Tuesday, January 29, 2008

Metabolic Advantage again!

Richard has an excellent post on the whole "Is a Calorie just a Calorie" controversy!

180 Degree Errors

Read the whole thing, but his conclusion is worth repeating:

So I think we have a 180 degree error and Taubes is right: hyper caloric intake, in itself, does not cause us to be fat. Hyper insulin causes us to be fat, and that issues forth a whole cascade of problems (effects), one of which is hyper caloric intake. Repeat. And the effect of that cause is that very nearly everyone in the diet and nutrition establishment has been [conveniently] fooled.

Incidentally, Richard has arrived somewhere close to my current practice - low carb diet plus intermittent fasting.

Before anyone wades back in on this debate, take the time to watch Taubes lecture at Berkeley. You do not have to buy the book - he explains the key issues in the lecture.

Art Devany has also commented on Taubes: Energy Balance is Dynamic

This isn't really metabolic advantage, but Alwyn Cosgrove mentions also that the composition of your food is important simply due to what is called the Thermal Effect of Food (TEF):

The thermic effect of food (TEF)- or thermogenic effect - is a term used to describe the energy expended by our bodies in order to consume (bite, chew and swallow) and process (digest, transport, metabolize and store) food.

For most people this total number typically accounts for about 7-10% of calories consumed based on the Standard American Diet (SAD....)

Breaking it down ...Protein foods typically have a TEF of 25 -30%. Carbohydrate foods require about 5-10%. Fruits are around 15% Cruciferous vegetables are around 30% and fats are somewhere between 0 and 3%.

So you can see where I'm going with this ... if you just exchanged 100 calories of carbs for 100 calories of protein -- you'd actually in effect - burn off another 20-25 calories. If you swapped 100 calories of fat for 100 calories of vegetables -- you'd eat up an extra 27-30 calories.
Now I wouldn't necessarily agree with all of Cosgrove's conclusions with respect to diet (it looks low fat!), but it is another element to think about.

21 comments:

randy said...

Chris,
Your insistance on using opinion pieces from the web and ignoring published scientific results has significantly lowered the status of your site in my view. You are now posting INCORRECT information.

You do your readers (and I consider myself one) a disservice by referencing opinions as fact with double checking the actual science behind the claims.


Specifically:
Chris Wrote:
"hyper caloric intake, in itself, does not cause us to be fat. Hyper insulin causes us to be fat, and that issues forth a whole cascade of problems (effects), one of which is hyper caloric intake.
"

Reply:
Bullshit. The weight loss, carb, insulin connection has been studied
extensively. Even though INCREASE insulin level are found in High Carb diets there is NO difference in weight gain or loss in subject with lower insulin levels.
See references 1,2,3,4,5.

Chris Wrote:
"So you can see where I'm going with this ... if you just exchanged 100 calories of carbs for 100 calories of protein -- you'd actually in effect - burn off another 20-25 calories. If you swapped 100 calories of fat for 100 calories of vegetables -- you'd eat up an extra 27-30 calories.
"

Reply:
Double Bullshit.
If these numbers are true then we would see a HUGE difference in the weight loss studies.

In fact their is an increase in calorie burn with higher protein diets but it quit small. Its on the order of ~12Kcal/1000Kcal for every 10% increase in protein content. Thats a about a bit of a bannana.
Also these results comes from labatory findings, not some ramblings of a blogger.

See References [a], [b]

[a]Is a calorie a calorie
http://www.ajcn.org/cgi/reprint/79/5/899S.pdf

[b]Eisenstein J, Roberts SB, Dallal G, Saltzman E. High-protein weightloss
diets: are they safe and do they work? A review of the experimental
and epidemiologic data. Nutr Rev 2002;60:189–200.

[1]
Effects of an 8-Week High-Protein or High-Carbohydrate Diet in Adults
With Hyperinsulinemia
http://www.pubmedcentral.nih.gov/articlerender.fcgi?&artinstid=1868379


1.Effect of diet composition on the hyperinsulinemia of obesity. New
England J of Med 1971 Oct 7;285(15):827-31.
PMID 5570845

Discussion:
Women were on eucaloric diets to mantain weight on both high and low
carb diets. No difference in weight loss or gain on either diet.
In another experiment women were rotated on high and low carb 1500 cal
diets (cross over design) and weight loss was equivalent on both
diets.

[2]
Effects of an 8-Week High-Protein or High-Carbohydrate Diet in Adults
With Hyperinsulinemia
http://www.pubmedcentral.nih.gov/articlerender.fcgi?&artinstid=1868379


[3]Effect of diet composition on the hyperinsulinemia of obesity. New
England J of Med 1971 Oct 7;285(15):827-31.
PMID 5570845

Discussion:
Women were on eucaloric diets to mantain weight on both high and low
carb diets. No difference in weight loss or gain on either diet.

[4]Similar weight loss with low- or high-carbohydrate diets
A Golay, AF Allaz, Y Morel, N de Tonnac, S Tankova and G Reaven
Department of Medicine, Geneva University Hospital, Switzerland.


The goal of this study was to evaluate the effect of diets that were
equally low in energy but widely different in relative amounts of fat
and carbohydrate on body weight during a 6-wk period of
hospitalization. Consequently, 43 adult, obese persons were randomly
assigned to receive diets containing 4.2 MJ/d (1000 kcal/d) composed
of either 32% protein, 15% carbohydrate, and 53% fat, or 29% protein,
45% carbohydrate, and 26% fat. There was no significant difference in
the amount of weight loss in response to diets containing either 15%
(8.9 +/- 0.6 kg) or 45% (7.5 +/- 0.5 kg) carbohydrate. Furthermore,
significant decreases in total body fat and waist-to-hip circumference
were seen in both groups, and the magnitude of the changes did not
vary as a function of diet composition. Fasting plasma glucose,
insulin, cholesterol, and triacylglycerol concentrations decreased
significantly in patients eating low-energy diets that contained 15%
carbohydrate, but neither plasma insulin nor triacylglycerol
concentrations fell significantly in response to the higher-
carbohydrate diet. The results of this study showed that it was energy
intake, not nutrient composition, that determined weight loss in
response to low-energy diets over a short time period.


[3] Weight-loss with low or high carbohydrate diet?Golay A, Eigenheer
C, Morel Y, Kujawski P, Lehmann T, de Tonnac N.
Department of Internal Medicine, University Hospital Geneva.


OBJECTIVE: With obesity being recognized as an important
cardiovascular risk factor, it is important to determine the optimal
hypocaloric diet for decreasing that risk. The goal of this study was
to compare the effects of two hypocaloric diets of similar caloric
value, but differing in carbohydrate content (25% and 45%). SUBJECTS:
Sixty-eight out-patients were followed for 12 w. DESIGN: The patients
were assigned to one of two groups that received either a low (25%
CHO, n = 31) or a high (45% CHO, n = 37) carbohydrate hypocaloric diet
(5.0 MJ/d, 1200 Kcal/d). RESULTS: After 12 w, the mean weight loss was
similar and did not differ significantly between the two groups: 10.2
+/- 0.7 kg (25% CHO) and 8.6 +/- 0.8 kg (45% CHO). Furthermore, loss
of adipose tissue was similar, 8.1 +/- 0.5 kg (25% CHO) and 7.1 +/-
0.7 kg (45% CHO). Despite a high protein intake (1.4 g/kg/ideal body
weight) there was loss of lean body mass: 2.2 +/- 0.4 kg (25% CHO) and
1.4 +/- 0.3 kg (45% CHO). The waist/hip ratio diminished significantly
(P < 0.001) and identically in both groups. The fasting blood glucose
(even though normal, along with cholesterol and triglyceride
concentrations, were significantly decreased after weight loss. The
fasting blood insulin which was mildly elevated before weight loss
decreased more markedly with the 25% CHO diet compared to the 45% CHO
diet (P < 0.003). The glucose/insulin ratio improved significantly (P
< 0.05) after weight loss with both diets (0.17 +/- 0.04 mmol/mU (25%
CHO) vs 0.10 +/- 0.03 mmol/mU (45% CHO). CONCLUSIONS: Neither diet
offered a significant advantage when comparing weight loss or other,
metabolic parameters over a 12 w period. However, considering the
greater improvement of fasting blood insulin, the glucose/insulin
ratio and blood triglyceride, the low carbohydrate diet (25%) could be
more favourable in the long-term. The improvement of fasting blood
insulin could be explained by the differences in monounsaturated fat
composition in the low carbohydrate diet.

PMID: 8968851 [PubMed - indexed for MEDLINE

[5]Effect of a high-protein, energy-restricted diet on weight loss and
energy expenditure after weight stabilization in hyperinsulinemic
subjects
http://www.nature.com/ijo/journal/v27/n5/abs/0802270a.html

Chris said...

Hi Randy. Thanks for continuing to visit and comment on the bullsh*t I am posting.

You said:

"You are now posting INCORRECT information.

You do your readers (and I consider myself one) a disservice by referencing opinions as fact with double checking the actual science behind the claims."

Where on earth are you getting this? I did not reference Richard's post as "fact" - it is his experience and opinion - and I don't fully agree with Cosgrove. Richard's sentence I quoted started with "I think...." Doesn't sound like he or I am asserting a fact? In his blog he is discussing his opinion. So what? He is free to do that. I pointed to it because I liked reading it. So what. It was not presented as fact. You do *yourself* a disservice in that accusation. This is a blog, my thoughts, my interests, not a peer reviewed journal.

I have pointed to scientific papers as well as blogs. There are different opinions on *all* these things.

Richard's post, Art Devany's post and Taubes lecture - did you watch it/read them? - tie together things like calories and insulin.

As someone else commented, this is getting like a theological debate - especially now as you are accusing me of referencing opinions as facts. That is wrong and totally out of order.

Thanks for the papers you referenced. (I would seriously be interested in your take on Taubes lecture)

Chris said...

Randy

very quick further comment - I've not had time to go through this all yet:

The final paper you refer to - Luscombe 2003 - has its low carb diet at 45% of calories as carbs. not what I would call low carb.

The paper before that - Golay et al - has 45% as high carb. So, is 45% of carlories as carb high or low? It is not as straight-forward as you make out.

The other thing to think about is the proportion of fat. There is an *opinion* that low carb diets need to be high fat nto high protein. Only an opinion of course.

Chris said...

Randy - the last Golay et al paper that you quote above was *not* a metabolic ward study - it was on outpatients....however, even so the low carb diet was healthier with respect to insulin and triglycerides. Plus the lower carb dieters *did* lose more (although it was not deemed statistically significant). I'd need the full paper to look through all the results.

The first Golay paper also saw the low carb diet better at weight loss (again not deemed statistically significant, althoguh I'd liek to see the actual resutls rather than the mean in the abstract) and also did better in terms of glucose,
insulin, cholesterol, and triacylglycerol concentrations.


By the way - I'm much more convinced by high fat diets than high protein diets.....only my opinion again...

randy said...

Chris,

My criticism is not that you are posting "opinions" its that your not providing contrary experimental data. Post all the "opinions" you like but your not going to garner much respect from scientifically oriented folks if you continue to leave out the "hard data" side of the story.

The last studies that posted were in regard to the claims regarding "hyperinsulimia".
and weight loss. These were the papers available that specifically conrolled for this issue and found that insulin levels were NOT determinant.
I make no claims about the effects of "low fiber" high carb diet on TG and insulin levels

Please show me where in the "Golay" paper it says that there was a 'significant' weight loss with a p value < 05. If you want to go around disregarding P values then the bullshit factor rises exponentially.

I provided papers in my original post on this topic that conpared low carb/ high fat to high carb/low fat and once again found NO diffence. Please review them

Here's one of those studies that kept protein constant and varied fat and carb level from 0 to 85%:

Energy intake required to maintain body weight is not affected by
wide variation in diet composition
http://tinyurl.com/2lxpub.

Here the original studies I provided again and there are more.

http://www.medscape.com/viewarticle/493991_6
If a password is required, I suggest you join.


The full relevance of some of these studies is contained in the full
papers so the abstracts may seem incomplete.


Here's the metabolic ward studies:


Predictability of weight loss
W. M. Bortz
JAMA. 1968;204:101-105.


Kinsell LW Calories do count
http://tinyurl.com/38kzx8


Metabolic effects of substituting carbohydrate for protein in a low-
calorie diet: a prolonged study in obese patients.
http://tinyurl.com/38gejt


Metabolic effects of carbohydrate in low-calorie diets.
http://tinyurl.com/2wkonk


Energy intake required to maintain body weight is not affected by
wide
variation in diet composition
http://tinyurl.com/2lxpub


Protein metabolism during weight reduction with very-low-energy
diets:
evaluation of the independent effects of protein and carbohydrate on
protein sparing.
http://tinyurl.com/34wl5o


Is a calorie a calorie?1,2,3,4
http://www.ajcn.org/cgi/content/full/79/5/899S


Some Metabolic Changes Induced by Low
Carbohydrate
http://www.ajcn.org/cgi/reprint/20/2/139?maxtoshow=&HITS=...//


Fat, Carbohydrate, Salt,
and Weight Loss


http://www.ajcn.org/cgi/reprint/20/10/1104?maxtoshow=&HITS=10&hits=10...


Similar weight loss with low- or high-carbohydrate diets
http://tinyurl.com/2ta9gn


Effect of a high-protein, energy-restricted diet on weight loss and
energy expenditure after weight stabilization in hyperinsulinemic
subjects
http://www.nature.com/ijo/journal/v27/n5/abs/0802270a.html


Is a calorie a calorie
http://www.ajcn.org/cgi/reprint/79/5/899S.pdf


Effects of an 8-Week High-Protein or High-Carbohydrate Diet in Adults
With Hyperinsulinemia
http://www.pubmedcentral.nih.gov/articlerender.fcgi?&artinstid=1868379
Ketogenic low-carbohydrate diets have no metabolic advantage over
nonketogenic low-carbohydrate diets.
http://tinyurl.com/2opt67

Richard Nikoley said...

I'll echo Chris here.

I hope that my own blog entries come under the category of "my individual experience" and "my thinking."

Frankly, I don't know for sure, don't have time to go through the studies, and really don't care that much. I'm losing a lot of weight. I attribute it more to the fasting than the low-carb diet. Since I have gone even lower carbs and more fat in conjunction with the 30-hr fasts, and workout, fat loss has increased substantially.

Best of all, I feel great, and I'm off three medications I've been on for six years.

I'm not interested in being right except for getting the results I'm out to get.

Chris said...

Randy
you said:
"My criticism is not that you are posting "opinions" its that your (sic) not providing contrary experimental data. Post all the "opinions" you like but your (sic) not going to garner much respect from scientifically oriented folks if you continue to leave out the "hard data" side of the story."

Are you serious??

This is only a blog, not The British Medical Journal. It says at the top that it is a place where I put things that I find interesting. There are two sides (at least)to most of the things I write about. I cannot post everything about every topic but I assume that people can think for themselves and have access to google and pubmed to search around topics to find out more information....if they are interested. If they disagree fine. If you don't like my style or approach - then I am a grown up and think I can live with that....


Maybe you should start your own blog to put your side of the argument?


With respect to your position on this topic - the papers that you think are important are listed in your comments and people can look at those for another aspect of the debate.

By the way, did you ever look at the Taubes lecture or De Vany's posts?

Cheers

Chris

CR said...

Just a guess, "randy" isn't going to watch Taube's lecture, or read the book. His mind is already made up. And as has often been pointed out in other presentations, when you read the entirety of these papers you find data at odds with the abstracts or the conclusions.

As you noted, 45% of calories from carbs in a supposedly "low-carb" diet! That's low carb in what universe?

Anyway, good posts, Chris, it's good to get many sides of the issues so people can make up their own mind. I would definitely suggest that people occasionally take the time to actually read the papers that people like randy present to support their positions. You''ll often find the actual data is very different from randy's characterization.

randy said...

Chris Wrote:
"Are you serious??
This is only a blog, not The British Medical Journal. It says at the top that it is a place where I put things that I find interesting."

Reply:
So you feel no need to apply any filtering to the material you post regardless of how outrageous and unsupported it is.

I refer specifically to the idea that dietary protein comes with a automatic 25% reduction in calories compared to fat. Do you really think its in the best interst of your site or your readers to post this sort of disinformation?

Chris Wrote:
There are two sides (at least)to most of the things I write about.

Reply:
Yea, there is the side thats evidence based and the side that not.

Regarding the Taube web lecture. At 1 (hour):35 in Taube proposes a metabolic ward study to test his theory. That experiement has been done and the results don't support his theory.

Here's the link
tinyurl.com/2lxpub

Regards
Randy

Anonymous said...

So I did watch Taubes lecture. Interesting. Particularly where he admits at the end that he has no evidence to support his hypothesis and he begs someone to do it for him. He even states that it wouldn't be expensive (less than half of the advance on his book BTW). But he doesn't acknowledge the existence of numerous metabolic ward studies showing that his hypothesis is flawed. Then in the Q&A he admits that starch may not be a problem at all and that it just may be fructose that is the issue. He never mentions that combing fats with carbs, as in a normal meal, lowers the glycemic load. Nor does he mention that insulin response is so variable that something like white bread ranges between 44 and 132 depending on the individual.

If Taube's book is as weak as his lecture, it doesn't say much for the low carb movement.

Chris said...

Randy

I'm getting bored. You want a filter? it is what I find of interest. If you do not like it then report me to the Blog police. I think you have lost the plot.

"Yea, there is the side thats evidence based and the side that not."

Whatever...

Anon

whatever x 2

randy said...

Chris,

By filter I meant your common sense!

Randy

Chris said...

whatever

Anonymous said...

If you don't want your dogma challenged, turn off comments. It's a shame that you are against critical thinking and discussion of science.

terrence said...

Chris - I enjoy your blogg very much. And it is YOUR blogg; you are free to post whatever you want. I find some of your items more interesting than others; but, I am quite happy to leave the selection and commentary to you – it is YOUR blogg.

However, I must say, I find Randy’s dogmatism shrill, tedious, and a waste of time and pixels (I put the dropping anonymous left at January 30, 2008 1:16 PM in the same category).

You can, of course, allow any type of comments you want (or none)– it is YOUR blogg. However, if you continue to allow Randy to comment, I will simply skip his droppings (I do not have any desire or time to spend on his shrill dogma). Comments can add to a post, or they can detract – Randy REALLY detracts. I am sorry I wasted a bit of time reading his shrill dogmatic crap.

Randy and anonymous January 30, 2008 1:16 PM think you should run YOUR blogg in the way they want you to. If they want a place to expound their petty dogmatism, they could set up their own blogg, or bloggs. But, that would take time, effort, intelligence, and dignity on their part; and, it is much easier to take a free ride on someone else’s blogg. They do not exhibit any of these characteristics, so you may continue to be plagued with their silliness. I will not read any of their crap.

terrence said...

Chris - I forgot to thank you VERY much of the time and effort you put into YOUR blogg. I really appreciate all you do here. You post a lot of stuff that I most likely would not have found, but for YOUR blogg. Thank you VERY much!

Chris said...

Thanks Terence.

Sasquatch said...

Yeah this blog is great. Keep up the good work. Of course you have to treat any health-related blog with skepticism, as it is a person's opinion, but I find your posts well-reasoned.

I think people who want more information about the carbohydrate hypothesis should read Taubes' book. Whether you agree with him or not, you are guaranteed to learn something because of the huge amount of ground he covers. It's a very rigorous book with an enormous number of primary literature references.

But really, keep in mind that we didn't eat concentrated sugar and white flour until very recently in our evolution. We invented a whole new food group in the last 10,000 years (far less for some descents), and hunter-gatherers who don't eat that stuff are dramatically less susceptible to modern diseases. I would direct anyone who is interested to the studies of part-hunter-gatherer vs industrialized Kuna indians in Mexico. It's all age-matched data, so I don't want to hear the tired old "they only lived to 25 years old" argument. This is just a recent example of a large body of evidence showing the same thing in populations throughout the world. A skeptic might point out that it's only a correlation, which is true, but it also fits remarkably well with the biochemical story of insulin function and fat synthesis.

Chris said...

Thanks for the comments Sasquatch - good points.

the witch said...

Wow, Chris, sorry to see you're getting harrassed by Colpo-ites. They all seem like they're as crazy and obsessive as he is!

Chris said...

Emma - thanks.

It just all got a bit silly up there. Water off a duck's back though!