Dr Ludwig - The Carbohydrate-insulin Model Of Obesity

[lindisfel]

It is interesting to note how long this debate has been going...I don't expect it will be settled soon...

This thread has been instructive and interesting.
It basically has divided into two divergent threads:
How we need to treat the majority of people with blood glucose issues in a compassionate and effective way leading to their remission. And the wider scientific study into the whole spectrum of metabolic divergence in humans.

On the second issue I think how I read it there seems to be a degree of oversimplification on our side of the argument! The human body is immensely complex.
In that I respect the depth of years of scientific study by the one's who spent their lives studying the subject.

I can live with that as long the present arrangement with modifications works for the majority, but don't let's pretend, like the climate skeptics and young earth creationists, all of science is on our side.

It is not black and white.
D.

 

[kokhongw]

@lindisfel from Dr Roy Taylor's Newcastle studies to Virta's program I would think that remission is likely for up to 50% of T2D, especially if they are newly diagnosed. That is significantly better than any current stats available. And those who don't try it, won't know if they are responders...

As they scale up their programs we will know if the statistics holds.

 

[Winnie53]

I want to say, I don't care about the research. I care only about finding what works for me.

But then I remember that every choice I've made over the last three years has been a long process of sorting through information...study results, expert opinions on how to practically apply them, listening to what's worked and not worked for fellow diabetics...then trusting my gut and committing to one choice at a time...the foods I'm eating, the supplements I take, how and when I measure my glucose, how to time my walks, what lab tests to have done...so I guess I really do care.

Interestingly, the diabetics I know who are successful in restoring and/or maintaining their health make a similar commitment. Taking charge of our health. It's a huge investment of time, but so worth it.

And of course I have my favorites. Robert Lustig, M.D. of University of California San Francisco is one - (he recently retired). And Jeffrey Bland, Ph.D., the father of functional medicine in the US and mentor to Mark Hyman are two more. (I'm listening to Dr. Hyman interview Dr. Brand on his "The Doctor's Farmacy" podcast right now. If you haven't listened to this new podcast yet, check it out. There's a new one on YouTube every Wednesday). I could list so many more...

Interesting quote kokhongw. I feel like we have enough information now to make reasonably informed choices at least. I like what diabetes author Jenny Ruhl says about diets: choose a diet, follow it exactly as described for three months, then decide to continue it, modify it, or start the process again with a different diet. Find the diet that works best for you.

 

[lindisfel]

@lindisfel from Dr Roy Taylor's Newcastle studies to Virta's program I would think that remission is likely for up to 50% of T2D, especially if they are newly diagnosed. That is significantly better than any current stats available. And those who don't try it, won't know if they are responders...

As they scale up their programs we will know if the statistics holds.

Yes, that's the most important thing.

However I am a pragmatist and was an engineer and like scientists I like to know why.

Sure the Newtonian model works for most of physics but we wouldnt have cancer treatment machines ( linear accelerators) without Einstein's model and what will Stephen Hawking and his successors gives us that helps our progress. Quantum theory has extended our knowledge on how our bodies work we cannot ignore the science and live in ignorance, it is part of being human to keep asking, why?
D.

 

[lindisfel]

Hi Winnie,
Men have feet of clay, but I admire your faith and loyalty to your chosen gurus.
D.

I want to say, I don't care about the research. I care only about finding what works for me.

But then I remember that every choice I've made over the last three years has been a long process of sorting through information...study results, expert opinions on how to practically apply them, listening to what's worked and not worked for fellow diabetics...then trusting my gut and committing to one choice at a time...the foods I'm eating, the supplements I take, how and when I measure my glucose, how to time my walks, what lab tests to have done...so I guess I really do care.

Interestingly, the diabetics I know who are successful in restoring and/or maintaining their health make a similar commitment. Taking charge of our health. It's a huge investment of time, but so worth it.

And of course I have my favorites. Robert Lustig, M.D. of University of California San Francisco is one - (he recently retired). And Jeffrey Bland, Ph.D., the father of functional medicine in the US and mentor to Mark Hyman are two more. (I'm listening to Dr. Hyman interview Dr. Brand on his "The Doctor's Farmacy" podcast right now. If you haven't listened to this new podcast yet, check it out. There's a new one on YouTube every Wednesday). I could list so many more...

Interesting quote kokhongw. I feel like we have enough information now to make reasonably informed choices at least. I like what diabetes author Jenny Ruhl says about diets: choose a diet, follow it exactly as described for three months, then decide to continue it, modify it, or start the process again with a different diet. Find the diet that works best for you.

 

[first14808]

It is interesting to note how long this debate has been going...I don't expect it will be settled soon...

Science can move slowly. Phlogiston was a generally accepted theory by chemists for around 100 years, until newer chemists challenged the consensus. The Ludwig paper has an interesting quote that a "calorie is a calorie", which is trivially true. But eating 1000 calories of sugar, or 1000 calories of grass would have very different results, even though they're both high carbs. One's easily digested and absorbed, the other isn't.

 

[lindisfel]

But surely, first, they would give off the same amount of phlogiston if burnt!

Science can move slowly. Phlogiston was a generally accepted theory by chemists for around 100 years, until newer chemists challenged the consensus. The Ludwig paper has an interesting quote that a "calorie is a calorie", which is trivially true. But eating 1000 calories of sugar, or 1000 calories of grass would have very different results, even though they're both high carbs. One's easily digested and absorbed, the other isn't.

 

[Winnie53]

Hi Winnie,
Men have feet of clay, but I admire your faith and loyalty to your chosen gurus.
D.

Translation please. That went right over my head. [giggle]

If you don't "get" functional medicine, I understand, it's still an American thing, but you have Michael Ash DO, ND, BSc (Hons) RNT in the UK. He's another favorite of mine. Oops, not sure. Are you in the UK or elsewhere?

Jeffrey Bland, Ph.D. is one of my heros because I had swollen feet and ankles for 10+ years. Nothing I did helped. The doctors did what they do, including lab work and an ultra sound to insure blood flow was adequate, but had no answers, though one prayed over my feet which was very sweet. I was reading Jeffrey Bland's book, and he just happened to mention the problem I was having...suggested trying 500 mg/day of vitamin B5. It worked, which I found interesting because I've taken a B-complex off and on for twenty years.

 

[Winnie53]

@lindisfel from Dr Roy Taylor's Newcastle studies to Virta's program I would think that remission is likely for up to 50% of T2D, especially if they are newly diagnosed. That is significantly better than any current stats available. And those who don't try it, won't know if they are responders...

As they scale up their programs we will know if the statistics holds.

kokhongw, one of the things that frustrates me to no end is people not taking charge of their health, so while I agree with what you're saying, I still want to believe that 100% of type 2 diabetics can put their diabetes in remission. I will continue to believe this until proven otherwise. I even heard Canadian nephrologist Jason Fung say something along those lines yesterday. Perhaps not 100%, but close.

 

[lindisfel]

Hi,
I think there are other causes of diabetes. I know of someone who got their weight down and hba1c with low carb, but only returned to non diabetic with a low hba1c when they had an adrenal tumour out.
D.

 

[lindisfel]

If it works I wouldn't knock it.

Yes I am in the UK.
Was in the States a bit in the 90s, Florida, Texas and California.
Got the impression it was a bad country to be poor in! Very nice people.
My mother and sister were into that sort of thing quite a lot. Tried it once when my wife was ill and we felt we seriously needed help but finished up with a brilliant surgeon instead.
regards
Derek

Translation please. That went right over my head. [giggle]

If you don't "get" functional medicine, I understand, it's still an American thing, but you have Michael Ash DO, ND, BSc (Hons) RNT in the UK. He's another favorite of mine. Oops, not sure. Are you in the UK or elsewhere?

Jeffrey Bland, Ph.D. is one of my heros because I had swollen feet and ankles for 10+ years. Nothing I did helped. The doctors did what they do, including lab work and an ultra sound to insure blood flow was adequate, but had no answers, though one prayed over my feet which was very sweet. I was reading Jeffrey Bland's book, and he just happened to mention the problem I was having...suggested trying 500 mg/day of vitamin B5. It worked, which I found interesting because I've taken a B-complex off and on for twenty years.

 

[Indy51]

Written in her usual irreverant style*, It's The Wooo's takedown of the Hall/Guyenet rebuttal. Man, she hates Guyenet with a passion

http://itsthewooo.blogspot.com/2018/07/the-strawman-cih-is-not-supported-by.html

[*The style that prompted Guyenet to call her "One Extremely Disrespectful Zealot" for her trashing of his hyperpalatable theory of obesity.]

 

[kokhongw]

Written in her usual irreverant style*, It's The Wooo's takedown of the Hall/Guyenet rebuttal. Man, she hates Guyenet with a passion

http://itsthewooo.blogspot.com/2018/07/the-strawman-cih-is-not-supported-by.html

[*The style that prompted Guyenet to call her "One Extremely Disrespectful Zealot" for her trashing of his hyperpalatable theory of obesity.]

Thanks...this really resonate with me...since I have been experiencing it for well over 30 years.

First argument presented is "postprandial hunger from carbz isn't real lol" which is one of Guyenet's FAVORITE sound bites. It only illustrates he has NEVER interacted with a real live obese person, the very subject he purports to be a master in studying, lol. Like, you can literally go to any rando blue collar job, talk to fat people who went on keto diets and they will affirm this is a thing. "Oh yea, i used to get hungry as HELL 1.5 hours after eating - cured that on atkins dude, no more shaking, sweating, irritability and ravenous eating shortly after a meal!" Like, this doesn't even warrant a real response. He is stating it is "controversial" that it is a thing people with insulin and glucose regulation disorders experience increased hunger and counter regulation to declining glucose 1-1.5 hrs after a simple carbohydrate load. Such an argument can only come from the wonders of obesity research: where a so called "expert" can exist who has NEVER, EVER personally interacted, examined, studied humans with the disease he claims to be proficient in understanding.

 

[bulkbiker]

Thanks...this really resonate with me...since I have been experiencing for well over 30 years.

I even get it when I have carb like low carb things like keto bread.. still can't eat only one piece... have to finish it all.

 

[kokhongw]

kokhongw, one of the things that frustrates me to no end is people not taking charge of their health, so while I agree with what you're saying, I still want to believe that 100% of type 2 diabetics can put their diabetes in remission. I will continue to believe this until proven otherwise. I even heard Canadian nephrologist Jason Fung say something along those lines yesterday. Perhaps not 100%, but close.

I too would like to believe that 100% can find remission. But the unfortunate reality is such that many won't. As it is, less than 1% T2D achieve and maintain remission in a study to justify Bariatric Surgery. So we find ADA embracing and touting Bariatric surgery for T2D remission, but not dietary intervention that works. Low carb effectiveness is grudgingly being acknowledged with all its purported risks and dangers with the qualifier that one size does not fit all. Fasting in any form is still considered unsustainable...although probably all can find one form that fits them...

 

[first14808]

But surely, first, they would give off the same amount of phlogiston if burnt!

Well, that is how calorimeters work. And googling 'bomb calorimeter' shouldn't get you a knock on the door from the anti-terrorist mob. Phlogiston's a good science experiment. Easy to laugh at given the scientific knowledge available today, but given the science of the day, it was part way there as a plausible theory. But being science, knowledge advanced and the theory superceded. Sometimes, as the saying goes it advances one death at a time when bitterly defended consensus are overturned by a mass of overwhelming evidence.

But that's the key part. Often papers are effectively commissioned to support a position, as seen in pro- & anti- tobacco lobbying. The good news should be that given our double epidemics of obesity and diabetes, more funding should be available to do some decent science. Downside is it'll take time to conduct statistically meaningful and population relevant studies.

 

[Winnie53]

I too would like to believe that 100% can find remission. But the unfortunate reality is such that many won't. As it is, less than 1% T2D achieve and maintain remission in a study to justify Bariatric Surgery. So we find ADA embracing and touting Bariatric surgery for T2D remission, but not dietary intervention that works. Low carb effectiveness is grudgingly being acknowledged with all its purported risks and dangers with the qualifier that one size does not fit all. Fasting in any form is still considered unsustainable...although there's probably all can find one form that fits them...

Today I came across this article, "Dietary Protein Is Important in the Practical Management of Prediabetes and Type 2 Diabetes", published in the January 2015 issue of The Journal of Nutrition... https://academic.oup.com/jn/article/145/1/164S/4585788 Reading it is an exercise in frustration, for me at least. And it serves well as an example of the challenges diabetics face in making the "right" choices for themselves.

 

[lindisfel]

A few days ago I was talking with a group of elderly gents, most of them younger than me. A fair number of them have T2D.
After telling them cos I don't eat refined carb I don't feel hungry after breakfast and dont need to eat much until evening and that carbs block the satiety hormone!
One carb eater said," That must why when I had a large fish meal the other day without carbs at lunch time, I didn't feel ready for food for the rest of the day!"

So the learned gent has got his wires crossed somewhere in his rebuttal.
D.

If it works I wouldn't knock it.

Yes I am in the UK.
Was in the States a bit in the 90s, Florida, Texas and California.
Got the impression it was a bad country to be poor in! Very nice people.
D.

Thanks...this really resonate with me...since I have been experiencing it for well over 30 years.

 

[Indy51]

Part 2 of Wooo's takedown of Hall/Guyenet's 'debunking':

http://itsthewooo.blogspot.com/2018/07/postprandial-hyperinsulinemia-and-risk.html

 

[kokhongw]

Part 2 of Wooo's takedown of Hall/Guyenet's 'debunking':

http://itsthewooo.blogspot.com/2018/07/postprandial-hyperinsulinemia-and-risk.html

This study in question references another Gardner work, where patients are eating almost exactly the same diet, and we are drawing conclusions about VLC diets for some reason. In this case, the "low fat" diet is eating 212 carbs / 48%, and the low carb group is eating 132/ 29.8%. Again, Gardener uses his design where pts are basically told to eat as they please, and so patients and up picking restrictive diets that are not particularly restrictive. The diets end up looking the same, so no appreciable metabolic shift can even be observed - in spite of a core belief of most insulin hypothesis proponents involving a necessary shift to fat metaboism. As with his other study, there is a small bias in favor of greater weight loss for low carb even in this context (-5.3kg vs -6kg) , but it is deemed not"statistically significant". As in the first case, the fact that there is ANY difference when the diets were very similar, IS statistically significant. A difference of just 18% carbs, resulted in almost 1/6th more weight loss than the conventional lower fat diet. The problem with Gardner studies is they test only slightly reduced carb diets, then attribute the very slight improvement in weight loss as "insignificant". What on earth are you expecting when your entire study design is not powered to even test a low carbohydrate diet. Are they to lose more weight by magic? Somehow they are going to lose substantially more weight, eating barely differently from the competing lower fat diet?
.

Thx for the followup post...Gardner's study simply highlight the fact that if people are given vague dietary guidelines, they end up "thinking" they are on a low carb diet when they are likely not low enough to address their metabolic condition...to achieve/maintain regular ketosis etc.

Hence a Virta type program where key metabolic markers are being constantly tracked would give a much higher success rate, because the diet/lifestyle/medication can be adjusted to target.