The Carb-Sane Asylum

U nless you've been living under a "rock" in the world of nutrition, you're aware that Stephan Guyenet "debated" Gary Taubes on the Joe Rogan Experience podcast. It took me several days broken up to watch/listen to the whole thing. In a nutshell, it was Science & Substance (Stephan Guyenet) versus Stories & Slander (Gary Taubes). Rather than summarize, there were several points made that I'd like to address. In no particular order. I'll include this intro with links to prior topics as this series progresses.

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...

This post was prompted by the following article on Medscape Why Aren't We Prescribing Pills for Obesity? It is written by Caroline M. Apovian, MD  I'd encourage you to read this whole thing first, as I'm genuinely interested in that response. Additionally I'm curious as to whether or not your response changes after reading this blog post (or other sources I'm about to link to).

s ummary This post discusses a few studies on BMI and body composition and CVD mortality.  It was prompted by a Twitter conversation wherein Rob made claims regarding  frail obese people , and that obesity science must address body composition to move forward.  The idea being that people with BMIs up to 40 don't have a "weight" problem, they have a fat problem, and the solution is to gain more lean mass then lose fat mass whether or not there is net weight gain/loss/neutrailty in the process.  BMI is essentially a useless measure.     There are a lot of people, particularly in the "strong women" and Healthy-At-Every-Size (HAES)/related communities putting forth a similar message, that weight doesn't matter, and the former, especially, promoting lifting heavy weights and "thickness".  A sizeable proportion of people from just about every corner of the internet is fixated on the concept of preserving and/or building lean mass.   ...

T his mix of snarkasm and practical advice is brought to you by Facebook Memories reminding me of a post I made around a year ago -- The #LCHF Weight Loss Industry & Evangelizing Low Carb  -- and the upcoming Keto Clarity Academy event featuring Melanie Miller and Jimmy Moore "influencing" people on how to stay healthy for the holidays. The holiday season will be soon upon us, and even those who celebrate no December holidays will likely still have to navigate related social engagements.  Let me preface this by saying that I recognize there are a number of people who absolutely cannot, or probably should not, stray from their dietary regimen.  There are others who, when they do, have a much harder time getting "back on the wagon" compared to whatever issues staying on plan will cause.  If you are any of these people, this blog post is not for you.  This blog post is aimed at all of those who are angst-ridden going into and through the upcoming holi...

Bumping Again! New Article in BMJ:   Analysis: Beating type 2 diabetes into remission * The original posting of this was shortly after the first papers published on the success of a very low calorie diet -- essentially a 6-800 calorie protein-sparing-modified-fast, protein shakes + non-starchy veggies -- in curing diabetes in relatively short order.  You may also be interested in the following posts: The Diabetes "Crash" Cure Revisited  (a follow-up to this one) Diabetes "Crash" Cures: VLCal vs. VLCarb Check Featured Comment (if any) for further updates from me. *In light of commentary below, I'll add that I am not a fan of using the term remission here.  Cancer does seem to strike at random most times and recurrence seems to be equally random.  At best we have few if any ways to predict who will see cancer return etc.  But Type 2 diabetes doesn't work that way in most.  The source of the beta cell dysfunction is pretty well k...

Preface: I have to say this.  Sorry, not sorry.  If you have children, and you want to help them with nutrition and health as they grow, teach them about food and teach them how to cook.   Get your own weight and health under control (if it's a problem) so that you can pass down good habits to your children.  Or do nothing.  None of my business.  But whatever you do, do not buy your child a copy of Fat Head Kids or let them within 50 yards of a showing of the Fat Head Kids movie if it ever comes out.  Put a block on your Hulu or whatever streaming service it is eventually on.  I cannot recommend more strongly against this. Every time I have watched snippets of some video of Tom talking about this book, or read the preview content on Amazon, I just get utterly creeped out by the whole thing, and Tom Naughton specifically.  Books for children should not include shirtless pictures of the middle aged author who goes on about boy boobs....

This series was inspired by my own "journey" through what I'm going to call disabilesity.   If you haven't done so and would like some personal background, read  Disabilesity ~ Part I: Intro and My Own Journey . This installment is about increased risks and rates of physical impairment, preceding and including formal physical disability, that have coincided with the rising rates of obesity.  A theme of this series is that unlike the chronic metabolic disease risks (diabetes, CVD, etc.), the impairment of physical ability is often overlooked.  In my opinion, this does a disservice, especially to younger obese individuals who are not properly educated/warned about these very real consequences.  Most people don't die of things like osteo arthritis, but quality of life can be greatly affected.

This post was inspired by my own "journey" through what I'm going to call  disabilesity.   It got insanely long and cumbersome, so I'll break it up into parts: Intro and My Own Journey of Disabilesity The Forgotten Disabilesity Epidemic How the Obesity Industrial Complex does a disservice to those at risk or suffering from Disabilesity It has been my observation for a while now that various interests I shall refer to collectively as the Obesity Industrial Complex, are only marginally interested in *fixing* any problems attributable to the obesity epidemic in affluent countries.  Instead, for various reasons and in varying ways, the different factions seem more intent on maintaining some level of the status quo for profit, relevance, notoriety or some combination of the above.

A llow me to share just one "a ha" moment I came to in the beginning of 2016.    Me photobombing Nobel laureate Michael Brown and Kevin Klatt (aka @Nutrevolve) October 2016 I'm kinda cute, huh?     I met my now husband the October after graduating from college and getting my first real job.  He was a co-worker and friend of my apartment neighbors and friends.  At the time I was far from the fattest I'd been, but I believe the pants I was wearing were size 14 at the time.  We hit it off instantly.  Movie magical type stuff.  In my sleep-deprived state the next day at work I even told my co-worker friend that "last night I met the man I'm going to marry".

SUMMARY: Back in the early days of the Asylum, there was a commenter who repeatedly fixated on "why do we overeat".  Eventually I coined the phrase "why-ning" for this questioning. This post is about how seeking external whys in the scientific literature is most likely a futile effort.  Science can provide easy answers, it turns out, to how to eat to normalize weight.  Putting that into practice in the *real world*, is a whole 'nother issue!!! If you struggle with weight ... if you're putting all manner of effort in anyway ... this post is a suggestion to alter your "why-ning".  From unproductive questions of why, to more productive, individual and personal questions of yourself as to why. It is emotionally incorrect these days to acknowledge that for many, adult obesity is, indeed, a lifestyle choice.  It may not be conscious.  It may not have started out that way (e.g. if you have always been obese).  Nonetheless, it is far more within o...

Introduction The current theme of metabolic research seems to have settled on physiological changes, post-weight-loss in the obese, that set the person up for almost assured failure and regain.  It has been reported that the super-obese (usually a term for BMI>40) tend to have REEs that are higher than would be predicted by standard, generally accepted models such as Harris-Benedict or Mifflin-St.Jeor.  This is both what was seen in the Biggest Losers "before" weight loss, and was reported in comments on this blog by Dr. Yoni Freedhoff, who measures REE in the obese he treats.   In order for a super-obese person to fully reverse their obesity, they will need to lose large amounts of weight -- 100, 200 or more pounds.   To do so, most will need to dramatically cut calories to lose at a rate that is motivating enough to sustain a fairly lengthy time period.  Even "fast" weight loss, reported by many, and especially gastric bypass patients, occurs over...

I am ( STILL ) working on a comprehensive post addressing "The Biggest Loser Regain" study and fallout.  But as I was going along the way, I'm finding some gems that really just need posts of their own.  This is one of them.  I'm also going to do my best to clean out the draft bin for the remainder of 2016!     [If you haven't seen the previous entry referencing this topic, here is a link .  If it is some time past the publish date of this current post, this link should be active for the TBLR post.]

I interrupt my usual stream of non-blogging for this general "off topic" post.   The Offending Tweet

A few years ago now, researchers led by George Bray of Pennington did a classic overfeeding study, to interesting result.  I blogged on that study in some depth here , but I'll include a brief summary now: Metabolic ward study Determined weight maintaining caloric intake over a period of 13-25 days on a standard diet P/F/C% of 15/25/60% The average maintenance calories for all participants was 2414 cals.  Overfed ~40% of calories or ~950 cal/day for 8 weeks. Carbs in the overfeed were slightly less than absolute amount at baseline, and were 40% of total overfeed calories. Total caloric intake for overfeed averaged 3375 cal/day, where excess calories came from fat and protein only.  The macro ratios of the overfeed diets in P/F/C% were: LP-6/52/42, NP-15/44/41 and HP-26/33/41. Below is the summary table I made for the calories and absolute quantities (grams) of the three macros:

A Facebook friend recently posted a screenshot of some papers he'd been reading this past month.  Being the geek that I am, I of course scanned the titles to see if there was anything I might be interested in, and I was shocked to discover this study for the first time!  Shocked in that I'd never seen it before or seen anyone reference it.  Read on and discover that this isn't quite true ...   (As of this post, full text available   HERE . ) Metabolic and behavioral effects of a high-sucrose diet during weight loss  ... 1997  ← Almost two decades ago!!

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...

If you interact with me at all on social media ... or if you just keep your eye on that Twitter feed over there on the right ... you're probably aware by now that Jimmy Moore is fasting.  Today would be Day 9, I think .... But first, a little intro from a podcast interview with Abel James -- aka the Fat Burning Man -- taped either shortly before or a day or so into the fast.

It seems to me that enough folks, including Kevin Hall PhD himself , have weighed in on the specifics of his recent LC ≠  more [body] fat burning smack down metabolic ward study that I didn't have the need to.  I do, however, have a bit of a retrospective look at things in the works.    But Gary Taubes has seen fit to respond in the New York Times, in most ridiculous fashion:   Diet Advice that Ignores Hunger .   First of all, Gary Taubes is no young whippersnapper, in fact he's a bit older than me.  I remind folks of this not to pick on his age, but to put some context to how ridiculous this notion that hunger on extreme diets has been ignored.  Does he not recall the widespread use of amphetamines and their OTC counterparts in the form of Dexatrim and such?   Seriously ... diet pills to curb hunger have always been around, they've just fallen a bit out of favor due to the inefficacy of most.    If you really want a flas...