Category Archives: Ketosis

the insulin-obesity hypothesis is under attack

Posted on May 15, 2016 | 25 comments

…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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Posted in Advanced nutrition, diabetes, diet, Dietary fat, empty calories, Grains, insulin, Ketosis, Leptin, Protein, sleep, Sun, TPMC

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Social jet lag

Posted on May 5, 2016 | 4 comments

Social jet lag is basically a general term that refers to circadian arrhythmia.  Sort of like insulin resistance, it’s rampantly abundant — some have estimated a prevalence of up to 75%!  Social jet lag can be induced by shift work, East/West travel, late meal timing, artificial light at night, sleeping late, not enough sunlight in the morning, etc., etc.  And while any of the above insults, by themselves, may not really screw up your circadian rhythms, you can see how easy it is for one person to fall prey to nearly of them:

Eat a late dinner, stay up late using artificial light (eg, computer, smart phone, etc.), sleep late the following day so you skip breakfast and don’t get any sunlight in the morning.

CIRCADIAN MISMATCH ACCOMPLISHED

This increases your risk for a wide variety of ailments, ranging from cancer to diabetes to bipolar disorder: no bueno.

One key mediator of the effects of LIGHT is melatonin.  Artificial light at night suppresses melatonin.  Sunlight in the morning can blunt the impact of this!  It all ties in together.  Gravitas.

Great review article here.

 

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Posted in Advanced nutrition, angiotensin, Bromocriptine, Cabergoline, chronopharmacology, circadian, diabetes, diet, Dopamine, Energy balance, Ketosis, Leptin, melatonin, resveratrol, Sun

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Insulin resistance is a spectrum

Posted on April 25, 2016 | 43 comments

The history of low fat diets is riddled with crappy low fat food-like products.

Food quality matters.

Free full article on Patreon! <- link

Take a group of obese people and assess insulin sensitivity however you like: some researchers demand nothing less than a hyperinsulinemic-euglycemic clamp (Gold Standard), others are OK with insulin levels during an oral glucose tolerance test.

Next, divide the people up based on this — there are a few ways you can do it.  You can: take the top half vs. the bottom half (a method which includes everyone); take the top third vs. bottom third (excluding the middle third); take the top quarter vs. bottom quarter (excluding the middle 50%), etc.

THIS MATTERS because in referencing this topic, many people claim most obese are insulin resistant.  They may be more insulin resistant than lean people, but even within obese people, there’s a spectrum, and the spectrum matters in this #context.

 

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Posted in Advanced nutrition, diabetes, diet, Dietary fat, empty calories, Energy balance, fat, fiber, insulin, Ketosis, Protein, Sugar

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Rodent keto studies

Posted on April 5, 2016 | 9 comments

Next time someone says VLC/keto is harmful or at least not helpful for fat loss because of a new rodent study, they’ll probably be wrong.

BOOKMARK THIS ONE GUYS.

Rodent studies on ketogenic diets or exogenous ketones are valuable and interesting in a variety of #contexts, although I’d argue that regulation of fat mass isn’t really one of ’em.

For starters, rodents aren’t particularly ketogenic – it’s rare to see ketones >1 after an overnight fast even in long-term ketoadapted mice.  Also, many rodents gain weight until they die, whereas humans plateau and stay relatively weight-stable for their entire lives (at least historically, and I’m not talking about yo-yo dieting).

Skeletal muscle, on the other hand, seems more similarly regulated: keto isn’t muscle-sparing in either specie… most people, perhaps unwittingly, increase protein intake on keto, and THIS spares muscle (N.B. this is simply to spare muscle, whereas in non-keto dieters, it’s not uncommon to see increased muscle in the #context of high protein).  That’s because carbs are more anabolic than fat.  QED.

There’s just a fundamental difference in the way fat mass and appetite is regulated between the species.  There are many similarities, which is why these studies are still valuable, but fat mass isn’t one of ‘em.

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9 Comments

Posted in Advanced nutrition, diet, Dietary fat, Energy balance, fat, insulin, Ketosis, muscle, pair-feeding, Protein, TPMC

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AMYLIN

Posted on March 15, 2016 | 33 comments

Brief background reading: amylin (according to Wikipedia)

 

In a study by Hollander on type II diabetics, the synthetic amylin analog pramlintide was tested (Hollander et al., 2003).  In this year-long RCT, over 600 patients were treated with placebo or up to 120 ug pramlintide BID (twice per day).  On average, these subjects were obese (BMI 34), diabetic for ~12 years, and had an HbA1c of 9.1%.  After one year, HbA1c declined 0.62% and they lost about 1.4 kg… not very impressive.

 

But it’s not all bad news; after viewing those relatively negative results (3 lb weight loss over the course of 1 year), another group of researchers led by Louis Aronne and Christian Weyer believed amylin had yet to be tested proper.  So they designed a better study; it was shorter, used higher doses of pramlintide, and they enrolled obese yet non-diabetic patients (Aronne et al., 2007).  They opted for higher doses of pramlintide (240 ug TID [three times per day]) because in dose-escalation studies, the incidence and severity of adverse drug reactions was consistently low at all doses tested.

 

They chose to study obese-er subjects (BMI 38, compared to 34 in the Hollander study) because obese subjects lose fat more readily than lean people, so if the study is designed to measure fat loss, then it is better to select a population of subjects where more fat loss is predicted.  They selected non-diabetic subjects for a similar reason; diabetics must regularly inject insulin which promotes the accumulation of fat mass — this could counteract any fat reducing effects of pramlintide.
In other words, it was a more powerful and better designed study.

 

After 16 weeks, pramlintide-treated subjects lost an average of 3.6 kg (~8 lbs), or about half a pound per week.  30% of patients lost over 15 pounds (1 lb/wk)!  Importantly, the weight loss didn’t appear to have reached a plateau by week 16, so it would have most likely continued along a similar trajectory had the study been longer.  There were no side effects, and a battery of psychological evaluations showed that the patients receiving pramlintide felt it was easier to control their appetite and BW, they didn’t mind the daily injections, and overall well-being increased.  At the very least, these evaluations meant the subjects weren’t losing weight because of nausea or malaise.  In fact, it was quite the opposite.

 

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33 Comments

Posted in Advanced nutrition, diet, Dietary fat, Energy balance, fat, insulin, Ketosis, Leptin, liver, microbiome, muscle, pair-feeding, Protein, TPMC

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Ketone supps

Posted on March 5, 2016 | 16 comments

1st Generation: ketone salts.  Only problem is the huge dose of salt limits how much you can take without adverse effects… but these are the ones on the market.

 

2nd Generation: ketone esters.

Advantage: no salt, and probably “slow-release.”

Disadvantage: gonna be WAY more expensive than the salts (which are still pretty expensive).

 

 

~40 grams of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate (a ketone ester) (from Clarke et al., 2013):

 

ketone ester

 

They did this thrice daily, so some people were getting up to 170 grams.

ONE HUNDRED SEVENTY GRAMS

 

[keep that number in mind]

 

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Posted in Advanced nutrition, circadian, coconut, diet, Dietary fat, Energy balance, fiber, insulin, Ketosis, Leptin, microbiota, muscle, TPMC

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Tissue-specific fatty acid oxidation

Posted on February 19, 2016 | 17 comments

Does it matter where fatty acids are oxidized, liver or skeletal muscle?  Of course, they’re oxidized in both tissues (quantitatively much more in the latter), but relative increases in one or the other show interesting effects on appetite and the regulation of fat mass [in rodents].

Warning: a lot of speculation in this post.

A LOT.

It’s known that LC diets induce a spontaneous decline in appetite in obese insulin resistant patients.  Precisely HOW this happens isn’t exactly known:  the Taubes model?  improved leptin signaling?  probably a little bit of both, other mechanisms, and possibly this one:

 

Exhibit A. Oxfenicine

 

oxfenicine

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17 Comments

Posted in coconut, diet, Dietary fat, Energy balance, insulin, Ketosis, Leptin, liver, muscle, TPMC

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Muscle growth sans carbs

Posted on February 4, 2016 | 38 comments

1.  net muscle growth = synthesis – breakdown

2.  need =/= optimization

3.  #context

 

muscle sans carbs

 

I’m totally cool with keto, honestly!  but still don’t really like seeing stuff like the above graphic and people interpreting it to mean “KETO IS MUSCLE-SPARING.”

 

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38 Comments

Posted in Advanced nutrition, circadian, diet, Dietary fat, fat, insulin, Ketosis, muscle, Protein, sleep

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New low carb protein bars

Posted on January 4, 2016 | 42 comments

Warning: this post isn’t #Paleo Certified™.   It’s more about convenience, choosing the lesser evil.

Quest Nutrition led the charge in low carb, high protein, fibre-rich bars.  “Fibre-rich” is really the key in allowing a bona fide “low carb” bar with shelf-stability and decent texture.  Sugar alcohols have also been used in some, but due to the high incidence of maltitol-induced GI discomfort, ymmv.  But in general, you need one or the other to provide bulk and keep it together (except Epic Bars, which use black magic).

For the most part, the new bars have basically copied Quest’s formula with some new flavors.

 

Disclaimer #1: I’m a whole foods guy.  Not really #Paleo™, but when it comes to people’s actual lifestyles, I recognize convenience is a huge factor… and selecting the lesser evil is frequently the best option — eg, you can store a couple LC protein bars in your office, car, etc.; not so much with hard-boiled eggs or other protein-rich foods… and these options are WAY better than many other snacks or “fast-foods” out there.

Disclaimer #2: yeah, I keep a few of these bars in my office, just in case…

Quest recently switched from isomaltosaccharides to soluble corn fibre (SCF), which will likely impact GI effects.  YMMV!  Isomaltosaccharides are cool, but I’m not prepared to say they’re superior to SCF for everyone, in every #context (personally, for the ‘biome, I prefer brassicas, alliums, the gristly bits, galactooligosaccharides, et al.).
[it’d awesome if Bi2Muno would collaborate with one of these companies]

 

In these n00bs to the protein bar market, some of the biggest differentiating factors are cost, net carbs, ratio of fibre to sugar alcohols, flavor profiles, etc.

 

With no further ado, here are the newcomers:

[or just skip to the chart at the bottom]

 

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Posted in Advanced nutrition, diet, fiber, insulin, Ketosis, microbiome, microbiota, muscle, Protein

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The “Insulin Index”

Posted on October 14, 2015 | 58 comments

Similar to the glycemic index, which is an estimate of the rise in blood glucose after eating a particular food, the insulin index is an estimate of the rise in insulin after eating a particular food.  In general, these indices are obvious: processed carbs have high glycemic and insulin indices, whereas whole foods are lower.  Some exceptions are things like dairy and lean meat, which induce more insulin than you’d expect given to their low carbohydrate content…

STORY TIME

When some protein-rich foods were discovered to induce insulin secretion, people thought this information might help type 1 diabetics more accurately calculate their insulin dose.  Interesting rationale, worth testing.

Tl;dr: it didn’t work very well.

More of the protein-derived amino acids may have been incorporated into lean tissue, but the extra insulin load ended up causing hypoglycemia more often than not.  Hypoglycemia is acutely more harmful than hyperglycemia, and is still quite harmful in the long-term.  Some studies on incorporating the insulin index for type 1 diabetics are mixed, ie, increased or no change in risk of hypoglycemia, but no studies show it reduces the risk.

 

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58 Comments

Posted in Advanced nutrition, diabetes, diet, Dietary fat, Energy balance, fat, insulin, Ketosis, Leptin, muscle, Protein

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