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Dr Ludwig - The Carbohydrate-insulin Model Of Obesity

I know who Ludwig is but I'm not familiar with his work. This statement frustrates me...

"Maintain an adequate, but not high, intake of protein, including from plant sources c."

What's adequate? What's high?

Some explanation is provided here, but I need numbers...

"c By eliciting glucagon secretion, protein tends to balance carbohydrate from a metabolic perspective. However, large amounts of protein can also raise insulin secretion. Preliminary evidence suggests plant proteins stimulate less insulin, and may have a lesser anabolic effect, than animal proteins.46"

The study he based this information on isn't what I expected...

"46. Sanchez A, Hubbard RW. Plasma amino acids and the insulin/glucagon ratio as an explanation for the dietary protein modulation of atherosclerosis. Med Hypotheses. 1991;36(1):27-32."

I like much of Ludwig's dietary recommendations, but have a problem with the above. I've been gradually increasing my protein intake. After listening to a lot of lectures and interviews with Ted Naiman, M.D., I more recently bumped up my protein intake to 92 g a day. I feel better, my glucose readings are lower and more stable now. Could be a fluke, but time will tell. Will try to get a fasting insulin test done to see where I am right now.
 
When it comes to proteins...I felt that Benjamin Bikman gave a good presentation on why higher protein don't have the same insulinogenic effects when glucose is low...

This diagram shows the insulin response...on different diets. Insulinogenic effects of Protein is dependent on the underlying glycemic status...

upload_2018-4-10_14-16-8-png.26076


Taken from his presentation:-
 
That was interesting. And I really appreciated how he pulled all the information together at the end and gave specific recommendations. I was really shocked by how the body responds to protein when comparing the standard american diet (SAD) to the low carbohydrate diet. Wow. This just reinforces for me that I need to eat more protein for a while - (I eat around 50 nutrient dense carbohydrates a day so I should be okay) - to see where this takes me. Thanks kokhongw. :)
 
There is a study that rubbishes the Ludwig study, if I can operate my cut and paste on this phone I will paste it for you. I thought the debunking study had a few holes in it.
It is based on a study by Hall and Liebel.
D.
 
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Hall and Guyenet both hate Gary Taubes and CIM, so no real surprise that they'd be happy to co-author a rebuttal.
 
All I can say is that I raised the level of protein in my diet and my hair and skin recovered and my monitor didn't blink an eye. Job's a goodun.
 
Yes, I thought it was iffy! :)

10.1001/jamainternmed.2018.2920

One of them is a Keto expert. I wonder who pays the Piper?

If it works the theory might not get sorted properly for a year or two. After losing 3.5 stone on LCHF I am the same weight as I was in my early twenties 55 years ago.

Fact is low carb and keto don't make some people slim. Not fat shaming here but some of the keto gurus on the net don't look that slim to me round the mid section so those that have weight issues going on have more to deal with than having low insulin.
D.
 
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This is what really pees me off about academics.. while they are having their “my mouse theory is better than your mouse theory” arguments people are going blind and having their limbs amputated. I far prefer to listen to real world medics who can be judged by their successes. Who cares if the Virta study didn’t have a control group who got more ill? The patients health improved which is surely the most important factor. Dr Fung gets results.. we can see this.. does anyone really care if it is “anecdotal” .. give me an anecdotal “cure” over some professors theory any day of the week.
 
Virta Health makes millions of dollars out of low carb, it is a big business in the States and I guess we purists will have to choose our gurus wisely or come to a more graded or balanced view.
Academics have mainly their egos to support unless their masters that pay them keep them to their particular doctrine.

Most health care professional in the UK do have the best interests of patients at heart. It will be a sad day if private health care replaces the NHS in the UK.
D.
 
Thanks, I read his blog and found it insightful.
He recognises lc as a tool in the tool box but doesn't support Ludwig's hypothesis because it is far more complex and doesn't answer a number of questions.

For me LCgood fats works but my son in law is slim on whatever junk he puts in his body and also some are obese whatever they do with carbs.
It is not simple, much more is going on than some gurus pretend.
D.


kokhongw said:
Likely this
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2686143

They have been trading blows for many years...

Here is Stephan's blog
http://www.stephanguyenet.com/why-t...y-reply-to-ebbeling-and-ludwigs-jama-article/

An interesting side note is the Dr Michael Schwartz from UW heads the team that explored the FGF1 injection into the various mouse model to achieve diabetes remission. So he believes diabetes could be a neurological dysfunction...
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lindisfel said:
Virta Health makes millions of dollars out of low carb, it is a big business in the States and I guess we purists will have to choose our gurus wisely or come to a more graded or balanced view.
Academics have mainly their egos to support unless their masters that pay them keep them to their particular doctrine.

Most health care professional in the UK do have the best interests of patients at heart. It will be a sad day if private health care replaces the NHS in the UK.
D.
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I expect that Virta Health is a long way from making a profit, partly due to how much they are spending on marketing along with improving the platform recruiting lots of new staff and training the new staff. They have just raised a new investment if I recall correctly it was 45 million dollars. I expect they will need at least one more round of investment before they have become large enough to make a profit giving how fast they are aiming to expand.
 
ringi said:
I expect that Virta Health is a long way from making a profit, partly due to how much they are spending on marketing along with improving the platform recruiting lots of new staff and training the new staff. They have just raised a new investment if I recall correctly it was 45 million dollars. I expect they will need at least one more round of investment before they have become large enough to make a profit giving how fast they are aiming to expand.
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With Trump's help they may expand here when the Brexit, Tory free marketeers have their way.
God help us if we ever become a state like some Tories want, where the poor go without because they can't pay.
But I am getting off the point onto the real knitty of what really matters.
D.
 
the poor already go without sufficient food, enough clothing, adequate heating and good housing. They already have health choices removed for dental care due to a lack of NHS dentists, or social care. The future is already here.
 
lucylocket61 said:
the poor already go without sufficient food, enough clothing, adequate heating and good housing. They already have health choices removed for dental care due to a lack of NHS dentists, or social care. The future is already here.
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I know it's dreadful, our local church runs the town's food bank and it's just getting worse, there is even more need as each year passes.
I have known what it is to be poor my mother was widowed when I was six.
I pity the kids its very difficult for them to eat some idealized diet.

Funding has to be there to help people feed better when this new dietary advice roles out.
D.
 
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lindisfel said:
I know it's dreadful, our local church runs the town's food bank and it's just getting worse, there is even more need as each year passes.
I have known what it is to be poor my mother was widowed when I was six.
I pity the kids its very difficult for them to eat some idealized diet.

Funding has to be there to help people feed better with this new dietary role out.
D.
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I volunteer at a foodbank. The food available is high carb, and often highly processed. It has to be, to be easy to prepare and store, and some people only have access to a kettle. Yet another way that the poorest have their health compromised : (
 
Winnie53 said:
I know who Ludwig is but I'm not familiar with his work. This statement frustrates me...

"Maintain an adequate, but not high, intake of protein, including from plant sources c."

What's adequate? What's high?

Some explanation is provided here, but I need numbers...

"c By eliciting glucagon secretion, protein tends to balance carbohydrate from a metabolic perspective. However, large amounts of protein can also raise insulin secretion. Preliminary evidence suggests plant proteins stimulate less insulin, and may have a lesser anabolic effect, than animal proteins.46"
Click to expand...

Benjamin Bikman explained it well, and also echos what I was told when training, ie 1g+ per kg. Exact amount may vary depending on your own body's preferences. I think it'll also depend on ratio of fat to lean body mass, but a goal is to avoid cannibalising (or metabolising) our own lean muscle. Then if you're looking to do body building, protein quantities can increase massively. It amuses me when people spend lots of money on whey protein and don't instantly bulk up. Or at least bulk up with muscle.. A lot of exercise is also needed.

For me, I aim for around 1.2g/kg partly because that works out to a neat 100g or so of protein. That makes looking at labels easier. I also really recommend body monitoring scales that show fat:lean mass. If lean is dropping, it's a sign that you probably need to up your protein. If you're doing that and exercising more, it can also show why weight loss slowing or stalling isn't necessarily a bad thing. So when I started, I was 100kg with 66kg muscle. Now, I'm 85kg with 72kg muscle. So that messes up my BMI, but I'm happy with that :)
 
lucylocket61 said:
I volunteer at a foodbank. The food available is high carb, and often highly processed. It has to be, to be easy to prepare and store, and some people only have access to a kettle. Yet another way that the poorest have their health compromised : (
Click to expand...

I live in the US. Our local food bank has really changed and evolved. Years ago, they recognized that the quality of the food they were providing needed to be healthier.

They now provide meat, poultry, fish, fresh vegetables, fruits, and berries as available. All foods appropriate for low carb. Bakery's donate to the food bank too, foods no one should be eating, but it's a start.

Two of my friends depend on the food bank. One eats the low carb high fat diet.

lindisfel said:
Virta Health makes millions of dollars out of low carb, it is a big business in the States and I guess we purists will have to choose our gurus wisely or come to a more graded or balanced view.
Academics have mainly their egos to support unless their masters that pay them keep them to their particular doctrine.

Most health care professional in the UK do have the best interests of patients at heart. It will be a sad day if private health care replaces the NHS in the UK.
D.
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[Warning: Rant forthcoming...]

I also think Virta Health has a difficult road ahead. I'm following what they're doing. If they succeed, we'll all be better off for it. Anyone who doesn't have a lot of money can do what they're doing with a glucose meter, an android phone, and the low carbohydrate and/or ketogenic diet. I personally have been doing it successfully for 3 1/2 years with no medical supervision or guidance. I used the internet and books for guidance.

Right now, it looks like most of their clients are self-insured cities, counties, universities, etc. They're off to a great start. Wish them well.

After watching The Widow Maker documentary on the Diet Doctor website this weekend, I was shocked to learn that none of the big health insurers in the US are making the calcium artery scan available to their members because the average client switches health insurers every 5 years, so it doesn't make sense to them to pay $200 for a test that will benefit only the next insurer.

I can get that test for $150 cash at my hospital to learn the status of the calcium in my arteries and monitor it in the future to see if the lifestyle changes I'm utilizing are stopping the progression. Haven't done it yet, but plan to soon.

The reality is, with the exception of UK physicians like Dr. Unwin and his wife who is a psychologist, most medical practices do not have the funding needed to properly care for their type 2 diabetic patients, so they refer them to the nutritionists who have to follow the dietary guidelines, which has only succeeded in making most diabetics worse, not better. For this reason, I support all efforts to force those responsible for writing the dietary guidelines in the US to only make dietary recommendations that are science based. Thank you Nina Teicholz and the Nutrition Coalition.

[Sorry for the rant. It's not in anyway directed toward anyone posting on this thread. Two diabetic acquaintances are battling significant complications right now - (cellulitis and charcot foot). It's scary. Had they been appropriately treated, educated, and supported previously, this wouldn't have happened.]
 
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It is interesting to note how long this debate has been going...I don't expect it will be settled soon...
High-quality research will be needed to resolve the debate, which has been ongoing for at least a century.5 In 1941, the renowned obesity expert Julius Bauer described a key component of the CIM (the reverse direction of causality depicted in Figure B), writing in this journal: “The current energy theory of obesity, which considers only an imbalance between intake of food and expenditure of energy, is unsatisfactory…. An increased appetite with a subsequent imbalance between intake and output of energy is the consequence of the abnormal anlage [fat tissue] rather than the cause of obesity.”50 In view of the massive and rising toll of obesity-related disease, this research should be given priority.
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