Dr Jason Fung mauled by impeccable logic of Calorie Restriction fans...

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Dark Horse

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Okay, I just got this link in my email from my husband. From Peter Attia...

Am assuming he believes it worthy of posting and sharing here, but I'm at work and haven't read it, though I vaguely remember reading it previously, and it was likely above my ability to comprehend, both then and now, but perhaps you all can...

https://peterattiamd.com/do-calories-matter/
Yes, it's worth reading. I think it illustrates the different meanings people seem to be ascribing to CICO. What he describes as 'Current Dogma' equates to what many of the LCHF posters on here describe as CICO. When he later says that what you eat can affect both calories out (e.g. activity) and future calories in (via appetite), this is closer to what a scientist would consider CICO to mean. A lot of the disagreements in this thread do seem to be because people are using the term CICO to mean different things.

He's right that 1kcal = 1000 calories. However, when we informally talk about food intake, we talk about Calories (with a capital C) which is the same as a kilocalorie. In other words 1 Calorie = 1000 calories. Confusing. (Maybe we should use the scientific units, kilojoules.)
 
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Winnie53

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1spuds, well said. I'd like to add that it was medical professionals like you who got me on the right track in the mid-1990's. I've never looked back since. I agree with you completely.

Edited to add: But I also need to acknowledge that there really are medical professionals who are doing the right thing, if and when they can. Some changed the course of my life early on for the better. I owe my life to them.
 
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Guzzler

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Poor grammar, bullying and drunks.
Yes, it's worth reading. I think it illustrates the different meanings people seem to be ascribing to CICO. What he describes as 'Current Dogma' equates to what many of the LCHF posters on here describe as CICO. When he later says that what you eat can affect both calories out (e.g. activity) and future calories in (via appetite), this is closer to what a scientist would consider CICO to mean. A lot of the disagreements in this thread do seem to be because people are using the term CICO to mean different things.

He's right that 1kcal = 1000 calories. However, when we informally talk about food intake, we talk about Calories (with a capital C) which is the same as a kilocalorie. In other words 1 Calorie = 1000 calories. Confusing. (Maybe we should use the scientific units, kilojoules.)
This is what I get. Two people join a particular thread, both in the 'industry'. A thread on a Diabetes website and they concentrate all their efforts on weight, ignore question of TOFIism and sedentary lifestyle with weight loss and studiously ignore the whole concept of metabolic syndrome, insult members' inteligence by saying;
You didn't do it right
You couldn't possibly understand
You are misremembering or telling lies
You're not putting in the work
Have you seen my credentials?!
Accuse members of slavish zealotry or Guru worship

and then leave.
 

bulkbiker

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This is what I get. Two people join a particular thread, both in the 'industry'. A thread on a Diabetes website and they concentrate all their efforts on weight, ignore question of TOFIism and sedentary lifestyle with weight loss and studiously ignore the whole concept of metabolic syndrome, insult members' inteligence by saying;
You didn't do it right
You couldn't possibly understand
You are misremembering or telling lies
You're not putting in the work
Have you seen my credentials?!
Accuse members of slavish zealotry or Guru worship

and then leave.
Almost as if they were intending on selling us something?
 

Shiba Park

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Shiba Park, according to investigative journalist Nina Tiecholz, there are now more than 100 studies showing that the low carb high fat diet works. The ongoing 2 year results of the study being carried out by Indiana University (which I believe is being funded by Virta Health) is continuing to show excellent results...

https://www.virtahealth.com/research

It concerns me greatly that a nutritionist would think that we are "dogmatic in the promotion of LCHF" on this forum. I am not. I facilitate a group for type 2 diabetics and pre-diabetics with an emphasis on diet and walking. While I do encourage members to move toward the LCHF and/or LCHF/Keto diet, I respect our members choice of diet because I understand there is no one diet that works for everyone.

What keeps me up at night, often listening to lectures online when I can't sleep, is how to influence/persuade local physicians and nutritionists to tell their patients/clients about the low carb and ketogenic diet for weight loss, if needed, and stopping the progression of their diabetes and diabetic complications instead of just putting them all on Metformin, and advising them to eat less, move more. Currently, most newly diagnosed diabetics are NOT given this information. [Edited to add]: Thankfully this is slowly changing around the world, including in the UK thanks to this forum and Dr. David Unwin and his wife Jen. :)

My hope is that the posts here, which have been excellent, have helped shift the CICO poster's thinking, even if only a little bit.

Woah! Read what I actually wrote!

I'm not taking any side in this discussion, I'm just saying those in favour of LCHF really need to think of the perceptions being formed by new members to this forum with a different paradigm.

Chill, let new members catch up with the ideas of longer term members. Give them time to absorb the ideas, think about them and form their own conclusions.
 

bulkbiker

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let new members catch up with the ideas of longer term members

But most newly diagnosed T2's get little if any support from the Docs/DN's.

They arrive here in a state of shock usually with a high HbA1c which they want to reduce asap to avoid any nasty effects of high blood sugars. They know little if anything and need good advice asap.
 

1spuds

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Edited to add: But I also need to acknowledge that there really are medical professionals who are doing the right thing, if and when they can. Some changed the course of my life early on for the better. I owe my life to them.
I think most of them really do care.Its the free thinkers that challenge the dogma that are oh so special for us.Fung,he is one of them.
 

Shiba Park

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But most newly diagnosed T2's get little if any support from the Docs/DN's.

They arrive here in a state of shock usually with a high HbA1c which they want to reduce asap to avoid any nasty effects of high blood sugars. They know little if anything and need good advice asap.
Completely agree. I've no idea if either of the two new members were genuine or trolls, we'll see if they hang around and build a track record or not. But supposing they're genuine? While they weren't particularly receptive to alternative views, those views were given fairly, ahem, robustly... To the uninitiated, that gives a false perception of our community here. I know there was integrity in every reply, but might we have driven away two new members?
 

harrissilver

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Understand that LCHF may work for many people, and certainly endocrinology isn't my specialty, if something like calorie restriction didn't work, then why would Avatar nutrition be almost completely successful across all users who stick to program?
 

Winnie53

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Woah! Read what I actually wrote!

I'm not taking any side in this discussion, I'm just saying those in favour of LCHF really need to think of the perceptions being formed by new members to this forum with a different paradigm.

Chill, let new members catch up with the ideas of longer term members. Give them time to absorb the ideas, think about them and form their own conclusions.

I don't think this thread was directed to or intended for the "newbies". It wasn't my intention to in any way offend you. Apologies...
 
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Winnie53

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Completely agree. I've no idea if either of the two new members were genuine or trolls, we'll see if they hang around and build a track record or not. But supposing they're genuine? While they weren't particularly receptive to alternative views, those views were given fairly, ahem, robustly... To the uninitiated, that gives a false perception of our community here. I know there was integrity in every reply, but might we have driven away two new members?

I thought who they were and why they came here was clarified earlier. Neither were "newbies".
 

Winnie53

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Understand that LCHF may work for many people, and certainly endocrinology isn't my specialty, if something like calorie restriction didn't work, then why would Avatar nutrition be almost completely successful across all users who stick to program?

I think the article I linked to by Peter Attia answered your question.
 

Winnie53

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Apologies harrissilver. I see you're new here. What is Avalon and what is their track record for weight loss and maintaining the weight loss? Have they helped you or someone you know?
 

harrissilver

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Apologies harrissilver. I see you're new here. What is Avalon and what is their track record for weight loss and maintaining the weight loss?
Avatar Nutrition - they focus on the "if it fits your macros (IIFYM)" approach. basically set up how much protein and fat you want in your diet - as percentages - and then the rest goes to carb. They mostly function as a 25%pro - 30%fat - 45% carb diet, with diminishing carbs as you lose weight. They have an incredible track record. I've never used their program per se, but use those principles with a macronutrient calculator online.

There is also a reverse diet, slowly add in calories to boost metabolism without necessarily adding to weight gain.
 

Winnie53

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Oh, okay. That wouldn't work for me because I've had diabetes for 14 years now, but clearly it does work for some people. Are you thinking of trying it? :)
 

Walking Girl

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All I can do is share my experience. When I eat/drink fewer calories, I lose weight. When I eat/ drink more, I gain it. (Also known as “what happens on vacation :) )My macronutrients have ranged around both while gaining and losing, but seem to be pretty irrelevant. Movement helps, but is a relatively minor part of the equation.

I lost 42 kilos eating fewer calories. When I got to goal, I added calories until my weight stabilized. I continue to eat the number of calories that lead to a stable weight, and have been doing so for a little over 1 year now.. If I went back to eating the same calories I was pre-weight loss, I would gain the weight back.

I really do not understand the argument that CICO doesn’t work because people regain the weight. People certainly appear to be implying that weight gain occurs even if the person stays on the plan. If that’s true, then what caused the sudden reversal? I mean if reducing calories did not work, why would they have lost weight in the first place? And if they didn’t go off the diet, then what was the cause of the weight regain that followed?
 
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harrissilver

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All I can do is share my experience. When I eat/drink fewer calories, I lose weight. When I eat/ drink more, I gain it. (Also known as “what happens on vacation :) )My macronutrients have ranged around both while gaining and losing, but seem to be pretty irrelevant. Movement helps, but is a relatively minor part of the equation.

I lost 42 kilos eating fewer calories. When I got to goal, I added calories until my weight stabilized. I continue to eat the number of calories that lead to a stable weight, and have been doing so for a little over 1 year now.. If I went back to eating the same calories I was pre-weight loss, I would gain the weight back.

I really do not understand the argument that CICO doesn’t work because people regain the weight. People certainly appear to be implying that weight gain occurs even if the person stays on the plan. If that’s true, then what caused the sudden reversal? I mean if reducing calories did not work, why would they have lost weight in the first place? And if they didn’t go off the diet, then what was the cause of the weight regain that followed?
This is exactly it!
 

pdmjoker

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Yes, it's worth reading. I think it illustrates the different meanings people seem to be ascribing to CICO. What he describes as 'Current Dogma' equates to what many of the LCHF posters on here describe as CICO. When he later says that what you eat can affect both calories out (e.g. activity) and future calories in (via appetite), this is closer to what a scientist would consider CICO to mean. A lot of the disagreements in this thread do seem to be because people are using the term CICO to mean different things.

He's right that 1kcal = 1000 calories. However, when we informally talk about food intake, we talk about Calories (with a capital C) which is the same as a kilocalorie. In other words 1 Calorie = 1000 calories. Confusing. (Maybe we should use the scientific units, kilojoules.)
That is a really helpful assessment @Dark Horse , thank you. Nuance and accurate understanding is very important...

I found reference to the study included in a 1959 appraisal of the scientific literature for the effectiveness of obesity treatment. (I assume the vast majority, if not all, of dietary treatments mentioned would have been simple Calorie Restriction.) Much that is discussed is still relevant, it seems. The study is certainly relevant. The paper's title is "Stunkard A & McLaren-Hume M. The results of treatment for obesity: a review of the literature and report of a series. Arch. Intern. Med. 103:79-85, 1959"

Sadly the full original 1959 paper doesn't appear to be freely available. However, this is the Citation Classic link which is freely available:

http://garfield.library.upenn.edu/classics1983/A1983RP56700001.pdf

Note that it says "This study grew out of an attempt to resolve a paradox—the contrast between my difficulties in treating obesity and the widespread assumption that such treatment was easy and effective." and about the 100 patient study they conducted: "Furthermore, two years later, only two percent of patients had maintained their 20-pound weight loss."

Edit: to correct link!
 
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pdmjoker

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Okay, I just got this link in my email from my husband. From Peter Attia...

Am assuming he believes it worthy of posting and sharing here, but I'm at work and haven't read it, though I vaguely remember reading it previously, and it was likely above my ability to comprehend, both then and now, but perhaps you all can...

https://peterattiamd.com/do-calories-matter/

That's a really super post that you have given us a link for, thank you! In it Peter Attia's Alternative Hypothesis (which obeys the Laws of Thermodynamics):

Obesity is a growth disorder just like any other growth disorder. Specifically, obesity is a disorder of excess fat accumulation. Fat accumulation is determined not by the balance of calories consumed and expended but by the effect of specific nutrients on the hormonal regulation of fat metabolism. Obesity is a condition where the body prioritizes the storage of fat rather than the utilization of fat.

and he goes on to say:

Why is this different from Current Dogma? Current Dogma says it doesn’t matter what you eat, it only matters how many calories that food contains.​

and

The Alternative Hypothesis says it DOES matter what you eat and for reasons far beyond the stored heat energy in the food (i.e., the number of calories).​
 

pdmjoker

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417
Type of diabetes
Prediabetes
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I really do not understand the argument that CICO doesn’t work because people regain the weight. People certainly appear to be implying that weight gain occurs even if the person stays on the plan. If that’s true, then what caused the sudden reversal? I mean if reducing calories did not work, why would they have lost weight in the first place? And if they didn’t go off the diet, then what was the cause of the weight regain that followed?
Their body gradually switched into a more efficient way of working: called metabolic slowdown. This is a very sensible bodily strategy for keeping you alive through a food shortage. The trouble is that your body has no means of knowing that the food shortage is deliberate! I hope this helps...
 
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