Nutrient Fates after Absorption

Random Bump

This held the top spot in terms of readership here at the Asylum for quite some time.  Always worthy of a bump.

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Original post:  7/15/10

Nutrient effects: post-absorptive interactions BY ERIC JEQUIER   (1995)

After a meal, the metabolic fuel selection at the whole-body level depends on the plasma concentrations of nutrients such as glucose, non-esterified fatty acids (NEFA) , amino acids, and on hormonal responses. Over the last 10 years, there has been great interest in studying the metabolic effects following the ingestion or the intravenous (i.v.) infusion of the three macronutrients, carbohydrate (CHO), fat, and protein (or amino acids for i.v. infusion). The aim of the present brief review  {I'm thinking it's not so brief!}  is to summarize the main mechanisms which determine the post-absorptive interactions between the nutrients.

This is an older paper, but still recent enough to provide some good info on the basics.  I'm going to do something a bit different with this one and I otherwise would be quoting huge chunks.  So I'll do bullet point summaries with select summary quotes from the paper in italics.

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The NEAT part about Moving More

Random Bump!

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Original publish date:  4/21/12

In writing up a post on metabolic rate and weight loss, I couldn't help but come across a ton of stuff I had in my draft bin and hard drive vis a vis exercise, lean body mass and metabolic rate.  This got me thinking about the usefulness of ELMM = Eat Less Move More as a strategy to flip the CICO balance along with other things we can do.  

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The LC Dogma Duping of Robb Wolf ...

What duping?  Was he was duped, or does he dupe people?  

Roughly 10 months ago, Robb Wolf posted the first installment on his "current" views about carbohydrates in the diet:  Low Carb And Paleo: My Thoughts Part 1.  In it, Robb describes his changing views on dietary composition and body composition through his personal prism of going from highly active, running a gym, etc. to a more sedentary lifestyle involving lots of writing time.  As he relates:

I had a tough time remaining lean. I’d cut carbs…but to no effect on body composition. Slowly I realized, both by experimentation and by really looking at the literature: CALORIES MATTERED MORE THAN CARBS FOR BODY-COMP.

I have to say this was a pretty big shake-up for me. I’d assumed one could eat as much fat as one desired and STILL get leaner.

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The poor, misunderstood kilowatt•hour

I probably won't be around much longer.

You see Con Ed (my electricity provider) contacted me and said that because my usage this past year exceeded what my level payments cover, they will need to recalculate that payment.   Which got me thinking CON Edison.  Hmmmmm sounds conspiratorial.  So I investigated.

Well, they are pushing all manner of energy saving schemes!  How can I cut my bill?  And then I look at my bill.  My home intakes kilowatt•hours (kwh) ... but how can I know what to do to reduce that intake when I use:

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Calories ...

... or joules or ergs or foot·lbs or BTUs or eV or ...

These are all the same thing folks.  They are all units of energy. That we use different terms in different contexts doesn't mean we are talking about different things.  It's like different languages, be it vida or leben or liv or อายุการใช้งาน ... they all mean life.

The bastardizing of basic science in the Paleo and LLVLC realms is both ubiquitous and unrelenting.  This is what prompted me to start this blog.  I could really care less about the diet fads that come along that are obvious quackery, but this community is built on "our science is better" or "we understand the science", so wouldn't it be nice if that science is correct?

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Must See "TV" for those suffering from CDS

BUMP!  Original posting:  1/24/11

CDS = Calorie Denial Syndrome

BBC Story about Low Carb Dieting - Part 1
BBC Story about Low Carb Dieting - Part 2
BBC Story about Low Carb Dieting - Part 3
BBC Story about Low Carb Dieting - Part 4
BBC Story about Low Carb Dieting - Part 5

(HatTip to Wolfstriked for linking to this in comments.)

Just a few thoughts on this aside from the content so that my opinions will not cloud your listening of the presentation:

I found it interesting that they showed both Westman and Foster exercising (running and playing basketball) in their intros in the piece.  Indeed they are interviewed in their gym clothes!  Then there's Dr. Mary Vernon horseback riding.  Did we need so many closeup chewing scenes?  And, lastly, was the full rear (albeit blurred) Sipowitz moment in the shower, actually that rather lengthy soaping/showering scene, really necessary as a backdrop to the discussion of ketosis?

Stick a Toothpick in It? Taubes' 4-pronged Carb/Insulin "Fork" Loses its Tines

I'm bumping this today, because in the weeks to come I hope to update, flesh out, and reference it fully.  Looking back at something written almost 2 and a half years ago it seems rough, but nonetheless it  still summarizes what I call TWICHOO and the arguments against it pretty well.  

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This post updated slightly 6/22/2012.   Original publication date 1/23/11

In the comments at Jimmy's blog on my interview podcast, several comments either directly or by inference say I failed to make my case against Taubes.  Well, I think I did pretty much get to what I consider the four prongs of Taubes carb/insulin hypothesis, but I've decided to try and summarize this in a blog post.  Another common comment is that I'm somehow nit-picking at minutia, basically if folks lose weight on low carb, it doesn't matter the details of why.  To those, if they are reading this, I would say that any objective view of my arguments would lead to the conclusion that these are NOT minor details, they are the sum total of Taubes' evidence in support of his hypothesis.  Not only has he NEVER debunked the calorie-based theories on obesity, but almost all evidence in support of his "alternate" theory HAS been.  

I will not be referencing this post, it's all been done before here, and I don't have the time to trace down every link etc.  

So, what do the four prongs of the fork stuck in the potato above represent?  

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Calories (Again)

I don't know what it is about the CDS (Calorie Denial Syndrome) sufferers out there, but it seems that every couple of months or so we get a new wave of posts about calories from various corners of the Incestral Health Community.  For the most part, and as usual, these "complaints" are made against elaborately erected strawmen.  One must erect these to counter the obvious, you see.  But the CDS know better than the scientists and spin ever more convoluted explanations for why a calorie is not a calorie.  Of course it's not.  But newsflash!  Those who acknowledge the supremacy of calories in the overall picture recognize that nutritive intake is not solely for the purpose of energy production.  There.  Half your scarecrow strawmen now lie rotting in the field (or perhaps some David Duke inspired mental picture ... grin).

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The Hadza Hunter Gatherer Energy Expenditure Study

I've been asked by a few people to weigh in on a recent NYT article, Debunking the Hunter-Gatherer Workout, that discusses the following study (free full text):  Hunter-Gatherer Energetics and Human Obesity.  I didn't have a whole lot to say until I wrote this, and now it's rather long ... so I guess I did have quite a bit to say after all ;-)   But first, a little link love for Colby Vorland of nutsci.org who discussed this back in July:  Westerner energy expenditure compared to a hunter-gatherer population is equivalent.  In addition, Colby had discussed Energy expenditure and physical activity level are not higher in developing countries compared to industrialized.  I encourage reading both.

So from the NYT article:

We found that despite all this physical activity, the number of calories that the Hadza burned per day was indistinguishable from that of typical adults in Europe and the United States. We ran a number of statistical tests, accounting for body mass, lean body mass, age, sex and fat mass, and still found no difference in daily energy expenditure between the Hadza and their Western counterparts.

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Hardwired Calories Out

If you've heard it once, you've probably heard it a thousand times, that ELMM = Eat Less Move More is a failed strategy for weight loss.  The rationale is something like one or more of the following:

• A calorie is not a calorie, because two people who eat the same amount won't weigh the same, or gain or lose the same amount of weight
• The 3500 cal/pound fat figure is wrong because with deliberate overfeeding or caloric restriction, people don't gain or lose exactly as this formula would predict 
• If you eat less your metabolism will just slow down to compensate
• If you move more deliberately, aka exercise, you'll just move less later in the day and/or be so hungry you'll compensate by eating more. 

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A Fein(man), Fine Mess of Thermodynamics

I was truly baffled beyond all bafflement (is that a word?) that Feinman & Fine wrote "A calorie is a calorie" violates the second law of thermodynamics, let alone that it passed the peer review process to be published in any reputable journal.  In the abstract they write:

Here, we propose that a misunderstanding of the second law accounts for the controversy about the role of macronutrient effect on weight loss and we review some aspects of elementary thermodynamics.

Here I propose that it is their apparent misunderstanding of thermodynamics, as put forth in this "study", that accounts for most of the gimmickry surrounding low carb diets in the community.  In the section entitled "Thermodynamics", they write:

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The Smarter Science of Slim ~ General Thoughts

A few days back a copy of this book was donated to me, and for the past months or so the occasional query has come my way for my opinion of the book.  The author, Jonathan Bailor has a website that I've read bits and pieces of -- mostly the blog.   I think I know who the mystery guru some have been hinting at these past days, and I'm pretty sure I know why -- Bailor classifies foods as SANE or inSANE based on the acronym of four factors:

S = Satiety     A = Aggression (towards body fat formation)   N = Nutrition    E = Efficiency

We'll get back to that acronym later, but as I've also blogged on quite a few of his references and science here, it makes sense to me that searches for Bailor's book/website/diet might land someone here.   That and, I suppose, this post:  And the Cherry-Picking Baton has been passed.  So I've now read through the diet section of the book and have a full critique in the works (if I can stomach it).  I may or may not get to the exercise portion.   For now some general thoughts.

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The Insulin Paradox II ~ Lessons from Body Builders

In The Insulin Paradox, I laid out the following:

THE INSULIN PARADOX

When insulin levels are elevated, the uptake/esterification of fatty acids in fat tissue is enhanced while lipolysis/release of fatty acids stored as triglycerides is suppressed,  thus favoring fatty acid accumulation in adipose tissue.

YET

The low insulin state favors partitioning of fuel (mass) to fat tissue stores vs. lean tissue.

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Exercise & Adipose Tissue ~ Part I: Adipose Tissue & General Relationship

From the great research group of Keith Frayn, Aging Hippie linked to this article recently:

PHYSICAL ACTIVITY AND EXERCISE IN THE REGULATION OF HUMAN ADIPOSE TISSUE PHYSIOLOGY

In composing this post, it started to get rather long so I'll break it up into parts.  I'm going to do a bullet-pointed summary and excerpts for you.  Direct quotes will be in italics, regular font is my paraphrased summary, and non-indented/bulleted text is my general commentary.

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Great Interview on Fructose ~ The "Other" Side

This one is too good just to tweet.  One of those gems I mentioned the other day is David Despain's Evolving Health blog.  He's been posting quite a bit of late on fructose.  His latest:   Fate of fructose: Interview with Dr. John Sievenpiper.

It's definitely worth reading the whole thing, but I'll excerpt a few things that address the problems with many of the fructose studies and problems with them, and some nice correcting of Lustig & Co.:

• The 50th percentile for intake in the United States is 49g per day, which is just a little less than 10 percent per day of energy from fructose. ... the 95 percentile for intake for NHANES for fructose consumes 87g of sugar or little less than 20 percent energy.

It seems to me that sugar consumption in the US is often inflated, and the inflation is done by those who seem to have an "crisis agenda" -- by that I mean looking to whip up a crisis for the purpose of enacting legislation or finding a new tax revenue stream. So related to the quote above, Sievenpiper takes issue with the "superphysiological doses" of fructose used in most studies.

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Rapid Weight Loss Tanks Metabolism? The TBL Study

Thanks to Yoni Freedhoff of Weighty Matters blog for providing me with the full text of this one.  Check out his take on the results.  Update 11/11/13:  Full text now available free HERE.

Context: An important goal during weight loss is to maximize fat loss while preserving metabolically active fat-free mass (FFM). Massive weight loss typically results in substantial loss of FFM potentially slowing metabolic rate.

Objective: Our objective was to determine whether a weight loss program consisting of diet restriction and vigorous exercise helped to preserve FFM and maintain resting metabolic rate (RMR).

Participants and Intervention: We measured body composition by dual-energy x-ray absorptiometry, RMR by indirect calorimetry, and total energy expenditure by doubly labeled water at baseline (n = 16), wk 6 (n = 11), and wk 30 (n = 16).

Results: At baseline, participants were severely obese (×± sd; body mass index 49.4 ± 9.4 kg/m²) with 49 ± 5% body fat. At wk 30, more than one third of initial body weight was lost (−38 ± 9%) and consisted of 17 ± 8% from FFM and 83 ± 8% from fat. RMR declined out of proportion to the decrease in body mass, demonstrating a substantial metabolic adaptation (−244 ± 231 and −504 ± 171 kcal/d at wk 6 and 30, respectively, P < 0.01). Energy expenditure attributed to physical activity increased by 10.2 ± 5.1 kcal/kg·d at wk 6 and 6.0 ± 4.1 kcal/kg·d at wk 30 (P < 0.001 vs. zero).

Conclusions: Despite relative preservation of FFM, exercise did not prevent dramatic slowing of resting metabolism out of proportion to weight loss. This metabolic adaptation may persist during weight maintenance and predispose to weight regain unless high levels of physical activity or caloric restriction are maintained.

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Does a "calorie not in" equal a "calorie out"?

Apparently not!

According to this study, how one creates a caloric deficient can make a difference.

The Impact of Exercise Training Compared to Caloric Restriction on Hepatic and Peripheral Insulin Resistance in Obesity

Context: It has been difficult to distinguish the independent effects of caloric restriction versus exercise training on insulin resistance.

Objective: Utilizing metabolic feeding and supervised exercise training, we examined the influence of caloric restriction vs. exercise training with and without weight loss on hepatic and peripheral insulin resistance.

Design, Participants, and Intervention: Thirty-four obese, older subjects were randomized to: caloric restriction with weight loss (CR), exercise training with weight loss (EWL), exercise training without weight loss (EX), or controls. Based on an equivalent caloric deficit in EWL and CR, we induced matched weight loss. Subjects in the EX group received caloric compensation. Combined with [6,62H2]glucose, an octreotide, glucagon, multistage insulin infusion was performed to determine suppression of glucose production (SGP) and insulin-stimulated glucose disposal (ISGD). Computed tomography scans were performed to assess changes in fat distribution.

Results: Body weight decreased similarly in EWL and CR, and did not change in EX and controls. The reduction in visceral fat was significantly greater in EWL (−71 ± 15 cm2) compared to CR and EX. The increase in SGP was also almost 3-fold greater (27 ± 2%) in EWL. EWL and CR promoted similar improvements in ISGD [+2.5 ± 0.4 and 2.4 ± 0.9 mg · kg fat-free mass (FFM)−1 · min−1], respectively.

Conclusions: EWL promoted the most significant reduction in visceral fat and the greatest improvement in SGP. Equivalent increases in ISGD were noted in EWL and CR, whereas EX provided a modest improvement. Based on our results, EWL promoted the optimal intervention-based changes in body fat distribution and systemic insulin resistance.

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The First Law of Thermo still doesn't violate The Second Law

Well, I've been meaning to weigh in on the Bray overfeeding study (Effect of Dietary Protein Content on Weight Gain, Energy Expenditure, and Body Composition During Overeating) that made a bit of a splash a little while back. George Bray is especially hated by ardent low carb advocates because he wrote a particularly unfavorable review of GCBC published in Obesity Reviews.   Bray is what Adam Kosloff refers to as a "Calorie Wizard":

Regardless of diet, it is a positive energy balance over months to years that is the sine qua non for obesity. Obese people clearly eat more than do lean ones, and food-intake records are notoriously unreliable, as documented by use of doubly labelled water.  Underreporting of food intake is greater in obese than in normal-weight people and is worse for fat than for other macronutrient groups.  Accepting the concept that obesity results from a positive energy balance does not tell us why energy balance is positive.  This depends on a variety of environmental factors interacting with the genetic susceptibility of certain individuals.  Weight loss is related to adherence to the diet, not to its macronutrient composition.

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Response to Moore/Kosloff Podcast II: Commentary

These days I choose the LLVLC podcasts I listen to wisely and having read Beyond Caloriegate etc. would likely not have tuned into LLVLC Episode 559: Adam Kosloff Says It’s Time To Move ‘Beyond Caloriegate’ were it not for the heads-up that landed in my Inbox informing me that Adam had mentioned me (it's around the 16 minute mark).   So I listened to it and, in light of our correspondences, was left with a bad  taste in my mouth.     So, a couple points in that regard that concern me, some general comments on the whole podcast, this "overstoring" in the "black box" concept and such, and Oh the antagonism!!  Perhaps we need to have "drinking game Sundays" here at the Asylum where I serve up Cherry Pickin Martinis (Taubes), Spiked Pink Leptinade (Rosedale), Frozen Leptin Drops (Kruse), F'en Wheat Belly Buttons (Davis), and I'll have to dream up a few more (feel free to contribute ideas in comments!!).  We'll call the game "antagonism".  You know the game ... ever play Bob?  Participants will have to do a shot every time Jimmy uses the word  antagonism.  But I digress ...  

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Just Eat Less - Move Moore, Jimmy

Note:  I wrote and never published this post a while back, but after listening to the deluded Jimmy Moore in his podcast conversation with Adam Kosloff, I decided to dust this off and publish it up.  I was brought up in the discussion by Adam, and I'll be responding to that exchange on this blog shortly.  Jimmy, if you're ever going to get control over your situation, you need to listen to Lalonde over Kosloff, Colpo over Eades, Me over Taubes.  Or better yet, the underlying message of this post ... listen to YOURSELF.  Go back and read your own blog and listen to some of your old podcasts.  The answers are right there.  Eat Less, Move Moore.

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