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2017-07-18 07:00 by Karl Denninger
in Personal Health , 186 references
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Artificial sweeteners are bad for you! screams the headline in various places, all with a cite to this journal piece.

RESULTS: From 11 774 citations, we included 7  trials (1003 participants; median follow-up 6  mo) and 30 cohort studies (405 907 participants; median follow-up 10  yr). In the included RCTs, nonnutritive sweeteners had no significant effect on BMI (mean difference –0.37  kg/m2; 95%  confidence interval [CI] –1.10 to 0.36; I 2  9%; 242  participants).

In the included cohort studies, consumption of nonnutritive sweeteners was associated with a modest increase in BMI (mean correlation 0.05, 95% CI 0.03 to 0.06; I 20%; 21 256 participants). Data from RCTs showed no consistent effects of nonnutritive sweeteners on other measures of body composition and reported no further secondary outcomes. In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type  2 diabetes and cardiovascular events. Publication bias was indicated for studies with diabetes as an outcome.

That sounds outright bad.

Go read the entire paper.

You'll notice something striking: There is not one reference anywhere to any sort of control for total carbohydrate intake or even mention of it.

This is very important for a simple reason: You study these sorts of groups because you're trying to intervene in weight control by substituting sugar, usually in drinks, with non-sugar substitutes.

Ok, so what else did you tell the people in the study, either then or in related conversations?

You know damn well what the "standard advice" is: Cut (especially saturated) fat intake for weight control.

This is a problem because, as you know if you've read my column there are exactly three foods -- carbohydrates, proteins and fats.

If you remove fats you must increase something else to remain steady in calorie count.  That something can only be carbohydrates or proteins.

Proteins are expensive and typically need to be prepared (not exclusively, but mostly.)  Cheap, fast carbs are easy, shelf-stable and can be grabbed at a moment's notice but all of them are damn near perfect analogues to sugar once you eat them.

In other words they turn into sugar as soon as they go down the pie hole.  Thus if you replaced fats with fast carbs you are quite-likely to have added more net glycemic load to your system than you removed by substituting artificial sweeteners.  In other words you made the problem worse instead of better!

What's equally bad and maybe worse is that if you substitute vegetable oils for saturated (animal) fats you are dramatically shifting your Omega 3:6 balance the wrong way which is both directly insulin response suppressive and pro-inflammatory at the same time.

If you're crazy enough to have done both then you're really screwed.

So unless you control for both of these factors, which I see no mention of the studies in question having done and there was no attempt to quantify or qualify for this in the published work it does not surprise me one bit that only "substituting artificial sweeteners for sugar" either does nothing net-net or in fact makes the problem worse.

That doesn't make artificial sweeteners bad.

All the other crap which you are constantly hammered on if you're overweight and told to eat is what's bad!

Now if you can find me a study that leaves the participants diets alone except for substituting artificial sweeteners for sugar in, say, drinks on a provable basis and then checks directly for insulin resistance changes I'm interested.  This of course would be truly surprising as an outcome because if you substitute two cans of sugared Coke a day for Diet Coke and make no other changes in what you eat or drink you're 300 calories net negative a day which is enough to lose half a pound a week.

That study would be extremely hard to do and you'd probably have to recruit all people of normal weight who otherwise have no reason to modify their diets because if you include overweight or obese individuals managing to evade the confounding factor of carbohydrate and vegetable oil substitution is nearly impossible and outside of a sealed, locked-down prison controlling what people actually eat .vs. what they report -- that is, getting truthful data in this regard -- is flatly impossible.

I know plenty of people who claim to eat like a bird; what they claim to eat is trivially tallied to well under 1,200 kcal/day, which is pretty-much the minimum metabolic requirement for an adult (perhaps 100 less for a woman.) 

Virtually to an individual they are all visibly overweight and I've yet to see one of said people lose a material amount of body mass over a sizable period of time.  It is flatly impossible that their self-reported eating habits are factual; a whole bunch (like 1,000+!) kcal/day are coming from somewhere or they'd be dropping 2-3lbs/week every week until they literally died, so they're obviously consuming something other than what they claim when I'm not around them.

That's a fact folks.

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2017-07-10 07:00 by Karl Denninger
in Personal Health , 209 references
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This is flat-out nuts.

“Same girl, same day, same time. With a camera angle and clothing I can change my body into something that society would deem more acceptable than the photo on the right,” she wrote about the two images.

Smith blames the media for setting unrealistic expectations of beauty for people to uphold. “The media constantly wants us to be more filtered, more posed, more flexed. Making us ashamed, afraid and resentful of our bodies, our natural vessel.”

Meh.

Your natural vessel doesn't have a gut.  It got the gut because of what you decided to put down the pie hole.

Is it "beautiful"?  That's up to you.  But what's not in question is whether it's healthy.

It's not.

As for "self-esteem" cut the crap Smith.  Self-shame is a powerful corrective force if you allow it to be.

It should be.

Not because I want it to be, or you want it to be, or anyone else wants it to be.

Rather, the reason is that ten, twenty, thirty, forty years from now you'll pay for those extra pounds and probable insulin resistance you're racking up.  You'll pay for it in morbidity and quite-possibly early mortality, never mind monetarily.

And that is all a product of a lie you tell yourself and others: There's nothing wrong with me being this way.

Yes, objectively, there is.  It's a physically-damaging state.  It's progressively damaging.  It's harmful.  It's a bad idea.  And it's unnecessary; you need only change what you put in your pie hole and that fat belly will go away.

With it will go the increased risk of diabetes, heart disease, joint damage, kidney destruction, amputations, hip replacements, blindness and death.

Your choice -- but also your consequence.

What's not within your rights is to tell others that your choice has no consequence, that one choice is not superior on an objective basis to the other, and that there's something "wrong" with people pointing out that in fact you are fat.  Not outrageously so -- yet -- but nonetheless even today the pattern you are setting for yourself has very real and negative long-term consequences.

It's your decision to make, but the costs are yours as well.

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2017-06-28 07:00 by Karl Denninger
in Personal Health , 796 references
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God, the Stupid is strong....

Placing a plastic sheath in the gut triggers weight loss and could reverse diabetes, according to health experts.

The treatment has a similar effect to a gastric band but avoids the need for risky and expensive surgery.

Instead, a 2ft (60cm) sheath known as the EndoBarrier is positioned at the top of the small intestine using an endoscope — a thin, flexible tube inserted via the mouth — while the patient is under general anaesthetic or sedation.

This device is a plastic sleeve that basically covers the first couple of feet of the small intestine, preventing food from being absorbed there.  It's "wired" in place.

So why am I throwing aspersions at this, when the results are pretty dramatic?

Because it's an invasive procedure, it's expensive and the same results or better can be had by getting carbohydrates out of your diet -- at zero cost and procedure risk.

Second, there's no long term study on this thing thus far, but I'm certainly not sold on the long term (decades long!) safety of such a device -- even though it is removed after a year or so.  Does it engender some sort of change in the intestinal wall?  Who knows.  We won't know for years or decades and you are the lab rat.  By the way, in case you were unaware you only have one intestine, can't grow a new one, and without a small intestine you're dead as you can't absorb nutrients from your food.

Look folks, when you get down to it the science on this is quite simple:

1. When you eat fast carbohydrates, any of them, they are turned into sugar in the body -- and quite rapidly.  Fast carbohydrates include all refined grains of any sort (e.g. anything with wheat, rice, etc) and nearly all white vegetables (potatoes, etc.)  Many of these "foods" are turned into sugar in the gut as fast or even faster than plain old table sugar is absorbed and most of them are nearly as fast.

2. When there is glucose available for your body to burn it will do so in preference to burning fats.  That's because it's metabolically "easier" to burn glucose and insulin inhibits the breakdown of fats to fatty-acids, which is necessary for fat to be metabolized, and in addition it stimulates the production of fat from glucose.  This does not mean it's better to burn glucose, just that it's easier.  You can't, for example, make the argument that you should live on nothing but alcohol even though alcohol is in fact a carbohydrate and is burned first before other carbs.  You'd be laughed out of the room if you tried to argue for a "booze only" or even "booze heavy" diet, so that you have a metabolic preference for carbs does not mean you should consume them.

3. The required daily amount of carbohydrate in your diet is zero.  That is, there is no metabolic requirement for them whatsoever.  Your body is able to function perfectly well without any carbohydrate going down your pie hole.  While the brain requires glucose your body can manufacture what it needs from fats and will do so to meet your brain's requirements.  The rest of your tissues can run perfectly well on fats for fuel.  Note that in point of fact your body's cells do not actually run on glucose -- they run on ATP, which is synthesized by the body.  It's simply easier (metabolically) to do so from glucose (or glycogen stores) than fats and your metabolic systems are biased so as to inhibit fat metabolism in the presence of glucose.

4. There are multiple populations that have hundreds of years or more of history eating nearly-zero carbohydrate and none of them have elevated risks of serious health problems.  In fact those populations tend to have near-zero rates of obesity along with cardiac disease and diabetes.  However, with no known exceptions every one of those populations that have introduced carbohydrates in any sort of volume into their diets have seen obesity, diabetes and heart disease rates increase; some of them have seen rates skyrocket from among the lowest in the world to the highest.

5. There are no good "vegetable" oils.  Some are worse than others but none are good.  Some nut based oils (e.g. coconut) are perhaps better, but were talking in relative terms, not absolutes.  Unsaturated oils are not shelf-stable without chemical modification -- that's what "unsaturated" means, that there are open chemical bond sites on the hydrocarbon chain.  Hydrogenated oils (if that word appears anywhere on the label) are trans-fats and the safe amount of them in your diet is zero.  All plant-based oils are high in Omega-6 and while you do need some small amount of them in their natural form they are pro-inflammatory and thus promote heart disease.  Note that historically the balance of Omega-3 (mostly in animal flesh) and Omega-6 (mostly in plants) was about 1:1.  Concentrating the amount of Omega-6 oils by processing plants into oils has dramatically increased the ratio to, in most people, 10:1 or more!

6. The pharmaceutical industry is well aware of point #5 and has been for decades.  In fact all of the OTC NSAIDS (Ibuprofin, aspirin, etc) work by reducing the metabolism of Omega-6 fatty acids into inflammatory compounds.  Let that sink in for a minute or two: Both your doctor and the pharmaceutical industry know, as a matter of scientific fact, that consuming these oils fuels inflammation because the method of action of some of the most-widely used over-the-counter drugs is to reduce that metabolic process.

Those who argue for a "plant-based" diet, especially for weight control or metabolic problems are deluding themselves.  That's math and metabolic science folks.  It's impossible to have a "plant-based diet" that is not heavy on fast carbohydrates, extremely high in Omega-6 oils or both.  This is simply due to the fact that "good" vegetable sources of nutrients are sparse in calories and thus you can't possibly eat 1,800kcal of them in a day.  It can't be done.  Doubt me?  Go look at the calorie count for a cup of broccoli and then tell me how much broccoli you need to eat!

Those foods that are high in caloric content and vegetables are also either fast carbs or Omega-6-rich vegetable oils.  The exception for those who want to eat "plant based" is if you allow for cheeses and eggs you can (mostly) get there if you exclude vegetable oil products.

When you eat carbohydrate until it is completely metabolized your body does not burn fat -- including the fat around your belly!  What's worse is that carbohydrates spike your insulin level and when it falls after you eat them you get hungry.  It is very hard to resist your body telling you to go raid the refrigerator.

If you are overweight or obese and want to burn the fat on your body you cannot do so until all of the carbohydrate in your system, in your digestive system in the process of being released into the blood or in the form of glycogen in your liver is exhausted.  That's metabolic fact; in order to burn fat your body has to engage in metabolic processes that produce ketones, otherwise known as "ketosis" but it will not do so as long as carbohydrates are available because it is metabolically easier to burn carbohydrates than it is to burn fats and as long as insulin levels are high metabolism of fats is biochemically inhibited.

That process is not dangerous, it's natural, perfectly fine and it is in fact the only way to lose weight.

If you have excess carbohydrate in your system beyond what is required for your body at any given point in time that amount will first be converted into glycogen and stored in the liver and muscles. Muscle storage is local to that muscle because muscles lack the enzyme necessary to release the glycogen back into the blood; "mobile" glycogen, that is, available to the body as a whole, is limited to that which can be stored in the liver.  Between these two you can store about 2,000 kcal of energy.  When that storage is full any additional carbohydrate will be converted into fat -- that is, weight -- and stored on the body.

Further, if you are already metabolically compromised (and if you're fat then you are) it's even worse.  The more carbohydrate you take in the more your body is unable to cope with it and effectively convert it into glycogen and consume it because your cells do not respond normally to the insulin signal in your blood.  In other words your cells are "starving" even though you have eaten enough carb-based foods.  If you're metabolically compromised, say much less outright diabetic then there is no excuse for eating any carbs beyond that which you must consume to get needed vitamins and similar and choosing fruits over low-carb vegetables is idiotic.  Broccoli has more vitamin C in it than do oranges -- by a lot -- and at the same time it has nearly zero impact on blood sugar where an orange, being full of sugars, is the opposite.  It's even worse if you juice that orange since that greatly increases the rate the sugar is absorbed.

And finally if you try to "substitute" animal fat and protein sources with vegetable-based oils you're ridiculously unbalancing the Omega-3:Omega-6 balance of fats which directly promotes inflammation and heart disease.

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2016-06-18 05:00 by Karl Denninger
in Personal Health , 1218 references
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The often-heard comments when someone says they're eating HFLC include "your kidneys will explode", "Atkins was really bad for him (Mr. Atkins)", "You'll have a heart attack", "You can't be athletic doing that; you need carbs" and more.

I would like to put some perspective on this.  Yes, this is anecdote; it's a sample size of one with no double-blind, of course -- that is, my personal experience.

Some background: Somewhat over five years ago I essentially went hard-core Atkins-induction coupled with "Couch-to-5k."  At the time I was unable to run one half mile without stopping, climbing a few sets of stairs was work, even summer lawn mowing was a strenuous exercise -- while the heat was certainly not helpful, neither was exercise tolerance.  I was "nominally healthy" in that I was not diabetic, but my body mass had risen from about 155 in High School to right around 210, plus or minus a couple.  I had several times undertaken fairly severe exercise regimes, including hour-long daily stints on a stationary recumbent bike I purchased, in an attempt to lose weight, along with a low-fat, "eat plants" diet -- without success.  I could drop 10lbs without much trouble, but no more, I was ravenously hungry all the time, and as soon as I cut back on the exercise the weight came right back on and stayed.

I'm absolutely certain that I was insulin resistant even though my blood glucose was normal -- I'd get the "hangries" if I attempted to not eat in the morning immediately on waking, and was often hungry for something by mid-afternoon after eating a carb-laden (and low-fat) lunch.  If there was a bag full of M&Ms in front of me and I had one, the entire bag would be gone within a couple of hours.  The same for a tin full of cookies.  A loaf of home-made bread (I have a bread-maker) would be lucky to make two days; the first big, thick slice would get consumed and I'd want two more an hour later.

In short despite my outward metabolic signs being ok, but being overweight (not obese) I know exactly where I was headed -- for both obesity and diabetes.  I'm sure of it.

So in early 2011 I decided I'd had enough -- that the conventional wisdom was either wrong or I was simply going to be consigned due to bad genetics to get older, fatter, and sicker.  The latter is what we have all been sold and I was determined to not simply give up.

Since that was the consensus, I saw no harm in trying something else -- after all, the odds were that I would not make it worse, at least not quickly, and when it comes to things like heart attacks and strokes they take years to develop, weeks or months.

So I went full-on, zero-carb Atkins induction, bought a pair of Nike running shoes and a Garmin 305 with a heart rate strap to track my exercise.

I'm not going to tell you that this was an easy path, at least at first.  I modified the Couch-to-5k thing (you can look it up online) in only one way -- the very last segment of each work-out I ran as hard and fast I could.  At the start this was maybe an eighth to a quarter of a mile, but it would grow to a half-mile later.  Other than that I pretty-much followed the program.

I could not run a half-mile when I started.  Not even close.

I felt like I'd been hit by a bus every.... single... day.

But I kept with it, both on the food and running.  After the first two weeks I added back green vegetables, but otherwise ate zero carbohydrate -- and that included alcohol.  Instead of three times a week I tried for five, and got up at 0500 every day to do it because living in Florida it's hot, even in May.

In the first week, five pounds disappeared.  I knew this would happen and probably be (mostly) water.  The next week and pretty-much every week thereafter, however, another one or two came off.

About two months later I ran a full 3.1 miles for the first time, without slowing to a walk or stopping.  It was not easy, but I did it, and by now it was the middle of June.

Eight months later, roughly that Thanksgiving, I was down to about 160.

I looked at the Garmin stats.  I had lost 50 lbs, which is about 175,000 calories. Running is about 120 calories a mile, according to a heart-rate adjusted GPS machine, and I had run roughly 500 miles at that point, or 60,000 calories worth.

Only one third of the body mass I lost was due to exercise.  That's a numerical fact; the rest was lost due to changing what I ate.

I slowly lost about another 5 lbs; my body weight now fluctuates around 155, +/- 5, assuming I'm reasonably good.

And there it has stayed for the last five years -- whether I'm training for a half-marathon, the Wicked Triple (three races in two days of close to a marathon distance in total), hiking part of the AT, sitting on my ass enjoying a vacation or whatever else I might be doing.  My exertion levels have literally been all over the map, yet my body mass has not.

What has remained constant, more or less, is my adherence to the consumption of food things (and not consuming others!) that I have laid out many times -- you can read that list right here.

Now here's what's changed long-term when it comes to my person and my health that I haven't talked about much:

  • Since I was a child I have had horrid problems with seasonal allergies to the point of being nearly useless twice a year for a month or so.  No amount of medication, OTC or prescription, has ever successfully controlled this completely.  Benedryl works fine but knocks me flat on my ass, and anything containing pseudoephedrine makes me feel extremely uncomfortable -- I'm one of the people who just can't use any decongestant containing that substance.  I was basically forced to remain indoors, in an air-conditioned space, for two months out of the year and maintain a high-quality pollen filter in my car's airhandler -- or else.  I also avoided travel to woodsy and other flowery areas during the times they were in bloom for obvious reasons.  Slowly, over the last couple of years, my seasonal allergies irrespective of where I am in the country have completely disappeared.  Last spring I hiked a piece of the AT through the spring bloom, complete with thousands of bees pollinating the flowers, and had exactly zero trouble.  Five years ago that would have been unthinkable.  This appears to be correlated with....

  • My general inflammation level has, I believe, dropped quite a bit.  I had always had "on and off" acne problems, even as an adult.  As a teen it was bad, but it never went completely away -- until I got rid of the carbs.  The same is true of skin issues; I always had them on and off, especially in the winter when the air is dry.  Again, completely gone the first winter and they have stayed gone since.  Gee, I wonder what's going on in my coronary arteries?  Betcha it's not bad things but no, I'm not paying a couple of grand to get CT+contrast scanned to find out for sure.  (The one exception: perfumes in laundry detergents will still "get" me, so I have to watch out for that.)
     
  • I have no adverse blood glucose reaction to sugar intake.  I have, a couple of times in the last year, "challenged" my body with heavy sugar intake just to see what happens; typically with a large dose of milk chocolate or heavily sugar-laden confections like donuts.  I've not been able to drive my blood glucose over 110 with such a challenge despite intentionally trying.  I don't know if I could actually drive my blood sugar to anywhere near 140 today (the upper boundary of what they call the "normal" reaction to such a test) if I literally sat and ate a bag of sugar.  Note that while I was never diabetic I'm very sure my metabolism was compromised.  For those who wonder if your metabolic systems can heal over time if you stop insulting them, the answer appears to be "Yes."

  • I don't like sugar any more.  Things with a lot of sugar in them taste like crap.  Raw white sugar now has a smell to it that I associate with being "medicinal" and is not at all pleasant.  It sort of smells like poison, in fact -- hmmmm.... maybe it is?

  • I have no "hangries" -- ever -- or carb-cravings.  I often have no desire to eat anything before roughly lunchtime; I'll get up in the morning and am simply not hungry.  This means that if I eat something around lunch, and then around dinner, I'm effectively fasting 18 hours out of every day.  It's not because I'm trying, it's because I'm not hungry.

  • If I do work out a lot my appetite goes up.  If I don't it goes down.  I don't have to think about it, count calories, make efforts to restrict my consumption of food or anything like that.  It's simply this: If I'm hungry I eat.  If I'm not I don't.  Oh, and since I'm not gorging myself on hangries my capacity for food has shrunk.  Yes, it appears my stomach is smaller, in that I get full faster -- and it empties slower too.  An interesting observation that I cannot correlate with fact, but I sure can with how I feel if I try to stuff myself for some reason.

  • My exercise tolerance has gone up massively.  The other day I worked on wrecking out part of my gazebo floor (it needs replaced) which involved using a Wonder Bar, saw and moving sand (via shovel and yard cart) that had accumulated under them and then mowed most of the back yard -- in 90ish degree weather with 85%+ humidity.  It was hotter than Hell, but other than needing to stop and get a drink a couple of times it wasn't all that bad.  I would have heat-stroked out trying this a few years ago -- literally.  Likewise I might go run a 5k tonight, and while the sun will be down it won't be any cooler.  Yes, it will be hotter than hell, but I'm not concerned about not being able to do it.  This I attribute to the exercise, not the diet.  But, with an extra 50lbs I suspect I wouldn't be able to move my additional mass irrespective of my cardio condition anywhere near as well as I can today.

  • I am far faster running now than I ever was -- including in High School!  I was never able to break the 9 minute mile barrier on a 3 mile run, with my "typical" time being around 30 minutes.  My PR now is 7:00 flat on a timed 5k race and 7:49 on a half-marathon.  This isn't a singular result either; my kid, who ran one season with the HS cross-country team, has half-way adopted my way of eating over the last six months -- and not only has her appearance improved she has also taken more than two minutes a mile from her time, breaking the 10 minute/mile threshold for the first time in the last couple of weeks.  Don't tell me you can't perform athletically on a low-carb diet -- that's a damned lie.

I'm not going to tell you this was all easy, because it wasn't up front.  Yes, carb-cravings are real.  A week or so back while in a group having a conversation that turned to food I remarked that I do not, as a rule, eat carbs -- my carb intake is for the most part beer, and only a couple a day maximum.  A nurse who was there proceeded to say that "Atkins causes kidney disease" and further that she "has cravings for carbs and thus needs them."  Both are false; first, Atkins is high fat, not high protein.  It is true that high protein diets can cause kidney problems but that's not Atkins; that's doing it wrong!  Second, meth causes cravings too, but that doesn't mean you need meth -- it means you're addicted to it!  Carbs are the same deal; when challenged as to the specific nutrients that you need that are in carbs, of course, she had no answer.  That would be because there aren't any; the amount of carbohydrate you actually require in your diet is zero.  I gave up; oh, she was complaining about having big snoring problems too (gee, I wondered, if you lost some weight what might happen to that........) This, however, is illustrative of the attitude of many in the so-called "health business"; their 4 hours of class at some point was not only insufficient most of what was in there is flat out wrong and even when taking this path might help alleviate a person problem they're experiencing they won't try it!

Here's my view, more than five years into this: I've seen exactly zero bad effects from adopting this lifestyle, and multiple good ones.  My indicators of metabolic health have improved, my exercise tolerance is up massively, I am more able to perform athletically today than I was when I was 17 despite being three times as old, I have zero glucose tolerance trouble evident when challenged, I am never "hangry", I do not crave carbs and in fact find things with sugar in them "too" sweet yet I count no calories or make other conscious attempt to control my food intake and my body mass is approximately what it was 35 years ago and hasn't moved more than a few pounds in either direction for the last five years.  The only exception was when I was in a relationship, eating far too many carbs (and knew it) and five more pounds went on -- literally as soon as I cut that crap out they disappeared within a couple of weeks.

Why would I change what I'm doing now, when for the last five years it has worked -- effortlessly -- to not only halt what was an obvious and visible (albeit slow) decrease my personal vitality and health that many would simply attribute to old age, but almost-completely reversed it -- and in many cases my health and physical abilities now exceed those of my teen years!

Yes, I'm a data set of one.

Now tell me why would you not run your own experiment.

I'm all ears.

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How does this sort of tripe wind up in print?

Aamodt is a neuroscientist, book author and former editor of a leading brain research journal. She also has become a prominent evangelist of the message that traditional diets just don't work and often leave the dieter worse off than before. And she's an enthusiastic proponent of mindful eating.

"I define it as eating with attention and joy, without judgment," Aamodt said in an interview. "That includes attention to hunger and fullness, to the experience of eating and to its effects on our bodies."

Riiiight.

Look folks, there are people who have a mental disorder when it comes to food.  I accept this, because it is trivially shown to be true.  But the vast majority of people who are overweight are not sick in the head or suffering from some psychosis -- they've been actively misled as to what's going on and the media spurs this with its crap "reporting" such as this article.

Likewise, the "energy balance" folks (all of whom like to wag their finger and scold) are correct but intentionally misleading.  That is, it is absolutely true that since a pound of body mass is roughly 3000-3500 calories (there is some debate on exactly what the number is but this is close enough; within 20%) if you wish to lose weight you must consume fewer calories than your body burns.

There's no escaping that; it's math.  Isn't it funny, however, that these people never bother to continue their mathematical exercise?  We'll get to why not in a minute, so hold that thought.

There is, unfortunately, also no escaping the fact that running, one of the highest calorie-consuming exercises, only burns about 100-120 calories a mile -- more if you're very heavy (it takes more energy to move your fat ass) and less if you're not, but again, we're talking about a 20% tolerance here and for the most part the figure is about the same irrespective of other factors.

This, by the way, means that you must run approximately a marathon to lose a pound!

No Mildred, you cannot outrun your fork and anyone who tells you otherwise is completely full of crap.

Yes, we have an obesity epidemic; fully 40% of US women are obese along with 35% of men -- and even worse, one in five adolescents!  This is a ridiculous percentage and what's really awful is that those who are in this position are setting themselves up for utterly horrible, slow and painful ways to die -- first through amputations, then blindness and kidney disease, and finally heart attack and stroke, all after decades of avoidable suffering and restricted physical capability.

It seems that every couple of years someone else comes along with yet another crackpot theory on why it is that people get and stay fat -- and then both get sick and die as a result.  They all keep trying to make the case that it's not your fault in some form or fashion, using words like "easy" to describe their particular prescriptive answer, knowing full well that this sells books.

After all, if you told people it was their fault or would be hard how many of them would pay you for the book -- the speech -- or the "counseling"?

But all these theories are just that -- theories, and IMHO they're all full of crap when it comes to long-term success.

Here are some facts for you and they are trivially proved through nothing more than casual observation of the world around you and arithmetic you learned in the first and second grades:

  • Every organism in the animal kingdom has a regulatory mechanism in its body that is autonomous for controlling how much food said organism takes in.  Absent that since "food" generally tastes good to said organism all animals would continually fill their stomachs to their maximum capacity as often as possible, eschewing virtually anything else other than sex, until they all died of obesity-related disease.  Clearly this does not happen "in the wild" but it sure does when a creature's "natural" diet is disrupted.  Witness all the "fat cats" that eat packaged kibble, then compare the nutrients in said kibble with that in a mouse or bird. The prosecution rests, your (dis)Honor.

  • Since it requires 3,300 calories to gain or lose a pound as a human and there are 365 days in a year in order to regulate your body size within one pound per year over time you must manage to control your caloric intake and expenditure within 10 calories per day.  For some perspective that is less than 1/10th of an ounce of potato chips!  If you wish to count them accurately use Pringles (all chips the same size and mass) and you will find that to control your body mass that accurately through voluntary action would require that you keep your consumption accurate to within one potato chip daily.  Certainly you cannot do this irrespective of the form and type of food you consume through "mindful", that is, volitional conduct.  The accuracy required simply cannot be met.

  • Remember, however, that there are a lot of things that go on in your body that require maintenance at this sort of accuracy and none of them are voluntary.  Your blood pressure, glucose level, blood pH, uric acid, water content, potassium level, dissolved CO2 and oxygen saturation are just a few examples of literally hundreds.  Any of these parameters that go materially out of "normal" range will cause serious disease and in many cases instant death.  Yet your body knows how to regulate all of them, as does every other animal's body on the planet, and all of that regulation in every organism that is alive happens without a scintilla of conscious thought.

So what's actually going on?

Don't ask NBC news; they claim nobody knows:

"Numerous foundations, industries, professional societies, and governmental agencies have provided hundreds of millions of dollars in funding to support basic science research in obesity, clinical trials and observational studies, development of new drugs and devices, and hospital and community programs to help stem the tide of the obesity epidemic," the journal's editors, Dr. Jody Zylke and Dr. Howard Bauchner, wrote in a commentary.

"The obesity epidemic in the United States is now 3 decades old, and huge investments have been made in research, clinical care, and development of various programs to counteract obesity. However, few data suggest the epidemic is diminishing," they added.

Did you all flunk basic organic chem, then biochem and simply ignore the monstrous body of evidence that has been accumulated on this problem?

There is one basic fact that has to be dealt with by anyone propounding on our obesity epidemic: 

Your body knows how to regulate its caloric intake in light of highly-variable energy expenditure and do so within 10 calories a day.  If it did not the species Homo Sapiens would have gone extinct centuries ago just as would any other species that could not regulate its caloric intake.

Therefore the question must be this and only this:

Why is that regulatory system not working, can a fat person restore it to normal function, and if so how?

I believe we know the answer to that question but admitting it means admitting that the medical and "nutrition" folks have been lying to overweight people for decades and, in fact, they know damn well they've been lying which means they should all be in prison for the outrageous harms they have inflicted on millions of Americans.

Let's start with history.  Homo Sapiens (that is, our specific species) has been on this planet for about 200,000 years.  Our direct lineage in that regard is the matter of some dispute, but what is not in dispute is that until about 12,000 years ago we had no industrial mode of food production whatsoever.  That is, for better than 90% of the species' time on this planet we ate only that which we could obtain without processing, other than perhaps rudimentary cooking.

The epidemic of heart disease, obesity and diabetes is a 20th century+ phenomena.  It therefore must be traced to something (or a group of somethings) that happened in that time frame.  Ancel Keys claimed it was dietary saturated fat that led to heart attacks and strokes.  He cherry-picked his data, however, which made his advocacy not a mistake but a lie, and a fairly easy one to prove too.

So would anyone care to guess where it began?

I'll help you. It began right here with a dramatic increase in use of a very dangerous substance.

About 20-30 years following that ramp in cigarette consumption, guess what happened?  Lots of heart attacks and strokes.  Do you think this was a function of "fat in the diet" or do you think this had something to do with per-capita cigarette consumption going from ~200 in 1912 to twenty times that rate by 1959?  When you go from an average of less than one cigarette a day per-person to close to a full pack a day what do you think is going to happen to heart disease and stroke rates, with about a 20 year lag?

That's exactly what did happen.  Duh.

Then there's Crisco and other related trans-fats.  They came on the market in the early 1900s too and were in fact sold as healthier than animal fats.  But we now know that transfats greatly increase the risk of heart disease, while the association with saturated animal fats in fact runs the other way -- among European diets the highest in saturated fat (the Mediterranean nations) have the lowest cardiovascular disease rates. 

Between smoking and transfats is the causal chain clear yet or do I need a bigger clue-by-4?

Now let's look at obesity, which began to spike in the 1980s.

Again, what changed?

Simple: The US Government played hell with its "war on fat" predicated on the lie told by Keys (among others) and told people to cut it out of their diets.  But there are only three foods at a macro level -- fats, carbohydrates and proteins.  If you remove fat from the diet you must increase one or both of the others.

What got increased?  Carbohydrates -- specifically, cheap, fast and highly-processed carbohydrates.

And what do we know about carbohydrates, especially fast, processed carbohydrates such as grains (e.g. breads, pastas, etc), sugars and similar?  They all produce a large insulin response in the body.

Oh, and if that's not enough carbohydrate consumption also increases systemic inflammation and "bad" cholesterol, which prompts cholesterol in the body, a necessary component of our metabolic system, to perform the job it is present to do -- that is, to encapsulate and attempt to repair said inflammation.  Blaming cholesterol for heart attacks (and trying to reduce it through chemicals) is like blaming it for the inflamed finger you have after sticking yourself with a thorn -- rather than removing the thorn!

Finally, with few exceptions these "foods" have only existed in our diet for the last few hundred to few thousand years -- an inconsequential period of time on the evolutionary time scale.

In other words there is no evidence that our bodies know how to process these carbohydrates without harm because we did not evolve in their presence and thus our genetic coding was not selected through evolution to favor said energy sources.  The same is true for vegetable-based oils (PUFAs), none of which have been ingested in material quantity by humans for more than 100 years.

You would have to eat a full bushel of corn to get a tablespoon of corn oil and utterly nobody would (ever) eat a bowl of cotton seeds!

Now let's look at what we know to be fact in the context of body mass regulation.

Hunger (the desire to eat) is largely mediated by leptin and the hypothalamus, a small structure in the brain.  This structure is responsible for regulating not only hunger but also body temperature, sleep, and thirst.  In short some of the most-essential regulatory functions are directly controlled by this part of the brain and still more are via other structures that it interacts with, mostly via and through hormones.  This has been known since modern medicine has existed.

Now here's the nasty piece of the puzzle nobody wants to talk about, but which I believe is key to the entire obesity issue:

Insulin is a leptin antagonist.

That is, quite simply:

The higher your insulin level the less active leptin is in signaling satiety.

Therefore insulin resistance, even at a level that is sub-clinical and does not result in an increased blood glucose level as long the body is able to produce enough insulin, and your cells are still able to respond, to hold blood glucose within normal limits.

But irrespective of your ability to maintain a normal blood sugar that elevated insulin level will still result, in every case, in a desire to eat more food.

The condition of an elevated insulin level tips the balance of the body's signalling and thus makes unconscious control of caloric intake within the required tolerance, given access to food in excess of metabolic requirements, virtually impossible.

This then leaves you with only voluntary caloric restriction (e.g. "dieting") as an option which we know you cannot maintain over the long term as the precision required cannot be met through conscious control.

Worse, the divergence between needs and desires is all in one direction -- overeating and if your "diet" is a low-fat one where the substitution is made with carbohydrates you make your desire to overeat worse.

This is why when you cease dieting you almost-invariably gain all the weight back plus more -- your "dieting" has in fact done more damage to the metabolic systems that control your desire to eat!

Again, that insulin is a leptin antagonist is not a theory it is a biochemical fact.

The only means by which one can resolve the problem at a biochemical level is to remove the leptin antagonist.

Achieving that requires lowering insulin levels, and that can only be safely done (without skyrocketing your blood glucose) by restricting carbohydrate intake, especially rapid-acting carbs such as sugars, grains and starches.

It is not a coincidence that this is a corrective action in that it coincides with removing "foods" from your diet that your body was never designed to process and in fact at no time in our evolutionary history did such "foods" exist.  Those who make claims to the contrary that the intake of such "foods" in any quantity whatsoever are "safe" have the burden of proof to show how the body can handle such intake without any of the normal biochemical processes going out of the normal range.

The body of evidence found in the form of rampant obesity and insulin resistance, all of which exactly correlates with the "war on fat" by medical "authorities" and substitution of fast-acting carbohydrates in its place, strongly suggests that these foods are not safe and cannot be made safe; they can only be avoided or the consequences of consuming them accepted exactly as the correlation with smoking and transfasts correlated exactly with the rise in heart disease with the expected 20-30 year lag!

"Mindful eating" will not change your insulin levels nor improve your body's leptin signalling.

Getting the pasta, potatoes, rice, sugars and grains out of your diet, on the other hand, will. If you want the full list read this article.

As a "side effect" of following same, if you actually do it, I predict that your pants will fall off.

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