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.
Posted in Advanced nutrition, empty calories, Energy balance, insulin, Ketosis, muscle, strength, TPMC
Tagged carbs, empty calories, energy balance, exercise, insulin, ketogenic, ketones, ketosis, muscle, nutrition
I’m not vegan but the “Anti-Vegan Because B12” argument is lame. B12 insufficiency is largely due to malabsorption, not steak deficiency.
Also, oysters SMOKE meat for B12. Seriously, over a full day’s supply in one medium-sized oyster. Can meat do that?
Many people take supps, but somehow anti-vegans think B12 invalidates veganism. It doesn’t. Also, 1) tons of B12 in oysters; 2) nori B12 works in humans and rats; and 3) mushrooms still haven’t been ruled out as a legit source. Whether you consider these foods vegan or not is a different story. Many non-vegans are B12-deficient, too -> all the steak in the world won’t help if you can’t absorb it.
I’m not undermining the severity of B12 deficiency, just noting some basic facts.
My bias: things like T2DM, obesity, and even some cancers and mood disorders are due primarily to circadian arrhythmia, sleep, & LIGHT… and secondarily to diet.
When it comes to diet, mostly plants plus some animal is optimal for humans in our modern #context, regardless of which Ice-Age Paleo-Fairy Tale™ you subscribe to. Things like sleep, LIGHT, and activity, among others, seem way more important than debating historical [theoretical] dietary minutiae.
Lastly, this particular debate isn’t “vegan vs. keto.” THEY’RE NOT MUTUALLY EXCLUSIVE. “Eco-Atkins” is a thing. Animals provide a convenient source of LC protein, but it can be done without them.
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
Posted in Advanced nutrition, diabetes, diet, Dietary fat, empty calories, Energy balance, fat, fiber, gluten, insulin, muscle, Protein, sleep, TPMC, Trans fat
Tagged body composition, calories proper, carbs, diet, empty calories, energy balance, fat, insulin, ketogenic, ketones, ketosis, muscle, nutrition, obesity, Paleo, processed food, protein, soda, sugar, trans fat
So, we have another “high protein” weight loss study (Smith et al., 2016). Or really, a “low (0.8 g/kg) vs. moderate (1.2 g/kg) protein weight loss study.” In brief, it took ’em about 6 months to lose 10% of their starting body weight, then were given 4 weeks of weight stability before “after” measurements were taken.
Important: this was not a contest to see who would lose more weight; they kept going and adjusting food intake until both groups lost 10%. Not really ad lib, but otherwise a good study design imo. The intervention was relatively weak (eg, protein 0.8 vs. 1.2 g/kg), but on the plus side, that’s realistic and very “do-able.” If you’re interested in super-high protein diets (3-4 g/kg), check out research by Jose Antonio.
Big yet not unexpected finding: the low protein group lost about twice as much muscle than the normal protein group.
The isocaloric normal protein group lost more fat and less muscle than the low protein group.
But then everyone freaked out because the low protein group experienced a significant improvement in muscle/liver insulin sensitivity whereas the normal protein group didn’t:
-The headlines were hilarious, like, “high protein makes weight loss not work anymore.”
-Then some critics jumped the shark and blamed it on “liquid calories,” because whey protein shakes are totes non-Paleo, and #JERF.
-TBH, I found more interesting the changes in adipose insulin sensitivity…
The normal protein group had the most insulin sensitive adipose of all groups… yet they lost more fat mass despite eating just as much or even slightly more than the other groups.
Does this mean they’re doomed to regain the weight? I don’t think so, as high dietary protein is one of the strongest predictors of weight loss success long-term.
HERESY! the low protein group had: 1) lower basal insulin than the normal protein group; 2) lower adipose insulin sensitivity; 3) ate less (NS); yet lost less fat mass.
In other words, the normal protein group had higher basal insulin, more insulin sensitive adipose tissue, and slightly higher food intake (NS). According to the insulin model, they should’ve lost less fat mass than the low protein group, but they didn’t.
Is this another chink in the armor of the insulin model?
The truth seems to be: people lose weight on both LC and LF diets by giving up junk food. On LC, this is accomplished by giving up carbs; on LF, this is accomplished by switching to better carbs. Some people adhere better to one diet or the other. Maybe insulin sensitivity has something to do with it.
Insulin from high protein: not bad?
Insulin from good carbs: not bad?
Junk food: no bueno.
So maybe just maybe it’s not just ze insulin…
Back to the protein…
This was not sorcery; it’s been seen before in a variety of different paradigms: dietary protein has a profound impact on nutrient partitioning.
Yes, even when it’s liquid calorie insulinogenic whey protein isolate bro-shakes.
Yes, even when it’s not crazy-high levels of protein… seriously, 1.2 g/kg is not “high”
+ + + + + + + + + +
Past blog posts on [the non-sorcery of] dietary protein:
Holiday feasts, the freshman 15, and damage control
Dietary protein, ketosis, and appetite control.
Nutrient Partitioning: …a *very* high protein diet.
Protein “requirements,” carbs, and nutrient partitioning
Cyclical ketosis, glycogen depletion, and nutrient partitioning
Meal frequency, intermittent fasting, and dietary protein
+ + + + + + + + + +
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Posted in Advanced nutrition, chocolate, clamp, diet, Dopamine, fat, insulin, muscle, Protein, TPMC
Tagged body composition, calories proper, carbs, diet, energy balance, energy expenditure, fat, insulin, ketogenic, ketosis, muscle, nutrition, obesity, Paleo, processed food, protein
:::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.
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.”
no one in their right mind would say lentils & beans cause diabetes
Posted in Advanced nutrition, circadian, diabetes, diet, Dietary fat, empty calories, Energy balance, Exercise, fat, fiber, Fish, Fructose, gluten, Grains, insulin, Ketosis, melatonin, mortality, muscle, Protein, sleep, smoking, strength, Sugar, Sun, TPMC
Tagged Atkins, calories, calories proper, carbs, circadian rhythm, diabetes, diet, empty calories, energy balance, exercise, fat, fiber, high fructose corn syrup, insulin, ketogenic, nutrition, obesity, protein, soda, sucrose, sugar, trans fat
This article isn’t about alcohol tolerance. It’s about your liver.
Tl;dr: with a basic knowledge about alcohol metabolism and ketoadaptation, drinking on keto gives me pause.
It might be nothing, but it gives me pause.
Alcohol is metabolized primarily by alcohol dehydrogenase, producing acetaldehyde and reducing equivalents as NADH. This pathway produces energy.
Or more specifically, ketone monoesters and carbs. Literally, this study was a high-dose ketone monoester supp sans caloric or carb restriction. I know, weird right?
Non sequiter nutrition notes, #context, etc.:
1) ketone esters =/= ketone salts. Ketone salts are either sodium or potassium-dominant. Ketone esters are essentially salt-free. Possibly helpful background reading here.
2) nutritional ketosis =/= starvation ketosis =/= ketone supp ketosis. Because #context.
Starvation ketosis, but not nutritional ketosis, is muscle-sparing. Ketone supps sans carb restriction might be.
3) the theory of ketone supps for sport is: 1) ketones are an energetically favorable fuel; and 2) they’ll spare glycogen, theoretically allowing prolonged duration of moderate-to-high intensity performance. Adding in carbs will likely further this.
4) I have no studies to support this, but the idea of ketone supps in the #context of high carb doesn’t sit will with me. Seems like high levels of both substrates = mitochondrial overload and oxidative stress. Maybe.
5) there’s a gradient of fuel use during exercise:
-explosive power: creatine, anaerobic
-high intensity: glycogen, anaerobic
-low intensity: fatty acid oxidation, aerobic
But it’s a gradient with a lot of overlap, and ketoadaptation further blurs the lines.
Posted in Advanced nutrition, Dietary fat, endurance, Energy balance, Exercise, fat, insulin, Ketosis, muscle, Protein, TPMC
Tagged calories proper, carbs, diet, energy balance, exercise, fat, insulin, ketogenic, ketones, ketosis, muscle, nutrition, sugar
Recent comments about FASTER have upgraded this study to “the only long-term study on fat-adaptation.” Needless to say, I disagree. Again.
Side note: FASTER had no randomization or intervention (ie, confounded by selection bias, among others); they basically recruited long-term low carb & high carb ultra-endurance runners and measured the stuffings out of ’em.
Ultimately, they showed a very high maximal fat oxidation rate in low carb ultra-runners, 1.5 grams per minute. This is important because MAXIMAL HUMAN FAT BURNING CAPACITY
In previous studies on SAD (Standard Athletic Diet haha), maximal fat oxidation at similar VO2max% has been reported to be much lower, <1 g/min (eg, Hetlid et al., 2015 and Volek et al., 2016).
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.
Posted in Advanced nutrition, diet, empty calories, Energy balance, insulin, Ketosis, Leptin, TPMC
Tagged body composition, calories, carbs, diet, energy balance, energy expenditure, insulin, ketogenic, nutrition, obesity
Study: a handful of average-bodied Crossfitters in their mid-30’s were recruited and told to either: 1) keep doing what they’re doing; or 2) go full keto. Crossfit 4x/week. Strength testing before and after 6 weeks (Gregory et al., 2017).
I’ll start with the best part: KETOADAPTATION IS A REAL TRUE THING THAT WORKS (P<0.05). Otherwise, this group’s performance would’ve plummeted. It is known.
The performance test was time to complete a 500-meter row, 40 body weight squats, 30 abdominal mat sit-ups, 20 hand release pushups, and 10 pull-ups.
Tl;dr: both groups knocked about a half a minute off their time!
The key here is duration: 6 weeks of ketogenic dieting is adequate to restore performance back to baseline. <3 weeks is not.
Here’s the downside (sort of):
Basically, the keto group dropped carbs and failed to compensate by upping other calories. I know I know, spontaneous ad lib appetite reduction, but this is a study on PHYSICAL PERFORMANCE.
And in further support of “muscle growth sans carbs,” keto dieters upped protein by 15% and this still wasn’t enough to compensate for the reduction in carbs/insulin: they still lost a bit of lean mass (NS). Imagine if they hadn’t increased the brotein? yikes
so basically, they lost body fat because CICO and retained lean mass because exercise and protein haha jk
Admittedly, it was cool to see the body comp changes, but we know fat loss eventually plateaus and people start eating maintenance calories again (maybe a bit more if Ebbeling can be believed). And this is where they remain for the rest of their lives (hopefully). So at 6 weeks, they were still losing weight, nowhere near where they’re going to be for the rest of their lives, but THAT’s where I’d like to see performance testing (ie, at a stable body weight). Don’t get me wrong, I hate myself in advance for making this critique: the researchers should’ve pushed more calories in the keto dieters bc this is a confounder in a study on PHYSICAL PERFORMANCE… but this doesn’t really matter in the big scheme of things because Blackburn’s group did that and showed the results were the same haha
On another note, I don’t think people should expect an additional performance boost from being more ketoadapted (or more fat-adapted or whatever), primarily because whether the study is 3 weeks or 6, performance never really gets better than baseline in experienced athletes. With more advanced training techniques, sure (and I think this is common), but not more keto- or fat-adaptation.
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Also, I’m open to suggestions, so please don’t hesitate to leave a comment or contact me directly at drlagakos@gmail.com.
Affiliate discounts: if you’re still looking for a pair of hot blue blockers, Carbonshade is offering 15% off with the coupon code LAGAKOS and Spectra479 is offering 15% off HERE. TrueDark is running a pretty big sale HERE. If you have no idea what I’m talking about, read this then this.
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.
Posted in Advanced nutrition, diet, Dietary fat, Energy balance, Ketosis, muscle, Protein, TPMC
Tagged Atkins, body composition, calories proper, carbs, energy balance, energy expenditure, exercise, insulin, ketogenic, ketones, ketosis, muscle, nutrition, protein