"Dr. Andrew B. Chung, MD/PhD" schrieb:
>
> Thorsten Schier wrote:
>
> > As far as I know, there are no studies which really proof that
> > carbohydrates cause obesity. But there are no studies either which
> > proof
> > otherwise.
> >
>
> Actually there are studies that prove that weight loss is achievable
> with caloric reduction independent of the macronutrient composition of
> the food being ingested.
Well, yes. Weight loss is also achievable with caloric restriction
independent of the weight of the food.
The question is, to what extend patients can follow such a diet in the
long run and how healthy that is.
Or when it comes to the causes of obesity: What causes people to overeat
in the first place?
> This is consistent with the observation that obesity in not rampant in
> parts of world where the majority of the world's population is eating
> proportionately higher amounts of carbs (ie Rice).
Rice is better than potatoes and white bread because it has a lower
glycemic index.
And of course it is much better than sugar, because it contains no
fructose and fructose is known to cause insulin resistance. As long as
your not insulin resistant, you can probably get away with consuming
considerable amounts of carbs.
> >
> > So scientists have to make up their mind on less solid evidence.
>
> Most scientists already *know* that carbohydrates do not cause
> obesity.
They *think* that they know. That is not necessarily the same.
> > You
> > believe that carbohydrates are innocent, other people believe
> > otherwise.
> >
>
> Go ahead and cite a reference where a credentialed scientist states
> the latter.
"Carbohydrates with high glycemic indexes and high glycemic loads
produce substantial increases in blood glucose and insulin levels after
ingestion. Within a few hours after their consumption, blood sugar
levels begin to decline rapidly due to an exaggerated increase in
insulin secretion. A profound state of hunger is created. The continued
intake of high-glycemic load meals is associated with an increased risk
of chronic diseases such as obesity, cardiovascular disease, and
diabetes. "
Low-glycemic-load diets: impact on obesity and chronic diseases.
Bell SJ, Sears B.
Sears Labs, 222 Rosewood Drive, Suite 500, Danvers, Massachusetts 01923,
USA.
[email protected]
(
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=12940416&dopt=Abstract)
> >
> > > >
> > > > > > However
> > > > > > that may be, cutting out most carbs will cause a vast
> > majority
> > > > of obese
> > > > > > people to lose weight.
> > > > >
> > > > > Cutting out anything will cause weight loss.
> > > >
> > > > But if you are insulinresistent, and a vast majority of obese
> > > > persons
> > > > are, cutting out fat and protein leaves you hungry most of the
> > time
> > >
> > > Cutting out anything is going to cause some hunger.
> > Hyperketonemia to
> > > suppress hunger is not a good thing.
> >
> > I don't think so.
> >
>
> Are you a physician?
No. However, I have a university diploma in biology and so I think I am
able to read and understand medical articles and abstracts.
So far, no one has been able to show me evidence that ketosis induced by
a low-carb diet might be harmful.
> >
> > > >
> > > > because it
> > > > produces reactive hypoglycaemias.
> > >
> > > Hypoglycemia in insulin-resistant individuals come largely from
> > > overconsumption of simple sugars and not from cutting out either
> > fat
> > > or protein.
> >
> > You are aware of the fact that for example most kinds of bread raise
> > the
> > blood sugar as much and as quickly as does sucrose, if not more so?
> >
>
> Not a fact to be aware of.
>
> Anyone who has taken a biochemistry course can explain this to you.
Then go ahead.
> >
> >
> > > > Besides you have a high level of
> > > > insulin in your blood which tends to prevent wheight loss.
> > > >
> > >
> > > Insulin resistance leading to need for elevated levels of insulin
> >
> > > happen *after* weight gain and not before.
> >
> > Your opinion.
>
> My clinical experience plus what is currently known about Metabolic
> Syndrome (MetS). I have never seen a thin type 2 diabetic.
>
> Nor have I ever seen a thin person with MetS.
Well, Eades and Eades (Protein Power) have.
> > It remains to be seen wether it is based on facts. Surely
> > you can point to a study back up your thesis?
> >
>
> Simply google "Metabolic Syndrome" and "Syndrome X" for literally
> hundreds of references.
Should be easy for you then to cite just one study that supports your
position.
> >
> > For another opinion:
> >
> > "It is concluded that hyperinsulinemia is a pathological driving
> > force
> > in producing both incipient obesity by overstimulating white adipose
> >
> > tissue and liver metabolic activity, and concomitantly producing
> > incipient muscle insulin resistance."
> >
> > Hyperinsulinemia and its Impact on Obesity and Insulin Resistance
> > Reference:
> > Cusin, I., Rohner-Jeanrenaud, F., Terrettaz, J., et al.,
> > "Hyperinsulinemia and its Impact on Obesity and Insulin Resistance,"
> >
> > International Journal of Obesity and Related Metabolic Disorders,
> > 16(Suppl 4), 1992, pages S1-S11.
> >
> > (http://atkins.com/Archive/2002/1/11-61705.html)
> >
>
> Interesting article where the investigators implanted insulin pumps in
> otherwise healthy rates and overfed these animals to prevent
> hypoglycemia. These animals became overweight (because they were
> overfed).
>
> Imho, the authors are erroneous in their conclusion because they could
> not control for weight gain.
According to the abstract the elevated insulin caused the larger food
intake. They don't say anything about offering them more food than the
control group or about force-feeding the rats. And they say that the
rats _got_ hypoglycemia. So this does not sound as if they overfed them
in order to prevent this.
> >
> > > >
> > > > > Problem is that research
> > > > > studies indicate that such "dieting" has dismal long-term
> > success
> > > > rates..
> > > >
> > > > Could you point to such a study?
> > >
> > > http://jama.ama-assn.org/cgi/content/abstract/289/14/1792?etoc
> >
> > What has this to do with low-carb diets?
>
> It has to do with dieting in general. Reread the discussion.
Well, small wonder they failed, if they used a low-fat diet. This proves
nothing about the efficacy of low-carb dieting.
> > They don't mention the kind of
> > the commercial program. Under "Author Affiliations" however, they
> > list
> > Weight Watchers International, so that we can hazard a guess about
> > the
> > nature of this program. I believe Weight Watchers isn't really
> > low-carb,
> > rather the contrary.
> >
> > >
> > > > Of course people have to stick to this
> > > > way of life, if they return to the old eating habits, they will
> > > > again
> > > > gain wheight.
> > > >
> > > > > > In addition, it offers a whole host of other
> > > > > > health benefits like reduced bloodpressure
> > > > >
> > > > > That happens from losing weight.
> > > >
> > > > No.
> > >
> > > Sorry, yes.
> >
> > Eades and Eades (Protein Power) state otherwise. They claim to have
> > successfully treated hypertension caused by fluid retension in
> > normalweight patients with their low-carb diet.
>
> Hyperketonemia does evoke (unhealthy) diuresis. This would be an
> undesirable side effect. Failing kidneys likely will completely fail
> during this scenario of diuresis brought on by high protein intake.
> If you don't believe me, ask your friendly neighborhood nephrologist
> (kidney specialist) about this.
It is my understanding that physicians frequently prescribe diuretics in
order to lower blood pressure. And now you claim diuresis to be a bad
thing. That there might be medical conditions that make diuresis
dangerous is another question. Most of us don't have failing kidneys,
however.
> >
> > > > Hyperinsulinemia (elevated levels of insulin in the blood)
> > causes
> > > > fluid retension and thus high bloodpressure (there are other
> > ways
> > > > insulin promotes high bloodpressure, but this is probably most
> > > > important).
> > >
> > > If that were true, then medications lowering insulin levels (by
> > > increasing insulin sensitivity) would be known for blood pressure
> > > lowering properties. They aren't.
> >
> > Oh, they are, even if you may not be aware of it:
> >
>
> Haven't seen it.
Perhaps because if you prescribe such medications your primary objective
is to achieve blood sugar control, not to reduce insulin levels. So in
many cases the insulin levels will remain more or less the same, only
that now they make a better job of reducing blood sugar.
>
> >
> > "In conclusion, metformin treatment increased insulin action,
> > lowered
> > blood pressure, improved the metabolic risk factor profile and
> > tended to
> > increase the fibrinolytic activity in these mildly hypertensive
> > subjects. These results support the view that insulin resistance
> > plays a
> > role in hypertension, and may open up a new field for the
> > alleviation of
> > abnormalities associated with cardiovascular disease."
> >
> > J Intern Med. 1991 Feb;229(2):181-7.
> >
> > Treating insulin resistance in hypertension with metformin reduces
> > both
> > blood pressure and metabolic risk factors.
> >
> > Landin K, Tengborn L, Smith U.
> >
> > (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1900072&dopt=Abstract)
> >
> > "There was a significant decrease in blood lipids (trygliceride and
> > cholesterol), an increase in HDL-cholesterol and a reduction in
> > blood
> > pressure in diabetics taking metformin"
> >
> > Eur J Clin Pharmacol. 1993;44(2):107-12.
> >
> > Metformin for obese, insulin-treated diabetic patients: improvement
> > in
> > glycaemic control and reduction of metabolic risk factors.
> >
> > Giugliano D, Quatraro A, Consoli G, Minei A, Ceriello A, De Rosa N,
> > D'Onofrio F.
> >
> > (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8453955&dopt=Abstract)
> >
> >
>
> Metformin does not directly decrease insulin resistance.
The authors of at least the first of the above articles seem to believe
otherwise: "Treating insulin resistance in hypertension with metformin
...."
However that may be, perhaps you could just say what medications you had
in mind. Please give a concrete example.
> It blocks
> the metabolism of disaccarides (simple sugars like sucrose).
Could you please elaborate on this and give a source? I didn't found
anything like this in what I read about metformin. According to the
articles I read, metformin reduces insulin resistance and suppresses
hepatic glucose production (mainly that from gluconeogenesis).
Besides, it is my understanding that disaccarides are digested into
their parts (for example glucose and fructose) before entering the blood
stream. So I'm a bit confused how metformin should influence their
metabolism.
> This
> does effect weight loss which probably accounts for much of the effect
> on blood pressure.
In the first study, the body weight remained unchangend. And yet there
was a reduction in blood pressure.
> >
> > > > As lowcarb diets reduce the amount of insulin in the blood,
> > > > the bloodpressure goes down.
> > >
> > > With LC diets blood pressure does down with weightloss +/-
> > diuresis
> > > and vasodilatory effects of hyperketonemia.
> >
> > So ketosis does not seem to be that bad after all.
> >
>
> Try drinking some acetone and get back with us on that.
Next time you are going to tell us that potassium is poisonous because
people die when they get a large amount of it injected.
> >
> > > > This works even in people who are not
> > > > overweight to begin with.
> > > >
> > >
> > > See above.
> > >
> > > >
> > > > > > and lower triglcerides.
> > > > >
> > > > > This also happens largely from losing weight.
> > > >
> > > > Again, no. If you honestly believe this, I urge you to inform
> > > > yourself
> > > > about this, to the benefit of your patients.
> > > >
> > > > To get you started:
> > > >
> > > > "Triglycerides. The most dramatic and
> > > > consistent lipid response to a very-low-carbo-hydrate
> > > > diet is a moderate to large decrease in
> > > > fasting triglyceride levels and postprandial
> > > > triglyceride responses to a fat-rich meal,14
> > > > both independent risk factors for cardiovascu-lar disease.15,16
> > > >
> > >
> > > Actually triglycerides have been shown to be a CAD risk factor
> > > primarily in those with metabolic syndrome and not in other
> > folks..
> >
> > Now, first you denied that low-carb diets reduce triglcerides
> > independently of weightloss
>
> Still do.
>
> > and when you were shown otherwise
>
> Where?
Below.
> > you seem
> > to deny the relevance of elevated triglycerides.
> >
>
> Perhaps you should read what I wrote again.
You make it sound as if elevated triglycerides were not a health concern
for most people.
> >
> > With limited success, though, because the majority of overweight
> > persons
> > and almost all obese persons _have_ metabolic syndrome, so it is
> > relevant for them. And a most dieters will be overweight or even
> > obese.
> >
> > > > [...]
> > > > Paradoxically, a low-fat/high-carbohy-drate
> > > > diet exacerbates atherogenic dyslipi-demia
> > > > if the patient does not lose a significant
> > > > amount of weight or increase his or her level
> > > > of physical activity.26,27
> > >
> > > Therefore, when there is weight loss, triglycerides will be
> > lowered
> > > independent of whether the diet is LC or HC.
> > >
> > > > However, a very-low-carbohydrate
> > > > diet improves all aspects of
> > > > atherogenic dyslipidemia, decreasing fasting
> > > > and postprandial triglyceride levels, increasing
> > > > HDL, increasing LDL size, and decreasing
> > > > insulin, independent of weight loss.14,23"
> > > >
> > >
> > > Ime, this effect has not been independent of weight loss. Without
> >
> > > weight loss, LC dieters rarely improve their lipid profile.
> >
> > The authors of the article I cited seem to think otherwise
>
> Where?
I repeat:
"However, a very-low-carbohydrate
diet improves all aspects of
atherogenic dyslipidemia, decreasing fasting
and postprandial triglyceride levels, increasing
HDL, increasing LDL size, and decreasing
insulin, _independent of weight loss_.14,23"
(Emphasis added)
> > and what's
> > more, they cite studies to back up their view. I also cited some
> > studies
> > to support this. Can you do the same for your view?
>
> Yes. However, you'll need to prove your point first.
At least I presented evidence to support my view. You seem strangely
reluctant to do the same for yours.
> >
> >
> > > > Volek and Westman, Very-low-carbohydrate weight-loss diets
> > revisited
> > > > -
> > > > Cleveland clinic journal of Medicine, Volume 69 - Number 11 -
> > > > November
> > > > 2002, pp. 849-862
> > > >
> > (http://atkins.com/img/assets/862/Volekand_Westman_Ketogenic_Review.pdf)
> >
> > I notice that you didn't bother to read the article because if you
> > had,
> > you would hardly have passed up the opportunity to tell us that the
> > authors were in part financed by the Atkins Foundation.
> >
>
> My preference is to discredit studies on the basis of either flaws or
> lack of scientific merit rather than harp on where the funding came
> from.
Good.
> >
> > > > "These results indicate that the effects of lowfat diets on
> > > > lipoprotein
> > > > metabolism are not limited to higher fasting plasma triglyceride
> > and
> > > >
> > > > lower HDL cholesterol concentrations, but also include a
> > persistent
> > > > elevation in RLPs. Given the atherogenic potential of these
> > changes
> > > > in
> > > > lipoprotein metabolism, it seems appropriate to question the
> > wisdom
> > > > of
> > > > recommending that all Americans should replace dietary saturated
> > fat
> > > >
> > > > with CHO."
> > > >
> > >
> > > The wiser recommendation is for folks to eat less across the
> > board.
> > >
> >
> > Except for food high in carbs of course.
> >
>
> No exceptions.
Not even for foods rich in transfats or sugar?
> >
> > > >
> > > > Abbasi F. et al., High carbohydrate diets, triglyceride-rich
> > > > lipoproteins, and coronary heart disease risk. - Am J Cardiol.
> > 2000
> > > > Jan
> > > > 1;85(1):45-8.
> > > >
> > (http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=11078235&dopt=Abstract)
> >
> > > >
> > > > "Improvements in plasma lipids induced by the ad libitum
> > consumption
> > > > of
> > > > a high-CHO diet seem to be partly mediated by changes in body
> > > > weight,
> > > > whereas lipid changes induced by the high-MUFA diet seem to be
> > > > independent of changes in body weight."
> > > >
> > > > Archer WR. et al., Variations in body composition and plasma
> > lipids
> > > > in
> > > > response to a high-carbohydrate diet. - Obes Res. 2003
> > > > Aug;11(8):978-86.
> > > >
> > > >
> > > > > Without carbohydrates, there will be hyperketonemia. This is
> > not
> > > > a good
> > > > > thing physiologically.
> > > >
> > > > Now this is funny, because you are promoting a diet on which
> > many
> > > > dieters may be in ketosis as well, at least according to your
> > > > reasoning.
> > > >
> > > > Some time ago you stated in this group:
> > > >
> > > > "Irrespective of the insulin, if someone is catabolizing a large
> >
> > > > amount
> > > > of fat
> > > > (ie 40 lbs) in a short period of time (ie in less than 8
> > months), it
> > > > is
> > > > likely
> > > > they are inadvertantly ketogenic (not enough carbs for the
> > amount of
> > > >
> > > > catabolized
> > > > fat). It is the ketosis that is bad for the arteries, IMO."
> > > >
> > > >
> > (http://groups.google.de/groups?q=g:...e=UTF-8&[email protected])
> >
> > > >
> > > > Now the person the discussion was all about lost this weight on
> > > > Ornish,
> > > > that is a very high carbohydrate diet.
> > > >
> > > > A person following your two-pound approach and eating a more
> > > > balanced
> > > > diet would get much less carbohydrates
> > >
> > > But enough to keep the Kreb cycle running. It only takes a few
> > > ounces. Folks really have to work at it to reduce the level of
> > > carbohydrates to cause hyperketonemia. It does not happen
> > accidently
> > > except in folks who are starving themselves. And, 2 pounds of food
> > a
> > > day is a long way from starvation.
> > >
> > > > and therefore likely be in
> > > > ketosis if he is losing moderate amounts of fat, at least
> > according
> > > > to
> > > > what you stated in the discussion I cited.
> > > >
> > >
> > > Depends on the rate of weight loss. The 2PD approach brings about
> >
> > > slow and steady weight loss cruising right into maintenance.
> > >
> > > >
> > > > Or think about all those poor POWs of Camp Cropper who,
> > according to
> > > >
> > > > Mu_nstruck, came from obese to thin in a matter of months, on a
> > diet
> > > >
> > > > allegedly not unlike your two-pound diet. They must have been in
> >
> > > > deep
> > > > ketosis.
> >
> > Losing so much weight as the POWs of Camp Cropper allegedly have in
> > just
> > a few months can hardly be called "slow and steady". So either what
> > happend to these prisoners had nothing to do with the two-pound diet
> >
> > (which would raise the question, why you didn't notice this on your
> > own)
> > or else the weigth loss on the two-pound diet isn't all that slow
> > and
> > steady.
> >
>
> I can only write from my experiences.
Than it is strange that you didn't notice that what happened to those
prisoners was so different from your experience. Or if you noticed, that
you didn't tell us. If I had my own diet to promote, I would hate people
to get a wrong idea about it.
> >
> > > >
> > > > (<[email protected]>)
> > > >
> > > > > > If
> > > > > > you are interested in how this works, I'd recommend the book
> >
> > > > "Protein
> > > > > > Power" by Michael and Mary Eades to you.
> > > > > >
> > > > >
> > > > > I prefer peer-reviewed journal article to books like "Protein
> > > > Power."
> > > > >
> > > > > The latter sounds too much like "White Power."
> > > >
> > > > Do you really think you can discredit the work of the Eades'
> > with
> > > > this,
> > > > er, association of yours?
> > > >
> > >
> > > The title's already done it for me. Sorry.
> >
> > I notice that you take every possible excuse to close both eyes when
> > it
> > comes to the merits of low-carb diets.
> >
>
> Pray tell why are you a big proponent of low-carb diets when there is
> obviously minimal data to support it despite its 30 year history?
I think this is a bit of a blind spot for you. For some reason you seem
to choose to ignore all evidence in favor of low-carb diets, of which
there is plenty. Some of it was presented to you in this thread.
Than this is a matter of personal experience. I lost about 25 kg (in
somewhat more than half a year) on a low-carb diet. When I started to go
off the diet, at least partly (mostly by eating too much chocolate) I
regained 5 kg. Now that I'm back on the diet I already have lost again 4
of the 5 regained kg. My blood pressure has fallen considerably, as well
as my triglycerides. Cholesterol has remained the same. I'm less tired
than I used to be. And this diet is a way you can lose weight and yet
don't have to be hungry all the time.
I also read in alt.support.diet.low-carb, so I know that I'm not the
only one who has lost weight and impoved health on this diet. It is
particulary interesting how many diabetics have managed to control their
blood sugar with low-carb diets. You will note that the corresponding
low-fat group has almost no traffic. Don't seem to be many successful
dieters there.
Thorsten
--
"Nothing in biology makes sense, except in the light of evolution"
(Theodosius Dobzhansky)
