To low carb or not?

[Steve]

In a thread on another forum, a huge debate broke out over whether or not low carb dieting is the best approach to use. People seem to hold onto the notion of being "correct" when it comes to diet and exercise to the point it's scary! Anyway, in attempt to interject some objectivity into the mix, as I'm not married to one approach over the other, I made a post that many people seems to enjoy and learn from. Since this is still a "hot topic" in today's media, I figured I'd share my response here and welcome any discussion.

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but I truly believe that weight loss is more than just a thermodynamic equation.

And this is really the crux of things in my opinion. Anyone saying that building a better body and better health is solely about calories is very misguided. Obviously a calorie deficit comprising nothing but gum drops and jujubes isn't going to promote leanness and health as well as a diet comprising lean meats, abundant veggies and fruits, a balance of saturated, mono and polyunsaturated fats, etc.

At the end of the day though, I think you'd be hard pressed to show me sufficient peer-reviewed academic research that shows people losing weight in a calorie surplus or gaining weight in a calorie deficit, assuming we're talking about tissue weight and non-diseased people. But who cares about that since we're not here solely for weight loss. People, knowingly or not, are more interested in health and body composition.

And this latter focus requires calorie control AND nutrient control. One without the other is a pointless proposition. Anyone who's arguing that there aren't nutrient needs that need to be accounted for independently of calorie intake is sorely mistaken.

The people claiming that "all calories aren't the same" aren't grasping the specifics. A calorie is a calorie is a calorie... just as a meter is a meter. A calorie is merely a unit of measurement. You're confusing nutrients with calories... they aren't interchangeable. Nutrients provide our bodies energy that, for the time being, we quantify with an outdated metric known as the atwater system and calories. Yes, nutrients are not created equal in the "body's eye" which should be obvious to anyone. But that's not the same as saying, "all calories are not equal."

When you delve into the research pertaining to nutrient manipulation, if there are any clear trends, it's that there is no One Way that's right for everyone. People who espouse high carb diets to everyone are misguided just as people who espouse low carb diets to everyone are misguided. Individually tailoring a diet to the individual in question is a must if lasting change is going to be realized.

We've data out there supporting the idea that low carbohydrate approaches are better for some while higher carbohydrate approaches are better for others, further exemplifying why any blanket recommendations are sort of silly. Anyone who works with a wide array of folks in the fat loss setting can vouch that a myriad of diets work depending on the person and the situation. I can say this... in my experience, lower carb approaches tend to work best for my obese clients and by and large, moderate carb approaches tend to work best for my leaner clients. This most likely has something to do with insulin resistance/sensitivity issues which has already been mentioned in this thread.

And if you're truly trying to show that there is some sort of metabolic advantage for anyone eating low carb, you need to wait for sufficient research to be conducted comparing low vs. moderate or high carb approaches THAT MATCH protein and calories. The research simply isn't there yet though. James Krieger, an author and published researcher whom I highly respect and communicate with, put it perfectly when he said:

1. The proposed metabolic advantage (MA) for low carb diets is a hypothesis, not a fact
2. There is inadequate data to support the MA hypothesis
3. There is inadequate data to reject the MA hypothesis
4. The MA hypothesis does not trump the concept of energy balance. It postulates inefficiencies in energy metabolism, which would translate to an increase in measured energy expenditure (due to heat loss) in a living organism. Thus, if the MA was true, "calories out" would increase for a given "calories in".
5. A definitive study examining 24-hour energy expenditure (using room calorimetry), comparing a ketogenic diet to a traditional diet (with matched protein intake) for subjects in an energy deficit, has not been performed. This is the only study that will adequately test the MA hypothesis in humans
6. Weight loss still requires an energy deficit. If a MA exists, it still cannot make up for an energy surplus or energy balance. To assert otherwise is to assert that energy can be created or destroyed out of thin air, or that human tissue can be created in the absence of any energy input.

Mind you, his published paper on MA actually supports the MA hypothesis.

and that a person who gets too large of an insulin response will have problems with weight loss, resistant or no.

Yea, it's true that having elevated insulin levels blocks fat oxidation and lipolysis on a meal by meal basis. But what happens if, say, you eat one huge meal and spike insulin to the moon, store fat, shut off lipolysis, etc. and then don't eat again for the rest of the day?

If that one meal was only 1,000 calories and you need 2,500 a day to cover your total daily energy expenditure, why exactly is the body just going to hang on to those calories when it needs them to survive?

And this doesn't even begin to factor in things like rate of digestion... eating even a high-carb diet does not necessarily imply chronically elevated insulin. And low carb zealots (not suggesting you're a zealot) tend to look at things in a vacuum... insulin promotes fat storage, carbs spike insulin, therefore carbs make us fat. They leave out, as already mentioned, the myriad factors that also play a role in fat metabolism such as acylation stimulation protein, catecholamines, HSL, etc.

As I noted above, in the game of weight loss it is about thermodynamics before anything else. In the game of body composition and health, it's much more complex however.

For anyone interested in learning more about insulin and its relation to lipogenesis, I can't recommend Jame Krieger's series on it which you can find here:



That's part 1 and you can continue on to the other parts from it.

 

[FitnessT]

I remember reading that a while back.

I think James has some good points, but he doesn't really have any good argument for why a low carb diet isn't the right way to go. Insulin is not bad, but too much is. Over time as we you more and more carbs, your pancreas will try to "predict" the amount of insulin to release, which leads to excessive amounts in many cases. Some people are more susceptible than others.

Also, insulin might be an appetite suppresent, but in excess leads to hypoglycemia, which is a major carb-craving stimulant.

As for dairy: because of James I actually allow some dairy in my diet, but it is important to note that dairy should only be used after a while of achieving stable blood glucose/insulin levels. You want your pancreas to be working right, so that you blood glucose doesn't get lowered too much.

And eating 1000 calories in a meal, when your expenditure is 2500 seems impossible. I would think someone would be really hungry most of the time. 1000 calories is not a big meal... a big meal is like 2000-3000 calories. 1 meal/day at 1000 cals/meal would probably lead to unhealthy short-term weight loss.

Just my 2 cents..

 

[Jeanette401]

Well, I imagine one reason for avoiding low carb would be if you're one of the people who feel like utter crap on it Also, most people's implementation of low carb tends to be quite low in fiber and quite free with fats of all kind. I know that I personally dropped my LDL numbers by 70 points by ditching low carb.

Then again, Steve's point wasn't that you should avoid low carb, it's that individual responses differ to much to make it a one size fits all solution.

Over time as we you more and more carbs, your pancreas will try to "predict" the amount of insulin to release, which leads to excessive amounts in many cases. Some people are more susceptible than others.

I find this a bit confusing, actually. It was my understanding that the primary reason for over production of insulin was insulin resistance. That is, even if you eat the same amount of carbs as you have for the last 5 years, your body needs to produce more and more insulin to get the same response. I have never seen or heard of a study that suggested that in the absence of insulin resistance too many carbs will result in over production. For example, the Okinawa traditional diet is high in carbs, but I don't believe they have a particularly high incidence of too high insulin.

(This is especially confusing to me as from what I've read, protein also causes a large amount of insulin production - why would only carbs cause too much insulin, but protein not have the same result?)

You also say that in excess, insulin results in hypoglycemia, but how often does this happen? Do a lot of people eating at a caloric deficit end up hypoglycemic? (This one I've never looked at before, so I have no clue).

 

[JamesKrieger]

I think James has some good points, but he doesn't really have any good argument for why a low carb diet isn't the right way to go.

I never claimed a low carb diet isn't the right way to go.

My position on low carb diets is explained very clearly in this excerpt from :

Of course, I already sense a bunch of strawmen coming my way, including accusations that I am somehow against low-carbohydrate diets. I am not. In fact, I have attended the Nutrition & Metabolism Society conference (an organization that is heavily interested in low carbohydrate diets), been a reviewer for their journal, and have either met or know high-profile scientists in the low-carbohydrate arena, including Eric Westman, Marie Vernon, Richard Feinman, Jeff Volek, and others. I have also published research on low-carbohydrate diets myself. Low-carbohydrate diets are certainly an effective strategy for some people intending to lose weight…but they are not the only strategy, nor are they the best strategy for everyone. And they do not work for the reasons that some people think they work.

Insulin is not bad, but too much is. Over time as we you more and more carbs, your pancreas will try to "predict" the amount of insulin to release, which leads to excessive amounts in many cases.

There is no evidence whatsoever that eating more and more carbs over time leads to excess insulin release. Hyperinsulinemia is due to insulin resistance, not carbohydrate consumption.

Also, insulin might be an appetite suppresent, but in excess leads to hypoglycemia, which is a major carb-craving stimulant.

This is another oft-made claim that has very little scientific support. The only evidence for this is when insulin is injected in a fasted state, which is not relevant to physiological conditions of eating carbohydrate.

 

[neanderpam107]

Well, obviously, I guess lowcarbing is the 'right way to go' for myself. And, after all, I can only say for myself.

I weighed 272 lbs. 11 years ago. Of course I'd tried diets, exercise, the gamut. I'm also asthmatic, have an incredibly high IgE (my allergies are not just sniffles...), I have Hashimoto's hypothyroidism (very well replaced with porcine thyroid), RA and also a left leg prosthetic (car accident, years ago). I also have Celiac.

i weigh 114 lbs today. I've been maintaining for over nine and a half years. I picked up a copy of Protein Power one day, and the rest is history (doesn't that sound so simple??!! LOL I wish!).

You just can't imagine the feeling when nurses or other health practitioners say 'Well, you've lost it...you can go back to eating 'normally' now". I look at them and say 'Lots of whole grains then...for the Celiac in me???". Then they look concerned, (quick look at the chart, sigh) and say 'Oh, well, you can have gluten free baked items'. All that rice. All that starch...I'm familiar with lots of starch...it's what helped make me so fat in the first place.

So MANY people won't read the books though. I eat more vegetables NOW than before I started lowcarb. i lost weight at about 30 to 50 net carbs a day (that means I subtracted fiber from carbs), and now I maintain at about 50 to 80 net carbs a day.

I no longer have a high A1c, I no longer take oral insulin (maybe I'll have to when I'm old, but I'm only 56 now ).

So, I let people debate about lowcarb...even in the same room, and quietly smile, as I eat some celery sticks wrapped in lean ham and turkey.... and I hold my husband back from commenting and bringing attention to me...because they just need to read the science behind lowcarb, insulin resistance, and how 'lowcarb' doesn't ever mean 'NO carbs, eat all you want, don't pay attention to supplements and exercise'.

I'll let everyone else debate while I revel in my new life...my new healthy life.

 

[Karrmer]

If you're obese it's essentially always because you're consuming too many worthless carbohydrates (those that don't come from a fruit/vegetable/nut).

Nobody has gotten obese eating a "low carb" diet, by this I mean completely obstaining from grains/sugars/etc. Nobody. Please, if you genuinely think you know someone that went from a normal weight to obese eating this way, no matter how much they try to stuff themselves, I'd love to see it.

Accepting this, you kinda have to wonder what is causing weight gain then? It's obviously an insulin issue, and no, eating proteins does not spike your insulin. A piece of beef isn't spiking your insulin.

Health concerns aside, which may have merit but I definitely don't agree with it, it would take someone with a very genetically messed up body to not lose a large amount of actual fat and little protein and muscle mass on a proper low carb diet.

I often hear the argument that "low carb diets only work because you're just eating less calories, it's the same as any reduced calorie diet." I guess this could be argued, but the reality is that it is really impossible to eat enormous amounts of calories without resorting to terrible carbohydrate. I used to be able to down 5,000 or more calories in a meal (Jack in the Box, large oreo shake + large pumpkin pie shake + large coca cola + a meal + some delicious sides). Yep, I stuffed my face that bad.

I recently tried eating as much bacon as I possibly could and I got about 9 pieces in before I was so full I wanted to puke - because there was a lot of *healthy* fat and it filled me up too much. 9 pieces of bacon is something like 700 calories.

COMPLETELY eliminate the worthless foods (carbohydrate is a completely unnecessary macronutrient, though I would recommend getting carbs from fruits and vegetables) and you will lose weight, a lot of it, without doing anything else. Eat all you want, because shockingly, you won't want to eat that much once you ditch the sugar and grain dependency for good.

 

[Jeanette401]

Look, I did Atkins for 5 years. Nobody is arguing that it doesn't work.

What's being argued is the claim that it's the best and healthiest way to lose weight for everyone.

Obviously if it were the healthiest for me, I wouldn't have seen a dramatic improvement in my cholesterol numbers when I stoppedd. Equally obvious, if you're one of the people who feels like crap when low carbing, or who has serious social issues, it may also not be the best choice.

Again, the point of this thread wasn't to claim that somehow low carb didn't work, it's to argue that it's not magic, that insulin is not the devil, and that there are alternatives.

Also, I could eat 9 pieces of thick bacon no problem And potentially follow it up with half a dozen slices or more of some nice havarti... I can eat half a pound of cheese without blinking. Now, I might not be hungry for longer than if I'd eaten the same volume of lettuce or sweet potato or something, but I don't know if that would really spare me calories.

Some people can eat as much as they want on low carb and not have an issue. That is not true for all people.

Also, I refer you to this study:

In it they test 50g of glucose, protein and glucose/protein combinations. To quote

The insulin area following glucose was only modestly greater than with a protein meal (97 +/- 35, 83 +/- 19 microU X h/ml, respectively).

In other words, 50g of glucose produced 97 units of insulin, and an equivalent amount of protein produced 83. That's with pure glucose. As the study goes on to say, having protein with your glucose increases insulin further, which is considered a good thing in diabetics because they need the insulin to control their high blood sugar.

If you want to talk about the greatness of low carb, go ahead. But at least get your facts straight and recognize that just because it's the greatest thing ever for you, it doesn't mean that the obesity crisis would be solved if only everyone could see the Truthiness of low carb.

 

[Karrmer]

If the only options people had for food were meat, fruits, vegetables, and some seeds/nuts then yes, absolutely, without a doubt the obesity epidemic would be solved.

No one gets obese eating that way. You MUST consume a lot of grain/sugar/bad carbs to get there. The end. That's just how it is.

Grains are absolutely unnecessary for humans. You do not need them, at all, ever. If you're feeling "lousy" when low carbing it isn't because you don't have enough grain, it's because of some other factor, but grains are not needed to make you feel good. You can get real carbohydrate from plenty of other sources that are actually good for you.

 

[JamesKrieger]

If you're obese it's essentially always because you're consuming too many worthless carbohydrates (those that don't come from a fruit/vegetable/nut).

The hard evidence does not support your statement.

A good example is a comparison of the diet of the traditional Pima Indian to the American Pima Indian. The traditional Pima and Mexican Pima had a diet of 60-80% carbohydrate, including tubers and grains. The American Pima has a diet of only around 50% carbohydrate. Yet the American Pima shows dramatically higher rates of obesity.

There are large bodies of epidemiological data showing higher grain consumption is actually associated with lower BMI's.

Nobody has gotten obese eating a "low carb" diet, by this I mean completely obstaining from grains/sugars/etc.

There are plenty of obese people who have failed to lose weight on low carb diets. Just go on any low carb forum and you will find quite a few. I have also had individuals who told me they gained weight on low carb diets.

Nobody. Please, if you genuinely think you know someone that went from a normal weight to obese eating this way, no matter how much they try to stuff themselves, I'd love to see it.

It's actually pretty easy to gain weight on a low carb diet if your fat intake is high enough. All you need to do is douse your salads in high fat dressing (such as Caesar salad) or use large amounts of oils and soft fats with your meals. It makes it very easy to add calories that do not promote satiety.

Accepting this,

But your accepting something without the data to back it up.

you kinda have to wonder what is causing weight gain then? It's obviously an insulin issue,

Really? If it's so obviously an insulin issue, .

and no, eating proteins does not spike your insulin. A piece of beef isn't spiking your insulin.

In fact, beef is high in the amino acid leucine, which stimulates insulin release from the pancreas.

I often hear the argument that "low carb diets only work because you're just eating less calories, it's the same as any reduced calorie diet." I guess this could be argued, but the reality is that it is really impossible to eat enormous amounts of calories without resorting to terrible carbohydrate.

No, it's not impossible. Not even close. A typical restaurant Caesar salad, which has almost no carbohydrate, often has more than 1,000 calories. I could easily eat three of these in a day and already have consumed 3,000.

I recently tried eating as much bacon as I possibly could and I got about 9 pieces in before I was so full I wanted to puke - because there was a lot of *healthy* fat and it filled me up too much. 9 pieces of bacon is something like 700 calories.

Bacon is a poor example because 1. Eating that much bacon is monotonous 2. The fat is solid in bacon, which requires chewing and slows down your eating 3. The bacon contains a significant amount of protein which is satiating.

anything else. Eat all you want, because shockingly, you won't want to eat that much once you ditch the sugar and grain dependency for good.

Yet there are plenty of people who do exactly this yet still struggle.

 

[Karrmer]

When did I advocate eating trash restaurant salads and salad dressings?

Eat nothing but meat, fish, poultry, vegetables, and fruit and I have a hard time believing you'll hit 600 pounds.

Prove me wrong.

 

[JamesKrieger]

When did I advocate eating trash restaurant salads and salad dressings?

Eat nothing but meat, fish, poultry, vegetables, and fruit and I have a hard time believing you'll hit 600 pounds.

Prove me wrong.

Now you're shifting the goalposts.

You said:

"If you're obese it's essentially always because you're consuming too many worthless carbohydrates (those that don't come from a fruit/vegetable/nut)."

I gave you one example how you can easily become obese that has nothing to do with carbohydrate. I also gave you scientific evidence that grains (which you demonized) do not contribute to obesity.

The problem is with your logic. Sure, it is tough to become obese when consuming mostly meat, fish, vegetables, etc. But this is because of the filling effect of the high protein intake and high fiber intake. It has nothing to do with insulin or carbohydrate. It also does not mean that if someone is obese, is it because of "worthless" carbohydrate intake.

 

[San2]

Eat nothing but meat, fish, poultry, vegetables, and fruit and I have a hard time believing you'll hit 600 pounds.

I love meat, and can eat boatloads of it. Some fruit is very high in calories and fructose, while containing little else. Certain vegetables are high in calories as well.

I think that if I wanted to, I could easily hit about 3500 - 5000 calories each day just from the stuff mentioned above.

Of course that diet is also lacking in a few essentials, but that's a different topic. I'm curious about your answers to James' questions and the things he pointed out though.

 

[Karrmer]

I love meat, and can eat boatloads of it. Some fruit is very high in calories and fructose, while containing little else. Certain vegetables are high in calories as well.

I think that if I wanted to, I could easily hit about 3500 - 5000 calories each day just from the stuff mentioned above.

Of course that diet is also lacking in a few essentials, but that's a different topic. I'm curious about your answers to James' questions and the things he pointed out though.

His arguments were nothing more than awkwardly pointing out that one Indian culture that happens to consume 50% carbohydrate gains more weight than the other that consumes more - without any evidence here - but it is irrelevant because 50% carbohydrate is still hilariously too high.

I also clearly stated above, and I can quote this if you can't see it, that I advocated a diet of meat/fish/poultry/vegetables/and some fruits/nuts/seeds. Most dietary intake should be from the protein and fats from the meats, lots of vegetables, and less of the rest.

You guys still seem to believe someone can get obese eating like this but I highly doubt it's ever happened. Neither of us has any genuine evidence to prove it either way but every single obese person I have ever seen (and that is a lot) is addicted to sugar and terrible carbs. All of them. They stuff their faces with candy bars and donuts and soda and pizza, etc. If you *REALLY* think you know a person that genuinely ate zero grain or sugar of any sort and ate just what I said above and managed to hit the good old American Obese weight of the ridiculous 350-400 lb or higher mark, I don't know how to argue with you, because it really isn't true.

Maybe you can get yourself to 20 or 30 lbs overweight, but the reality is that very obese people are doing it by scarfing down sugar, bread, etc (and doing so in combination with a lot of fat, of course).

There are plenty of studies of cultures (inuit) that eat nothing but fat and protein and are completely healthy and of a very acceptable weight. There are plenty of studies of cultures (Asia) that eat almost nothing but grain/carb and are "healthy" and maintain normal weight.

The obvious devil is combining a lot of fat with a lot of sugar/grain. I don't find a high carbohydrate/extremely low fat diet viable because it lacks satiety and generally leads to failure. I'll also agree with the side that follows the belief that these excessive carbohydrates are creating a lot of issues, especially inflammation.

It's extremely easy to post "studies" supporting any claim on any topic that anyone wants to make. Whether these studies were conducted with real scientific merit is questionable, like the hilarity of the whole lipid hypothesis that became the law we all used to live our lives by, even though it was garbage.

 

[clever_plant]

When did I advocate eating trash restaurant salads and salad dressings?

Eat nothing but meat, fish, poultry, vegetables, and fruit and I have a hard time believing you'll hit 600 pounds.

Prove me wrong.

No, actually you're the one making a claim that on such a diet you will not hit 600 pounds no matter what, therefore the burden of proof is on you.

As it is now, the research, like steve said, neither confirms nor rejects the hypothesis. The fail that is most peoples logic is then "oh, they're equal", alas no. Since we HAVE science that shows that following standard nutrient advice and eating the energy you need is healthy, and we do NOT have evidence that confirms that a low carb diet is healthy or superior in neither short nor long run, the science based thing to do is to go with the safe bet.

Now if low carb diets works for you, go for it, but when you make a new claim, the burden of proof is on you.

This is sort of how atheists doesn't have to prove that god doesn't exist, since they are rejecting a claim, not making it. (Please note that I don't intend to state my opinion of god, it is simply a clear example that everyone understands).

 

[San2]

I wanted to reply, but clever_plant said it all quite nicely already. Nothing to add.

 

[JamesKrieger]

His arguments were nothing more than awkwardly pointing out

Awkwardly? Please define awkwardly.

that one Indian culture that happens to consume 50% carbohydrate gains more weight than the other that consumes more - without any evidence here -

Without any evidence? I linked you directly to an article I wrote, which itself links directly to the studies on the Pima indians.

but it is irrelevant because 50% carbohydrate is still hilariously too high.

Really? Hilariously too high? Then why did the Pimas with the HIGHER carbohydrate intake have less obesity?

And why am I slim with a carbohydrate intake of 50-60%?

And why did the people lose weight despite increasing their carbohydrate intake? And they didn't improve the quality of their carbs either.

I don't know how to argue with you, because it really isn't true.

You don't know how to argue because you're making statements for which you have no evidence to support them with. You are simply making assertions and giving out personal anecdotes.

Not only that, but you've made claims that are demonstrably incorrect and inconsistent with science, such as your statement that carbs make you fat through the action of insulin (which has been demonstrated time and time again to not be true).

Maybe you can get yourself to 20 or 30 lbs overweight, but the reality is that very obese people are doing it by scarfing down sugar, bread, etc (and doing so in combination with a lot of fat, of course).

Sugar and bread were around LONG before obesity was a problem. So why did it all of sudden become a problem despite the fact that these foods have been around for centuries?

There are plenty of studies of cultures (inuit) that eat nothing but fat and protein and are completely healthy and of a very acceptable weight. There are plenty of studies of cultures (Asia) that eat almost nothing but grain/carb and are "healthy" and maintain normal weight.

Why do you put "healthy" in quotation marks? Because you refuse to believe they are healthy with a high carbohydrate intake, despite all the evidence to indicate that they're just fine?

The obvious devil is combining a lot of fat with a lot of sugar/grain.

You keep trying to demonize grain, yet you still fail to explain why there is an inverse relationship between BMI and grain intake in epidemiological studies.

I don't find a high carbohydrate/extremely low fat diet viable because it lacks satiety and generally leads to failure.

That's fine if it doesn't work for you. But how do you know that it's the high carbohydrate intake, and not due to a low protein intake? Remember, you can't change one macronutrient without changing another.

It's extremely easy to post "studies" supporting any claim on any topic that anyone wants to make.

I find that this is generally the catch-all excuse someone throws out when they haven't thoroughly examined all of the available scientific research in the field.

Whether these studies were conducted with real scientific merit is questionable,

Interesting claim when it is apparent you haven't read many (if any) of these studies.

I would also agree with others here that the burden of proof lies upon you, as you are the one making the assertion.