Monday, September 5, 2011

Questions to WHS


Stephan summarizes his model here:  http://wholehealthsource.blogspot.com/2011/08/roadmap-to-obesity.html

These are the questions I posed (I'll be interested to see if he answers):
A proposition on what the purpose of a metabolic system is:
-fueling the brain is the highest priority of the metabolic system, the most critical element being oxygen, second is glucose/ketones IOW a "brain specific fuel."
-possibly the next most critical function is hydration
-not as time critical, but critical, is prevention of an excessively high level of blood glucose to prevent damage to the nervous system
-after that, the priorities are to distribute fuel to keep the body moving, and then to ensure long term viability via distribution of essential nutrients to support growth, healing, and the mechanisms of long term health

In other words, for a model to explain a condition like obesity, or how to reverse it, I would expect it to reflect the primary drivers of metabolic purpose.  I understand how the carb/insulin/fat model aligns with the priorities as I understand them - that model explains the role of insulin in defense of excess blood sugar, it explains why we get the ketogenic response in the absence of carb intake (brain fuel source redundancy, in combination with the fact that most cells exhibit metabolic flexibility to either help control glucose levels from exceeding healthy levels, but easily burn fat for most purposes when glucose is not abundant), it explains why we observe very high blood concentrations of free fatty acids in the absence of fat intake with high carbohydrate intake (liver production of palmitic acid from glucose), and in this model we observe that in the obese, many indicators of metabolic derangement can be reversed via carb restriction alone in just a few days (and less rapidly so with non-carb restriction of calories).   


IOW, the carb/insulin/fat model is compelling for me because it fits within a coherent model which satisfies the important "WHY" question:  why do we have a metabolic process.


I am working through an understanding of the model you advocate - is there a post in which you've highlighted how that model also meets the metabolic purpose?  IOW - why is it good that the body as a "set point"?  What purpose does it serve, what survival/adaptability function is enhanced, via "set point/leptin signaling?"  I can see how leptin signaling serves us in the carb/insulin/fat model, but the light is not yet on for your advocated model.


As I read the comments, I'm surprised by how many of the commenters on "both sides" (and Taubes, but he likely didn't read it) can't see the significance of this part of your post:  "According to USDA data, Americans today eat an astonishing 425 more calories per day than they did in 1970** (11).  That is the reason for the obesity epidemic, plain and simple.  However, that fact doesn't tell us why we're eating more calories, so its usefulness is limited."  (my italics/underline/bold)


I'm also curious, in your experiment w Kresser, how you will define palatability in a way that differentiates that quality from carbohydrate in general, sugar specifically, in real food.


For me, as I have become habituated to carb restriction, regular, non-sweetened/salted food tastes much better.  My "addictive" behaviors as regards sweets have been regulated.  My pleasure in eating sweets now is decreased.  I cannot remember the last time I "ate big", and I don't feel the desire to eat big.  My body fat has modulated between 10% and 20% over the last 25 years (everyone else in my family spend at least half their lives overweight; I don't have a genetic super-metabolism).  Prior to age 20, I couldn't eat enough to gain weight, ever since, it has required significant experimentation to find a strategy to maintain a healthy weight, despite hours of weekly exercise.  I can explain all of that - to my satisfaction - via the carbs/insulin/fat model.  I'm still a long way from that level of understanding in your model.


Lastly, thank the heavens the debate has moved beyond "saturated fat bad, plant based food good, exercise more and control your portion size."  


One more thought - when does the change in model from the carb/insulin/fat model to the Guyanet/pallatability model result in a clinical implementation that is different? It appears that carb control (~100g/day) is practically the same as palatability control.











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