Thoughts on Obesity, Part II

In my reading, I've come to the conclusion that, in some people, overweight may be a type of carbohydrate intolerance.

Insulin is the master hormone that orchestrates the metabolic changes that cause fat accumulation. It instructs the body to transport glucose and fat from the blood into the cells. It tells the liver to synthesize fat from sugar. It inhibits the release of fat from fat cells. There are no other hormones that have a similar range of effects.

Insulin is the "storage hormone". Don't believe me? Ask a type I diabetic. Type I diabetes happens when the pancreas no longer secretes insulin. These people are rail-thin until they are given insulin injections, at which point they often gain excess weight. Many deliberately skip injections to lose weight. Unfortunately, this has serious consequences as it allows their blood glucose to rise to dangerous levels unchecked.

If insulin is kept low, fat synthesis and storage are inhibited, and fat release from fat cells is increased. Carbohydrate is particularly effective at elevating insulin, acutely and chronically. As carbohydrate digests, it's broken down into glucose, which enters the bloodstream. The pancreas releases insulin in an attempt to keep blood glucose within a healthy range, and the storage begins. Refined carbohydrate is the worst offender, because it causes a large and rapid rise in blood glucose.

Regular overconsumption of carbohydrate causes insulin to be chronically elevated in many people [update- I no longer believe this is true. I now believe that only certain types of carbohydrate- namely wheat and sugar- cause a pathological increase in fasting insulin over time]. This comes along with "insulin resistance", whereby most or all tissues become desensitized to insulin. This is the tissues' way of saying "Stop! My energy stores are already full! I can't handle any more glucose or fat!".

Some people are able to maintain normal insulin levels (and sensitivity) in the face of a high-carbohydrate diet. This is probably partly genetic and partly environmental. Certain people, for whatever reason, have fat tissue that is prone to fat accumulation. It could be because they oversecrete insulin, or because their fat tissue is sensitive to the action of insulin, but probably both. It likely has to do with a combination of insulin resistance in non-fat tissue, and insulin sensitivity in fat tissue. Inactivity and fructose consumption (from corn syrup or sucrose) are also high on the list of suspects.

Fat tissue is typically the last to become insulin resistant because it acts as a valuable buffer to remove excess (and potentially toxic) glucose from the bloodstream. Unfortunately, simply being thin is not a reliable indicator that your body tolerates carbohydrate well. It can indicate either that all tissues are insulin-sensitive and insulin levels are low, or all tissues (including fat) are insulin resistant and insulin levels are high. The latter scenario leads to type II diabetes, pronto.

Since fat accumulation revolves around carbohydrate intake and insulin production, it makes sense that reducing carbohydrate causes weight loss. No more carbohydrate = a lot less glucose, and a lot less insulin to deal with it. This completely sidesteps the problem of insulin resistance, although that seems to respond favorably to carbohydrate restriction as well. Every time true low-carbohydrate diets are matched head-to-head with reduced-calorie, carbohydrate-rich diets, subjects lose more weight and have fewer problems with hunger on the low-carbohydrate diet. I discussed a recent study here.

The idea that you can achieve and maintain a healthy weight without cutting calories sounds too good to be true. In fact, all it represents is a return to our natural pattern of eating as human beings. It may involve breaking an addiction to carbohydrate. True hunter-gatherers eat between 0 and 35% of their calories as carbohydrate, and no refined carbohydrate [correction: a number of hunter-gatherer groups ate more than 35% carbohydrate, typically from starchy tubers]. In industrial nations, we eat approximately 50% of our calories as carbohydrate. Hunter-gatherers also exercise regularly, and don't eat Frosted Sugar Bombs for breakfast. This helps maintain good insulin sensitivity. Since we are genetically very similar to our hunter-gatherer ancestors, we would be wise to learn from their example.

Thoughts on Obesity, Part I

From the US Centers for Disease Control website:

Since the mid-seventies, the prevalence of overweight and obesity has increased sharply for both adults and children. Data from two NHANES surveys show that among adults aged 20–74 years the prevalence of obesity increased from 15.0% (in the 1976–1980 survey) to 32.9% (in the 2003–2004 survey).

In hunter-gatherer and some semi-agricultural societies, obesity is rare. In most, it's nonexistent. Wild animals typically do not accumulate enough fat to interfere with vigorous exercise, and when they do, it's because they're about to hibernate or migrate. Wild animals also tend to have similar amounts of body fat between individuals (at a given age and sex), unlike industrialized humans. This makes me think that obesity is an unnatural effect of our current lifestyle. Whatever the cause, it's getting progressively more common.

According to self-righteous nutrition experts, we know exactly what causes overweight. It's a character flaw known as overeating. Calories in, calories out. And the cure is to eat less. The problem is, this is not supported by the evidence. First of all, overweight people often eat no more than the thin. Second, weight gain is a highly individual process. Overfeeding under controlled conditions can produce more than 3-fold differences in weight gain between individuals fed the same number of calories.

Restricting calories is also fraught with problems. Each person's metabolism has a preference for a specific body composition within the context of a particular lifestyle. If total calories are restricted without changing diet composition, the body reacts vigorously to maintain homeostasis. Energy expenditure is reduced; muscle and organ mass diminish. The psychological effects are particularly bad, as anyone can tell you who has been on a low-calorie diet. In 1944, Ancel Keys undertook a calorie restriction trial in conscientious objector "volunteers" in Minnesota. They remained on a 1,570-calorie diet that was low in fat and protein and high in carbohydrate, for 24 weeks. Hardly a draconian calorie count. Here's a quote from the study:

As starvation progressed, fewer and fewer things could stimulate the men to overt action. They described their increasing weakness, loss of ambition, narrowing of interests, depression, irritability, and loss of libido as a pattern characteristic of "growing old".

Some of the men ended up suffering from neurosis and borderline psychosis before the end of the study, one culminating in self-mutilation. This is what we're being prescribed for weight loss?

There are some diet trends that have associated with rising obesity in the US. Per capita calorie consumption has increased. This increase is due to a higher consumption of carbohydrate. Total protein and fat consumption have been almost identical for the past 30 years. This period also saw increases in the consumption of unsaturated vegetable oils, hydrogenated vegetable oils and high-fructose corn syrup. It's hard to say from this association which of these factors (if any) has caused us to gain weight in the last 30 years, but it certainly isn't total fat or protein. Fortunately, we have other clues.

Cry me a river...

Or a couple of canals as well.

My Dad is going to have surgery on Wednesday. 1 week today and it will be all over thank goodness. Apparently the cancer is localised, hasn't spread, and is totally sortable.

One mill stones less.

I cant describe how I felt or how I feel now, but I wish that I could have the operation for him. I know what surgery is like and I know I can handle it... Dad's never been in hospital. Its so strange the way things change and you want to protect your parents rather than how it used to be. I would totally do it for him. In a blink.

So foodwise...
Today has been good. Banana for breakfast, Home made ratatouille on toast for lunch, then more ratatouille on pasta in the evening. 2 yogurts in the evening.

I am going to weigh in soon. I have been putting it off, I have to admit. What with having the curse and then having a couple of pig out days until I pulled myself together, I know that I need to see something nice. If I get on those scales and it hasn't moved in the right direction I will be devastated. So I am giving myself a little time to make absolutely sure that what I want to see WILL be there.

I will see how I feel tomorrow. I always take a drink to bed with me, and if I cant face weighing in, I always drink when I wake up. I never weigh after food or drink, so it tops the wondering instantly.

I also have not done any regular exercise since being banded. I am very active as you know, but I haven't joined a gym, or started a morning walk or any kind of routine. I am now glad that I haven't done this. If my weight starts to plateau out it will mean that at least I will have one more type of ammunition in my arsenal.

I so want to get the next half stone off. I cant wait.

Ripped Fuel Pills

As you may already know I have been reviewing fat burners to give you the best in diet products. In all this scam nowadays fat burning pills are difficult to find these days and therefore it is difficult to calssify any one pill as the best weight loss pill in the market today We all want to look for the most effective weight loss pills in market today but we are not patient. We want to loose belly fat as fast as it came on!!..
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Other pills like green tea fat burning pills, green tea pills have also become apparent now. Everybody has tried all sorts of thing… some have tried caffeine pills while others have used energy pills, ephedra and ephedrine pills. You can even get fat burning tablets, and fat burning vitamin from over the counter.
Whether you are a bodybuilder or a regular person you must dream of getting the “ripped” look. Even if you are healthy you want to try out the ripped fuel pills… you think this will give you a miraculous transforming your body.
I started this blog to give you a comparison on diff weight loss products and supplements in the market today. I would like for you to be able to compare these and then possible try something safely which is at the best an FDA approved diet pill or if not then has a sufficient safety profile that it does not cause you harm more than good. A diet pill is good if it is a safe otherwise it is just another toxic compound being injested by you.

Losing the Last 10 Pounds

MM wanted to lose the last 10 to 12 pounds. She has been at the same weight for the past couple of years despite already eating quite well (she's a vegetarian). MM is a middle-aged woman who found out she has a small brain tumor recently. Her quest to live everyday to the fullest includes losing the last 10 pounds.

She recently joined 24-Hour Fitness and has been amazed to lose six pounds in the first two weeks already! 24 Hour Fitness has about 400 clubs across the US. See her quest to lose the 10 pounds.

Say Hello to the Kuna

For those of you who haven't been reading the comments, we've been having a spirited discussion about the diet and health of hunter-gatherers here. I brought up the Kuna indians in Panama, who are immune to hypertension, live a good long time, do not gain excess weight, and seem to have less cardiovascular disease and cancer than their city-dwelling cousins.

I was hungry for more information about the Kuna lifestyle, so over the last few days, I've dug up every paper I could find on them. The first paper describing their lack of hypertension was published in 1944 and I don't have access to the full text. In 1997, a series of studies began, headed by Dr. Norman Hollenberg at Harvard. He confirmed the blood pressure findings, and collected data on their diet, lifestyle and kidney function. Here's a summary:

The Kuna are half hunter-gatherers, half agricultural. They cultivate plantains, corn, cocoa, yucca, kidney beans, and several types of fruit. They trade for sugar, salt, some processed cocoa and miscellaneous other foods. They drink 40+ oz of hot cacao/cocoa per day, some locally produced and some imported. A little-known secret: the Kuna eat an average of 3 oz of donut a week. They also fish and hunt regularly.

In the first recent study, published in 1997, the Kuna diet is described as 29% lower in fat than the average US diet (56 g/day), 23% lower in protein (12.2 g), 60% higher in cholesterol, and higher in sodium and fiber. The study doesn't specifically mention this, but the reader is left to infer that 65% of their calories come from carbohydrate. This would be from plantains, corn, yucca, sugar and beans. The fat in their diet comes almost exclusively from coconut, cocoa and fish: mostly saturated and omega-3 fats.

In the next study, the picture is beginning to change. Their staple stew, tule masi, is described as being 38% fat by calories (from coconut and fish), exceeding the American average. In the final study in 2006, Hollenberg's group used a more precise method of accounting for diet composition than was used in previous attempts. The paper doesn't report macronutrients as a percentage of calories, and I suspect the reason is that they aren't consistent with the previous papers. They have retreated from their previous position that the Kuna diet is low-fat and describe it instead as "low in animal fat", leaving plenty of room for saturated fats from coconut and cacao.

I was able to find some clues about their diet composition, however. First of all, they report the meat consumption of the Kuna at approximately 60 oz per week, mostly from fish. That's 8.6 oz per day, identical to the American average. They also reported the fat content of the cacao the Kuna produce locally and brew into their favorite 40-oz-a-day drink. It's 44.2% fat by weight. The low-fat cocoa drinks they used to calculate macronutrient totals are made from imported cocoa (cocoa is defatted cacao powder), ignoring the locally produced, full-fat cacao. If we assume half the chocolate they drank was locally produced, that's about 30 additional grams of fat a day, bringing their total fat intake to 8g above the average American. I suspect the authors chose to ignore the locally-produced cacao to lower the apparent fat intake of the Kuna, even though the paper states they drank both regularly.

By putting together the pieces from the later studies, a new picture emerges: a diet high in fish and moderate in protein, high in unprocessed fat (especially saturated and omega-3), and moderate in mostly unprocessed carbohydrate.

Here's my biased interpretation. The Kuna are healthier than their city-dwelling cousins for a number of reasons. They have a very favorable omega3:6 ratio due to seafood, wild game and relatively saturated vegetable fats. Their carbohydrate foods are mostly unprocessed and mostly from non-grain sources. They also live an outdoor life full of sunshine (vitamin D) and exercise. The chocolate may also contribute to their health, but I doubt it's a major effect. They're healthier than industrialized people because they live more naturally.

Another lesson to be learned from the Kuna and other exceptionally healthy indigenous peoples is that the human body can tolerate a fair amount of carbohydrate under the right conditions. Peter discusses another example of this, the Kitavans, on his blog. 50% carbohydrate while sitting in front of a desk all day, eating corn oil and getting no exercise = bad. 45% carbohydrate while hunting, relaxing and preparing whole, natural food in the sun all day = good.

An Aboriginal Diet for Weight Loss

Greg lost 40 pounds, normalized his blood sugar and no longer requires diabetes drugs.

His route to success? He went on an aboriginal diet. He could eat "all the fat he wanted, and all the seafood and meat and starch-free vegetables. Dairy fats like cream and cheese were fine, but not milk. Everything else with carbs -- bread, pasta, chips -- were off-limits. No ancestor of Wadhams' ever feasted on pasta and rice. Or ice cream bars."

With the urging of the local doctor (in the photo above), many people in his small village also went on a similar diet and experienced success.

It sounds like the Atkins diet, but it is a traditional aboriginal diet.

See the interesting story at The Town that Lost 1,200 Pounds.