Tag Archives: calories

Carbohydrates, calories, appetite, and body weight.

Posted on February 2, 2014 | 36 comments

The Optimal Diet, Atkins, South Beach, Paleo, Zone… all have one thing in common: some degree of carbohydrate restriction.

Low, lower, lowest: does it matter?

There are 4 relatively large, randomized ‘diet-induced weight loss’ studies that all reported fairly comprehensive food intake and body composition data. The studies ranged in duration from 24 weeks to one year and included anywhere between 50 and ~300 overweight and obese participants.

In general, participants assigned to the low fat intervention were advised to restrict calories and fat whereas those assigned to low carb were told they could eat as much as they wanted as long as it wasn’t carbs.

Your mileage may vary – but these studies cover a large number of subjects from a wide range of backgrounds, suggesting the results might be applicable across the board.  Conclusion?  the amount of body fat lost was much more strongly associated with the reduction in carbohydrates than calories.  The only modestly surprising aspect was the magnitude… (see the figures below).

The four studies, in chronological order:

Brehm 2003: over the course of 6 months, those who consumed an average of 163 grams of carbohydrate per day lost 8.6 pounds of body weight while those who consumed 97 grams lost 18.7 pounds.

McAuley 2005: 24 weeks; those who ate 171 grams lost 10.3 pounds, while those who ate 133 grams lost 15.2 pounds, and those who ate 107 grams lost 15.6 pounds.

Maki 2007: 36 weeks; those who ate 186 grams lost 5.7 pounds, those who ate 131 grams lost 9.9 pounds.

Gardner 2007: 1 year – those who ate 138 grams lost 10.3 pounds, 181 grams lost 3.5 pounds, 195 grams lost 4.8 pounds, and 197 grams lost 5.7 pounds.

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Posted in Advanced nutrition, diet, Dietary fat, Energy balance, fat

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Dietary protein, ketosis, and appetite control.

Posted on December 6, 2013 | 118 comments

“Dietary protein has a purpose, and that purpose is not carbs.”  Nor is it to break ketosis or stall weight loss.  

Drastically increasing protein intake may reduce the degree of ketosis in the context of a large energy surplus, but this is likely due more specifically to the large energy surplus than the protein.  This would explain why Warrior dieters (1 meal meal per day) often report reduced ketones if they eat too much protein.  It’s more likely that the 2000 kcal bolus is exerting it’s anti-ketotic effect by being a large energy surplus, such that anything other than 90% fat would blunt ketosis.  It’s not the proteins… Want proof?  Here’s an n=1 to try: give up Warrior dieting for a few days and try 3 squares.  My bet is that you’ll be able to increase protein intake and still register ketones as high or higher than before.  There are data to support this and reasons why it may not matter (below).

disclaimer: I don’t think “deep ketosis” is necessary to reap the benefits of carbohydrate-restriction.  But if you love high ketone meter readings, then this might be a better strategy to maintain deep ketosis while getting adequate protein. win-win.

if I hear: “oh no, I was kicked out of ketosis!” one more time… 

All of the studies below are confounded one way or another, but so are we humans.

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

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Low carbohydrate diets favorably impact testosterone levels.

Posted on November 17, 2013 | 43 comments

It is known.  Carbohydrate restriction improves (lowers) testosterone in women with PCOS.  It works for men, too… but by “works” I mean “increases.”

Decrease of serum total and free testosterone during a low-fat high fibre diet (Hamalainen et al., 1982) 

Intervention pseudo-crossover study: 30 healthy Finnish men in their 40’s were studied on their habitual high fat diet (40%  fat), then put on a low-fat (25%) high fibre diet for 6 weeks, then switched back to high fat.  The high fat diet was also higher in saturates, P:S ratio 0.15 vs. 1.25.

free T

 

Free testosterone levels declined on the low fat diet, but they recovered after 6 weeks of going back to their high [saturated] fat dieting (p < 0.01).

Some observational data: Testosterone and cortisol in relationship to dietary nutrients and resistance exercise (Volek et al., 1997)

…fat, and in particular saturated fat, is associated with increased testosterone levels [in men]:

observational

 

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Posted in Advanced nutrition, clamp, diet, Dietary fat, fertility, insulin, sex, testosterone

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Protein Leverage Hypothesis

Posted on November 10, 2013 | 40 comments

Inverse Carb Leverage HypothesisTM

Protein Leverage Hypothesis: Dude eats 15% protein on a 2000 kcal diet (75 g protein).  Exchange 25 grams of protein with carb, and he’s now eating 10% protein on a 2000 kcal diet (50 g protein).  Theory states Dude will increase total food intake to get back those 25 grams.

Ergo, Protein Leverage Hypothesis:

protein leverage hypothesis

Disclaimer: I don’t care much for the Protein Leverage Hypothesis.  It might be true, but that doesn’t mean it matters.  It works well in rodents, but obese patients eat tons of protein.  The rebuttal to this is that the protein in their diet is too diluted with other [empty] calories.  They’re overeating because of low protein %.

The flipside, confirmed ad nauseam in rodent studies, is that frank protein deficiency increases food intake.  Frank protein deficiency means negative nitrogen balance & tissue loss… not just skeletal muscle; organs, too.  Incompatible with survival.

Feed someone a low protein low fat diet, they get hungry.  If it’s ad libitum, they eat more.

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Posted in Advanced nutrition, diet, Dietary fat, empty calories, Energy balance, Protein, TPMC

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Nutrition Disinformation III

Posted on August 23, 2013 | 4 comments

but they actually get it right this time.   Big HT to George Henderson for bringing this ms to my attention.

In Nutrition Disinformation, Part I, the Mediterranean diets employed by Estruch & colleagues were discussed.  The study subjects’ need for antidiabetic drugs, insulin, and anti-platelets all increased over the course of 5 years.  The media and even the authors themselves reported the opposite, touting the benefits of Mediterranean diets.  Thus begat the Nutrition Disinformation series.

Nutrition Disinformation 2.0 was a follow-up to an older post on the Look AHEAD study, when the results were finally published.  The intensive lifestyle intervention consisted of a pharmaceutical-grade low fat diet (ie, LFD + a little bit of Orlistat), and exercise.  By the end of 10 years, medication use was modestly lower in the intensive lifestyle group compared to controls, but it was markedly increased from baseline.  Therefore, I deemed it egregious to say their intervention was “healthy.”  In the context of Nutrition Disinformation, “healthy” means you’re getting better.  The need for insulin, statins, and anti-hypertensives should decline if you’re getting better.

In part 3 of the series, Yancy must’ve been following the Nutrition Disinformation series 🙂 and decided to conduct a subgroup analysis on the patients in his previous low carb vs. low fat + Orlistat study.  Weight loss was roughly similar, but all other biomarkers improved more on low carb.  In the new publication, Yancy analyzed data selectively from the diabetic patients in his original study to generate a “Medication Effect Score (MES).”  MES is based on what percentage of  the maximum dose was a patient given, and adjusted for the median decline in HbA1c experienced by patients on said drug.  A bit convoluted, but I’m on board (at least tentatively).

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Posted in Advanced nutrition, diet, empty calories, Energy balance, fat, insulin, Orlistat, TPMC

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Calories schmalories, alcohol, and chocolate

Posted on August 15, 2013 | 50 comments

Some calories count, others don’t.  Some calories work in some people, but not others.  Does this sound like an irrefutable Law of Nature?  No, but it is a perfectly acceptable tenet of the Laws of Energy Balance (a construct of my design).

Do alcohol calories count?  Sometimes, but not this time:

The energy cost of the metabolism of drugs, including ethanol (Pirola & Lieber 1972)

This was a study on bona fide alcoholics who participated because they were promised treatment.  Metabolic ward.  FYI, one gram of alcohol burned in a calorimeter produces ~7.1 kilocalories; alcohol = 7.1 kcal/g.

Calories required to maintain body weight (ie, = total energy expenditure) was assessed the old-fashioned way: feeding them enough calories to maintain a stable body weight – they counted calories but relied on the bathroom scale to establish a baseline.  #TPMC.  After a week of weight stability, they ISOCALORICALLY exchanged carbohydrates for alcohol, and broke CICO.

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Posted in Advanced nutrition, chocolate, diet, Dietary fat, empty calories, Energy balance, TPMC

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All my organs hurt and I think I’m going blind.

Posted on July 26, 2013 | 38 comments

People, this is how you should eat.

There have been a lot of diet postings lately, and they are some of the healthiest diets you could imagine.  Please click the links to get the full versions, which include lifestyle tidbits, other pearls, and WHY.  And take notes.  I’ve just listed some of the foods here for the sake of brevity (and as an excuse to link to the diets).

Disclaimer: all of these diets fall somewhere on the “low carb” spectrum.  I don’t eat low carb because I have to*, I do so because it’s healthy, convenient for my lifestyle, and I rather like the foods.  *I say I don’t “have to” because I have no underlying health problems or carb-sensitive GI issues.  The people below are also far healthier than most (from what I can gather)… but if you are overweight &/or obesity-prone, or glucose-intolerant &/or diabetic, then you might want to consider following any of them.

Hyperlipid (Petro Dobromylskyj): The Optimal Diet
butter, egg yolks, cocoa, dark chocolate, macadamia nuts, sour cream, beef, green veggies.  His stats: BW stable, 28” waist, greying beard.  Peter will outlive us all.  And take over the world if he ever has the desire to do so.

Anna Fagan (Lifextension): Low Carb Paleo, probably keto
eggs, butter, avocado, cheese, shrooms, bacon, salmon, tea, coffee, nuts, sardines, lamb, pork, eggplant, cream  –> “high fat =/= fat.”  She’s currently off studying paleoanthropology somewhere in Turkey (?).

Jane Plain (ItsTheWooo): Ketogenic
cream, sour cream, nuts, butter, beef & fatty meats, pepperoni.  She, too, is rather fit.  The Scribble Pad = diet & lifestyle vs. psychoneuroendocrinology & metabolism (mixed with equal parts humor & gravitas).

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Posted in chocolate, coconut, diet, Dietary fat, fat, Ketosis, Protein

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Energy Balance > CICO

Posted on July 18, 2013 | 40 comments

The regulation of energy balance is a long-term process, and it can’t be maintained by counting calories on a day-to-day basis.  Taubes once wrote that exercise doesn’t cause weight loss because it builds up an appetite, so you end up sucking down a Starbuck’s Jumbo Calorie Bomb on the way home from doing Yoga at the gym.  This is probably somewhat true, but this little gem from 1955 exposes some very interesting nuances.

Edholm(Edholm et al., 1955)

These researchers rigorously measured food intake and did a comprehensive assessment of energy expenditure during a wide variety of activities – lying down, standing, walking, gun cleaning, stair climbing, dressing, etc., etc.

Divide and conquer

The individual differences: big people expend more energy on life.  most of the time.

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Posted in Advanced nutrition, diet, Energy balance, Leptin, muscle

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On calorie information posted in restaurants

Posted on July 5, 2013 | 19 comments

“This is biology, not mathematics.”

It’s law in some places.  It’s a burden on restaurants.  And it will do nothing for the cause – like trying to put out a candle by pressing the off button on your remote control.  In other words, a waste.

Here’s some of the “science” behind it.

Exhibit A.
In a study by Dumanovsky, fast-food customers were surveyed prior to and after mandatory calorie labeling in New York.  25% of the people reported “seeing calorie information,” and 10% of them said it affected their buying decision (ie, 2.5% of all fast-food consumers surveyed thought they knew enough about “calories” to be scared of them).  After the law went into effect, 64% of people noticed the calorie information, and 20% of them were affected by it (=12.8% of all fast-food consumers thought they knew enough about “calories” to be scared of them).  Sooo, the proportion of people making misinformed decisions quintupled.  Calorie Labeling = Nutrition Disinformation.  It’s misleading, and usually wrong.

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Posted in Advanced nutrition, diet, empty calories, Energy balance, fat, TPMC

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Look AHEAD – Nutrition Disinformation 2.0

Posted on June 27, 2013 | 1 comment

The day you’ve all been waiting for has finally arrived.  Results from the Look AHEAD study have been published.  When I first wrote about this study (HERE), it had been prematurely halted because the intervention was providing no benefits.  Everybody was in a state of shock and awe because Low Fat didn’t save lives.  But that was before we even had the data.  

Reminder: the “intensive lifestyle intervention” consisted of a Low Fat Diet & exercise.  The results?  Yes, they lost more weight than control, but they also took more Orlistat (of which I’m not a fan, see HERE for why):

orlistat

Orlistat = pharmaceutically enhanced low fat diet. 

Their normal diets were not healthy, but neither was low fat –>

med use

Medication use increased drastically in both groups.  The pundits have gone wild because medication use was lower in the intensive Low Fat group at the end of the study, but this is Nutrition Disinformation 2.0.  Eerily reminiscent of the recent Mediterranean Diet study, the conclusions are the same: keep eating poorly and the need for medications will increase.  You can call it a lot of things, but not “healthy.”  The alternative –>  How to define a “healthy” diet.  Period.


Significant adverse events:SAE

The only thing to reach statistical significance was more fractures in the intensive Low Fat group, but you didn’t read any headlines that said “Low Fat breaks bones.”  Imagine if that happened on low carb [sigh]  The next closest thing to statistical significance was increased amputations in the intensive Low Fat group :/

gem:History of CVD

Translation: if you were healthy at baseline, then you could tolerate a low fat diet.  Otherwise, not so much.  This is exactly what happened in the Women’s Health Initiative.

Ha

needless to say, none of the “possible explanations” they considered were Low fat diet Fail.

calories proper

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Posted in diet, Dietary fat, empty calories, Energy balance, Exercise, fat, mortality

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