“Wait… what? nutrient partitioning?”
Calories In, Calories Out should not be interpreted as “eat less, move more,” but rather kept in its more meaningless form of: “if you eat less than you expend, you’ll lose weight.” At least then, it’s correct… meaningless, but correct. Eating less and moving more is no guarantee of fat loss, in part, because total energy expenditure isn’t constant and there’s that whole thing with nutrient partitioning.
For obese insulin resistant folks, this is Low Carb’s strong suit: it causes “eat less, move more”spontaneously.
For some obese insulin sensitive patients, for whatever reason, their adherence and success is greater with Low Fat. You might say, “yeah, but those suckers had to count calories.” To that, I’d counter with: “it doesn’t matter, THEY WERE MORE SUCCESSFUL COUNTING CALORIES ON LOW FAT THAN NOT COUNTING ON LOW CARB.” The spontaneous reduction in appetite obviously didn’t cut it. Do not be in denial of these cases.
There are different obesity phenotypes – insulin resistant and insulin sensitive being two examples – and they respond better to different treatments. Three other distinct obesity phenotypes: isolated impaired fasting glucose (IFG); isolated impaired glucose tolerance (IGT); and combined IFG/IGT. They exist. Might they respond differently to different levels of carb intake? Dietary protein or fat? Exercise? Sleep? My money’s on “yes.”
The new Taubes video is great; he is undoubtedly aware of Chris Gardner’s epic work but fails to address this critical point.
CICO isn’t really wrong unless “CI” assumes we can actually accurately count calories and “CO” is interpreted as exercise. No one is arguing that Low Carb breaks the Laws of Thermodynamics; when people lose weight on a low carb diet, it’s because fewer calories were consumed than were expended. The point is, for obese IR on LC this happens spontaneously and requires no knowledge of CI or CO. Does it work for everybody? …well, sort of, but some do better on Low Fat <- FACT.
Cases where LF beat or at least tied LC: see insulin sensitive ppl in Pittas, Cornier, & Ebbeling http://t.co/mpBTWEHn4v @DrEades @rnikoley
— Bill Lagakos (@CaloriesProper) December 1, 2014
How to make low fat work for you? (I’m not kidding) (well, maybe a little)
1) Be young and fit (markers of insulin sensitivity).
2) Carbs must be Paleo-friendly. This is not a negotiation.
3) You’re gonna have to count calories (every LF study confirms this). Find out your baseline, and shoot for a few hundred less. This is harder because Paleo foods are less likely to come with a nutrition facts label, so just know this: if you’re not losing weight, then you’re not in an energy deficit &/or counting wrong. Calories in must go lower. Nobody said this was going to be easy. If you start to lose muscle, try upping the protein and decreasing the energy deficit.
4) You don’t really need to watch fat intake & shouldn’t opt for “fat-reduced foods” since: 1) they’re usually crappy; and 2) “calories in” are going to be closely monitored. In other words, don’t expect a big difference between high carb and very high carb diets… the impact of insulin on adipose tissue saturates at very low levels of insulin. Wait… what? nutrient partitioning?
