I’ve been writing about obesity and something called hyper-insulinemia for about as long as I can remember. For those of you who don’t know, many people nowadays have something called metabolic syndrome, which is a cluster of symptoms including obesity, high blood pressure, elevated insulin levels, and high cholesterol. The main component of all of these is something called hyper-insulinemia (which is also called insulin resistance).
What I just wrote is pretty much accepted as fact nowadays. What is still up for debate is a) whether insulin resistance is the cause or the effect of obesity and b) whether insulin plays a larger role in weight loss than originally believed. You see, there are two competing genres in this war on the bulge. On one side of the ring you have those people who believe a calorie is a calorie, and the only thing required to lose weight is a bit of will power. For those that continue to gain weight, the people in this camp simply dismiss them for people lacking the will to watch what they eat or to make a bit of time for exercise.
Photo by ieatstars on Flickr
What bothers me about that camp is that most of the people I know who have always been a bit stocky are basically always watching what they eat, and always making time for exercise. These people aren’t eating huge meals, or eating cookies non-stop — they make an honest attempt to lose weight, but simply are unable to shed any pounds.
On the other side of the ring are those people who do not believe in the caloric theory of food (which basically says that food that you put into your body gives the same amount of energy as burning it, which is actually the definition of a calorie), but rather believe that weight loss and weight gain are the result of the complex nature of hormones in the body.
I’ve been reading medical research papers routinely for about eight years now, and there is growing consensus, at least in my mind, that there are parts of caloric theory is wrong, and that some parts of the endocrine theory are correct. The following is a brief exert from an article I read years ago – pay special attention to the stuff in bold (and also bear in mind that Harvard Medical is one of the most prestigious research universities in the world):
Five recent studies have shown that subjects on some form of the [low carb] diet lost twice as much weight as those on low-fat, low-calorie diets. In general, the more carbohydrates consumed, the less body fat is lost. Meanwhile, an additional five studies conducted by the National Institutes of Health failed to demonstrate any link between eating fat and developing heart disease.
In other words, the recommendations that put a whole nation on a low-fat, high-carbohydrate diet have been overthrown and the USDA Food Pyramid toppled. Nevertheless the Department of Agriculture still maintains this standard for a healthy diet. Why has the USDA not responded to information that alternative medicine practitioners have known for years?
The Harvard researchers suggest that the low-fat-is-good-health hypothesis has failed the test of time. The current obesity epidemic, as well as a significant rise in Type 2 diabetes, began in the early 1980s with the rise of the low-fat dogma.
“For a large percentage of the population, perhaps 30 to 40 percent, low-fat diets are counterproductive,” concludes Eleftheria Maratos-Flier, director of obesity research at Harvard’s prestigious Joslin Diabetes Center. “They have the paradoxical effect of making people gain weight.” Nevertheless, he notes, that still leaves a sizeable proportion of the population who might benefit from the whole-grain, complex carbohydrate diet favored by low-fat advocates.
I once lost about 50 lbs in about five months, simply by giving up the majority of carbohydrates in my diet. I wasn’t going to the gym at the time (although I was walking places), and I didn’t really watch my portion sizes. Contrast that to the six or seven years of “dieting” I did before that which consisted of three or four visits to the gym each week along with the recommendation from a nutrtionist that my diet consist of no more than 20% fat ( the majority of my diet was supposed to come from carbohydrates), during which I slowly gained about 40 lbs.
The point of this article isn’t to swing my low-carbohydrate hammer at anyone. I think dieting is really a personal preference, and if what you are doing is working then go ahead and continue that. However, if you’re one of those people that has struggled for years despite advice from doctors or nutritionists, then I encourage you to read up on insulin resistance and make up your own mind.
To that end, I’m going to keep writing about the subject, and giving a bit of advice when I can. I also might do something along the lines as Rebecca, and do a for-charity multi-month weight loss event or something.
[…] of the reason I wrote the last article on insulin resistance is so I could continue to talk about that subject without continually explaining what it is I was […]
On the other side of the ring are those people who do not believe in the caloric theory of food (which basically says that food that you put into your body gives the same amount of energy as burning it, which is actually the definition of a calorie), but rather believe that weight loss and weight gain are the result of the complex nature of hormones in the body.
I don’t think anyone believes that the food you put into your body gives you the same amount of energy as burning it. Everyone knows that not all the calories in food end up in your body – for (a really simple) example, fibre is not digested by the body, but would be burned up in a calorimeter (the device you use to burn things to find out how much energy is in them).
Re: the bolded text and your comment “I think dieting is really a personal preference, and if what you are doing is working then go ahead and continue that – I think this brings up a really good point. Not everyone’s body is the same and I don’t think that there is one good diet for everyone. This, of course, is not what many people want to hear as people tend to want a magic bullet.
I once lost about 50 lbs in about five months, simply by giving up the majority of carbohydrates in my diet. I wasn’t going to the gym at the time (although I was walking places), and I didn’t really watch my portion sizes.
Out of curiosity (god, I say that a lot, don’t I?), what type of carbs had you been consuming? Were you eating a lot of simple carbs, or more complex ones? And what did you eat instead?
Well, I understand that fiber doesn’t make it in, but many research papers I’ve read have the author say “losing weight is as simple as cutting out 350 calories a day, and in ten days you’ll lose a pound,” or something along those lines. There are still those people that don’t get that the body is complex, and it doesn’t always work that way.. I.e., some people will respond to that by having their metabolism slow down to compensate for the lack of food, others will preferentially start burning muscle over fat (depending on your hormones etc). My points is, and I think you agree, is that the body is very complex, and you can’t apply a simple formula like some authors try to. Some people mistakingly bring up the conservation of energy or the 1st law of thermodynamics, which really don’t apply since the body is not a closed sysytem.
Well, to be completely honest, I wasn’t really huge on whole wheat bread back then. So a typical day would be a bowl of cereal for me, with maybe a turkey sandwidth on white bread for lunch and a piece of fruit, followed by some type of meat and salad for dinner. Sometimes I’d have warm milk before bed, and the odd piece of fruit during the day if I got hungry. I kept detailed food logs, and I was eating around 1400 calories a day, and going to the gym about 3 times a week (I was even training for the Sun Run for about three months during all of it) So, it’s pretty mind boggling to me that I didn’t lose any weight in all that time.
When I gave up most carbohydrates, I actually basically did the Atkin’s diet. That basically meant I switched carbs almost completely with fat (most people think Atkin’s is high protein, but it’s really not supposed to be). My protein went up a small bit (maybe 5% more of my daily calories), but I split the rest pretty equally amongst all three types of fat. If I knew then what I knew now, I’d eat more fish and less saturated fats. That being said, I lost a pile of weight, my high blood pressure normalized, and my lipid profiles became some of the best they had ever seen at the doctor’s office when I was all done.
If your goal is to reduce insulin, keeping protein down is important as well, since (and most people don’t know this) about half of protein metabolizes similarly to carbohydrates, and gives an insulin response as well. Fat basically hardly affects insulin at all, which is why there’s a diet called the “fat fast” which is almost entirely fat, and can lead to dangerous levels of fat loss since your blood insulin basically falls to almost zero.
The best weight loss program I ever followed was the Bob Greene one( same as Oprah).
I lost 111 lbs in just over a year. It’s a great program that basically allows you to eat what you want (within reason) with a few simple rules to follow. I stopped living by “the rules” and slowly gained some of the weight back. Since following the program again in the last month I have lost 11 lbs. The fundamental rules?
1. Eat within an hour of getting up.
2. Drink 2-3 litres of water a day.
3. Eat nothing after 6 p.m. ( Or a minimum of 4 hours before bedtime)
There’s also some bits about avoiding alcohol (ha ha) and making eating a conscious act (not eating in front of the tv etc).
Overall, a very simple program that was easy to follow and yielded great results. After the lazy winter I had, I’m back on “the program” and once again, happy about how it’s working.
I’m no expert, but here is why I believe that only calories matter, no matter what they consist of. If a person is consuming more calories than they are burning, they will store the remaining calories as fat, that part is not disputed. Weight loss is not possible without a calorie deficit, no matter what Internet and late night TV charlatans claim.
The part that is debated is in the opposite scenario: What happens when a person consumes fewer calories than they burn? Let’s assume that a person is consuming a caloric deficit, but insulin causes a portion of that energy to be stored as fat instead of being used as fuel. You eat 1500 calories of high sugar, insulin-spiking food and some of it is stored as fat, but you need 2000 calories as day to go about your life. Where do the other 500 calories needed for you to go about your day, come from? Fat storage. You may have temporarily stored some of the energy as fat, but that fat will be consumed later in the day to fuel your activities. How can a person NOT lose fat with a consistent calorie deficit without defying the laws of thermodynamics?
I think that people eat more than they think they do, or in the case of people who log their food and still don’t lose weight…their basal metabolic rate is lower than the outdated prediction charts indicate. Someone in that situation needs to get a body fat composition test and find out their lean muscle mass, which is a more accurate way to predict metabolic rate, and thus calories needed in a day.
True, but you can obtain that deficit by altering your metabolism. And simply cutting 300 calories out of your diet may not work since your body will adjust it’s metabolism down to compensate. There’s a well known set-point theory where the body resists changes in weight by automatically adjusting it’s metabolism to compensate for dietary changes.
You see, you’re assuming the body is simple, when it’s not. Given a 500 calories deficit, the body may down regulate your metabolism to compensate. Another scenario is that your body may preferentially break down protein (it will break down muscle cells) instead of fat. What people don’t seem to understand is that you cannot break down fat without glucagon, and glucagon is low when insulin is high. So, if you have high amounts of insulin in your blood, your body will not be able to break down fat — it will either go for protein, or you will hit the wall as they say in sports, that is your body will be unable to meet the demands that you are placing on it.
I agree people probably eat more than they think they do, but it’s not as simple as BMR charts in my opinion. I actually have a lot of LBM, and yet my if I were to calculate the calories I need to maintain my current weight (basically my BMR + activity level), it would be rather low.
True, but you can obtain that deficit by altering your metabolism.
Yes, and that would be a good thing, since you would have to increase your metabolism to create the calorie deficit. I’ve read about the set point theory and the body does adjust it’s metabolism, but it isn’t an on-off switch, it’s a gradual change and by maintaining a small calorie deficit you can “stretch out” the time in which you can lose fat before your metabolism reestablishes homeostasis with the new lowered metabolism. Given a 500 calorie deficit, your body will eventually down regulate your metabolism to that point, but in the meantime, you will lose fat. Once you achieve homeostasis, you will stop losing fat and maintain your weight. I think we agree on that point.
At this point your metabolism and calorie intake are equal, you maintain weight. To continue losing fat, you must lower your calories or increase your metabolism. You are right that it isn’t that simple. Someone who goes on a diet, or otherwise induces a big calorie deficit will lose some muscle mass along with the fat. I think the key is to not go too low on calorie restriction and do some resistance training to try to maintain as much muscle mass as you can while losing fat, in effect, try to blunt the metabolism lowering effect.
I just don’t believe that there are millions of people walking around with high levels of body fat, high levels of LBM, and whom are maintaining caloric deficits. Something has to give! If muscle mass is providing the additional calories, as you suggest, then people would be wasting away. A few, maybe, have hyper-insulinemia but I don’t think it explains the levels of obesity that we are seeing.
if I were to calculate the calories I need to maintain my current weight (basically my BMR + activity level), it would be rather low.
In comparison to what?
You said it yourself — once these people hit a new lowered metabolism, they either increase their exercise level or decrease food. If they do neither (which is probably typical), they won’t lose more weight.
In terms of metabolic syndrome, it depends which source you read. However, the number of people with clinically accepted metabolic syndrome is above 10%. If you do the math, that’s tens of millions of people in North America:
And in terms of my LBM, my LBM is high for my body weight, and my metabolism is slow. I have no idea why. But those charts and LBM -> BMR calculators always over-estimate my BMR.
1. I can’t dispute the numbers of people accepted as having metabolic syndrome. Obviously there is a correlation between being overweight and having metabolic syndrome, but which is the cause and which is the effect? Perhaps, metabolic syndrome and insulin resistance are caused by being overweight and the entire affair can be avoided with exercise and portion control, but not necessarily carb cutting.
2. My bias toward the calorie is a calorie camp is a result of my own personal experiences. I may not be overweight anymore, but a few years ago I was 70 pounds heavier. My weight loss solution was to watch portions and exercise like crazy and, in retrospect, I ignored food composition. I continued eating the things that I had always eaten, just less of it. I became a runner and still run and train for marathons and ultra marathons. For me, insulin resistance is definitely not a problem. Carbs that I consume go immediately to replenish glycogen stores with little, if any, fat storage. Low carb worked for you and that’s great. Maybe both camps are correct, depending on the person, levels of activity, genetics, and any number of unknown variables.
3. I reread my previous posts this morning and they seemed a bit combative to me. That was not my intention and I apologize. Maybe I should have inserted more smileys. 🙂 I’m passionate in my belief that everyone can live a fit and healthy life and I just can’t accept that some people are destined to be overweight. In reality, I understand that there are medical maladies out there that really do have the effect of keeping people unhealthily overweight, but for every person who has one of those illnesses, there are 10,000 people who think they can’t lose weight, but really can.
I’d agree with that, as would alot of the researchers I’ve read. Some people are sensitize to insulin, and can lose weight easily just be reducing portion sizes etc. Others appear to have to watch carbs etc. I tried eating the low-fat diet for years to lose weight, and all I did is put on weight. However, switching to low-carb drastically helped me lose weight. So, I think it depends on the person, and I don’t think there’s a one size fits all.
The hard reality is that even though some people are physically capable of losing weight, socially it’s difficult. Think of how much work it took you to lose, and now try to imagine a single mom with three kids doing the same. Even now, I find it challenging to make time to exercise, and by comparison, my life is rather flexible.