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  #1   ^
Old Wed, Jun-18-08, 16:39
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Daryl Daryl is offline
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Default Dr Eades: low carb & calories - part 2

Quote:
Since I started the previous post on this subject with a letter, I’ll do the same for part 2. God knows we have enough like these to fill a book. In fact, this one was in a book. We published the portion below in The Protein Power LifePlan.

A lady from New England wrote to us complaining that she had diligently followed our low-carb diet to the letter yet, had lost only four pounds over the first few weeks of the program. She included her food diary to show that she was indeed doing a low-carb diet. Here it is:

BREAKFAST: a four-egg omelet with cream cheese, five or six pieces of bacon or sausage, and coffee.

MID-MORNING SNACK: 4 ounces of nuts and 2 to 4 ounces of cheese.

LUNCH: a large bowl of tune or ham or chicken salad make with real mayonnaise, a bag of pork rinds, and a diet drink.

MID-AFTERNOON SNACK: nuts and cheese again.

DINNER: a 16 ounce piece of prime rib, a green vegetable, and a small salad.

DESSERT: sugar-free gelatin and whipped cream and coffee.

When we received this letter MD and I wanted to shake this woman and say: Does it not surprise you that you’re not gaining weight on your diet? I’m sure the only reason she lost the 4 pounds was that she dumped a bunch of excess fluid as a result of her insulin falling. If you run the calculations you will find that this woman was eating somewhere around 5,000 calories per day. She was definitely not creating a deficit. And she wasn’t losing…but she wasn’t gaining either.

The difficult part of any diet - including a low-carb diet - is the bucking up and staying with it during the weight loss phase. It’s pretty easy for most people right at the start because the weight comes off quickly at first, and most people feel so much better just getting off the carbs. As the early days turn into weeks and (in some cases) months, the diet becomes monotonous for many. Weight loss slows down, the great feelings of renewed health and more energy are still there, but have become the norm instead of something new and exciting, and the urge to expand the palate becomes intense.

First, it’s a little nibbling here and there of the forbidden foods, leading a carb creep. And, as I pointed out in the earlier post, many start snacking on calorically dense, low-carb foods, with cheese and nuts being the greatest offenders. Ultimately the weight loss goes from a crawl to stopping altogether. Frustration sets in, and many people bolt from the program saying: Hey, if this isn’t working for me, why am I torturing myself with it? From this mindset it’s a short hop to being face down in the donuts.

I can tell you from both personal experience and the experiences of thousands of patients that this middle time of low-carb dieting (the time between the heady early days and maintenance) can be a drag. And can be fraught with weight-gain peril if you get sloppy with your carb and/or calorie counting. But if you hang in there, you will be rewarded with great dividends.

Once you’ve reached maintenance you can pretty much eat all you want without gaining as long as you watch your carb intake. Like the lady who wrote the letter above, you can feast on all kinds of cheese, nuts, meats, etc. while remaining at your new lowered weight. The calories that come from these sources will sabotage your weight loss if you eat too many of them, but won’t make you gain weight as long as you keep your insulin low.

As you may recall from the earlier post, a lowered insulin levels opens the door to the fat cells, allowing fat to come out to be burned. If your dietary intake meets all your body’s energy needs, however, your body will simply use these dietary calories and leave the calories in your fat cells alone. And you won’t lose. But lowered insulin levels pretty much prevents fat from going into the fat cells, so even if your caloric intake goes up - as long as your insulin stays low - you won’t store more fat in the fat cells. And your weight will stay the same.

How can this be?

The phenomenon is pretty vividly demonstrated in people with type I diabetes, the type of diabetes in which no (or very little) insulin is produced. Most of the time these people get their diagnosis of diabetes when they come to the doctor because they are losing weight like crazy while eating everything in sight. It’s not all that unusual for a person with new onset type I diabetes (who isn’t aware of having the disorder) to lose 40 pounds in a month. These people have no insulin and a lot of glucagon. Without the insulin they can’t store fat, so they dump fat from their fat cells. Much of this fat is converted to ketones since there is no insulin to shut off the process. The glucagon makes them convert muscle protein to sugar even though their blood sugar levels are already sky high. The end result is that these people have elevated levels of sugar in their blood and elevated levels of ketones. They dump both sugar and ketones in their urine, but not enough to account for the amount of weight they lose. The combination of calories lost to ketones and urine can add up to a few pounds per month, but not 40. Other factors are at work. The body has the ability to waste calories, but doesn’t usually do so unless it has to. In the case of type I diabetes it has to. And people with uncontrolled type I diabetes eat and eat and eat and lose and lose and lose.

The same phenomenon holds true in low-carb dieting. Insulin is low and glucagon is high, making it difficult to gain weight. That’s not to say it can’t be done, but it is difficult. Which means that once you lose your weight and get to maintenance, if you keeps your carbs (and thus your insulin) low you can pretty much go back to snacking on cheese, nuts and other high-fat, high-caloric density foods without the fear of gaining. You won’t lose, but you don’t want to lose on maintenance. You simply want to maintain.

You will ditch these extra calories by a number of means. Your caloric-wasting systems will be going full blast. You will be futile cycling, increasing the mitochondrial proton leak, increasing the number of uncoupling proteins, and spending extra energy converting protein to glucose. You will also increase your NEAT. What’s NEAT? It’s Non-Exercise Activity Thermogenesis. Your total energy expenditure is composed of four things: resting metabolic rate, the thermogenic effect from food (the energy required to metabolize what you eat), thermogenesis from exercise and activity, and NEAT. NEAT is from all the little things you do without conscious effort - fidgeting, moving more, moving more briskly, stretching, standing more, etc. These are activities that you don’t really think about but that you perform to dissipate extra energy. It’s why you feel more like exercising after you get going on a low-carb diet; it’s why you perceive your energy levels to be higher. And it’s why you’re less hungry. Your body has access to its stored fat and is using it and even wasting it. As Key’s showed in his semi-starvation studies, subjects on low-fat, reduced-calorie diets pretty much got rid of most of their NEAT in an effort to conserve energy. The opposite happens on a higher-calorie low-carb diet.

Blowing off this excess energy is what allows you (and the woman who wrote the letter at the start of this post) to eat a lot yet still maintain. But it comes at a price. There is a caveat.

If you crank up your intake of fat calories and at the same time increase your carb intake you are going to gain like crazy. Why? Because you will increase your insulin levels and drive this fat into the fat cells. And it will happen quickly.

Most people reading this will probably say, that would never happen to me. But it can and does. Especially when people start guestimating how many carbs they’re eating. A couple of years ago I posted about a survey done at the peak of the low-carb diet mania showing that people who thought they were on low-carb diets really weren’t. They were cutting the carbs, but not enough to bring about insulin lowering to the point required to enjoy the benefits of low-carb dieting. Men who claimed to be on low-carb diets were consuming on average about 145 grams (3/4 cup sugar equivalent) of carbs per day while women were eating on average 109 grams of carb per day. For most people this is way too much.

So, if you keep carbs low and keep calories in check you will lose weight. If you keep carbs low and don’t worry about the calories you will maintain. A commenter on the earlier post put it brilliantly and succinctly:

Eat low carb = you CAN’T GAIN fat.

Eat low carb ≠ you WILL LOSE fat. [unless, of course, you create a caloric deficit]

I noticed that in a number of comments about this post people had come to the same conclusion empirically. They wrote that whenever they jacked up their consumption of cheese, nuts and other calorically-dense low-carb foods their weight loss stalled. But as long as they kept the carbs low, they didn’t gain. As always, I welcome comments on this issue. I’m keen to hear the experiences of all.


http://www.proteinpower.com/drmike/...alories-part-2/
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  #2   ^
Old Wed, Jun-18-08, 17:55
Citruskiss Citruskiss is offline
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Well, hooray for being able to add back in the cheese, nuts, mayo or whatever once in maintenance, without fear of gaining - provided the carbs are still in check. This is pretty neat. A good 'consolation prize' for having to watch it a bit while in weight-loss mode.
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  #3   ^
Old Wed, Jun-18-08, 18:11
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skeeweeaka skeeweeaka is offline
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Great article, needs to be in the stall section lol....definitely!
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  #4   ^
Old Thu, Jun-19-08, 08:21
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francisstp francisstp is offline
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Is it just me or has the Doc not posted anything especially insightful in months? I know his book took a lot of time and energy but "calories are a factor in weight loss too", really?

For regulars of his blog (and books even more) the only new info from this post is the names of the various processes by which the body gets rid of extra calories. The rest is basically a condensed version of this other post of his, which dates from last November only.

I'm a big fan and it's why I feel a need to address this point. Sorry for being picky...
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  #5   ^
Old Thu, Jun-19-08, 08:31
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MandalayVA MandalayVA is offline
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Quote:
Originally Posted by francisstp
Is it just me or has the Doc not posted anything especially insightful in months? I know his book took a lot of time and energy but "calories are a factor in weight loss too", really?

For regulars of his blog (and books even more) the only new info from this post is the names of the various processes by which the body gets rid of extra calories. The rest is basically a condensed version of this other post of his, which dates from last November only.

I'm a big fan and it's why I feel a need to address this point. Sorry for being picky...


If your blog only focuses on one particular area, eventually you're going to run out of stuff to write about. I think he enjoys the discussions that occur and there's always new readers. If he recycles, at least he does it entertainingly.
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  #6   ^
Old Thu, Jun-19-08, 09:50
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LessLiz LessLiz is offline
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I think that this is one topic, at least, that bears reiterating and I don't find Dr. Mike being completely consistent in what he says, either.

On the one hand, he has consistently said in his books that too many calories result in no weight loss. He's since pointed out on a couple of occasions that it doesn't result in weight gain, either.

But I sometimes think he doesn't think things completely through. A few weeks ago he embraced high fatting at around 80% cals from fat to lose weight -- this was advising someone try what Elle did. So here's a question: if you meet your protein requirement and you are eating very high fat where are your calories?

According to him my protein requirement is 102g per day, which is 408 cals. If I eat no carbs at all then I am eating 2040 cals to have 80% of them come from fat while meeting that protein requirement. If I eat 20g of carbs, not net carbs, then I must eat 2440 cals total. If I eat 20g net carbs with 10g fiber then I must eat 2640 cals total. At 2040 cals I maintain, and I'd bet most women my size do as well.

I posted a comment about this very issue. We'll see if it makes it through and gets a response.

Last edited by LessLiz : Thu, Jun-19-08 at 10:07.
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  #7   ^
Old Thu, Jun-19-08, 09:58
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lowcarbUgh lowcarbUgh is offline
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I've never understood why so much protein? Most women don't need 100 grams of protein.
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  #8   ^
Old Thu, Jun-19-08, 10:03
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Nancy LC Nancy LC is offline
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What would you replace the protein with then? Carbs?

I think the question most of us would like answered (but he probably doesn't know the answer) is why can some of us eat very little (in calories) and still not lose weight?
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  #9   ^
Old Thu, Jun-19-08, 10:11
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ReginaW ReginaW is offline
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Quote:
Originally Posted by lowcarbUgh
I've never understood why so much protein? Most women don't need 100 grams of protein.


Protein requirements are tied to body weight....at 197, I'd say her minimum on a low-carb approach is 98g at 0.5g/lb....+/- 10% as buffer, the range is 89-108g a day to target....that is, of course, unless she has diabetes and that level of protein is specifically impacting her glycemic control, then I'd say tweak it downward a bit or spread it out more ove the day.
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  #10   ^
Old Thu, Jun-19-08, 10:14
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ReginaW ReginaW is offline
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Quote:
Originally Posted by Nancy LC
What would you replace the protein with then? Carbs?

I think the question most of us would like answered (but he probably doesn't know the answer) is why can some of us eat very little (in calories) and still not lose weight?


Conservation of energy in a perceived famine...our primal metabolism and brain only knows two things - survive and reproduce - if you're not eating enough, subtle and seemingly minor downregulation happens to conserve energy - body temp, blood flow, heart beat, etc. are slightly lowered to save energy to keep you alive, bringing your basal metabolic rate downward, slowly leaving you with less a calorie deficit than you think, effectively inhibiting further loss of stored energy needed to keep you alive until energy intake is increased when the "famine" is over.
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  #11   ^
Old Thu, Jun-19-08, 10:15
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LessLiz LessLiz is offline
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I don't know what most women need for protein during weight loss, and I rather doubt anyone else does. Too much conflicting information.

I will say that eating what Eades recommends for protein does a better job of controlling my appetite than anything else I've tried. If I drop that level I get hungry. If I drop it and replace it with fat I feel continually sick.

Nancy, that is where I am headed. When I say I got tested for thyroid function recently, I don't mean TSH levels -- I mean complete panels and there is nothing wrong. I do not have adrenal fatigue, I do not have yeast issues. I have stopped eating anything that can be pointed to as a problem, and I'm now losing weight, but I'm doing it at 1000 cals a day. Following an initial loss of almost 8 pounds I am sitting still, which is okay because it hasn't been that long. I've done 1000 cals at a lower protein level and that is not fun.

Still, nothing has changed the fact that I have to eat damned few calories to lose. I want an answer, too, but I don't have faith that anyone has an answer.

Regina, that's a nice theory but it doesn't parallel my experience. I can eat a lot more food, many more calories, and maintain. I can eat a little more and maintain. But there is nothing that has allowed me to eat any level of calories and lose consistently except for low levels of calories -- including recommended supplements.
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  #12   ^
Old Thu, Jun-19-08, 10:22
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lowcarbUgh lowcarbUgh is offline
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Quote:
Originally Posted by Nancy LC
What would you replace the protein with then? Carbs?

I think the question most of us would like answered (but he probably doesn't know the answer) is why can some of us eat very little (in calories) and still not lose weight?


I'd replace the protein with fat, not carbs. Very few people have read Bernstein's book and his slant is a little different, but very much designed to reduce insulin levels in type 2s and requirements in type 1s. His suggestion for a stall is reduce the amount of protein in one meal by 1/3. If you start losing a pound a week, do nothing. If that doesn't work, reduce the amount of protein in another meal by 1/3 until you start losing 1 pound a week.

The formula for the Bernstein plan is CHO 6-12-12, meaning no more than 6 carbs for breakfast, 12 for lunch and 12 for dinner. Protein is also restricted and the typical amount for women is PRO 2-3-4, for a total of 9 ounces of protein a day.

He's been living healthy with severe type 1 diabetes on this formula for 35 years and his A1c is 4.5.

Last edited by lowcarbUgh : Thu, Jun-19-08 at 10:28.
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  #13   ^
Old Thu, Jun-19-08, 10:23
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Nancy LC Nancy LC is offline
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Yeah, the old 'starvation mode' explanation. Logically then eating more calories one should lose weight, yet that doesn't happen either. At least, not for many of us. I don't necessarily gain, depends how many I eat, but I also don't lose.

No, there's something going on here that I haven't heard anyone explain or be able to fix. I guess we just need to wait for someone really smart with research money to figure it out.

Quote:
I'd replace the protein with fat, not carbs.

But if you're already trying to eat 80% of your calories from fat... have you ever tried that? It is really hard.

I can't even get close to that since I can't eat dairy or nuts. Oh sure, I gorge on avocados but there's only so many you can eat in a day!

I try not to fuss too much over percentages. I'm pretty happy with how my body is responding to Paleo eating. I think my weight loss issues, or lack thereof, has something to do with my overall health which I think Paleo eating addresses at least in part.

Last edited by Nancy LC : Thu, Jun-19-08 at 10:28.
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  #14   ^
Old Thu, Jun-19-08, 10:27
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rightnow rightnow is offline
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Quote:
Originally Posted by francisstp
Is it just me or has the Doc not posted anything especially insightful in months? I know his book took a lot of time and energy but "calories are a factor in weight loss too", really?

For regulars of his blog (and books even more) the only new info from this post is the names of the various processes by which the body gets rid of extra calories. The rest is basically a condensed version of this other post of his, which dates from last November only.

I'm a big fan and it's why I feel a need to address this point. Sorry for being picky...


I thought something similar a bit ago (and I too am a huge fan). It occurred to me that one problem in our field is that there is only occasionally something new to talk about, but someone with a popular blog needs to post regularly. So I think sometimes he's just kinda waxing on. Blogs aren't as careful as books, and there are always different situations and even moods that might affect how he says whatever he says, which can cause one thing to seem to not perfectly jibe with another for example. I let it slide but I was not in favor of his first calorie post (since it was greatly 'if you're not losing weight on my plan you must be wrong about what you're eating', which I see as no diff than standard docs assuming all overweight people lie or are morons about food intake). But a daily blog or even weekly is a lot of work especially with a busy schedule. So I'm giving him the benefit of the doubt. ;-)
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  #15   ^
Old Thu, Jun-19-08, 10:27
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lowcarbUgh lowcarbUgh is offline
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Quote:
Originally Posted by ReginaW
Protein requirements are tied to body weight....at 197, I'd say her minimum on a low-carb approach is 98g at 0.5g/lb....+/- 10% as buffer, the range is 89-108g a day to target....that is, of course, unless she has diabetes and that level of protein is specifically impacting her glycemic control, then I'd say tweak it downward a bit or spread it out more ove the day.


I would agree that 100 grams is the proper amount to *maintain* a weight of 197.

Anyone who has IR really needs to read Bernstein.
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