I agree with that statement as well. I was thinking, but didn't express, that in my comment that "in this arena" the distinction wasn't an issue for me.

I do completely agree that outside the already converted, the issue of how we present the concepts are crucial. I think we see that in science today. It seems to be a recurring theme that studies and findings that suggest that weight loss maybe much more difficult than "eat less, exercise more" are swept minimized or the conclusions twisted to continue to blame the obese and reaffirm the "eat less, exercise more" message.

I'll add a comment that I was amazed at the vitriol and rejection aimed at Gina Kolata's book Rethinking Thin even on this forum. Her basic message was that eat less, exercise more doesn't work and encouraged us to accept the poor results of traditional diet & exercise and stop blaming the obese for not being strong enough to lose weight. I thought that basic message was important. I think it was the fact that she didn't figure out that there was hope for the obese in the alternative of the carbohydrate hypothesis that makes everyone here dismiss her. I agree she missed it, and it would have been a far more powerful book if she had got it. Instead of the dismal future for obesity she ended her book with, she could have looked forward to a world where we accept the carbohydrate hypotheses, it's proven, and the world changes it's dietary pattern accordingly.

My own personal theory is that *most* people fail at a low-carb diet because of the environment. There are too many obstacles to it. Family, friends, the media, the medical establishment, all tell you it's not right. It's hard to keep the faith in the face of all of that. It really is. And even if you can believe it's the right way to eat, it's even harder to practise it in the face of the way the rest of society eats. If the world believed and accepted that the carbs are the problem, and that became the new, accepted "healthy way of eating", I think there would be a profound decrease in obesity rates pretty quickly because low carb is not inherently difficult to do.

Totally agree. Sadly, I don't think we'll see, in our lifetime, carbohydrate restriction as standard of care. <sigh>

Stuart, true delta-E is ever changing by the minute, but over time - a day, a week, a month - we can measure it to a certain degree as a baseline starting point to establish the energy required to maintain weight.

Is it perfect? No, and I didn't say it was. But it is what we have at this point in time and while an "estimate" of energy required to maintain, it's accurate enough to determine what would be a calorie deficit.

My point was and remains, that delta-E (simplistically) does not increase because one modifies their diet to restrict carbohydrate. With that you could argue because of increased wasted energy, through futile cycling etc., that delta-E has increased -- and in a sense you would be correct because the level of caloric intake would need to increase to overcome the wasted energy and maintain weight, but it wouldn't be because delta-E increased, but because wasted energy would need to be replaced to reach delta-E. So, I could argue that delta-E hasn't changed and the difference is that more energy is being wasted, thus establishing and maintaining a calorie deficit more easily.

But ya know what? Who cares? I'm not going to continue to split-hairs with you about this, OK?

deleted message

This has been a fascinating discussion and if I'm reading it correctly, I believe y'all are much closer than you are differing, and as Regina said, you're mainly just splitting hairs.

So much of the science has still yet to be understood. Until we have the money for the large, controlled studies, or until we have the instrumentation to understand the multitude of complex processes from the inside, we'll still be guessing exactly how much of this works. I think we've got a pretty good idea of the gross processes, and a great deal of anecdotal and circumstancial evidence (the whole Diseases of Civilization chapter), but the science will be necessary in order to institute the radical change necessary to bring society along with us. I totally agree, and this will not change until we can change the narrative. My great hope now, is that some of the edges of the current narrative are beginning to fray with lots of conflicting advice and confusion over what's good and what's bad. I lieu of actual, good science, the other way to institute change is to change the narrative ahead of the science.

It was done once before, with low-fat. The story changed based on hunches without any hard science. It can be changed again. I would much prefer to change the perception of a good diet based on good science, and I definitely don't want to be like the low-fat crowd of the 60's and 70's. At the same time, even to introduce some doubt around the current dietary dogma would be a good thing.

Plane

Yeah, I'm not sure what all the fuss is about. I got interested in this thread because someone suggested that GCBC was implying that somebody who gained lots of bodyfat was likely to have some kind of metabolic 'defect'. I think this is dead wrong. What I think GCBC explains really clearly is that if you eat high fat/ carbs (and too much of it for your energy expenditure- including whatever 'energy wasting mechanisms human metabolism is capable of) the human body is expressly designed to gain a lot of bodyfat. And I think it's unlikely that nature designed bodyfat gain control mechanisms, because carbohydrate was never very plentiful, even seasonally, so it was never an issue.

It's the people who don't gain a lot of bodyfat with that kind of dietary approach who really have the metabolic 'defect', as inconvenient a truth that is to the people who so desperately want to be able to lose bodyfat and eat fatty carby food as well - as the post neolithic world (and particularly the 21st century advanced World makes it so easy and 'desirable' to do - the 'environment' factor Valerie mentioned). In spite of the clear emerging evidence that human health inevitably l suffers from continuing to eat that kind of food, whether or not we get fat in the process. The people who work true to design and get fat and go on eating fatty/carby food long enough to actually develop metabolic problems, will probably find it much more difficult to lose the excess bodyfat even if and when they do ditch the carbs. But this forum is testament to the fact that low carb will still be the easiest and most effective way to lose bodyfat, even for the carb/fat damaged morbidly obese people, because only by eating low carb will a fat burning hormonal environment be established. And the many people who don't trash their metabolisms in the process of eating high fat/carbs (some people just resist the damaging effects for longer) still seem able to lose bodyfat by just eating less of the food that they gained weight so efficiently eating to excess - like the ex- athletes PJ mentioned. But they're still the long term losers, because even though they might be able to shed the pounds if the calories are kept low enough, a high carb diet is not what humans were designed to eat.

And I agree, splitting hairs over whether delta whatever is even a clearly definable, much less a quantifiable energy measure is a bit beside the point . We do need accurate energy measures if 'studies' are ever going to sway the establishment one way or another. But concepts like Delta E are uselful as yet more as vague intellectual notions, rather than the rigorously and exactly quantifiable measure metabolic researchers so need it to be. I have no doubt that one day it will be just that.


Stuart

Okay, so, to change the topic a bit. Can we do an exercise in practical application of some of these ideas?

Assumption #1 - that as long as we keep the carbs in check (to whatever degree our individual metabolisms dictate), we won't gain weight. I think most of us agree, for the most part, on that.

Assumption #2 - to lose weight, we need to change our bodies from fat accumulation to fat release. We generally do that by lowering carbs.

Dilemma - there always seems to be those that, usually after substantial weight loss, hit a point where they stop losing. Assuming their carbs are still low, they haven't added back too many, what happened? Popular wisdom on this site (and others) is that you've hit an equillibrium where your body's caloric needs are equal to your caloric intake. Does this still make sense under Taubes' paradigm that it's fat accumulation/storage system that is the issue, not the calories in/calories out. If our bodies reach equillibrium at a point where we are fatter than we like, is a further cut in carbohydrate needed to start the fat release again? Or do we switch to counting calories? And if so, why do we think it will work now when it didn't work before?

My own personal experience is that I've hit this equillibrium. Any attempt I make to lose further at this point reminds me of my pre-LC experience where I lose weight, then regain it. Always just back to this equillibrium, not more.

I'm curious what you guys think about this.

Last night while having dinner, DH and I were discussing the concepts of study design to effectively compare low-carb to low-fat - and we pretty much came to the conclusion that one reason why the various trials comparing the two keep reaching the conclusion they're similar at the end of a year is because BOTH are effectively reducing carbohydrate along with calories. So we kicked around some ideas and realized a well-designed study to actually compare the two diets needs to be done differently than is currently the standard protocol.

How do you compare two diets, isocaloric in design, to compare the difference between carbohydrate levels?

Here is what we decided might be a good way to set one up:

Place subjects in a metabolic ward for two weeks to establish baseline energy requirements and allow ad libitum consumption of a wide variety of foods to determine daily calorie intake.

Pretending for a moment that the average intake is 2500-calories with 50% carbohydrate, 15% protein and 35% fat, the subjects are hypothetically consuming 312.5g of carbohydrate, 94g of protein and 97g of fat each day.

In order to investigate the difference between the diets for carbohydrate intake, the subjects need to maintain their carbohydrate intake for the low-fat diet - continue consuming 300-320g each day! This means that the manipulation of macronutrient intake needs to reduce fat and only fat in those being followed with a low-fat diet.....so if you're going to reduce calories to, oh, 2000-calories per day, the macronutrient ratios and absolutes change to 60% carbohydrate (300g), 19% protein (95g) and 21% fat (47g).

Keeping protein comparable and reducing carbohydrate means that, again, fat is what is altered in the low-carb arm of such a study.....20g each day means carbohydrate provides just 4% of energy, 95g of protein provides 19% of energy and the remaining 77% of energy is fat, or 171g each day.

You keep the subjects in a metabolic ward, maintain similar energy expenditure between the groups and watch and see what happens over 2-months with carbohydrate reduced versus carbohydrate maintained with just 500-calories removed from the habitual diet each day.

I'm not aware of any study designed like this - I think it would help to better understand how calories and carbohydrate effect weight loss and might be better able to begin to uncover if there truly is a metabolic advantage, because in this type of study, the subjects would be consuming the same carbohydrate level as the pre-diet intake in the low-fat arm and that would eliminate the confounding variable of what influence the reduction of carbohydrate exerted in previous studies where carbohydrate is reduced as calories are reduced in the usual protocols designing trials.

What do you think?

It certainly sounds worth doing as an experiment to help validate or disprove the carbohydrate hypothesis. I love the insight that usually carbohydrates are dropped in both diet groups and that this point could confound the data.

I'm not sure how it addresses your original problem of both diets tend to get to the same point after a year. Weren't those non-metabolic ward studies for the most part? Isn't that kind of like comparing apples to oranges? If you got promising results from your first study, wouldn't you need to then do a second, year long study, not in a metabolic ward, teaching dieters either low-carb or your low-fat, but as high as ever before carb diet and then measure them for the year to address your original issue?

Lowcarb is just magic.

Controlling calories through conscious deprivation within diet is the overwhelming no-brainer of our culture and that doesn't really work, as the % of diet success shows. So even if the technical detail might "end up amounting to that in a rather complex way we can't really even measure let alone prove at the moment," the reality is that going around saying it sounds exactly like what our culture spouts with the same words, but a different understanding of "why" those words mean something and "how" that is to come about. Given language exists for shared cultural understanding, maybe it'd help to find new language for expressing that. You can't really use those words without a mountain of semantic baggage falling into the discussion that torques understanding.

If you eat 1500 calories lowfat, starve yet lose muscle and not fat, vs. eating 1500 calories highfat, feel great keep muscle and lose fat, then to the semantics of communication, "caloric deficit" was not the issue to the individual's understanding, the composition of the dietary intake was.

In that case, "eat less carbs, more protein and especially more fat" is what is "working" on the descriptive level. The micro-detail of why that might be working, based on a zillion complex and not so complex body processes, is a bit of a different subject of course.

I do think that reducing insulin, which causes less repression of the USAGE of energy from the fat cells (hence the body may be "burning more calories" merely because finally it CAN -- for all I know, there is nothing that happens to 'make' it burn more calories, but rather, that something CEASES to happen which is 'reducing/prohibiting' its burning more calories), is probably the key component. This may result in 'caloric deficit' at the end of equation. But since culturally the "implied meaning" of "caloric deficit" is based on standard charts for BMI and 'caloric requirements' and "eating less than that," using that terminology (even if technically correct) could be a little confusing.

Well, as many like to point out, a diet in free living conditions is confounded because what you're doing is really seeing how well you've educated your group about how to follow a diet, not truly establishing a good measure of the diet's effect --- especially when it's obvious in the data that neither group truly follows the diet through the year. It's something I've pointed out a number of times in various trials comparing low-carb with low-fat....the low-carb group usually stays "low" for carbohydrate for a few months and then carbohydrate creeps up.....the low-fat group usually can stay "low" for fat a few months and then it too creeps up.

So to actually test the diets, you'd need to have a tightly controlled set of groups and control what they're actually eating to see the effects of diet rather than seeing whether your groups are compliant with recommendations to actually consume the diet.

The main problem with the metabolic ward studies we have to look at is that they're starvation level calories - 1000-calories a day or less - and that level doesn't really answer the question about how a low-carb diet performs compared to a low-fat diet because we already know starvation level calories works to reduce body fat - the body is starving! That's why I'd really like to see a protocol with just a 500-calorie a day reduction (or less, even just 300-calories or 200-calories) from habitual intake, with carbohydrate maintained in the low-fat group and carbohydrate reduced in the low-carb group.

Ok, I have been reading this thread and loving it. I have been googling many of the things I have read about insulin and its role in energy storage or release. The question I have after reading the last 4 pages is kind of long, so bear with me.

According to Wikipedia, and I know it's not the best reference in the world but I don't feel like going through all that research again,

"Ketone bodies are three water soluble compounds that are produced as by-products when fatty acids are broken down for energy. They are used as a source of energy in the heart and brain. In the brain, they are a vital source in fasting."

Now, here is where it gets confusing, some days I am in a calorie deficit because I am not that hungry and don't eat while working. Big time deficit, as I do very physical work. I understand why I lose weight in that situation. However, some days I am not working, (I work part time in winter), and I am not in a calorie deficit since I am eating more and sitting around the house doing stuff like cleaning the kitchen and watching tv and messing around on the computer. I still lose weight. Not as fast but I still do it.

Now, I have been eating between 15 to 45 carbs a day since I started and have found that any higher than 45 and I am not losing any weight and I am not in ketosis. If I am in ketosis, (and the strips verify it), and I am taking in more calories than I require am I not excreting calories? I guess the question I am trying to ask is

"Are the same ketone bodies that are running my metabolism the same ones that I am flushing down the toilet?"

Mike Eades blogged a while ago that he had found from long clinical experience that low carb only becomes effective for bodyfat loss if carbs are reduced below a critical amount and fat calories are reduced below a critical level. Smaller reductions in either would 'tend' to slow weight gain, but he used to hear the 'Ive slashed my carb intake, why aren't I losing bodyfat?' complaint regularly.

I think the emphasis in metabolic studies so far, both epidemiological and actual metabolic ward studies is trying to compare data across samples is never going to as effective as comparing individual variation in rate of bodyfat change rather than just absolute change. Which is exactly what low carb clinicians do. Because the very nature of clinical practice means that the 'expertise' of the physician is focussed on the individual, whereas 'studies' deliberately try to eliminate individual differences, to make the 'data' less subjective. Which in terms of the march of scientific process, is probably a really good principle. Except that it makes the process of unravelling the complexities of human metabolism that much more difficult, because calorie/carb intake and bodyfat change is so intertwined (and intertwined differently in each individual, AND intertwined differently again even in that individual on any particular day).

Most doctors treat obesity according to the deeply flawed prevailing paradigm and routinely fail in the attempt. A few (an increasing few, thankfully) work out how important a factor carbohydrate restriction is and have an enviable success rate. It's no wonder the ones who go on toeing the party line get so annoyed. "How could these maverick low carb 'upstarts' go on making us look like idiots". I have no doubt that 'studies' will eventually comprehensively establish the intricate detail of why carbohydrate restriction is so important. But it will probably be decades. And the clinical evidence exists right now. Atkins treated 10's of thousands of patients. Likewise Lutz, the Dr's Eades, Krasnewski(Sp?) et al. Why don't funding starved metabolic researchers just review these guy's patient records.
It's all there, in the meticulous detail all doctors are trained (and required by law) to keep.

For example, a study might interpret a weight gain on isocaloric lowered carb intake as being anti low carb. But for that specific individual, not only might the degree of carbohydrate restriction be insufficient to have any effect whatsoever on rate of weight change, but calorie restriction at that particular carb intake could well be the most effective bodyfat loss strategy. Which could be interpreted as evidence for low calorie being 'more effective' for bodyfat loss than low carb. But that interpretation would be wrong.

I just don't think you will ever be able to establish that at any calorie intake, lowering carbohydrate (thus producing a better (even if only marginally better) fat burning hormonal environment is going to be more or less effective than lowering calories still further.

Calories and the hormonal environment (carb levels) just interact so intricately and interact so differently for each individual, that trying to argue that 'calories' don't matter, or only carbs affect actual bodyfat loss. And although I think Gary Taubes is the first dietary approach writer to even begin to recognize how importance hormonal environment is, I don't think he is suggesting that it is the only determinant of whether a person gains,
maintains or loses bodyfat. Calories also matter.

As Mike Eades often observes, it doesn't matter how hormonally conducive a metabolism is for fatburning, if enough dietary fat is being consumed, it won't be bodyfat that is burnt. And if the hormonally fat burning conducive environment isn't encouraged by restricting carbs enough for that individual, calories will have to be reduced to unsustainable (not to mention unhealthy and metabolically damaging) levels before bodyfat loss occurs.

As a long term and enthusiastic Low carb IF'er, I also find it really interesting how eating frequency affects at what point the hormonally fat burning conducive body (low carb) is forced to start using bodyfat even if lots of dietary fat is consumed at the less frequent meals. Particularly if that 'intermittently' high fat isn't as likely to be stored when it is consumed. Maybe the more constantly available dietary fat from eating regular meals makes it less likely that a body hormonally conducive to fat burning will actually burn bodyfat.

Stuart

Now that's an interesting idea.

I've heard many say that since the low-fat folks are the same folks who've said "eat several times a day" that maybe that advice should be shoved where the rest of it is. But I think that could be throwing the baby out with the bathwater so to speak. In plant studies when they let them drink as often as they want, they drink a little every couple hours. In animal studies when you let them freely feed, they don't eat once every day or two, they eat a little every once in awhile. So that seems like it might just be a 'norm' of sorts.

On the other hand, that could be only more reason why something like IF might force more fat-burning than regular meals.

The problem is, I don't see how anybody can do IF unless they are close to thin already. I tried it. I loved it -- eating is my biggest problem, IF solved 50% of my meal issues by wiping them out, heh. The not eating every other 24 hours was a breeze, no problem.

But it is nearly impossible for me to get sufficient calories and protein/fat even when I'm eating from 7am to 7pm, unless I eat so much at once that (a) it's ridiculous and (b) even the protein at that point is likely to kick my blood sugar high just from overdose. (And my trainer friends assure me >40g per meal of protein isn't real useful as protein as it's converted anyway, but the insulin response is what I'm primarily trying to avoid.) It was impossible for me to get the numbers I felt I needed on IF (min: 2200 cal 130 prot, with 5% carb ratio to prot/fat) since if I don't eat enough I don't lose weight, and so I finally figured I'd have to wait till my caloric requirements were a heck of a lot lower before I went that route. I don't understand how anybody supersized could do that and get enough food into the half a day allowed for eating! But aside from that complaint, I thought it was handy.

Have their been any comparisons of weight loss between LC and LC-IF?

One of the best I know of is in the 'Countdown Buddies and Challenges' sub forum here. The record of the latest iteration of this study has been started recently by MizKitty. It's called Low Carb Intermittent Fasting (3). I actually take an interest in quite a few Low carb/ IF forums. Anyone who tries it reports improvements in bodyfat loss rates over Low Carb alone. Not usually spectacularly so. But it's important to realize that a lot of people add IF to Low Carb because their bodyfat loss has stalled on LC alone. IF seems to unfailingly get it moving again.

I personally don't even want to lose anymore bodyfat. And yet even I have lost subtle amounts of midriff fat, and gained muscle without trying by adding IF to long term low carb.

PJ, everyone IF's right now, unless they get up in the middle of the night to preserve the 'regular' frequency of meals. That's why even non low carbers are in ketosis when they wake up after (usually) at least an eight hour fast.

You don't have to eat just one meal a day. Most people do about a four hour eating window. Over four hours, you wouldn't find it that difficult to get in your minimums. And Nancy opens her window at 11 am (not sure when she stops eating). Everyone chooses the eating window that suits them. At the moment you 'choose' the conventional fast/eating window that tradition has established as the norm (ie. three squares with an overnight fast). But don't forget that you are already IF'ing. If you prolong your 'normal' overnight fast by even half an hour, you've already 'ramped up' your intermittent fast length. And as someone who used to be mortally terrified of going without food for longer than three waking hours, the fact that I now alternate between 20 and 22 daily fasts with no hunger during my fast is surely testament enough to the habitual nature of most hunger. I'm sure I could get perfectly accustomed to even longer fasts. But then I too would have trouble getting enough to eat and would lose weight precipitously.

And FWIW, I do think the 'norm' or voluntary anything as being a good indication of what's actually good for us is a bit risky. If we automatically chose what was good for us, we'd avoid carbohydrate assidously, surely. But do we? Avoiding carbohydrate is the intellectual modification of a big evolutionary gap in instinctive behaviour. In other words, we never developed an onboard ability to limit carbohydrate. Because there was never the need. Nature did it for us. Until very recently (the neolithic) there just wasn't a lot of carbohydrate around, ever. Seasonally there was more, certainly. But even then, carb sources were both low in sugar and starch. The 'high starch' yams traditionally gathered with a lot of digging effort by Australian Aborigines, are universally mostly fibre.

Stuart