Category Archives: empty calories

The current state of affairs in nutri-Twitter

Rant.

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1) It’s almost as if you’re either:

a red meat-eating 110% keto-advocate

or

you think red meat and a ketogenic diet is harmful.

 

If you don’t say the diet is magical, the zealots will try to trick you into, or outright accuse you of saying it’s harmful.

Further,

 

2. And the protein/kidney debate re-surfaced again recently. To be clear: no studies have shown direct harmful effects of protein on kidney function. The studies cited by KDOQI are observational and on end-stage renal disease. Not mild kidney disease or slightly impaired renal function. If I had ESRD, I’d rather play it safe and not enroll in one of Jose Antonio’s high protein diet studies (~4.4 g/kg lol).

I’m pro-LC and HP but not anti-LF. Humans have thrived on a wide variety of diets over time regardless of macronutrient composition. Food quality seems more important in this context.

3. If ketones are muscle-sparing, then…

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CARBOTOXICITY [screaming face emoji]

Noxious Effects of Exaggerated Carbohydrate Intake (Kroemer et al., 2018)

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This blog post is about the above mentioned article. Disclaimer (qualm #1): it is very pro-low carb and refused to include any neutral or negative points about low carb. For example, had it been within the scope of the article, the authors may have said despite excluding the majority of carbohydrate-containing foods, low carb diets actually aren’t restrictive at all. In other words, this is not an unbiased review article.

 

 

Qualm #2: the authors say people have long-recognized the problems of lipid excess and it even has a name, “lipotoxicity.” But these revolutionaries thought the problems of carbohydrate excess need to be recognized so they coined the term “carbotoxicity.” Are we to believe these dorks never heard of “glucotoxicity” even though it was coined before lipotoxicity even was?!

The review is about the molecular, cellular, and neuroendocrine mechanisms that link a prolonged energy surplus to disease and accelerated aging. It doesn’t really distinguish how the energy surplus is established, specifically, but every now and then they throw out there “carbz.” Ignoring that, there are actually some pretty good points.

The history of dietary carbs had three major, transformative steps. The first was the transition from hunter-gatherers to agriculture which shifted the carbs from fruits, seeds, tubers, nuts, roots, and bulbs to a range of cereals (in Europe), rice (in Asia), corn (in Mesoamerica), and potatoes (in South America). And in Weston Price fashion, this was associated with an increase in dental cavities (probably more cause than correlation here).

Acarbose blocks carb digestion, D-glucosamine blocks glycolysis.

If you’re interested in setting up consultations with me, reach out: drlagakos@gmail.com.

For the rest of this article and more, head over to Patreon! Five bucks a month for full access and there are many other options. It’s ad-free and you can cancel if it sucks 🙂

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20% off some delish stocks and broths from Kettle and Fire HERE

If you want the benefits of  ‘shrooms but don’t like eating them, Real Mushrooms makes great extracts. 10% off with coupon code LAGAKOS. I recommend Lion’s Mane for the brain and Reishi for everything else

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FOOD PROFILE

Hey Fam, announcement: I’m moving to Patreon soon — will still post about 4-5 articles per month with at least 1 open to the public. The rest will be for Patrons. I’m still trying to figure it out and I’m open to suggestions!

 

I loved this – when describing the two study diets, which differed markedly in carb content (10% vs. 53%), the authors said they were similar in energy, protein, and “FOOD PROFILE,” meaning low-processed, lower-glycemic foods.

Non-industrial foods.

Hunger-free Diet(s).

BOOM!

Visceral adiposity and metabolic syndrome after very high-fat and low-fat isocaloric diets: a randomized controlled trial (Veum et al., 2016)

 

What happens when you give up industrial foods and start following a Hunger-free Diet (regardless of carbz)?

 

 

EVERYBODY LOSES WEIGHT

 

 

And le saturated fat? Industrial foods are the problem, not saturated fat. One group went from 48 to 31 grams per day (LFHC), the other group went from 42 to 81 (VLCHF): all metabolic parameters improved in both groups.

 




 

Even their livers shrank:

 

 

My only qualm: everyone lost a bit of muscle. NOT SURPRISING when you cut calories & protein and don’t exercise. Protein dropped by about ~25 grams in both groups. When you cut calories, you need to up protein or start lifting heavy shit otherwise you’ll lose muscle. The ketonez won’t help.

 

 

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The BROAD Study or Meat

Is eating meat necessary?  Optimal?

THE ANSWER MAY SURPRISE YOU

Hint: it’s more important to not eat processed refined junk foods.

 

Exhibit A. The BROAD study: a randomized controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease, or diabetes (Wright et al., 2017)

Tl;dr: it worked.

 

 

The longer version: it was a low-fat vegan diet supplemented with 50 ug B12 (methylcobalamin) daily.

 

Participants were advised to eat until satiation.

We placed no restriction on total energy intake.

Participants were asked to not count calories.”

 

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Ketones inhibit lipolysis

Petro just posted a brief article about acipimox & the insulin hypothesis.  Similar to insulin’s forte, acipimox inhibits lipolysis.  This leads to expansion of adipose tissue, and eventually, weight gain.

Acipimox acts on the same receptor as niacin and ketones, GPR109a.  That is, all three of those agents inhibit lipolysis.  We’ve discussed some of the implications of this on fuel partitioning HERE.

 

ketone-supp-physiology

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The Hunger-Free Diet(s)

It started out as “lose weight without hunger on LCHF” and went all the way to “effortless fasting on keto.”  Works for some and it might be true, but the same can be said for low fat diets!  The key, I think, in both contexts, is simple: fewer processed & refined foods… something the Paleo movement got right, imo (although I still think many low-calorie sweeteners are way less unhealthy than HFCS & sugar).

The logic:

1) add “good calories” like almonds to your diet and appetite spontaneously compensates by eating less other stuff: energy neutral

2) you don’t compensate for added “bad calories” like sugar-sweetened beverages: positive energy balance

3) remove bad calories from your diet and you don’t compensate by eating more other stuff: negative energy balance

 

Book: Good Calories, Bad Calories

 

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Keto myths & facts

:::begin rant:::

Trigger warning?  Maybe.

Disclaimer: I’m pro-LC (P<0.05), but not anti-LF because LF works better than LC for some people.  And with the exception of things like keto for neurological issues, I think macros take a back seat to many other factors.

Myths: carbs cause insulin resistance (IR), diabetes, and metabolic syndrome.  Carbs are intrinsically pathogenic.  If a healthy person eats carbs, eventually they’ll get sick.

And the only prescription is more keto.

cowbell

And of course all of this could’ve been prevented if they keto’d from the get-go.

Proponents of these myths are referring to regular food carbs, not limited to things like Oreo Coolattas (which would be more acceptable, imo).  Taubes, Lustig, Attia, and many others have backed away from their anti-carb positions, yet the new brigade proceeds and has even upped the ante to include starvation.  Because “LC = effortless fasting?”

Does this sound sane?

“No carbs ever,
no food often…
otherwise diabetes.”

oreo-coolatta

no one in their right mind would say lentils & beans cause diabetes

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Gypped by GIP

Dr. Johnson’s recent paper is nothing short of a monster.  They did a TON of experiments.  Here, I only want to focus on one aspect.

The insulin-obesity hypothesis in a nutshell (very oversimplified): more insulin = more fat mass and vice versa.

I know I know, it was mice fed standard rodent chow, but also included models relevant to human biology like reduced insulin and caloric restriction, which may reflect certain aspects of ketogenic diets and intermittent fasting… and some of the results actually do reflect what happens to humans.  Some.

 

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Hey CICO, I’m playing by your rules.

Brief background: the notorious Ebbeling study of 2012 showed an apparent metabolic advantage of a ketogenic diet.  After losing some weight, participants were assigned to low fat (LF), low GI, or ketogenic diets.  As expected, energy expenditure (EE) declined in all groups after weight loss.

 

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the insulin-obesity hypothesis is under attack

…but it isn’t dead, imo, because that would be really hard to do.  Like, seriously.

 

 

side note: please consider the modern views of Taubes, Lustig, Gardner, Attia, and others on Carbs™.  They’re less “Carbs-cause-obesity, keto-for-all, etc.,” and more thinking it might not be Carbs™ per se, but rather processed and refined foods.  And #context…  And I tend to agree at the moment (nuances and caveats are subject to change, as more evidence accumulates).

 

disclaimer: I haven’t seen the full text of Hall’s recent study, but that’s not really relevant to what I want to discuss.  In other words, I don’t think the full text will provide any additional details on this particular point.

 




 

Tl;dr: this study was not designed to prove or disprove metabolic advantage or the insulin-obesity hypothesis.

It’s in the study design:  four weeks of low fat followed by four weeks of low carb.  We KNOW that weight loss slows over time (especially if calories are controlled, as they were in this study).  It has to do with the order of treatments.

Weight loss-slowing over time in the Minnesota Experiment:

 

 

Minn-Starvation-weight

 

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