Links - 5th September 2019 (1) (Weight Loss/Keto/Fasting)

Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss - "Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate."
Yet more proof that the Carbohydrate-Insulin hypothesis is bunk
Kevin Bass summarises this as:
"On an isocaloric basis:
1. Replacing carbs with fat lowers blood sugar;
2. Replacing carbs with PUFAs and MUFAs improves lipids;
3. Replacing carbs with fats does not improve blood pressure, fatty liver, visceral fat, or waist circumference."
And claims that this is driven by an increase in unsaturated fat by percent (which swamps the increase in raw saturated fat intake)

Pentagon eyes ketogenic diet in bid to build more lethal warriors - "Top Pentagon officials say research has shown that human bodies in ketosis — the goal of the popular and controversial ketogenic diet — can stay underwater for longer periods, making the fat- and protein-heavy eating plan a potential benefit to military divers. It is one example of a rapidly growing trend as military researchers zero in on how nutrition and certain drugs can enhance how fighting men and women perform in battle... Beyond the pros and cons of the diet, however, lie philosophical questions about how much control the armed forces can and should exert over the physical bodies of the recruits who make up its ranks. The military long has held members to physical fitness standards and weeded out those with substance abuse problems, but some scholars argue that the diet debate crosses a new ethical boundary."

Keto and Paleo diets: what they leave out might just be what you need - and you may gain weight, not lose it - ""For the first month, I bounced out of bed every morning. I slept very well, I woke up feeling like I had slept 12 hours. I felt like that brain fog had lifted," she recalls."The second month, I started to feel very heavy and I actually gained weight. In the third month, something felt wrong."Banks began to experience fatigue and severe anxiety. On a visit to her doctor, blood tests revealed that Banks' diet had caused hormonal imbalances that led her to gain weight. She decided to come off the diet... "There is no one Paleo diet. Paleo was whatever you could grub together and find when you were a Neanderthal," says Christopher Gardner, director of nutritional studies and professor of medicine at Stanford University in California. "Some were heavy in meat, some were heavy in fish, some were practically vegetarian … it depends what part of the world you were living in back then.""

Substantial increase in body weight since 1960s due to interplay between genes and environment - "the findings also show that BMI has increased for both genetically predisposed and non-predisposed people since the 1960s, implying that the environment remains the main contributor to the obesity epidemic."

The Ketogenic Diet: Does it live up to the hype? The pros, the cons, and the facts about this not-so-new diet craze. - "Low-carb advocates in the late 1990s and early 2000s thought maybe they had stumbled on the key to fighting flab: insulin. Insulin is mainly a storage hormone: Its job is basically to help nutrients get into cells.
The low-carb / insulin hypothesis, dramatically oversimplified, went like this:
Insulin makes stuff go into cells.
Stuff that goes into fat cells makes us fat.
If we don’t help stuff go into cells, then we won’t get fat. We might even lose fat.
Carbs (in their digested form of glucose) stimulate insulin release.
Therefore eating fewer carbs = less body fat.
Unfortunately, insulin is not the only player. There’s never only one player in the team sport and complex system that is your body.Nor does insulin act alone. Energy storage is governed largely by our brain, not a single hormone.The other upside to the low-carb approach was that people often ate more protein and more fat. When we eat protein and fat, we release satiety hormones, particularly CCK, which is one of the main hormones that tells us we’re full. More protein and fat means we’re often less hungry. Which means we eat less. Which means we lose fat. It’s the “eating less” part (not the insulin part) that actually matters... You may find it easy to eat less when all you can eat is protein and fat. But after a while, you may grow tired of bringing your own whole salmon to parties, and wonder what the other 95% of the grocery store is up to. You may start to have fantasies about a threesome: you, Oreos, and chocolate sauce. Not only that, you may be getting some serious scurvy and other nutrient deficiencies.For women in particular, lowering carbohydrate intake seems to have negative effects.Women’s bodies go on high alert faster when they sense less energy and fewer nutrients coming in. Many women have found that the low-carb diet that worked great for their husband not only didn’t work for them, but it knocked out their menstrual cycle on the way out the door."

Keto diet doesn't help females lose weight, study says - "female mice on the keto diet were less likely than males to lose weight, and more likely to experienced impaired blood sugar control... After 15 weeks on the keto diet, the male mice experienced losses of body weight and body fat, while the female group actually gained weight. The researchers speculated that estrogen might be interfering with the weight-loss process, so they removed ovaries from some of the mice. This caused females to start experiencing the same weight-loss effects observed in the male group... The male mice experienced another, less desirable change: Their livers showed stronger signs of fibrosis — the thickening and scarring of connective tissue — and fatty storage than the female mice. The males had higher levels of a hormone called FG21, which previous studies have shown is released in response to liver damage."

Intermittent fasting: Surprising update - "They compared a form of intermittent fasting called “early time-restricted feeding,” where all meals were fit into an early eight-hour period of the day (7 am to 3 pm), or spread out over 12 hours (between 7 am and 7 pm). Both groups maintained their weight (did not gain or lose) but after five weeks, the eight-hours group had dramatically lower insulin levels and significantly improved insulin sensitivity, as well as significantly lower blood pressure. The best part? The eight-hours group also had significantly decreased appetite. They weren’t starving.Just changing the timing of meals, by eating earlier in the day and extending the overnight fast, significantly benefited metabolism even in people who didn’t lose a single pound."

Skipping a few meals with intermittent fasting may help people avoid cancer, diabetes, and heart disease - "There’s clear evidence that fasting, when done right, can reduce a person’s chances of developing long-term health issues like diabetes, heart disease, and multiple sclerosis (MS). And it helps some people lose weight, too.Dr. Miriam Merad, director of the Precision Immunology Institute at Mount Sinai School of Medicine, said the typical modern diet of constant eating is making our immune system cells work overtime, and it’s not good for long term health... a type of immune cell called a monocyte, which our bodies typically release to fight off infections and wounds. Monocytes are inflammatory, and the white blood cells can cluster to heal the body when we’re injured. But any time we eat food, monocytes are also standing guard in case we ingest any threatening microorganisms. This is especially true when we eat (and drink) sugar. Monocytes also accumulate in fat tissue, contributing to chronic disease... Researchers have known for a long time that caloric restriction is tied to a host of health benefits. Periodic fasting can help people steer clear of long-term health problems like diabetes, high cholesterol, and obesity. It can also can boost the production of a protein that strengthens connections in the brain and serve as an antidepressant. Some scientists even think fasting can help people live to a ripe old age by keeping cells healthy and youthful longer. Merad now tries to eat dinner a few hours earlier than she used to, and she said other researchers in her lab (as well as her husband) are also experimenting with their own versions of intermittent fasting plans, like skipping breakfast."

Obese People Get More Satisfaction From Food - "people who were obese showed significantly heightened perceptions of initial food satisfaction, whereas the gradual reduction of satisfaction that is typical with increased consumption — in this case, of chocolate — occurred at a slower rate compared with persons of normal weight and persons who were overweight."

Does Intermittent Fasting Boost Your Metabolism? - "Studies have shown that when it comes to weight loss, intermittent fasting can be just as effective as traditional calorie restriction, if not more... Fasting can cause a rise in blood levels of human growth hormone, an important hormone for promoting fat loss... However, women don't always experience the same benefits from fasting as men do, and it's not currently clear if women will see the same rise in human growth hormone... Increases in norepinephrine generally lead to larger amounts of fat being available for your body to burn.Fasting leads to a rise in the amount of norepinephrine in your bloodstream... Many people believe that skipping meals will cause your body to adapt by lowering its metabolic rate to save energy.It's well established that very long periods without food can cause a drop in metabolism. However, studies have shown that fasting for short periods can actually increase your metabolism, not slow it down"

Does Fasting cause (or cure) Hunger? - "The biggest worry about fasting is dealing with hunger. People assume that hunger will get worse and worse until you cannot help yourself and start an IV donut slurry in your garage... Ghrelin, the hunger hormone, increases appetite and weight gain... eating all the time sounds like it will turn off hunger and ghrelin. But that’s far too simplistic. Surprisingly, the answer to turning down ghrelin (and hunger) is the opposite — fasting... hunger is not simply a function of ‘not having eaten in a while’. At 9:00, you have not eaten for about 14 hours, yet you are the least hungry. Eating, remember, does not necessarily make you less hungry... Look at the average ghrelin levels over 24 hours. Over the entire day of fasting, ghrelin stays stable! In other words, eating nothing over 33 hours made you no more or less hungry than when you started! Whether you ate or did not eat, your hunger level stayed the same. Eating more sometimes makes you more hungry, not less. In the same vein, eating less can actually make you less hungry. That’s terrific, because if you are less hungry, you will eat less, and are more likely to lose weight... women would be expected to have more benefit from fasting because their hunger can be expected to decrease better than men. Notice, too, how much higher women’s ghrelin level reaches. I suspect this correlates to the clinical observation that many more women are ‘addicted’ to certain foods eg. chocoholics. Sugar addicts. etc. So many women have remarked how a longer fast seemed to completely turn off those cravings. This is the physiologic reason why. A few other notes about the hormonal changes of fasting. Notice that cortisol does go up during fasting. Yes, fasting is a stress to the body and cortisol acts as general activator as well as trying to move glucose out of storage and into the blood. So, if too much cortisol is your problem, then fasting may not be right for you. Insulin also goes down, which is what we expect. Growth hormone, as we’ve previously noted, goes up during fasting. This helps to maintain lean muscle tissue and to rebuild lost protein when you start to eat again. An interesting study of food cravings found exactly what we have been discussing. When patients were put on low calorie diet (1200) versus very low calorie (500) diets, food cravings didn’t change much on the former, but virtually disappeared on the latter. Yes. By eating almost nothing, food cravings did not get worse, they got much, much better."

Keywords: hunger is largely psychological
Can you eat fast food on the Keto diet? - "While vegans can be orthorexic, it is often prevalent in “counting” diets, in which you incessantly keep track of the percentage of carbohydrates versus fats and protein, for example.The ketogenic diet is one such example. While I’ve written positively about this diet, and many studies confirm its efficacy for weight loss, longevity, and cardiovascular health, there is always the danger of slipping into an orthorexic state of mind. I’ve witnessed people starting out with ketogenic diets treat gluten like the world’s most dangerous toxin. Restriction of carbs should not result in the complete avoidance of them.Yet that’s how the brain is designed: the emotional and physical high we get when changing our diet is correlated with advocacy, often to the point of blind devotion"
This helps explain why diets are like religion

Do calories matter? - Peter Attia - "What you eat actually changes how you expend energy. Similarly, how you expend energy changes what (and how) you eat. To be even more nuanced, what you eat further impacts what you subsequently eat. As you increase (or decrease) in size, this impacts how you expend energy... When you exercise your appetite rises relative to when you don’t exercise. When you eat a high carb meal you are more likely to eat again sooner compared to when you eat a high fat/protein meal due to less satiety... Is it relevant to our bodies that olive oil has about the same energy density (i.e., calories) as biodiesel (also known as fatty-acid methyl-ester)? Or, is it more relevant to us that consuming olive oil has a very different effect on our bodies than consuming biodiesel beyond anything to do with the calories contained within them? Obviously consuming equal caloric amounts of olive oil versus biodiesel will have a very different impact on our body. Why then is it so hard to appreciate or accept that equal caloric values of olive oil and rice could also have very different impacts on our body?"
Too bad he ends off by alluding to the Carbohydrate-Insulin hypothesis, which has no empirical support (in fact, the reverse)

Why Are We Still So Fat? - The New York Times - "There is just one almost uniformly effective treatment, and it is woefully underused: only about 1 percent of the 24 million American adults who are eligible get the procedure.That treatment is bariatric surgery, a drastic operation that turns the stomach into a tiny pouch and, in one version, also reroutes the intestines. Most who have it lose significant amounts of weight — but many of them remain overweight, or even obese. Their health usually improves anyway. Many with diabetes no longer need insulin. Cholesterol and blood pressure levels tend to fall. Sleep apnea disappears. Backs, hips and knees stop aching... when a very fat person diets down to a normal weight, he or she physiologically comes to resemble a starving person, craving food with an avidity that is hard to imagine... Obesity’s genetic connection was conclusively demonstrated in the 1980s in a series of papers showing that body weight is strongly inherited, almost as strongly as height. Children adopted as infants ended up with weights like those of their biological parents. Twins reared apart ended up with nearly identical body weights... For now, researchers wish people — including fat people themselves — would stop blaming the obese for their problem. “This idea that people should eat less and exercise more — if only it were so simple”"