Monday, September 5, 2011

Hyperlipid Weighs In On Taubes/Guyanet "Dust Up"

Should we abandon the carbohydrate hypothesis of obesity?

Peter is a tough read - hope to summarize his post this week.  Highlights many of the critical issues wrt "Food/palatability" and weighs in on the side of "carbohydrate drives insulin drive fat accumulation".

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.











Saturday, September 3, 2011

About Taubes, Guyanet, Science, AHS and Missing Rulers

From most recent and going back:

Guyanet answers Taubes:  http://wholehealthsource.blogspot.com/2011/09/response-to-gary-taubes-framing-debate.html

Taubes answers Guyanet conflict from AHS:  http://www.garytaubes.com/blog/

Guyanet describes the conflict at AHS:  The Carbohydrate Hypothesis of Obesity: a Critical...

I'm still trying to digest Guyanet's perspective, which is tough because it is not laid out in a book, but is also less lengthy than Taubes cryptic, 400+ page masterpiece Good Calories Bad Calories.  I found GCBC to be so profound, I read it four times with multiple additional forays into it to answer specific questions as they occurred to me.

I hope it won't take as long to digest Guyanet's description of the wretchedly titled "food palatability" hypothesis.  Here's a summary:
Carbohydrate consumption per se is not behind the obesity epidemic.  However, once overweight or obesity is established, carbohydrate restriction can aid fat loss in some people.  The mechanism by which this occurs is not totally clear, but it has nothing to do with removing the supposed suppressive effect of insulin on fat release from fat cells.  Carbohydrate restriction spontaneously reduces calorie intake (as does fat restriction), suggesting the possibility that it alters body fat homeostasis, but this alteration likely occurs in the brain, not in the fat tissue itself.  The brain is the primary homeostatic regulator of fat mass, just as it homeostatically regulates blood pressure, breathing rate, and body temperature.  This has been suspected since the early brain lesion studies of the 1940s (47) and even before, and the discovery of leptin in 1994 cemented leptin's role as the main player in body fat homeostasis.  In some cases, the setpoint around which the body defends these variables can be changed (e.g., hypertension, fever, and obesity).  Research is ongoing to understand how this process works.

A couple of points in the interim:
1.  They are not arguing about whether or not carb restriction is helpful for people that are over weight.
2.  They are not arguing about whether or not Taubes' message on the faulty science of fat and saturated fat is incorrect.
3.  In short, one thinks the key to treating obesity is by eating to avoid hormonal dis-regulation, aka metabolic derangement.  The other thinks it is about hormonal dis-regulation also - but a different hormone.  One focuses on insulin function, one on leptin.  I'm not at all sure they are not both correct, but can't tell yet.
4.  As Guyanet frames it:  I'd like to begin by emphasizing that carbohydrate restriction has helped many people lose body fat and improve their metabolic health.  Although it doesn't work for everyone, there is no doubt that carbohydrate restriction causes fat loss in many, perhaps even most obese people.  For a subset of people, the results can be very impressive.  I consider that to be a fact at this point, but that's not what I'll be discussing here.  

The good news is that there's a fight between two, smart researchers and they both agree on fat.  The bad news is that this is too much like a couple guys in rain coats yelling "mine's bigger!" but neither can afford a ruler (my thanks to Coach Glassman for the analogy!).  However, aside from ego, it matters not "who's is bigger".  This kerfuffle only starts to matter if it results in the advancement of our understanding of how to use diet to optimize health.

I hope it will come down to this - both will propose a research study design that will test the relevant hypothesis, and those studies will be funded.  From that or those defining studies, we may get useful information about how to help people that are obese get well faster, and we may find out how to help lean, well people stay well if they want to.  There are a number of good intervention studies that show carb restriction is effective.  Perhaps there's a Guyanetesque refinement that will make carb restriction more effective or less restrictive.

On the Guyanet post, many have weighed in to say the equivalent of "I don't mind if you have a way to refine what Taubes is saying, but his book saved my life, don't get too personal in your writing."  I have a similar gratitude to Taubes - his book made an structured understanding of the science of diet possible to a guy like me who would never have a chance to pursue such an understanding via academia - and in a way that serves my style of learning far better than simple reading and test taking.  GCBC was a literal answer to my prayers and I spent two satisfying years digging through it.

I take it as a given that Guyanet has also helped many people, and has a great voice on elements of the paleo model that is not found elsewhere in the blogosphere.

If they do it right, all of us curious onlookers will benefit from the debate, and hopefully they will both be handsomely rewarded for their contributions to our collective understanding.

Brilliantly Simple To Say, Challenging To Do

Thought for the weekend from WHS:

"Don't eat processed crap." 

Can you do it?

Hope your long weekend is prosperous in rest and fun.  Farewell, summer 2012, you were a great one in many ways.  Hello and welcome, fall 2012, and thanks for the hunting season, cooler weather, football games with family and the coming adventures in CrossFit!
 

Friday, September 2, 2011

Fat Loss, Exercise, and Food

From a note I received from http://www.precisionnutrition.com/:
Outside of the 3-5 hours you exercise per week, what are you doing with a good chunk of the other 165 hours?  You’re eating. 

That’s why an exercise program is never enough to see real, honest-to-goodness body transformation - and why knowing how to change the way you eat is so vital to changing your life.

And here’s the exciting part: fitness professionals are finally figuring this out. And as a result, we’re seeing some welcome changes in the fitness industry.

In five years, knowing how to help change a clients’ eating habits will be what separates the "personal trainer" from the person who changes lives.

I was first exposed to this idea about four years ago via a discussion board post from CrossFit's founder, Greg Glassman.  Alwyn Cosgrove repeatedly says "You cannot out train a bad diet."  Many folks have a hard time believing this, because the opposite idea has so often been stated, it is believed, despite being unproved:  "Just exercise enough and you will lose weight."  That this strategy can work for some makes it all the more confusing for the many - who find they do not achieve their body composition and/or health goals via exercise alone

While it is not debatable that body fat accumulation reflects the First Law of Thermodynamics - energy cannot either be created or destroyed - therefore, if one accumulates a pound of fat, then one must have ingested more calories than one has expended.  What the "first law" does not account for is "why". 

Human behavior is complex and defies any simple analysis which might invoke will power, calories-in-calories-out, or "just burn a few more calories daily".  In complex systems, causality is rarely linear. 

An example goes as follows:
I propose fat accumulation is the result of a complex series of interactions between external demands on the human (do you have to work ten hours a day in the fields to grow/harvest/store/process your food?), internal hormonal signals (high carb consumption requires a series of responses to prevent damage to the organism from excess blood glucose), and information available to the human in question (do you know how to avoid hormone disregulating foods?  Do you know how to associate pain instead of pleasure to your unconscious mind's response to foods you think you should avoid?  Have you learned which foods result in satiety, and supress hunger for long periods, and which result in rapid return of hunger?). 

Restated - there are external circumstances which result in weight loss which are not related to human choice at all - for example, once you are in boot camp, you'll eat what you can and do your best to keep moving as directed.  There are internal responses which are not directly related to calorie intake which still result in fat accumulation.  And the more a human knows, the more likely they are to be able to impact the variables that result in fat accumulation.  Due to these variables and others, human fat accumulation is complex and not likely to be the same for most of those who suffer from either too much fat or too little.

This is a very, very general model, and the details could be worked out in a number of ways.  Hopefully, science will work its way through those details in my lifetime!  In the near term, we have to rely on human experience, which works much more rapidly than science, though is plagued by superstition, and about a million other truth distorting tendencies towards bias.

While short, intense exercise is therapeutic in a variety of ways and worth doing for its own sake regardless of weight loss intentions, I am not one who believes it is a requirement for fat loss - at least not for everyone.

If you would like to jump start your body recomposition effort, or have determined it is time to take your health into your own hands, call me today!  Like CrossFit, I will help you achieve faster results with less frustration!
901-517-0085, ask for Paul

Thursday, September 1, 2011

Classic Quote, Bell


"Do the things you suck at, and get ready to go from dud to stud. Remember, it’s what you think you already know that prevents you from learning. Do not let your ego paralyze your progress."
Mark Bell
http://library.crossfit.com/premium/pdf/CFJ_Underloading_Bell_July2011.pdf?e=1314928717&h=8969167ab23d749eef82bddab6553cf4

I Know It's Only High Cholesterol But I Like It ...

If you can hear the Rolling Stones tune in that title ... you are really good.

Take a look at Chris' videos, they tell a good tale.
http://chriskresser.com/i-have-high-cholesterol-and-i-dont-care