Thirteen, David Ludwig took up the cause in the USofA.  Are these the men and woman who made us fat? Adapted from Adele Hite's Eat...

Bump! Over on Twitter I was made aware that Dr. David Ludwig is coming out with a new book in January (HT Steven Snyder @NoGimmicksNutri) mentioned in this Time piece:   You Asked: Should I Count Calories?    The book is to be called Always Hungry   (affiliate link if you're going to buy it anyway!)   This is a similar title to the NYT editorial Ludwig co-wrote with NuSI's VP of Research last year, discussed in this post.  I also have a friend who attended an obesity conference recently at which Ludwig presented much of the same ideas.  It is repackaged TWICHOO (Taubes Wrong Insulin-Carbohydrate Hypothesis Of Obesity) , and what is most galling about all of this is that much of Ludwig's own research counters this ... Yet he perpetuates it?  From the article:

source:   Politico I have had several conversations since I wrote  Nina Teicholz Reports in the British Medical Journal ~ The Conflicts & Funding  and a petition to editors at The BMJ .  I have some of my answers, most of which were not provided to me in the interests of the same transparency demanded of others by the players themselves -- Nina Teicholz, The BMJ  and The Laura and John Arnold Foundation.  Details to follow.  First, some personal notes, an apology, and why the George Soros nod.  Then the goods insofar as I have them.

Blogstress Note:  This post has been in the draft bin for some time, most of it written very shortly after the JAMA article that sparked it.  As you'll see, it's more ranty than usual ;-)   I thought about toning it down or adding to it from the NYT editorial, but have just gotten too busy.  So I'm publishing it up -- as is -- before it exceeds its best-if-blogged-by date by too much!  There's probably some repetition with the Percentages post published up in the interim.  Please forgive typos, dropped sentences, incomplete thoughts, etc.  Dunno how many there may be, so here goes ... Let's Do Away With The Dietary Guidelines   The true cause of the obesity epidemic! ... if this is what it takes to save me from being bombarded with one more idiotic editorial in a peer review journal -- like the recent one in JAMA by Dariush Mozaffarian MD,DrPH and David S. Ludwig MD,PhD -- I'm jumping on board.  Oh!!  And this rank stupi...

image link Percentages are Often Meaningless    Summary: You can reduce the percentage of one item by increasing the total amount of all items.  This can give the illusion that you've reduced the amount of the item in question, but is just that ... an illusion. That previous post on this was inspired by yet another round of Fun with Numbers, this time courtesy of David Ludwig and Dariush Mozaffarian in JAMA ... and now the NYT    (I'm beginning to see a pattern here.  NYT is the publicity outlet for all JAMA editorial nonsense, much like Time is the outlet for BMJ's Open Season on Science Heart journal.)

A Continuation of  The Mechanisms of the Glycemic Index: A Fatty Acid Roller Coaster?  .... Quick summary of Ludwig's mechanism for high-GI making us fat v. 2002: High GI carb causes glucose and insulin to spike and fatty acids to plummet early on.  Then glucose plummets resulting in hypoglycemia and counterregulatory hormones kick in.  These bring glucose back or slightly elevated and cause fatty acid levels to rebound to levels reminiscent of a long fast making the person hungry (hypoglycemia) and hungrier (feeling fasted) so they eat more.     The Mechanism of High-GI ~ 2012 by Davis S. Ludwig In 2012, with colleague (often listed as a co-lead investigator) Cara Ebbeling and others, Ludwig published:   Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance .  In  JAMA .  I only mention this study here for two reasons.  First, to demonstrate that the 2002 review paper was not by t...

This post will focus on some statements made by a researcher who I've dubbed "America's GI Man", Dr. David Ludwig, in this review: The Glycemic Index: Physiological Mechanisms Relating to Obesity, Diabetes and Cardiovascular Disease , JAMA , 2002. A Note Regarding Definitive Statements in Review Papers As I found myself getting sucked down the Pubmed rabbit hole that is the GI, it was really this paper that took me past that point of no return.  I have taken a screenshot of the top of the PDF format of the article to convey a few things, and at this point I'm beginning to understand how it is that doctors can get sucked into bad paradigms when their "prestigious journals" put out "SPECIAL COMMUNICATION"s from their "CLINICIAN'S CORNER"

As I have quite a few tangential thoughts going on, in search of a cohesive theme here, I've decided I'd just throw up a few short posts, and perhaps come back and put them together at some later date. The Glycemic Index is credited to Canadian researcher David Jenkins, and originated, near as I can tell, with this paper:   Glycemic index of foods: a physiological basis for carbohydrate exchange
. INTRODUCTION :   Recent work has suggested that the carbohydrate exchange lists that have regulated the diets of many diabetics for over three decades may not reflect the physiological effect of foods. Such factors as food form, dietary fiber, and the nature of the carbohydrate have been shown to have a marked influence on the postprandial glycemia and allowances cannot be made for these in lists which take into account only the available carbohydrate content of foods. Currently, very good blood glucose control has been advocated for diabetics to reduce the incidence of lo...